COBB HOSPITAL: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- COBB HOSPITAL (EIN 58-0968382)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-13
- IRS object ID
- 201321339349302042
- Schema version
- 2011v1.5
- 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) |
|---|---|---|
| Timestamp | 2013-05-13T11:30:45-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PricewaterhouseCoopers LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| 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 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 580968382 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COBB HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % JAMES M SWARTZ | InCareOfName |
| Name Control | COBB | NameControl |
| Phone | 7707925023 | Phone |
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 |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | James M Swartz | Name |
| Title | VP of Accounting | Title |
| Date Signed | 2013-05-13 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2673303000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | REYNOLD J JENNINGS | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| 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 | 318580722 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.wellstar.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1984 | YearFormation |
| State Legal Domicile | GA | StateLegalDomicile |
| Activity Or Mission Description | To provide world-class charitable healthcare to the community | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 18 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 14 | NbrIndependentVotingMembers |
| Total Nbr Employees | 2630 | TotalNbrEmployees |
| Total Nbr Volunteers | 200 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 305272543 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 312941906 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 0 | InvestmentIncomePriorYear |
| Investment Income Current Year | 13150 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 3163632 | OtherRevenuePriorYear |
| Other Revenue Current Year | 5625666 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 308436175 | TotalRevenuePriorYear |
| Total Revenue Current Year | 318580722 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 137566556 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 136487616 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 145373579 | OtherExpensePriorYear |
| Other Expenses Current Year | 151642508 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 282940135 | TotalExpensesPriorYear |
| Total Expenses Current Year | 288130124 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 25496040 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 30450598 | RevenuesLessExpensesCY |
| Total Assets BOY | 187247660 | TotalAssetsBOY |
| Total Assets EOY | 188291475 | TotalAssetsEOY |
| Total Liabilities BOY | 120452266 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 126800535 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 66795394 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 61490940 | NetAssetsOrFundBalancesEOY |
| Mission Description | 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. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 247764948 | Expense |
| Revenue | 312941906 | Revenue |
| Description | As discussed herein, Cobb Hospital, Inc (an affiliate of Wellstar Health System, Inc.) operates as a charitable organization consistent with the requirements of Internal Revenue Code Section 501(c)(3) and the "community benefit standard" of IRS Revenue Ruling 69-545. In this regard, the governing body of the organization and/or its parent is composed of prominent citizens in the community, medical staff privileges in the hospital are available to all qualified physicians in the area consistent with the size and nature of the facility; the hospital operates a full-time emergency room open to all regardless of ability to pay; the hospital provides care to the needy members of the community consistent with its charity care policy regardless of their ability to pay for these services. The hospital's excess funds are generally applied to expansion and replacement of existing facilities and equipment, amortization of indebtedness, improvement of patient care, community benefits activity, and charity care. Cobb Hospital reinvested a total of approximately $18.0 million in capital expenditures for equipment upgrades and other capital improvements to better serve the community. Cobb Hospital was organized in 1984. The hospital affiliated with the Northwest Georgia Health System in 1993. In 1994, Northwest Georgia Health System helped form the PROMINA Health System and changed its name to Promina Northwest Health System. In 1998 Promina Northwest changed its name to Wellstar Health System and is now totally independent of Promina. Cobb Hospital is subordinate to, and subject to the authority of Wellstar Health System and its governing boards including the Hospital Authority of Cobb County. Cobb Hospital provides a full range of inpatient and outpatient services characteristic of a community hospital. The hospital is licensed to operate 382 beds and is presently staffed to operate 370 beds. The original hospital was constucted in 1968 and several major structural additions have happened since that time. The following stats constitute the overall program services provided during the reporting period ended June 30, 2012: Adult Discharges 20,882 Med/Surg Short Stay days 5,804 Emergency Room Visits (incl pediatric ER) 99,207 Outpatient Surgical Cases 7,423 Inpatient Surgical Cases 3,791 Outpatient Procedures Non-ED OP Radiology 62,944 GI Laboratory 1,773 Total FTEs (paid) 1,957 Community Benefit Reporting Community Outreach (incl system-wide alloc) $147,904 Unreimbursed Charity Care (at cost) $29,218,662 Medicaid Shortfalls (at cost) $ 8,204,712 Total $37,571,278. As an affiliate of Wellstar Health System, Cobb Hospital participates in many community and educational programs for the overall health and benefit of the area that they serve. Some examples of those programs are: Community Health/Education--screenings and educational opportunities such as denfensive driving for teens (offered at a minimal cost or at no cost), smoking cessation, heart smart school, CPR and others. System-wide over 200,000 residents from the community participated in these various screenings. The Public Relations department notifies the public of these offerings by publishing a quarterly mailer to community residents which costs the system over $80,000. Community Activities--sponsors blood drives, provides funding to school health programs for medical and dental preventive care. Community Events--Wellstar has an annual day for the Latino community geared at screenings and educational activities on a variety of health issues specifically for the Hispanic community. Sponsorships A group of employees also participated in the annual "Relay for Life: an event to raise funds and awareness for cancer research and prevention (held in conjunction with the American Cancer Society). System-wide a total of $10,000 was raised to support cancer research, education and patient services. Efforts are planned to expand this support in the coming years. Recognition and Accomplishments Cobb Hospital and Kennestone Hospital operate full-service clinics on the respective campuses to provide health related services to uninsured and underinsured who might not otherwise receive care. In FY2012 the clinics served a combined 9,000 patient visitors at a cost of almost $3 million. A clinic for senior wellness also opened in Cobb County. The system partnered with the local school systems to provide free health and safety education to nearly 50,000 area elementary students and approximately 8,000 adolescent students. In partnership with Cobb County law enforcement and YWCA, Wellstar started a program called Sexual Assault Nurse Examiner (SANE) for confidential and secure treatment of sexual assault victims. Approximately 100 patients were treated in the program. Cobb Hospital continued to serve as a Partner in Education site for mentoring South Cobb High School students with interest in pursuing healthcare professions. Thirty students participate in the program each year. Wellstar and the Cobb County Board of Education have partnered to provide student athletes with concussion testing in all sports related programs offered in the schools. This testing is provided free of charge to the student athletes as a proactive and preventive measure before participation is granted. Wellstar and Cobb Hospital again received the designation as a "Company that Cares" for its caring about patients, communities and team members. It is one of only seven health care systems and the only local system to achieve that distinction. Cobb Hospital and other Wellstar facilities continued to invest in state of the art cancer treatment with its Wellstar Cancer Program. More than 3,000 patients were treated in the system; 917 cyberknife radiosurgeries were performed; and almost 21,000 radiation therapy treatments were provided. Cobb, Douglas, Kennestone and Paulding hospitals continue to meet the Appropriate Care Measures (ACM) 93 percent threshold in quality for the Presidential Level of the Quality Honor Roll as reported by Georgia Hospital Association. Wellstar has seen its percentages move from a rating of 81.4 percent to a current rate of 94.6 percent. Cobb Hospital was named one of the Top 10 Best Hospitals in metro Atlanta by the US News and World Report magazine. Wellstar received a 3 STAR rating from the Society of Thoracic Surgeons for the quality of its cardiac surgery program. Only 12-15 percent of hospitals across the country receive this 3 Star rating, which denotes the highest category of quality for clinical excellence based on national standards. Kennestone Hospital specifically was in the top tier of cardiac programs across the country. This ranking helps to validate the addition of the cardiac surgery services several years ago as a product line to provide these services "closer to home". WellStar Cobb, Douglas and Kennestone are all accredited chest pain centers. All WellStar hospitals, physician offices, and administrative offices implemented a policy of a Tobacco-Free Environment on January 1, 2012. This initiative makes our campuses better equipped to institute tobacco cessation programs and to provide leadership in this area. It further meets the challenge of our credo which states that "at WellStar we believe in life well-lived". All five of WellStar's hospitals have earned Quality Respiratory Care Recognition (QRCR) for the ninth year in a row under a national program that attempts to help patients make informed decisions about quality respiratory services available in hospitals. Only about 15 percent of hospitals have applied and received this recognition. The designation ensures patient safety by agreeing to adhere to a strict set of criteria for quality respiratory services. WellStar implemented a new Enterprise Master Patient Index (EMPI) during the year. The project was activated at all of the system hospitals as well as the physician offices in an effort to enhance the patient experience and improve safety. The system provides more patient-centered care and helps eliminate duplicate medical records as the information gathered at registration is shared throughout WellStar. Wellstar Health System donated approximately $1.0 million in funds to the Georgia Highlands College Nursing program. The funds to be disbursed over two years will support the college's new Bachelor of Science in nursing as well as onsite programs for WellStar team members. It is the largest single contribution the college has ever received. The agreement expands the bridge program for licensed practical nurses who want to become registered nurses with an associate's degree. The program is available at GHC to students in Cobb, Douglas and Paulding counties. This will also help meet the educational needs of WellStar team members who are students at GHC. Having onsite access to learning opportunites so that nurses can learn and grow is critical to WellStar hiring and retaining nurses for the system. WellStar Cobb Hospital receive | Description |
| Total Program Service Expense | 247764948 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | true | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 2630 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 18 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 14 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | GA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | JAMES M SWARTZ | NamePerson |
| Telephone Number | 7707925023 | TelephoneNumber |
Address US AddressUS
| 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 | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (67 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| Randall Bentley | ||||||||
| Board Member Chair | 1.0 | X | 0 | 16769 | 0 | |||
| Robert N Cross MD | ||||||||
| Board Member | 1.0 | X | 0 | 4272 | 0 | |||
| TE Durham | ||||||||
| Board Member | 1.0 | X | 0 | 36443 | 1430 | |||
| Thomas E Gearhard MD | ||||||||
| Board Member | 1.0 | X | 0 | 441387 | 30593 | |||
| David Hafner MD | ||||||||
| Board Member | 1.0 | X | 0 | 17769 | 0 | |||
| Charles J Jones | ||||||||
| Board Member | 1.0 | X | 0 | 12580 | 0 | |||
| Connie Kirk | ||||||||
| Board Member | 1.0 | X | 0 | 4675 | 0 | |||
| Janie Maddox | ||||||||
| Board Member-Vice Chair | 1.0 | X | 0 | 15634 | 0 | |||
| Gary A Miller | ||||||||
| Board Member | 1.0 | X | 0 | 1742 | 0 | |||
| Steven W Oweida MD | ||||||||
| Board Member | 1.0 | X | 0 | 16946 | 0 | |||
| Tom Phillips | ||||||||
| Board Member | 1.0 | X | 0 | 6165 | 0 | |||
| Walter G Robinson | ||||||||
| Board Member | 1.0 | X | 0 | 3954 | 0 | |||
| Otis Brumby III | ||||||||
| Board Member | 1.0 | X | 0 | 2374 | 0 | |||
| W Allen Separk | ||||||||
| Board Member | 1.0 | X | 0 | 8095 | 0 | |||
| T Fitz Johnson | ||||||||
| Board Member | 1.0 | X | 0 | 3730 | 0 | |||
| Jeffrey Tharp MD | ||||||||
| Board Member | 1.0 | X | 0 | 508542 | 31417 | |||
| Charles Pete Wood | ||||||||
| Board Member | 1.0 | X | 0 | 13025 | 0 | |||
| Avril Beckford MD | ||||||||
| Board Member | 1.0 | X | 0 | 398842 | 21377 | |||
| A James Budzinski | ||||||||
| Exec VP and CFO | 2.0 | 0 | 932621 | 48453 | X | |||
| Reynold J Jennings | ||||||||
| President & CEO | 2.0 | 0 | 348685 | 14385 | X | |||
| David W Anderson | ||||||||
| Exec VP HR/OL/CCO | 2.0 | 0 | 503600 | 29075 | X | |||
| Donald Campbell MD | ||||||||
| Sr VP Physician Education | 2.0 | 0 | 599439 | 33540 | X | |||
| Barbara B Corey | ||||||||
| Sr VP Managed Care | 2.0 | 0 | 345736 | 22861 | X | |||
| Bruce Dean | ||||||||
| VP Real Estate & Dep Gen Consl | 2.0 | 0 | 282753 | 22320 | X | |||
| Marcia Delk MD | ||||||||
| Sr VP Med Affairs & CQO | 2.0 | 0 | 420637 | 32831 | X | |||
| Clarence H Evins | ||||||||
| VP Revenue Cycle Mgmt | 2.0 | 0 | 250193 | 18352 | X | |||
| Christopher M Kane | ||||||||
| Sr VP Strategic Plan&Bus Devlp | 2.0 | 0 | 396107 | 27207 | X | |||
| Kenneth C Kunze MD | ||||||||
| Sr VP Chief Med Officer | 2.0 | 0 | 698966 | 35591 | X | |||
| Louis W Little | ||||||||
| Sr VP Post Acute & Hosp Admin | 2.0 | 0 | 286719 | 24608 | X | |||
| Kimberly W Menefee | ||||||||
| Sr VP Public & Govt Affairs | 2.0 | 0 | 325382 | 22343 | X | |||
| Ronald J Strachan | ||||||||
| Sr VP & CIO | 2.0 | 0 | 492358 | 24507 | X | |||
| Lee Randolph Cook | ||||||||
| Sr VP & Administrator | 50.0 | 336765 | 0 | 23660 | X | |||
| MICHAEL GRAUE | ||||||||
| EXEC VP COO | 2.0 | 0 | 680247 | 43271 | X | |||
| ROBERT JANSEN | ||||||||
| Exec VP & Pres Med Group | 2.0 | 0 | 509124 | 26667 | X | |||
| ELLEN LANGFORD | ||||||||
| VP & COO PHY GRP | 2.0 | 0 | 275321 | 14655 | X | |||
| Robert Mandler | ||||||||
| VP Diagnostic Outreach | 2.0 | 0 | 266979 | 18768 | X | |||
| Jonathan B Morris | ||||||||
| Sr VP and CIO | 2.0 | 0 | 416394 | 27823 | X | |||
| Anthony M Trupiano | ||||||||
| Sr VP Supply Chain | 2.0 | 0 | 284073 | 16516 | X | |||
| Robin Wilson MD | ||||||||
| Sr VP Performance Innovation | 2.0 | 0 | 506787 | 32116 | X | |||
| Ilona L Wozniak | ||||||||
| VP Operations & COO Cobb Hosp | 50.0 | 278506 | 0 | 18289 | X | |||
| Joseph L Brywczynski | ||||||||
| Sr VP Health Parks Admin | 2.0 | 0 | 311785 | 19612 | X | |||
| Elizabeth A Hoffmann | ||||||||
| VP Budget & Analysis | 2.0 | 0 | 233775 | 11530 | X | |||
| Richard T Lopes MD | ||||||||
| Sr VP & Pres Wellstar Phy Grp | 2.0 | 0 | 757815 | 36938 | X | |||
| James M Swartz | ||||||||
| VP Accounting | 2.0 | 0 | 217871 | 14937 | X | |||
| Mary L Wesley | ||||||||
| Sr VP Nursing Services & CNE | 2.0 | 0 | 457717 | 21831 | X | |||
| Barbara G Ballard | ||||||||
| VP Homecare & Hospice | 2.0 | 0 | 259113 | 22697 | X | |||
| Carol S Edwards | ||||||||
| VP Cardiac Services | 2.0 | 0 | 325593 | 20146 | X | |||
| Beth Kost | ||||||||
| VP Compliance/Ch Privacy Offr | 2.0 | 0 | 269763 | 17725 | X | |||
| Elizabeth Person | ||||||||
| VP/CNO Patient Care Services | 50.0 | 243848 | 0 | 17231 | X | |||
| Chris Brett Scullen | ||||||||
| VP Pulmonology Operations | 2.0 | 0 | 188627 | 8053 | X | |||
| Adam C Thompson | ||||||||
| VP Surgery | 2.0 | 0 | 185584 | 10535 | X | |||
| Leo E Reichert | ||||||||
| Exec VP & General Counsel | 2.0 | 0 | 623353 | 36099 | X | |||
| Deborah DeVita Roegge | ||||||||
| VP Women's & Newborn Srv Line | 2.0 | 0 | 170369 | 7541 | X | |||
| Mary L Tavernaro | ||||||||
| VP Human Resources Operations | 2.0 | 0 | 224515 | 15552 | X | |||
| Carol B Maxwell | ||||||||
| VP Human Resources | 2.0 | 0 | 86518 | 4350 | X | |||
| Kenneth D Etheridge | ||||||||
| VP Finance and Hospital CFO | 50.0 | 345123 | 0 | 19449 | X | |||
| Thomas W McNamara MD | ||||||||
| VP Medical Affairs Cobb Hosp | 50.0 | 203605 | 0 | 12415 | X | |||
| Kem Mullins | ||||||||
| Sr VP and Hosp Administrator | 50.0 | 0 | 0 | 0 | X | |||
| Chester Zborowski | ||||||||
| VP Health Park Operations | 2.0 | 0 | 0 | 0 | X | |||
| Valery Akopov | ||||||||
| VP Chief Hospitalists Services | 2.0 | 0 | 0 | 0 | X | |||
| Allen Hoffman MD | ||||||||
| Exec Dir Community Clinics | 50.0 | 179664 | 0 | 15136 | X | |||
| Billy A Reid | ||||||||
| Dir Pharmacy | 50.0 | 165084 | 0 | 12300 | X | |||
| William Gonzalez | ||||||||
| Manager Pharmacy | 50.0 | 143053 | 0 | 16734 | X | |||
| Timothy Fullard | ||||||||
| Pharm Care Pharmacist | 50.0 | 142296 | 0 | 14271 | X | |||
| Tawana Moses | ||||||||
| Asst VP Operations | 50.0 | 169442 | 0 | 10714 | X | |||
| Gregory L Simone MD | ||||||||
| President & CEO | 0 | 248936 | 13892 | X | ||||
| Bonnie Wilson | ||||||||
| Exec VP and Gen Counsel | 0 | 244138 | 13763 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2207386 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 15140537 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1056106 | TotalOtherCompensation |
| Number Individuals GT100 K | 86 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Martin General Contracting Inc | |||||
| 3633 Ivy Gulledge Rd | DALLAS | GA | 30132 | General Contracting | 713967 |
| Quest Diagnostics | |||||
| PO BOX 740736 | ATLANTA | GA | 30384 | LAB SERVICES | 855526 |
| Surgical Operational Services Inc | |||||
| 505 Commerce Park Dr Suite G | MARIETTA | GA | 30060 | Consultant OR | 842949 |
| RCC Marietta | |||||
| PO Box 101518 | ATLANTA | GA | 303921518 | Medical Services | 1095400 |
| Cork-Howard Construction Inc | |||||
| 2121 New Market Pkwy Suite 118 | MARIETTA | GA | 30067 | GENERAL CONTRACTOR | 6519672 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 22 | NumberOfContractorsGT100K |
| Total Contributions | 0 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT REVENUE | 621990 | 311646354 | 311646354 |
| PATIENT EDUCATION | 621990 | 27374 | 27374 |
| MEDICAL RECORDS | 621990 | 537 | 537 |
| MEDICAID REIMB (MEANINGFUL USE) | 621990 | 1267641 | 1267641 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 312941906 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 27065 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 27065 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 27065 | TotalRevenueColumn |
| Exclusion | $27,065 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 13150 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 13150 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 13150 | TotalRevenueColumn |
| Exclusion | $13,150 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|
| CAFETERIA | 1929193 | $1,929,193 |
| PARKING | 962725 | $962,725 |
| PHARMACY REVENUE | 2282185 | $2,282,185 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 424498 | TotalRevenueColumn |
| Exclusion | $424,498 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 5598601 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 318580722 | TotalRevenueColumn |
| Related Or Exempt Function Income | 312941906 | RelatedOrExemptFunctionIncome |
| Exclusion | $5,638,816 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1407848 | Total |
| Program Services | 1238202 | ProgramServices |
| Management And General | 169646 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 111913433 | Total |
| Program Services | 98426889 | ProgramServices |
| Management And General | 13486544 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5744330 | Total |
| Program Services | 5052138 | ProgramServices |
| Management And General | 692192 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9199257 | Total |
| Program Services | 8090747 | ProgramServices |
| Management And General | 1108510 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8222748 | Total |
| Program Services | 7231907 | ProgramServices |
| Management And General | 990841 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 35491 | Total |
| Management And General | 35491 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9976613 | Total |
| Program Services | 9711804 | ProgramServices |
| Management And General | 264809 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19299 | Total |
| Program Services | 17872 | ProgramServices |
| Management And General | 1427 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13602659 | Total |
| Program Services | 11708299 | ProgramServices |
| Management And General | 1894360 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3655533 | Total |
| Program Services | 330334 | ProgramServices |
| Management And General | 3325199 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 87577 | Total |
| Program Services | 49525 | ProgramServices |
| Management And General | 38052 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 52067 | Total |
| Program Services | 28474 | ProgramServices |
| Management And General | 23593 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49308 | Total |
| Management And General | 49308 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 57415395 | Total |
| Program Services | 50496840 | ProgramServices |
| Management And General | 6918555 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13306141 | Total |
| Program Services | 5367873 | ProgramServices |
| Management And General | 7938268 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2395508 | Total |
| Management And General | 2395508 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| REPAIRS & MAINTENANCE | 4463346 | 3480446 | 982900 |
| MEDICAL SUPPLIES | 46157603 | 46157149 | 454 |
| OTHER EXPENSES | 425968 | 376449 | 49519 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 288130124 | Total |
| Program Services | 247764948 | ProgramServices |
| Management And General | 40365176 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6825 | BOY |
| EOY | 7025 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37865 | BOY |
| EOY | 27596 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 48302664 | BOY |
| EOY | 51290559 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5078180 | BOY |
| EOY | 6174822 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1753680 | BOY |
| EOY | 1576039 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 306813156 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 187431083 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 121765354 | BOY |
| EOY | 119382073 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10303092 | BOY |
| EOY | 9833361 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 187247660 | BOY |
| EOY | 188291475 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20393695 | BOY |
| EOY | 19872593 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 57208 | BOY |
| EOY | 29459 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 100001363 | BOY |
| EOY | 106898483 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 120452266 | BOY |
| EOY | 126800535 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 66795394 | BOY |
| EOY | 61490940 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 66795394 | BOY |
| EOY | 61490940 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 187247660 | BOY |
| EOY | 188291475 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 30450598 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -35755052 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Current Year Minus3 Years | CurrentYearMinus3Years |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4336556 | OtherCostOrOtherBasis |
| Book Value | 4336556 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 147916047 | OtherCostOrOtherBasis |
| Depreciation | 75230009 | Depreciation |
| Book Value | 72686038 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4870974 | OtherCostOrOtherBasis |
| Depreciation | 3576407 | Depreciation |
| Book Value | 1294567 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 147751189 | OtherCostOrOtherBasis |
| Depreciation | 108624667 | Depreciation |
| Book Value | 39126522 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1938390 | OtherCostOrOtherBasis |
| Book Value | 1938390 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 119382073 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DUE TO AFFILIATES | 4774742 |
| C&E MEDICAID PENDING | 5058619 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 9833361 | TotalBookValueOtherAssets |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ASSET RETIREMENT-OTHER LT LIAB | $602,705 |
| TAX EXEMPT BOND LIAB-DUE TO WH | $106,295,778 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 106898483 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Uncertain Tax Position | Identifier |
| Return Reference | SCHEDULE D PART X Line 2 | ReturnReference |
| Explanation | The following is a footnote from the combined financial statements of Wellstar Health System, Inc. and Affiliates related to the reporting of the organization's liability for uncertain tax positions under FIN 48. "Wellstar and all but one of its affiliates have been recognized as exempt from Federal income tax under Internal Revenue Code Section 501 (a) as organizations described in Section 501 (c) (3) and therefore, related income is generally not subject to Federal or state income tax. Community Assurance Corportion 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." | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 125. | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 29218662 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 29218662 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10140 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 56149808 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 47945096 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 8204712 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02850 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 85368470 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 47945096 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 37423374 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.12990 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1024029 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1024029 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00360 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1024029 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1024029 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00360 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 86392499 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 47945096 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 38447403 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.13350 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $13,485,901 | BadDebtExpenseAmount |
| Amount Attributable To | 3101264 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 102875402 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 112965790 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -10090388 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cobb Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3950 Austell Road | AddressLine1 |
| City | Austell | City |
| State | GA | State |
| ZIP Code | 300666340 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cobb Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 125. | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 300. | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Average Negotiated Rates | X | AverageNegotiatedRates |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Publication of Community Benefit Report | Sch H Part I Line 6a | Cobb Hospital, 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. |
| Cost to Charge Ratio | Sch H Part I Line 7 | For purposes of the IRS Form 990 Schedule H, Wellstar Health System and Affiliates (including Cobb 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. |
| Footnote on Bad Debt and Rationale for Community Benefit | Sch H Part III Line 4 | The following footnote is detailed in the Wellstar Health System, Inc. and Affiliates Financial Statements related to bad debt or uncollectible accounts: "During 2011, Wellstar adopted the provisions of FASB Accounting Standards Update (2011-07), Healthcare Entities (Topic 954). ASU 2011-07 requires the reclassification of the provision for uncollectible accounts associated with patient service revenue from an operating expense to a deduction from patient service revenue (net of contractual allowances and discounts)." "Wellstar recognizes patient service revenue associated with services provided to patients with third-party payor coverage on the basis of contractual rates for the services rendered. For uninsured patients that do not qualify for community financial aid, Wellstar recognizes revenue on the basis of its discounted rates for services provided. On the basis of historical experience, a significant portion of Wellstar's uninsured patients are unable or unwilling to pay for the services provided. Thus, Wellstar records a significant provision for uncollectible accounts related to uninsured patients in the period the services are provided." Subsequent to the end of the reporting period a propensity to pay review of patient accounts often results in prior year bad debt accounts which are deemed eligible for the organization's financial assistance policy. Those bad debt accounts are reclassified as charity and thus our rationale for including in community benefit. |
| Medicare Shortfalls | Schedule H Part III Line 8 | Cobb 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. |
| Collection Practices | Schedule 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. |
| Hospital Description | Schedule H Part V | Cobb Hospital is a general acute care hospital providing a full range of services, is licensed to operate 382 beds, and is presently staffed to operate 370 beds. It is located on an approximately 55-acre campus in Austell, Georgia and is housed within a complex of connected buildings containing a total square footage in excess of 599,000 square feet. The original hospital was constructed in 1968 and major structural additions have been made in several phases since that time. The hospital provides medical, surgical, obstetrical, pediatric, rehabilitative, and psychiatric inpatient care and outpatient care, including emergency services. The Cobb Hospital Women's Center operates 20 labor and delivery rooms, 40 post partum rooms, 6 antipartum rooms and a resource center and classrooms offering educational opportunities. |
| Needs Assessment | 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 ownership of the process. Community ownership, in turn, increases the credibility and sustainability of the health improvement efforts. |
| Patient Education of Eligibility for Assistance | Sch H Part VI Line 3 | Cobb 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. |
| Community Information | Sch H Part VI Line 4 | Cobb 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. |
| Affiliated Health System Role | Schedule H Part VI Line 7 | As stated in the Wellstar Health System, Inc and Affiliates audited financial statments for the period ended June 30, 2012, Cobb 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 its parent is composed of prominent citizens in the community, medical staff privileges in the hospital are available to all qualifed physicians in the area consistent with the size and nature of the facility; 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. Cobb Hospital committed approximately $21.2 million in capital expenditures for the year to meet those needs. |
| Publication of Fin Assistance Policy | Sch H Part V Line 13g | In addition to the other methods of posting the financial assistance policy, the hospital makes available for patients in admissions and outpatient registration areas a brochure including frequently asked questions. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Class Or Charter Travel | X | FirstClassOrCharterTravel |
| Travel For Companions | X | TravelForCompanions |
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Discretionary Spending Account | X | DiscretionarySpendingAccount |
| Housing Allowance Or Residence | X | HousingAllowanceOrResidence |
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | false | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | true | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (48 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Thomas E Gearhard MD | |||||||||||||
| 0 | 249303 | 0 | 184230 | 0 | 7854 | 0 | 23371 | 0 | 7222 | 0 | 471980 | 0 | 0 |
| Jeffrey Tharp MD | |||||||||||||
| 0 | 308337 | 0 | 89305 | 0 | 110900 | 0 | 26140 | 0 | 5277 | 0 | 539959 | 0 | 0 |
| A James Budzinski | |||||||||||||
| 0 | 464491 | 0 | 454394 | 0 | 13736 | 0 | 43675 | 0 | 4778 | 0 | 981074 | 0 | 0 |
| Avril Beckford MD | |||||||||||||
| 0 | 261712 | 0 | 49363 | 0 | 87767 | 0 | 21377 | 0 | 0 | 420219 | 0 | 0 | |
| Reynold J Jennings | |||||||||||||
| 0 | 339346 | 0 | 0 | 9339 | 0 | 14385 | 0 | 0 | 363070 | 0 | 0 | ||
| Gregory L Simone MD | |||||||||||||
| 0 | 248936 | 0 | 0 | 0 | 10168 | 0 | 3724 | 0 | 262828 | 0 | 0 | ||
| Bonnie Wilson | |||||||||||||
| 0 | 244138 | 0 | 0 | 0 | 10168 | 0 | 3595 | 0 | 257901 | 0 | 0 | ||
| David W Anderson | |||||||||||||
| 0 | 388078 | 0 | 100027 | 0 | 15495 | 0 | 25522 | 0 | 3553 | 0 | 532675 | 0 | 0 |
| Donald Campbell MD | |||||||||||||
| 0 | 314601 | 0 | 64127 | 0 | 220711 | 0 | 29646 | 0 | 3894 | 0 | 632979 | 0 | 0 |
| Barbara B Corey | |||||||||||||
| 0 | 276741 | 0 | 58195 | 0 | 10800 | 0 | 19361 | 0 | 3500 | 0 | 368597 | 0 | 0 |
| Bruce Dean | |||||||||||||
| 0 | 201641 | 0 | 72017 | 0 | 9095 | 0 | 16148 | 0 | 6172 | 0 | 305073 | 0 | 0 |
| Marcia Delk MD | |||||||||||||
| 0 | 337360 | 0 | 71529 | 0 | 11748 | 0 | 22572 | 0 | 10259 | 0 | 453468 | 0 | 0 |
| Clarence H Evins | |||||||||||||
| 0 | 191938 | 0 | 29473 | 0 | 28782 | 0 | 14197 | 0 | 4155 | 0 | 268545 | 0 | 0 |
| Christopher M Kane | |||||||||||||
| 0 | 318290 | 0 | 66617 | 0 | 11200 | 0 | 21485 | 0 | 5722 | 0 | 423314 | 0 | 0 |
| Kenneth C Kunze MD | |||||||||||||
| 0 | 569002 | 0 | 118114 | 0 | 11850 | 0 | 33824 | 0 | 1767 | 0 | 734557 | 0 | 0 |
| Louis W Little | |||||||||||||
| 0 | 224975 | 0 | 50944 | 0 | 10800 | 0 | 16978 | 0 | 7630 | 0 | 311327 | 0 | 0 |
| Kimberly W Menefee | |||||||||||||
| 0 | 258803 | 0 | 54544 | 0 | 12035 | 0 | 18482 | 0 | 3861 | 0 | 347725 | 0 | 0 |
| Ronald J Strachan | |||||||||||||
| 0 | 287145 | 0 | 49464 | 0 | 155749 | 0 | 22279 | 0 | 2228 | 0 | 516865 | 0 | 0 |
| Lee Randolph Cook | |||||||||||||
| 276688 | 0 | 48026 | 0 | 12051 | 0 | 18980 | 0 | 4680 | 0 | 360425 | 0 | 0 | 0 |
| Allen Hoffman MD | |||||||||||||
| 164352 | 0 | 14112 | 0 | 1200 | 0 | 7412 | 0 | 7724 | 0 | 194800 | 0 | 0 | 0 |
| Billy A Reid | |||||||||||||
| 155703 | 0 | 9381 | 0 | 0 | 9945 | 0 | 2355 | 0 | 177384 | 0 | 0 | 0 | |
| William Gonzalez | |||||||||||||
| 137338 | 0 | 5715 | 0 | 0 | 8823 | 0 | 7911 | 0 | 159787 | 0 | 0 | 0 | |
| Timothy Fullard | |||||||||||||
| 142023 | 0 | 273 | 0 | 0 | 8494 | 0 | 5777 | 0 | 156567 | 0 | 0 | 0 | |
| Tawana Moses | |||||||||||||
| 151889 | 0 | 16353 | 0 | 1200 | 0 | 10082 | 0 | 632 | 0 | 180156 | 0 | 0 | 0 |
| MICHAEL GRAUE | |||||||||||||
| 0 | 527427 | 0 | 138784 | 0 | 14036 | 0 | 33360 | 0 | 9911 | 0 | 723518 | 0 | 0 |
| ROBERT JANSEN | |||||||||||||
| 0 | 346951 | 0 | 98895 | 0 | 63278 | 0 | 21176 | 0 | 5491 | 0 | 535791 | 0 | 0 |
| ELLEN LANGFORD | |||||||||||||
| 0 | 186452 | 0 | 80169 | 0 | 8700 | 0 | 11975 | 0 | 2680 | 0 | 289976 | 0 | 0 |
| Robert Mandler | |||||||||||||
| 0 | 206312 | 0 | 31122 | 0 | 29545 | 0 | 14907 | 0 | 3861 | 0 | 285747 | 0 | 0 |
| Jonathan B Morris | |||||||||||||
| 0 | 267997 | 0 | 136358 | 0 | 12039 | 0 | 22332 | 0 | 5491 | 0 | 444217 | 0 | 0 |
| Anthony M Trupiano | |||||||||||||
| 0 | 237972 | 0 | 36641 | 0 | 9460 | 0 | 16516 | 0 | 0 | 300589 | 0 | 0 | |
| Robin Wilson MD | |||||||||||||
| 0 | 290890 | 0 | 205797 | 0 | 10100 | 0 | 21394 | 0 | 10722 | 0 | 538903 | 0 | 0 |
| Ilona L Wozniak | |||||||||||||
| 238675 | 0 | 30571 | 0 | 9260 | 0 | 16396 | 0 | 1893 | 0 | 296795 | 0 | 0 | 0 |
| Joseph L Brywczynski | |||||||||||||
| 0 | 249445 | 0 | 51540 | 0 | 10800 | 0 | 17759 | 0 | 1853 | 0 | 331397 | 0 | 0 |
| Elizabeth A Hoffmann | |||||||||||||
| 0 | 194472 | 0 | 30603 | 0 | 8700 | 0 | 9763 | 0 | 1767 | 0 | 245305 | 0 | 0 |
| Richard T Lopes MD | |||||||||||||
| 0 | 563490 | 0 | 98330 | 0 | 95995 | 0 | 35223 | 0 | 1715 | 0 | 794753 | 0 | 0 |
| James M Swartz | |||||||||||||
| 0 | 180180 | 0 | 28991 | 0 | 8700 | 0 | 9268 | 0 | 5669 | 0 | 232808 | 0 | 0 |
| Mary L Wesley | |||||||||||||
| 0 | 295174 | 0 | 151203 | 0 | 11340 | 0 | 18920 | 0 | 2911 | 0 | 479548 | 0 | 0 |
| Barbara G Ballard | |||||||||||||
| 0 | 218870 | 0 | 31523 | 0 | 8720 | 0 | 14225 | 0 | 8472 | 0 | 281810 | 0 | 0 |
| Carol S Edwards | |||||||||||||
| 0 | 260780 | 0 | 29770 | 0 | 35043 | 0 | 18289 | 0 | 1857 | 0 | 345739 | 0 | 0 |
| Beth Kost | |||||||||||||
| 0 | 225630 | 0 | 35433 | 0 | 8700 | 0 | 15958 | 0 | 1767 | 0 | 287488 | 0 | 0 |
| Elizabeth Person | |||||||||||||
| 209838 | 0 | 24323 | 0 | 9687 | 0 | 14587 | 0 | 2644 | 0 | 261079 | 0 | 0 | 0 |
| Chris Brett Scullen | |||||||||||||
| 0 | 159623 | 0 | 20304 | 0 | 8700 | 0 | 7837 | 0 | 216 | 0 | 196680 | 0 | 0 |
| Adam C Thompson | |||||||||||||
| 0 | 152126 | 0 | 24158 | 0 | 9300 | 0 | 7783 | 0 | 2752 | 0 | 196119 | 0 | 0 |
| Leo E Reichert | |||||||||||||
| 0 | 438716 | 0 | 168080 | 0 | 16557 | 0 | 28317 | 0 | 7782 | 0 | 659452 | 0 | 0 |
| Deborah DeVita Roegge | |||||||||||||
| 0 | 119681 | 0 | 0 | 50688 | 0 | 7048 | 0 | 493 | 0 | 177910 | 0 | 0 | |
| Mary L Tavernaro | |||||||||||||
| 0 | 191015 | 0 | 27108 | 0 | 6392 | 0 | 13871 | 0 | 1681 | 0 | 240067 | 0 | 0 |
| Kenneth D Etheridge | |||||||||||||
| 201008 | 0 | 135415 | 0 | 8700 | 0 | 18428 | 0 | 1021 | 0 | 364572 | 0 | 0 | 0 |
| Thomas W McNamara MD | |||||||||||||
| 153493 | 0 | 0 | 0 | 50112 | 0 | 11251 | 0 | 1164 | 0 | 216020 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Non-Fixed Payments | Form 990 Schedule J Part 1 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 (manager level employees and above). Those factors are: People goal for employee turnover Customer Service goal for employee engagement Quality & Safety goal for clinical excellence and patient satisfaction Financial goal for attaining a positive operating margin Confirmation of achieving these payout triggers is typically received through the annual external audit process and approved by the Board of Trustees at that time. In addition the incentive program has now been extended to all WellStar team members (non-manager level)on a somewhat smaller scale. |
| Severance Benefits | Pursuant to their respective employment agreements, the following groups of officers are entitled to severance payments based on their base salary and wages at that time in the event of certain identified circumstances. The officers with a severance payment period of 24 months as per their contractual agreement are: David Anderson Reynold Jennings The officers with a severance payment period of 18 months as per their respective agreements are: Joseph Brywczynski A James Budzinski Donald Campbell MD Randy Cook Barbara Corey Marcia Delk MD Michael Graue T Mark Haney Bruce Harrison Robert Jansen MD Christopher Kane Kenneth Kunze MD Lou Little Richard Lopes MD Kimberly Menefee Jonathan Morris MD Leo E Reichert Ron Strachan Anthony Trupiano Mary L Wesley Robin Wilson MD The officers with a severance payment period of 12 months as per their agreement: Barbara Ballard Bruce Dean Carol Edwards Darold Etheridge Lee Evins Robert Hamilton Elizabeth Hoffmann Beth Kost Ellen Langford Robert Mandler Carol Maxwell Elizabeth Person Deborah Roegge DeVita C Brett Scullen James Swartz Mary L Tavernaro Adam Thompson Ilona Wozniak During the calendar year, the following individuals received a payout in the amounts listed in accordance with their severance agreements as set forth above: Bruce Harrison $21,897 Gregory L Simone $248,936 Bonnie Wilson $244,138 | |
| Other Compensation | Form 990 Schedule J Part 1 Line 1b and 2 | While Wellstar Health System and its affiliates do not have a written policy regarding payment or reimbursement fo the items listed in Part 1 Line 1a, the organization follows IRS guidelines in the payment of any of these items to individuals listed in Form 990 Part VII Section A. These items are added as taxable wages on the individual's Form W-2 as appropriate. |
| Compensation Exceptions | On Schedule J of IRS Form 990 the following individuals were employed as officers of Wellstar Health System and its Affiliates during the reporting period but did not have salary and benefits in the calendar year for which this schedule applies: Kem Mullins, Chester Zborowski and Valery Akopov |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (8 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| Pamela Etheridge | |||
| Wife of Officer | 55003 | Employee of Wellstar | false |
| Greg Fortgang | |||
| Son-in-law of Trustee | 92895 | Employee of Wellstar | false |
| Greg Separk | |||
| Son of Trustee | 59724 | Employee of Wellstar | false |
| George Fleming | |||
| Brother of Officer | 60969 | Employee of Wellstar | false |
| Matthew Maddox | |||
| Son of Trustee | 39776 | Employee of Wellstar | false |
| Bonnie Miller | |||
| Wife of Trustee | 31510 | Employee of Wellstar | false |
| Jessica Haney | |||
| Daughter of Officer | 54545 | Employee of Wellstar | false |
| Greg Kost | |||
| Brother-in-law of Officer | 25034 | Employee of Wellstar | false |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (68 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| 990 T Explanation of Filing | Form 990 Part V Line 3 | Cobb Hospital generated no unrelated business income for the reporting period. As a result the attached 990T shows no activity. If subsequent review of the books reveals any unreported UBI we will file an amended return for the tax period ended June 30, 2012. |
| Form 990 Copy to Board of Directors | 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. 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. |
| Conflict of Interest Policy | Form 990 Part VI Section B Line 12 a-c | Our conflict of interest policy requires all covered persons to annually review the policy and then complete, sign and return the Conflicts of Interest Survey and Attestation to the Compliance Office. The policy requires an on-going disclosure obligation in the event a conflict arises during the year. The following is our process to regularly and consistently monitor and enforce this policy: Compliance identifies all covered persons who must complete the survey and attestation. Compliance verifies that the survey and attestation is distributed to these persons. Compliance verifies that these persons return a fully completed and signed survey and attestation. Compliance reviews each completed and signed survey and attestation to identify all conflicts listed in the document. All conflicts, potential conflicts and incidences of non-compliance are referred to the Chief Compliance Officer. The CCO takes appropriate action to completely resolve all identified conflicts and incidences of non-compliance. |
| Process for determining Exec Compensation | Form 990 Part VI Section B Line 15A & B | 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 compensation committee consists of three board members and the CEO for the system. In discussions about the compensation for the Chief Executive Officer, the acting CEO will recuse himself from that process but is a non-voting committee member for discussions on all other officers. The executive compensation philosophy empowers the committee to oversee the executive compensation process and administer the executive compensation program on behalf of the full board of trustee of Wellstar; provided, however, the full Board of Trustees evaluates and approves the compensation of the Chief Executive Officer. The philosophy requires annual disclosure of the committee's actions and decisions to the full board, which it has done. The committee is guided by the board-approved philosophy. Overall, the philosophy is intended to reward for organizational and individual performance. When performance is at a predetermined targeted level, the compensation is intended to be at or around the median of compensation paid to similar positions at similar organizations (the "market"). Wellstar's executive compensation philosophy defines the market as being comprised of comparable not-for-profit health care delivery systems, i.e., not-for-profit organizations similar in complexity and scale to Wellstar. To assist the committee in fulfilling its duties, the committee engaged the Hay Group to provide market compensation data to compare to the Wellstar positions whose compensation the committee oversees. The committee uses this data to provide context when making decisions in administering the compensation program. Accurate minutes of the committee's discussion and decisions are recorded during each committee meeting, and reviewed and approved at the following committee meeting. |
| DISCLOSURE OF FINANCIAL DOCUMENTS | 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. |
| Compensation | Form 990 Part V Line 2 | All compensation amounts reported on Form 990 Part V, Part VII, and Part IX as well as Schedule J represent compensation provided to individuals that provide services to the organization. Likewise, the number of employees reported on Form 990 represent the number of individuals providing services to the organization. All Federal employment tax responsibilities for these individuals (including Federal Employment Tax reporting responsibilities) are handled by Wellstar Health System, Inc (EIN 58-1649541). |
| Organizational Structure | Form 990 Part VI Line 6 & 7 | 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 and approval in connection with the governing body of the organization. These powers are presented in detail in the company's governing documents which the company makes available to the public upon request. |
| Officer's Hours | Form 990 General Statement | The officers devote their time to all of the organizations within Wellstar Health System that are listed in Schedule R, Part II. As such, the total hours worked by the officers across all of the organizations exceeds 40 hours per week. |
| AUDITED FINANCIAL STATEMENTS | Form 990 Part IV Line 12 and Part XI | WellStar Health System, Inc. is audited on an annual basis by an outside auditing firm, KPMG, and as part of that audit a consolidated financial statement is issued for all of WellStar Health System, Inc and its Affiliates. "The independent auditors report includes the accounts of Wellstar and its controlled affiliates, Kennestone Hospital, Inc., Cobb Hospital, Inc., Douglas Hospital, Inc., Paulding Medical Center, Inc., Wellstar Foundation, Inc. CHS Foundation, Inc., Community Assurance Company, Ltd., various Wellstar owned physician practices, a hospice facility, a nursing facility, home health business, and entities for infusion therapy and durable medical equipment. All significant intercompany accounts and transactions have been eliminated in combination. The Board of Trustees of Wellstar has the authority to approve appointments of the members of the board of trustees of all affiliate corporations." |
| CURRENT OFFICERS/DIRECTORS RELATIONSHIPS | FORM 990 PART VI, SECTION A LINE 2 | Two of the current officers and directors for Wellstar Health System, Inc. --EIN 58-1649541 are related to each other through family. Lou Little, Sr VP Post Acute Services and Administrator of Windy Hill Hospital is the brother-in-law of Gregory Simone, former President and CEO for the system. |
| Tax-Exempt Bonds Allocation | 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). Cobb Hospital, Inc. will report this tax exempt bond liability on Part X, Line 25 Other Liabilities. Cobb Hospital, 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. |
| Other Changes in Net Assets | Form 990 Part XI Line 5 | For the reporting period Cobb Hospital, Inc. had a change in net assets of ($44,175,628) related to transfers to affiliates as part of the allocation of income statement and balance sheet transactions over the year. |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Randall Bentley TITLE:Board Member Chair HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Robert N Cross MD TITLE:Board Member HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:TE Durham TITLE:Board Member HOURS:5 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Thomas E Gearhard MD TITLE:Board Member HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:David Hafner MD TITLE:Board Member HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Charles J Jones TITLE:Board Member HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Connie Kirk TITLE:Board Member HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Janie Maddox TITLE:Board Member-Vice Chair HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Gary A Miller TITLE:Board Member HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Steven W Oweida MD TITLE:Board Member HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Tom Phillips TITLE:Board Member HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Walter G Robinson TITLE:Board Member HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Otis Brumby III TITLE:Board Member HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:W. Allen Separk TITLE:Board Member HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:T. Fitz Johnson TITLE:Board Member HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Jeffrey Tharp MD TITLE:Board Member HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Charles "Pete" Wood TITLE:Board Member HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Avril Beckford MD TITLE:Board Member HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:A James Budzinski TITLE:Exec VP and CFO HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Reynold J Jennings TITLE:President & CEO HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:David W Anderson TITLE:Exec VP HR/OL/CCO HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Donald Campbell MD TITLE:Sr VP Physician Education HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Barbara B Corey TITLE:Sr VP Managed Care HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Bruce Dean TITLE:VP Real Estate & Dep Gen Consl HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Marcia Delk MD TITLE:Sr VP Med Affairs & CQO HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Clarence H Evins TITLE:VP Revenue Cycle Mgmt HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Christopher M Kane TITLE:Sr VP Strategic Plan&Bus Devlp HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Kenneth C Kunze MD TITLE:Sr VP Chief Med Officer HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Louis W Little TITLE:Sr VP Post Acute & Hosp Admin HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Kimberly W. Menefee TITLE:Sr VP Public & Govt Affairs HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Ronald J Strachan TITLE:Sr VP & CIO HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Lee Randolph Cook TITLE:Sr VP & Administrator HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:MICHAEL GRAUE TITLE:EXEC VP COO HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:ROBERT JANSEN TITLE:Exec VP & Pres Med Group HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:ELLEN LANGFORD TITLE:VP & COO PHY GRP HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Robert Mandler TITLE:VP Diagnostic Outreach HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Jonathan B Morris TITLE:Sr VP and CIO HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Anthony M Trupiano TITLE:Sr VP Supply Chain HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Robin Wilson, MD TITLE:Sr VP Performance Innovation HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Joseph L Brywczynski TITLE:Sr VP Health Parks Admin HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Elizabeth A Hoffmann TITLE:VP Budget & Analysis HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Richard T Lopes, MD TITLE:Sr VP & Pres Wellstar Phy Grp HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:James M Swartz TITLE:VP Accounting HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Mary L Wesley TITLE:Sr VP Nursing Services & CNE HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Barbara G Ballard TITLE:VP Homecare & Hospice HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Carol S Edwards TITLE:VP Cardiac Services HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Beth Kost TITLE:VP Compliance/Ch Privacy Offr HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Chris Brett Scullen TITLE:VP Pulmonology Operations HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Adam C Thompson TITLE:VP Surgery HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Leo E Reichert TITLE:Exec VP & General Counsel HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Deborah DeVita Roegge TITLE:VP Women's & Newborn Srv Line HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Mary L Tavernaro TITLE:VP Human Resources Operations HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Carol B Maxwell TITLE:VP Human Resources HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Kenneth D Etheridge TITLE:VP Finance and Hospital CFO HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Chester Zborowski TITLE:VP Health Park Operations HOURS:50 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Valery Akopov TITLE:VP Chief Hospitalists Services HOURS:50 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| CHS Foundation | ||||||||||
| 805 Sandy Plains Road | Marietta | GA | 30066 | 581649540 | Foundation | GA | 501 (c) (3) | 11 | WHS | true |
| Douglas Hospital Inc | ||||||||||
| 805 Sandy Plains Road | Marietta | GA | 30066 | 582026750 | Healthcare | GA | 501 (c) (3) | 3 | NA | true |
| Kennestone Hospital Inc | ||||||||||
| 805 Sandy Plains Road | Marietta | GA | 30066 | 582032904 | Healthcare | GA | 501 (c) (3) | 3 | WHS | true |
| Paulding Medical Center Inc | ||||||||||
| 805 Sandy Plains Road | Marietta | GA | 30066 | 582095884 | Healthcare | GA | 501 (c) (3) | 3 | WHS | true |
| Wellstar Foundation | ||||||||||
| 805 Sandy Plains Road | Marietta | GA | 30066 | 581627413 | Foundation | GA | 501 (c) (3) | 11 Type 2 | WHS | true |
| Wellstar Health System | ||||||||||
| 805 Sandy Plains Road | Marietta | GA | 30066 | 581649541 | Healthcare | GA | 501 (c) (3) | 11 Type 2 | NA | false |
Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Kennestone South Parking Deck | ||||||||||||
| 805 Sandy Plains Road | Marietta | GA | 300666340 | 582429775 | PARKING | GA | NA | Investment | 208549 | 1796385 | false | false |
| Cobb Hospital Parking Company LLC | ||||||||||||
| 805 Sandy Plains Road | Marietta | GA | 300666340 | 752999669 | PARKING | GA | NA | Investment | 75069 | 783098 | false | false |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Community Assurance Co | BusinessNameLine1 |
Address Foreign AddressForeign
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3rd Fl Barclays House Shedden Rd | AddressLine1 |
| City | George Town | City |
| Province Or State | Grand Cayman, BWI | ProvinceOrState |
| Country | CJ | Country |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 581649541 | EIN |
| Primary Activity | INSURANCE | PrimaryActivity |
| Legal Domicile Foreign Country | CJ | LegalDomicileForeignCountry |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WHS INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C | TypeOfEntity |
| Share Of EOY Assets | 59852977 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHS Foundation Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | J | TransactionType |
| Amount Involved | 223225 | AmountInvolved |
| Method Of Amt Determination | FMV | MethodOfAmtDetermination |