2023-05-14T19:31:22-05:00 2022-06-30 PricewaterhouseCoopers LLP 2001 MARKET ST SUITE 1800 PHILADELPHIA PA 19103 990 2021-07-01 200936376 WEST GEORGIA HEALTH FOUNDATION % JAMES M SWARTZ WEST 7709567827 793 SAWYER ROAD Marietta GA 300622222 JAMES M SWARTZ VP ACCOUNTING 7709567827 2023-05-11 true JAMES M SWARTZ 999009999 JOANNE KRUEGER DIRECTOR P01235586 2673303000 2023-05-10 2 2021 2023-04-26 12:10:37Z CANDICE L SAUNDERS 793 SAWYER ROAD Marietta GA 300622222 921047 false X www.wghealth.org X 2004 GA TO SUPPORT THE CHARITABLE ACTIVITIES OF WEST GEORGIA MEDICAL CENTER, INC. AND ITS AFFILIATES. 18 14 0 12 0 0 653951 537507 0 0 3897721 235888 57421 58684 4609093 832079 15329822 183643 0 0 0 0 0 0 0 307846 132948 15637668 316591 -11028575 515488 8141093 7492526 0 0 8141093 7492526 THE FOUNDATION OPERATES EXCLUSIVELY FOR THE BENEFIT OF THE WEST GEORGIA MEDICAL CENTER, INC. AND ITS AFFILIATED ENTITIES. false false 92793 TO PROVIDE FUNDS FOR THE SUPPORT OF WEST GEORGIA MEDICAL CENTER, INC. AND ITS AFFILIATES. SUPPORT INCLUDES BEREAVEMENT SERVICES, HOSPITAL VOLUNTEER PROGRAM, CAMP DOGWOOD - A GRIEF CAMP FOR CHILDREN AND THE CANCER CENTER 166210 166210 TO PROVIDE FINANCIAL SUPPORT TO WEST GEORGIA MEDICAL CENTER, INC. FOR THE OPERATION OF THE HOSPITAL AND HOSPICE CENTER AND CONSTRUCTION OF A FUNDING A NEW WELLNESS CENTER. 17433 17433 HELPING HANDS FAMILY ASSISTANCE PROGRAM- TO ASSIST PRESENT AND RETIRED WEST GEORGIA HEALTH SERVICES, INC. EMPLOYEES AND HOSPITAL AUXILIARY VOLUNTEERS WITH FINANCIAL SUPPORT IN TIMES OF CRISIS. QUALIFYING HARDSHIPS INCLUDE CATASTROPHIC ILLNESS OR ACCIDENT SUFFERED BY A RECIPIENT OR AN UNINSURED LOSS TO A PRIMARY RESIDENCE CAUSED BY FIRE OR OTHER MAJOR INCIDENT OF DISASTER. FROM JULY 1, 2021 TO JUNE 30, 2022, THE HELPING HANDS PROGRAM ASSISTED 28 WEST GEORGIA HEALTH SERVICES, INC. EMPLOYEES BY PROVIDING $17,433 IN MONETARY ASSISTANCE. 276436 true true false false false false false false true false false false false false true false true false false false false false false true false false true true true false false false false false false false false false false false false false true true false false false false 0 0 0 false false false false false false false false false false false false X 18 14 false false true false true true true true true false false true true true true true true true true false GA X JAMES M SWARTZ 7709567827 793 SAWYER ROAD Marietta GA 300622222 X CANDICE SAUNDERS PRESIDENT & CEO 1.0 49.0 X X 0 3624780 111032 JOHN BRENNAN EVP CHIEF CLIN INTEG OFFICER 1.0 49.0 X 0 2651304 110256 ROB SCHREINER EVP CHIEF PHYSICIAN EXECUTIVE 1.0 49.0 X 0 1963136 60405 KEM MULLINS EVP AMBULATORY & BUS DEV 1.0 49.0 X 0 1758042 78964 ANTHONY J BUDZINSKI EVP & CFO 1.0 49.0 X 0 1311524 110899 LEO REICHERT EVP & GENERAL COUNSEL 1.0 49.0 X 0 1160035 117488 VALERY AKOPOV SVP HOSPITAL DIVISION WMG 1.0 49.0 X 0 1060084 76014 ALAN MUSTER SVP SPECIALTY DIVISION WMG 1.0 49.0 X 0 840201 140491 DAVID JONES EVP CHIEF HUMAN RESOURCES OFCR 1.0 49.0 X 0 886597 72851 RICHARD CAPPS EVP CHIEF INFO & DIGITAL OFFCR 1.0 49.0 X 0 849070 73866 PAUL DOUGLASS MD TRUSTEE & PHYSICIAN 1.0 49.0 X 0 785281 89016 JILL CASE-WIRTH SVP NURSING SERVICES CNE 1.0 49.0 X 0 727440 80991 ARIF AZIZ MD TRUSTEE & SLL DIGESTIVE HEALTH 1.0 49.0 X 0 702518 87370 JOSEPH REPPERT SVP FINANCE 1.0 49.0 X 0 667031 81700 BARBARA COREY SVP MANAGED CARE 1.0 49.0 X 0 652028 91268 STEPHEN BADGER VP WMG STRATEGIC SERVICES 1.0 49.0 X 0 633361 104894 BETH KOST SVP CHIEF COMPLIANCE OFFICER 1.0 49.0 X 0 640389 83483 MICHAEL MCCULLOUGH SVP SUPPLY CHAIN 1.0 49.0 X 0 624734 72862 JULIE TEER SVP & WELLSTAR FOUNDATION PRES 1.0 49.0 X 0 659288 35012 PAUL MURPHREE VP MEDICAL OUTCOMES 1.0 49.0 X 0 579847 90862 JASON STEVENS SVP DEPUTY GENERAL COUNSEL 1.0 49.0 X 0 589307 80362 DAVID PRESTON VP BRAND AND MARKETING 1.0 49.0 X 0 604507 59977 SOPHIA MCINTYRE SVP WMG AMBULATORY CARE DIV 1.0 49.0 X 0 558038 51890 PETER R JUNGBLUT MD FORMER SVP & MEDICAL DIRECT0R 0.0 50.0 X 0 564533 40993 JENNIFER GIUSTI VP CLINICAL OUTCOMES 1.0 49.0 X 0 516446 87308 JAMES L HORNSBY TRUSTEE & PHYSICIAN 1.0 49.0 X 0 486086 90712 AVRIL BECKFORD MD TRUSTEE & SLL PEDIATRIC PHYS. 1.0 49.0 X 0 465188 80511 LINDA HUFFER VP POST ACUTE SERVICES 1.0 49.0 X 0 444896 72765 DANIEL ABAD VP TOTAL RWRDS & CHF EGMT OFCR 1.0 49.0 X 0 454424 62007 SNEHAL DOSHI SVP ANCILLARY AND SUPPORT SVC 1.0 49.0 X 0 436930 67197 KATHARINE LEONARD VP REAL ESTATE & FACILITY DEV 1.0 49.0 X 0 420076 74726 MARY TAVERNARO VP HUMAN RESOURCES OPERATIONS 1.0 49.0 X 0 388458 97234 LAURA DANNELS VP & CHIEF TALENT OFFICER 1.0 49.0 X 0 426432 50228 ELIZABETH LOUDERMILK VP FINANCIAL PLANNING 1.0 49.0 X 0 388114 86210 ANDREW COX VP CHIEF OF STAFF & LEADERSHIP 1.0 49.0 X 0 404521 64972 KIMBERLY TAACA VP WMG OPS SPECIALTY DIV 1.0 49.0 X 0 399205 65561 MAXWELL KAGAN VP FINANCE & CFO WMG 1.0 49.0 X 0 410726 51929 SANDRA LUCIUS VP HEAD OF CARE PLATFORMS 1.0 49.0 X 0 381258 68645 ELIZABETH PAPETTI VP WMG OPS HOSPITAL DIV 1.0 49.0 X 0 392522 54980 JOSEPH BRAUD VP INFO SECURITY & CISO 1.0 49.0 X 0 398971 47213 NICKOLOS YAITSKY VP HEAD OF DIGITAL PLATFORMS 1.0 49.0 X 0 365638 55060 JAMES SWARTZ VP ACCOUNTING 1.0 49.0 X 0 351167 57502 VARMA RAMESWAR VP PEDIATRIC OPS AND SVC LINE 1.0 49.0 X 0 325474 80030 DANYALE ZIGLOR VP HUMAN RESOURCE 1.0 49.0 X 0 325057 77097 THOMAS DRAPER VP CARDIOVASCULAR SERVICE LINE 1.0 49.0 X 0 334967 62525 FREDA LYON VP SYSTEM EMERGENCY SERVICES 1.0 49.0 X 0 325737 65883 JESSICA KOVALESKY VP CARE COORD POPULATION HLTH 1.0 49.0 X 0 356903 34639 PRANAV JAIN VP & CHIEF MED INFO OFFICER 1.0 49.0 X 0 359737 31223 LEANNE COOK VP CONSUMER ENGAGEMENT 1.0 49.0 X 0 314780 62413 CAROL TODD VP ASST GENERAL COUNSEL 1.0 49.0 X 0 297924 79251 STEVEN HUNT VP HUMAN RESOURCES 1.0 49.0 X 0 305045 69579 STEPHEN VAULT VP STRATEGIC COMMUNITY DEV 1.0 49.0 X 0 328137 44496 MARCUS CHARLSON VP SURGERY & ORTHO SVC LINE 1.0 49.0 X 0 311924 50825 ELLEN WRIGHT VP HIM CDI & POLICIES 1.0 49.0 X 0 310381 46057 KRISTEN TRICE VP DIAGNOSTIC OUTREACH 1.0 49.0 X 0 288210 65080 SONYA ALDY VP TALENT ACQUISITION 1.0 49.0 X 0 302784 49180 SOPHIA MARSHALL VP ORGANIZATION COMMUNICATION 1.0 49.0 X 0 308372 42063 IVY SPENCER VP CNO WMG 1.0 49.0 X 0 298656 51692 SUSAN JACKSON VP PHARMACY SVCS 1.0 49.0 X 0 274766 65278 ROBERT DECOUX VP CORPORATE MED STAFF SVCS 1.0 49.0 X 0 255374 70630 REBECCA RUHL VP COMPLIANCE CPO 1.0 49.0 X 0 270758 42841 JONATHAN MAURER FORMER VP INFO SECURITY & CISO 0.0 0.0 X 0 310880 921 MATTHEW TERRY SVP CHIEF STRATEGY OFFICER 1.0 49.0 X 0 283117 17783 SANA BRUNO VP LABORATORY SERVICES SYSTEM 1.0 49.0 X 0 240706 30040 LE JOYCE NAYLOR SVP & CHIEF DIVRS & INCLU OFCR 1.0 49.0 X 0 251142 5740 WILLIAM BELLANDO VP CHIEF TECHNOLOGY OFFICER 1.0 49.0 X 0 195083 17438 DONALD ZARKOU VP OF ONCOLOGY SERVICE LINE 1.0 49.0 X 0 178990 27557 TIMOTHY HANEY FMR SVP REAL EST FAC & DEV SVC 0.0 0.0 X 0 200797 0 ANDREW LEE FORMER VP CHIEF DIVERSITY OFF. 0.0 0.0 X 0 195245 2188 JOE CASTANON VP CONTRACT & VALUE ANALYSIS 1.0 49.0 X 0 180488 10935 ANDREW VON ESCHENBACH VP REVENUE CYCLE MANAGEMENT 1.0 49.0 X 0 166945 18604 AVIRAL SINGH VP BRAND & MARKETING STRATEGY 1.0 49.0 X 0 154669 30296 JASON KELSEY VP REHAB & SPORTS MED SERVICES 1.0 49.0 X 0 110768 39607 STUART DOWNS VP NURSING OPERATIONS 1.0 49.0 X 0 117644 23746 JAMES LORIMER SVP HR CONSULTING 1.0 49.0 X 0 128445 6490 MARK ROWE VP TALENT ACQUISITION 1.0 49.0 X 0 72978 5838 OTIS A BRUMBY III TRUSTEE 1.0 12.0 X 0 48384 0 T FITZ JOHNSON TRUSTEE 1.0 12.0 X 0 44226 0 RANDALL BENTLEY SR FORMER DIRECTOR 0.0 0.0 X 0 40163 0 CHARLES BROCK TRUSTEE 1.0 12.0 X 0 39679 0 DAVID HAFNER FORMER DIRECTOR 0.0 0.0 X 0 24610 0 MITZI MOORE TRUSTEE 1.0 12.0 X 0 7406 0 JAMES HOLMES TRUSTEE 1.0 12.0 X 0 7332 0 AMBICA YADAV TRUSTEE 1.0 12.0 X 0 5307 0 JAY CUNNINGHAM TRUSTEE 1.0 12.0 X 0 5000 0 O SCOTT SWAYZE MD TRUSTEE 1.0 12.0 X 0 4690 0 GREG MORGAN TRUSTEE 1.0 12.0 X 0 2530 0 H SPEER BURDETTE III TRUSTEE 1.0 12.0 X 0 2421 0 FRANK ROS TRUSTEE 1.0 12.0 X 0 1856 0 JOHN MCKIBBEN TRUSTEE 1.0 12.0 X 0 1831 0 ED RICHARDSON TRUSTEE 1.0 12.0 X 0 1532 0 MARK BERRY TRUSTEE 1.0 12.0 X 0 568 0 JEREMY STEFFENS VP ORGANIZATIONAL COMM 1.0 49.0 X 0 0 0 JESSICA ROSENBERG VP PHILANTHROPY 1.0 49.0 X 0 0 0 MICHAEL GARRARD VP REHAB & SPORTS MED SVCS 1.0 49.0 X 0 0 0 SHARON ROBINSON VP FDN STRATEGY & GROWTH 1.0 49.0 X 0 0 0 JOEL SHU FMR VP WELLSTAR CLINICAL PTNRS 1.0 49.0 X 0 0 0 0 25609521 2090254 0 true true false 0 36807 500700 800 537507 0 215133 215133 0 0 0 0 0 20755 20755 20755 20755 147652 36807 88968 58684 58684 0 0 0 0 0 0 0 0 0 832079 0 294572 166210 166210 17433 17433 0 0 0 0 0 0 0 0 0 0 0 0 0 40155 40155 0 0 1108 1108 0 0 0 0 0 0 0 0 0 0 REPAIRS & MAINTENANCE 6212 6212 PATIENT SERVICE EXPENSES 14109 14109 SHUTTLE EXPENSE 50000 50000 EDUCATION 7000 7000 14364 14364 316591 276436 40155 0 0 0 0 0 42730 77029 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8098363 7415497 0 0 0 0 0 0 0 0 8141093 7492526 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X -50000 -50000 8191093 7542526 8141093 7492526 8141093 7492526 515488 -1164055 X false true X true false X X 1 WEST GEORGIA MEDICAL CENTER INC 205497506 3 true 166210 0 1 166210 true false false false false false false false false false false false false false false true RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 8141093 734272 -968322 123714 290803 7492526 19685613 822150 3345351 528775 15183246 8141093 18958227 570516 483424 90000 236554 19685613 17672892 631904 954755 90000 211324 18958227 16332380 513548 1078160 93050 158146 17672892 0.05000 0.95000 false false 0 0 X SCHEDULE D, PART V, LINE 4 USE OF ORGANIZATION'S ENDOWMENT FUNDS: NET ASSETS ARE RELEASED FROM RESTRICTIONS WHEN EXPENSES ARE INCURRED TO SATISFY THE RESTRICTED PURPOSES, BY PASSAGE OF TIME OR BY OCCURENCE OF SPECIFIC EVENTS. NET ASSETS RELEASED DURING THE YEAR WERE PRIMARILY FOR THE CONTRIBUTIONS AND SUPPORT OF CONSTRUCTION OF ADDITIONAL FACILITIES, SPECIFIC MEDICAL AND CANCER TREATMENT EQUIPMENT, AND THE HOSPICE PROGRAM OF LAGRANGE-TROUP COUNTY HOSPITAL AUTHORITY. SCHEDULE D, PART X, LINE 2 The following footnote is related to the organization's application of FIN 48 (ASC 740): "WELLSTAR AND ITS AFFILIATES HAVE BEEN RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3), AND THEREFORE, RELATED INCOME IS GENERALLY NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES. 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. WELLSTAR HAS EVALUATED ITS TAX POSITIONS AND DOES NOT BELIEVE THERE ARE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF JUNE 30, 2022 OR 2021." GOLF OUTING 130706 36806 93900 16150 27540 5578 14588 POINSETTIA SALE 49540 49540 716 24016 2 4212 4212 380 184458 36806 147652 16150 27540 6294 38984 88968 58684 true WEST GEORGIA MEDICAL CENTER INC 1514 VERNON ROAD LAGRANGE GA 30240 205497506 501(C)(3) 166210 FMV N/A PROGRAM SUPPORT 1 0 Helping Hands Employee Program 28 17433 0 FMV N/A SCHEDULE I, PART I, LINE 2 PROCEDURE FOR MONITORING THE USE OF GRANTS: FUNDS WERE USED TO SUPPORT WEST GEORGIA MEDICAL CENTER, INC., A RELATED 501(C)(3) ORGANIZATION AND OTHER AFFILIATED HEALTHCARE PROVIDERS. THE HELPING HANDS FAMILY ASSISTANCE PROGRAM IS AN EMPLOYEE EMERGENCY ASSISTANCE PROGRAM. true true false false false false false true false ALAN MUSTER SVP SPECIALTY DIVISION WMG 0 524112 0 301654 0 14435 0 52993 0 87498 0 980692 0 0 ANDREW COX VP CHIEF OF STAFF & LEADERSHIP 0 309982 0 83695 0 10844 0 23938 0 41034 0 469493 0 0 ANDREW LEE FORMER VP CHIEF DIVERSITY OFF. 0 0 0 0 0 195245 0 0 0 2188 0 197433 0 153124 ANDREW VON ESCHENBACH VP REVENUE CYCLE MANAGEMENT 0 94231 0 50000 0 22714 0 13252 0 5352 0 185549 0 0 ANTHONY J BUDZINSKI EVP & CFO 0 770794 0 518859 0 21871 0 52207 0 58692 0 1422423 0 0 ARIF AZIZ MD TRUSTEE & SLL DIGESTIVE HEALTH 0 490385 0 205142 0 6991 0 54105 0 33265 0 789888 0 0 AVIRAL SINGH VP BRAND & MARKETING STRATEGY 0 148749 0 500 0 5420 0 1125 0 29171 0 184965 0 0 AVRIL BECKFORD MD TRUSTEE & SLL PEDIATRIC PHYS. 0 123922 0 332156 0 9110 0 28965 0 51546 0 545699 0 0 BARBARA COREY SVP MANAGED CARE 0 413112 0 222048 0 16868 0 23050 0 68218 0 743296 0 0 BETH KOST SVP CHIEF COMPLIANCE OFFICER 0 406236 0 218502 0 15651 0 33081 0 50402 0 723872 0 0 CANDICE SAUNDERS PRESIDENT & CEO 0 1565088 0 1621788 0 437904 0 54200 0 56832 0 3735812 0 419245 CAROL TODD VP ASST GENERAL COUNSEL 0 226518 0 61160 0 10246 0 29643 0 49608 0 377175 0 0 DANIEL ABAD VP TOTAL RWRDS & CHF EGMT OFCR 0 347127 0 97589 0 9708 0 40573 0 21434 0 516431 0 0 DANYALE ZIGLOR VP HUMAN RESOURCE 0 248296 0 67040 0 9721 0 43443 0 33654 0 402154 0 0 DAVID HAFNER FORMER DIRECTOR 0 24610 0 0 0 0 0 0 0 0 0 24610 0 0 DAVID JONES EVP CHIEF HUMAN RESOURCES OFCR 0 517493 0 348014 0 21090 0 43041 0 29810 0 959448 0 0 DAVID PRESTON VP BRAND AND MARKETING 0 384018 0 206410 0 14079 0 22895 0 37082 0 664484 0 0 DONALD ZARKOU VP OF ONCOLOGY SERVICE LINE 0 101543 0 25000 0 52447 0 16720 0 10837 0 206547 0 0 ELIZABETH LOUDERMILK VP FINANCIAL PLANNING 0 297418 0 80303 0 10393 0 37921 0 48289 0 474324 0 0 ELIZABETH PAPETTI VP WMG OPS HOSPITAL DIV 0 269843 0 77728 0 44951 0 24742 0 30238 0 447502 0 35648 ELLEN WRIGHT VP HIM CDI & POLICIES 0 209773 0 57139 0 43469 0 17317 0 28740 0 356438 0 32238 FREDA LYON VP SYSTEM EMERGENCY SERVICES 0 246524 0 67062 0 12151 0 32306 0 33577 0 391620 0 0 IVY SPENCER VP CNO WMG 0 215472 0 72741 0 10443 0 23767 0 27925 0 350348 0 0 JAMES L HORNSBY TRUSTEE & PHYSICIAN 0 319596 0 160969 0 5521 0 45528 0 45184 0 576798 0 0 JAMES SWARTZ VP ACCOUNTING 0 269519 0 72770 0 8878 0 24573 0 32929 0 408669 0 0 JASON KELSEY VP REHAB & SPORTS MED SERVICES 0 104913 0 500 0 5355 0 13273 0 26334 0 150375 0 0 JASON STEVENS SVP DEPUTY GENERAL COUNSEL 0 328266 0 168918 0 92123 0 44046 0 36316 0 669669 0 77976 JENNIFER GIUSTI VP CLINICAL OUTCOMES 0 354286 0 96157 0 66003 0 52035 0 35273 0 603754 0 54554 JESSICA KOVALESKY VP CARE COORD POPULATION HLTH 0 271781 0 75381 0 9741 0 24650 0 9989 0 391542 0 0 JILL CASE-WIRTH SVP NURSING SERVICES CNE 0 407474 0 219017 0 100949 0 49459 0 31532 0 808431 0 81495 JOE CASTANON VP CONTRACT & VALUE ANALYSIS 0 115392 0 30000 0 35096 0 1195 0 9740 0 191423 0 0 JOHN BRENNAN EVP CHIEF CLIN INTEG OFFICER 0 909257 0 590801 0 1151246 0 54200 0 56056 0 2761560 0 1133479 JONATHAN MAURER FORMER VP INFO SECURITY & CISO 0 0 0 0 0 310880 0 0 0 921 0 311801 0 81940 JOSEPH BRAUD VP INFO SECURITY & CISO 0 290472 0 96927 0 11572 0 5943 0 41270 0 446184 0 0 JOSEPH REPPERT SVP FINANCE 0 450008 0 138646 0 78377 0 48400 0 33300 0 748731 0 0 JULIE TEER SVP & WELLSTAR FOUNDATION PRES 0 525000 0 118449 0 15839 0 9869 0 25143 0 694300 0 0 KATHARINE LEONARD VP REAL ESTATE & FACILITY DEV 0 323074 0 87730 0 9272 0 46046 0 28680 0 494802 0 0 KEM MULLINS EVP AMBULATORY & BUS DEV 0 740400 0 557919 0 459723 0 25650 0 53314 0 1837006 0 445660 KIMBERLY TAACA VP WMG OPS SPECIALTY DIV 0 273078 0 79667 0 46460 0 43345 0 22216 0 464766 0 37026 KRISTEN TRICE VP DIAGNOSTIC OUTREACH 0 210366 0 68299 0 9545 0 22164 0 42916 0 353290 0 0 LAURA DANNELS VP & CHIEF TALENT OFFICER 0 311683 0 103846 0 10903 0 27516 0 22712 0 476660 0 0 LE JOYCE NAYLOR SVP & CHIEF DIVRS & INCLU OFCR 0 141347 0 57500 0 52295 0 1362 0 4378 0 256882 0 0 LEANNE COOK VP CONSUMER ENGAGEMENT 0 239005 0 64531 0 11244 0 18791 0 43622 0 377193 0 0 LEO REICHERT EVP & GENERAL COUNSEL 0 676982 0 455370 0 27683 0 51030 0 66458 0 1277523 0 0 LINDA HUFFER VP POST ACUTE SERVICES 0 311314 0 84555 0 49027 0 49877 0 22888 0 517661 0 31131 MARCUS CHARLSON VP SURGERY & ORTHO SVC LINE 0 238183 0 64809 0 8932 0 12854 0 37971 0 362749 0 0 MARY TAVERNARO VP HUMAN RESOURCES OPERATIONS 0 296126 0 80454 0 11878 0 31480 0 65754 0 485692 0 0 MATTHEW TERRY SVP CHIEF STRATEGY OFFICER 0 217059 0 50000 0 16058 0 5238 0 12545 0 300900 0 0 MAXWELL KAGAN VP FINANCE & CFO WMG 0 276515 0 80824 0 53387 0 23020 0 28909 0 462655 0 43657 MICHAEL MCCULLOUGH SVP SUPPLY CHAIN 0 397097 0 213940 0 13697 0 31096 0 41766 0 697596 0 0 NICKOLOS YAITSKY VP HEAD OF DIGITAL PLATFORMS 0 280010 0 76103 0 9525 0 10969 0 44091 0 420698 0 0 PAUL DOUGLASS MD TRUSTEE & PHYSICIAN 0 407740 0 369949 0 7592 0 34096 0 54920 0 874297 0 0 PAUL MURPHREE VP MEDICAL OUTCOMES 0 396906 0 107665 0 75276 0 52084 0 38778 0 670709 0 60466 PRANAV JAIN VP & CHIEF MED INFO OFFICER 0 274231 0 80000 0 5506 0 28614 0 2609 0 390960 0 0 RANDALL BENTLEY SR FORMER DIRECTOR 0 40163 0 0 0 0 0 0 0 0 0 40163 0 0 REBECCA RUHL VP COMPLIANCE CPO 0 184744 0 73381 0 12633 0 6450 0 36391 0 313599 0 0 RICHARD CAPPS EVP CHIEF INFO & DIGITAL OFFCR 0 566170 0 263206 0 19694 0 36186 0 37680 0 922936 0 0 ROB SCHREINER EVP CHIEF PHYSICIAN EXECUTIVE 0 600814 0 404548 0 957774 0 28900 0 31505 0 2023541 0 934146 ROBERT DECOUX VP CORPORATE MED STAFF SVCS 0 191030 0 52228 0 12116 0 36012 0 34618 0 326004 0 0 SANA BRUNO VP LABORATORY SERVICES SYSTEM 0 149134 0 50000 0 41572 0 14853 0 15187 0 270746 0 0 SANDRA LUCIUS VP HEAD OF CARE PLATFORMS 0 267311 0 72174 0 41773 0 49489 0 19156 0 449903 0 26731 SNEHAL DOSHI SVP ANCILLARY AND SUPPORT SVC 0 327600 0 96041 0 13289 0 25045 0 42152 0 504127 0 0 SONYA ALDY VP TALENT ACQUISITION 0 224453 0 69007 0 9324 0 10350 0 38830 0 351964 0 0 SOPHIA MARSHALL VP ORGANIZATION COMMUNICATION 0 231259 0 69082 0 8031 0 23450 0 18613 0 350435 0 0 SOPHIA MCINTYRE SVP WMG AMBULATORY CARE DIV 0 400005 0 145886 0 12147 0 43164 0 8726 0 609928 0 0 STEPHEN BADGER VP WMG STRATEGIC SERVICES 0 442983 0 128079 0 62299 0 52595 0 52299 0 738255 0 44298 STEPHEN VAULT VP STRATEGIC COMMUNITY DEV 0 250242 0 68753 0 9142 0 23494 0 21002 0 372633 0 0 STEVEN HUNT VP HUMAN RESOURCES 0 229694 0 66152 0 9199 0 24674 0 44905 0 374624 0 0 SUSAN JACKSON VP PHARMACY SVCS 0 232928 0 35440 0 6398 0 30133 0 35145 0 340044 0 0 THOMAS DRAPER VP CARDIOVASCULAR SERVICE LINE 0 260000 0 64353 0 10614 0 24912 0 37613 0 397492 0 0 TIMOTHY HANEY FMR SVP REAL EST FAC & DEV SVC 0 0 0 0 0 200797 0 0 0 0 0 200797 0 0 VALERY AKOPOV SVP HOSPITAL DIVISION WMG 0 516227 0 289587 0 254270 0 32358 0 43656 0 1136098 0 233626 VARMA RAMESWAR VP PEDIATRIC OPS AND SVC LINE 0 240266 0 74372 0 10836 0 50030 0 30000 0 405504 0 0 WILLIAM BELLANDO VP CHIEF TECHNOLOGY OFFICER 0 132701 0 50000 0 12382 0 6416 0 11022 0 212521 0 0 PETER R JUNGBLUT MD FORMER SVP & MEDICAL DIRECT0R 0 366558 0 191060 0 6915 0 18603 0 22390 0 605526 0 0 SCHEDULE J, PART I, LINE 4A SEVERANCE PAYMENTS: PURSUANT TO THEIR RESPECTIVE EMPLOYMENT AGREEMENTS, THE FOLLOWING GROUPS OF OFFICERS ARE ENTITLED TO SEVERANCE PAYMENTS BASED ON THEIR COMPENSATION AT THAT TIME IN THE EVENT OF CERTAIN IDENTIFIED CIRCUMSTANCES. THE SEVERANCE PAYMENT PERIODS ARE 24 MONTHS FOR EXECUTIVE VICE PRESIDENTS, 18 MONTHS FOR SENIOR VICE PRESIDENTS, AND 12 MONTHS FOR VICE PRESIDENTS. THE FOLLOWING OFFICER RECEIVED SEVERANCE PAY DURING THE 2021 CALENDAR YEAR FROM EITHER THE ORGANIZATION OR A RELATED ORGANIZATION: ANDREW LEE 41,930 JONATHAN MAURER 228,940 TIMOTHY HANEY 200,797 SCHEDULE J, PART I, LINE 4B PARTICIPATION IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN: DURING THE YEAR, VICE PRESIDENTS, SENIOR VICE PRESIDENTS, EXECUTIVE VICE PRESIDENTS AND CERTAIN PHYSICIANS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SPONSORED BY WELLSTAR HEALTH SYSTEM, INC. THE AMOUNTS RELATED TO THIS PLAN ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C). THE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM THE PLAN INCLUDED IN SCHEDULE J, PART II, COLUMN (B): ANDREW LEE 153,124 CANDICE L. SAUNDERS 419,245 ELIZABETH PAPETTI 35,648 ELLEN WRIGHT 32,238 JASON STEVENS 77,976 JENNIFER GIUSTI 54,554 JILL CASE-WIRTH 81,495 JOHN BRENNAN 1,133,479 JONATHAN MAURER 81,940 KEM MULLINS 445,660 KIMBERLY TAACA 37,026 LINDA HUFFER 31,131 MAXWELL KAGAN 43,657 PAUL MURPHREE 60,466 ROB SCHREINER 934,146 SANDRA LUCIUS 26,731 STEPHEN BADGER 44,298 VALERY AKOPOV 233,626 SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS TO OFFICERS: AS PART OF THE WELLSTAR EXECUTIVE COMPENSATION PHILOSOPHY A PERFORMANCE PAY PLAN WAS INSTITUTED SEVERAL YEARS AGO WHEREBY THE WELLSTAR BOARD OF TRUSTEES APPROVES AN ANNUAL INCENTIVE PLAN WHICH CONSISTS OF SEVERAL PERFORMANCE GOALS OR FACTORS THAT UPON ATTAINMENT WILL RESULT IN PAYOUTS TO ELIGIBLE PLAN PARTICIPANTS.THOSE FACTORS ARE: (1) PEOPLE & CUSTOMER SERVICE GOAL FOR EMPLOYEE "TRUST INDEX (2) QUALITY & SAFETY GOAL FOR CLINICAL EXCELLENCE AND PATIENT SATISFACTION; AND (3) FINANCIAL GOAL FOR ATTAINING A POSITIVE OPERATING MARGIN. CONFIRMATION OF ACHIEVING THESE GOALS IS TYPICALLY RECEIVED THROUGH THE ANNUAL EXTERNAL AUDIT PROCESS AND APPROVED BY THE BOARD OF TRUSTEES AT THAT TIME. FORM 990, PART I, LINES 7A & 7B UNRELATED BUSINESS INCOME WEST GEORGIA HEALTH FOUNDATION, INC. GENERATED NO UNRELATED BUSINESS INCOME ("UBI") FOR THE REPORTING YEAR. AS A RESULT THE FILED 990-T SHOWS NO ACTIVITY. IF SUBSEQUENT REVIEW OF THE BOOKS REVEALS ANY UNREPORTED UBI WE WILL FILE AN AMENDED RETURN FOR THE TAX PERIOD ENDED JUNE 30, 2022. FORM 990, PART IV, LINE 12B AUDITED FINANCIAL STATEMENTS WELLSTAR HEALTH SYSTEM, INC., AND ITS CONTROLLED AFFILIATES ARE AUDITED ON AN ANNUAL BASIS BY AN OUTSIDE AUDITING FIRM, KPMG, AND AS PART OF THAT AUDIT A CONSOLIDATED FINANCIAL STATEMENT IS ISSUED. THE INDEPENDENT AUDITORS REPORT INCLUDES THE ACCOUNTS OF WELLSTAR AND ITS CONTROLLED AFFILIATES INCLUDING COBB HOSPITAL, INC., DOUGLAS HOSPITAL INC., KENNESTONE HOSPITAL, INC., PAULDING MEDICAL CENTER, INC., WELLSTAR ATLANTA MEDICAL CENTER, INC., WELLSTAR NORTH FULTON HOSPITAL, INC., WELLSTAR SPALDING REGIONAL MEDICAL CENTER, INC., WELLSTAR SYLVAN GROVE HOSPITAL, INC., WELLSTAR WEST GEORGIA MEDICAL CENTER, INC., WINDY HILL HOSPITAL, WELLSTAR MEDICAL GROUP, LLC AND VARIOUS OTHER OWNED ENTITIES AS LISTED IN SCHEDULE R. ALL SIGNIFICANT INTERCOMPANY ACCOUNTS AND TRANSACTIONS HAVE BEEN ELIMINATED IN COMBINATION. FORM 990, PART VI, SECTION A, LINE 4 EFFECTIVE APRIL 2022, WELLSTAR HEALTH SYSTEM THROUGH BOARD RESOLUTION CHANGED THE COMPOSITION OF THE OFFICERS OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE CORPORATE MEMBER IS WELLSTAR HEALTH SYSTEM, INC. FORM 990, PART VI, SECTION A, LINES 7A & 7B POWERS OF THE BOARD AS PER THE ARTICLES OF INCORPORATION, THE SOLE MEMBER OF THE ORGANIZATION IS WELLSTAR HEALTH SYSTEM, INC., A GEORGIA NONPROFIT CORPORATION. AS A SOLE MEMBER, WELLSTAR HEALTH SYSTEM, INC. HOLDS CERTAIN POWERS OF ELECTION AND APPROVAL IN CONNECTION WITH THE GOVERNING BODY OF THE ORGANIZATION. THESE POWERS ARE PRESENTED IN DETAIL IN THE GOVERNING DOCUMENTS WHICH THE COMPANY MAKES AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART V, SECTION B, LINE 11B BOARD REVIEW OF FORM 990 INTERNAL STAFF PREPARES THE ORGANIZATION'S FORM 990. BEFORE FILING THE RETURN WITH THE INTERNAL REVENUE SERVICE AN EXTERNAL ACCOUNTING FIRM, PRICEWATERHOUSECOOPERS LLP, REVIEWS AND SIGN-OFFS ON THE COMPLETED RETURN OF EACH ORGANIZATION. 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 PRIOR TO FILING. THE ORGANIZATION'S CFO OR DESIGNEE SUBSEQUENTLY SIGNS THE RETURN FOR EITHER MANUAL OR ELECTRONIC FILING BY THE APPROPRIATE DUE DATE. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY OUR CONFLICT-OF-INTEREST POLICY REQUIRES ALL COVERED PERSONS TO ANNUALLY REVIEW THE POLICY AND THEN COMPLETE, SIGN AND RETURN THE CONFLICTS OF INTEREST SURVEY AND ATTESTATION TO THE COMPLIANCE OFFICE. THE POLICY REQUIRES AN ON-GOING DISCLOSURE OBLIGATION IN THE EVENT A CONFLICT ARISES DURING THE YEAR. THE FOLLOWING IS OUR PROCESS TO REGULARLY AND CONSISTENTLY MONITOR AND ENFORCE THE POLICY: COMPLIANCE IDENTIFIES ALL COVERED PERSONS WHO MUST COMPLETE THE SURVEY AND ATTESTATION. COMPLIANCE VERIFIES THAT THE SURVEY AND ATTESTATION IS DISTRIBUTED TO THESE PERSONS. COMPLIANCE VERIFIES THAT THESE PERSONS RETURN A FULLY COMPLETED AND SIGNED SURVEY AND ATTESTATION. COMPLIANCE REVIEWS EACH COMPLETED AND SIGNED SURVEY AND ATTESTATION TO IDENTIFY ALL CONFLICTS LISTED IN THE DOCUMENT. ALL CONFLICTS, POTENTIAL CONFLICTS AND INCIDENCES OF NON-COMPLIANCE ARE REFERRED TO THE CHIEF COMPLIANCE OFFICER. THE CCO TAKES APPROPRIATE ACTION TO COMPLETELY RESOLVE ALL IDENTIFIED CONFLICTS AND INCIDENCES OF NON-COMPLIANCE. FORM 990, PART VI, SECTION B, LINES 15A & 15B COMPENSATION OF OFFICERS WELLSTAR HEALTH SYSTEM, INC. HAS ENGAGED SULLIVAN COTTER TO WORK WITH THE GOVERNING BOARD AND COMPENSATION COMMITTEE TO REVIEW AND RECOMMEND EXECUTIVE COMPENSATION. THE EXECUTIVE COMPENSATION PROCESS AT WELLSTAR IS OVERSEEN BY A COMMITTEE OF INDEPENDENT TRUSTEES, WHICH FOLLOWS A BOARD-APPROVED EXECUTIVE COMPENSATION PHILOSOPHY. THE COMPENSATION COMMITTEE CONSISTS OF FIVE TRUSTEES. THE CEO AND CHIEF HUMAN RESOURCES OFFICERS PARTICIPATE IN AN ADVISORY ROLE, AND NOT AS VOTING MEMBERS. FURTHER IN COMMITTEE DISCUSSIONS ABOUT THE COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER, THE CEO RECUSES HIM/HERSELF FROM THAT PROCESS. 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 TRUSTEES 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. BASE COMPENSATION IS TARGETED AT THE MEDIAN BASE COMPENSATION PAID TO SIMILAR POSITIONS AT SIMILAR ORGANIZATIONS (THE MARKET). OFFICERS OF THE COMPANY ALSO RECEIVE VARIABLE COMPENSATION THAT IS DEPENDENT ON INDIVIDUAL AND ORGANIZATION PERFORMANCE. WHEN PERFORMANCE IS FULLY SUSTAINED AT A SATISFACTORY LEVEL, THE TOTAL COMPENSATION, BOTH BASE AND VARIABLE, IS INTENDED TO BE AT OR AROUND THE 75TH% OF COMPENSATION PAID TO SIMILAR POSITIONS AT SIMILAR ORGANIZATIONS. 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 SULLIVAN COTTER 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 PROVIDED TO THE FULL BOARD OF TRUSTEES FOR REVIEW. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS MADE AVAILABLE TO THE PUBLIC THE ORGANIZATION AND ITS AFFILIATES ARE SUBJECT TO THE OPEN RECORDS LAW IN THE STATE OF GEORGIA. THEREFORE, BY LAW, CITIZENS ARE PERMITTED TO INSPECT AND COPY ITS GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS AS MAY BE REQUESTED FROM TIME TO TIME. ADDITIONALLY, THE ORGANIZATION'S FORM 990 IS MADE READILY AVAILABLE ON THE GUIDESTAR WEBSITE. PERIODICALLY, THE ORGANIZATION PUBLISHES A COMMUNITY BENEFIT REPORT ONCE A YEAR FOR DISTRIBUTION TO THE PUBLIC. IN ACCORDANCE WITH O.C.G.A. SECTION 31-7-22 AND THE GEORGIA DEPARTMENT OF COMMUNITY HEALTH'S RULES AND REGULATIONS FOR HOSPITAL TRANSPARENCY CHAPTER 111-8-41 THE APPLICABLE DOCUMENTS ARE POSTED ON THE WELLSTAR.ORG WEBSITE IN THE WELLSTAR HOSPITAL TRANSPARENT INFORMATION SECTION. UNDER ITS CONTINUING DISCLOSURE AGREEMENTS FOR PUBLIC BONDS, OUTSTANDING FINANCIAL AND STATISTICAL INFORMATION IS POSTED AND REPORTED ON EMMA.MSRB.ORG ON A QUARTERLY AND ANNUAL BASIS. FORM 990, PART VII OFFICERS HOURS WORKED THE OFFICERS DEVOTE THEIR TIME TO ALL OF THE ORGANIZATIONS WITHIN WELLSTAR HEALTH SYSTEM THAT ARE LISTED IN SCHEDULE R, PART II. AS SUCH, THE TOTAL HOURS WORKED BY THE OFFICERS ACROSS ALL ORGANIZATIONS EXCEEDS 40 HOURS A WEEK. FORM 990, PART VII & FORM 990, SCHEDULE J COMPENSATION ALL COMPENSATION AMOUNTS REPORTED ON FORM 990, PART VII; PART IX, LINES 5-7; AND SCHEDULE J REPRESENT COMPENSATION PROVIDED TO INDIVIDUALS THAT PROVIDE SERVICES TO THE ORGANIZATION. LIKEWISE, THE NUMBER OF EMPLOYEES REPORTED ON PART V, LINE 2A REPRESENTS THE NUMBER OF INDIVIDUALS PROVIDING SERVICES TO THE ORGANIZATION. ALL FEDERAL EMPLOYMENT TAX RESPONSIBILITIES FOR THESE INDIVIDUALS (INCLUDING FEDERAL EMPLOYMENT TAX REPORTING RESPONSIBILITIES) ARE HANDLED BY WELLSTAR HEALTH SYSTEM, INC. (EIN 58-1649541). 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