2022-05-10T13:54:45-05:00 2021-06-30 PricewaterhouseCoopers LLP 2001 MARKET ST SUITE 1800 PHILADELPHIA PA 19103 990 2020-07-01 200936376 WEST GEORGIA HEALTH FOUNDATION % JAMES M SWARTZ WEST 7709567827 793 SAWYER ROAD Marietta GA 300622222 JAMES M SWARTZ VP ACCOUNTING 7709567827 2022-05-05 true JAMES M SWARTZ 999009999 JOANNE KRUEGER DIRECTOR P01235586 2673303000 2022-05-03 2 2020 2022-09-23 18:48:47Z CANDICE L SAUNDERS 793 SAWYER ROAD Marietta GA 300622222 4680804 false X www.wghealth.org X 2004 GA TO SUPPORT THE CHARITABLE ACTIVITIES OF WEST GEORGIA MEDICAL CENTER, INC. AND ITS AFFILIATES. 19 11 0 12 0 0 431792 653951 0 0 577861 3897721 64770 57421 1074423 4609093 154511 15329822 0 0 0 0 0 0 0 204867 307846 359378 15637668 715045 -11028575 19642135 8141093 6522 0 19635613 8141093 THE FOUNDATION OPERATES EXCLUSIVELY FOR THE BENEFIT OF THE WEST GEORGIA MEDICAL CENTER, INC. AND ITS AFFILIATED ENTITIES. false false 227942 0 0 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 15314212 15314212 0 TO PROVIDE FINANCIAL SUPPORT TO WEST GEORGIA MEDICAL CENTER, INC. FOR THE OPERATION OF THE HOSPITAL AND HOSPICE CENTER INCLUDING COVID CARE AND CONSTRUCTION OF A NEW CANCER CENTER. 15610 15610 0 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, 2020 TO JUNE 30, 2021, THE HELPING HANDS PROGRAM ASSISTED 28 WEST GEORGIA HEALTH SERVICES, INC. EMPLOYEES BY PROVIDING $15,610 IN MONETARY ASSISTANCE. 15557764 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 true 0 0 0 false false false false false false false false false false false false X 19 11 false false false 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 L SAUNDERS PRESIDENT & CEO 1.0 51.0 X 0 2484302 83983 JOHN A BRENNAN EVP CHIEF CLIN. INTEG. OFFICER 1.0 49.0 X 0 1414928 69561 LEO E REICHERT EVP & GENERAL COUNSEL 1.0 49.0 X 0 1201843 71364 ANTHONY J BUDZINSKI EVP & CFO 1.0 51.0 X 0 949190 76974 TIMOTHY HANEY FORMER SVP RE FAC & DVLP SVC 0.0 0.0 X 0 1015968 4020 KIMBERLY J RYAN SENIOR VP (END. 12/20) 1.0 49.0 X 0 882825 59528 JILL M CASE-WIRTH SVP NURSING SERVICES 1.0 49.0 X 0 880522 43402 KEM M MULLINS EVP AMBULATORY & BUS. DEV. 1.0 49.0 X 0 845714 61332 ALAN R MUSTER MD SVP SPECIALTY DIVISION WMG 1.0 51.0 X 0 753074 89304 ROB SCHREINER EVP & PRESIDENT MEDICAL GROUP 1.0 49.0 X 0 753883 45532 PAUL DOUGLASS MD TRUSTEE & PHYSICIAN 1.0 49.0 X 0 708888 44670 CARRIE O PLIETZ EVP & COO HOSP DIV (END 10/20) 1.0 49.0 X 0 633284 74102 DOUGLAS ARVIN CPA MBA FORMER SVP FINANCE 0.0 0.0 X 0 699797 5911 BETH KOST SVP, CHIEF COMPLIANCE OFFICER 1.0 49.0 X 0 602752 79274 VALERY A AKOPOV MD SVP HOSPITAL DIVISION WMG 1.0 49.0 X 0 621580 60168 DAVID JONES EVP CHIEF HR OFFICER 1.0 49.0 X 0 641493 24292 STEPHEN L BADGER FORMER VP STRATEGIC SERVICES 0.0 50.0 X 0 564988 89220 PETER R JUNGBLUT MD MBA FORMER SVP & MEDICAL DIRECTOR 0.0 50.0 X 0 474964 85154 STUART DOWNS VP NURSING OPS. (END. 3/21) 1.0 49.0 X 0 464869 79026 JOSEPH L BRYWCZYNSKI SVP HLT PARKS DEV.(END. 11/20) 1.0 49.0 X 0 467201 73582 BARBARA B COREY SVP MANAGED CARE 1.0 49.0 X 0 491783 47831 PAUL D MURPHREE VP MEDICAL OUTCOMES 1.0 49.0 X 0 459908 64389 MARY L TAVERNARO VP HUMAN RESOURCES OPERATIONS 1.0 49.0 X 0 439301 76914 SANDRA LUCIUS VP HEAD OF CARE PLATFORMS 1.0 49.0 X 0 479600 32946 DAVID W PRESTON SVP BRAND EXP. & COMMUNICATION 1.0 49.0 X 0 459086 52367 JAMES L HORNSBY JR MD TRUSTEE & PHYSICIAN 1.0 51.0 X 0 432736 77588 AVRIL P BECKFORD MD TRUSTEE & CHIEF PEDIATRIC OFF. 1.0 49.0 X X 0 463457 33307 LINDA HUFFER VP POST ACUTE SERVICES 1.0 49.0 X 0 437790 45922 JENNIFER J GIUSTI VP CLINICAL OUTCOMES 1.0 49.0 X 0 408600 54850 MICHAEL T MCCULLOUGH SVP SUPPLY CHAIN 1.0 49.0 X 0 398923 59565 JASON D STEVENS SVP DEPUTY GENERAL COUNSEL 1.0 49.0 X 0 386099 69737 SEAN P TURNER VP REV. CYC. MGMT. (END. 2/21) 1.0 49.0 X 0 397877 32751 ELIZABETH H LOUDERMILK VP FINANCIAL PLANNING 1.0 49.0 X 0 344688 62281 SHYROLL MORRIS VP ONC.&DIG.HEALTH (END. 2/21) 1.0 49.0 X 0 345462 56317 ANDREW LEE VP CHIEF DIV. OFF.(END. 12/20) 1.0 49.0 X 0 324352 61224 MAXWELL S KAGAN VP FINANCE & CFO 1.0 49.0 X 0 324968 54571 JAMES M SWARTZ VP ACCOUNTING 1.0 49.0 X 0 314307 63398 DANYALE ZIGLOR VP HUMAN RESOURCES 1.0 49.0 X 0 302298 60178 SNEHAL H DOSHI SVP ANCILLARY & SUPPORT SVCS 1.0 49.0 X 0 285912 76331 DANIEL ABAD VP TOTAL & CHIEF TM ENGAGE OFF 1.0 49.0 X 0 321083 38970 SONYA E ALDY VP TALENT ACQUISITION 1.0 49.0 X 0 312460 43610 BRADFORD B NEWTON VP INFO.TECH.ADMIN.(END.12/20) 1.0 49.0 X 0 305271 50481 JOSEPH BRAUD VP INFORMATION TECHNOLOGY OPS 1.0 49.0 X 0 326852 26904 KRISTEN S TRICE VP DIAGNOSTIC OUTREACH 1.0 49.0 X 0 302447 50964 JESSICA KOVALESKY VP CARE COORDINATOR 1.0 49.0 X 0 308456 43191 MARCUS P CHARLSON MD VP SURGERY 1.0 49.0 X 0 307077 42583 LAURA DANNELS VP & CHIEF TALENT OFFICER 1.0 49.0 X 0 311908 35856 AVIRAL SINGH VP BRAND & MARKET STRATEGY 1.0 49.0 X 0 290035 56694 ELIZABETH H PAPETTI VP OPS. HOSPITAL DIVISION 1.0 49.0 X 0 290712 51791 VARMA RAMESWAR MD VP PEDIATRIC OPERATIONS 1.0 49.0 X 0 285765 51716 ANDREW W COX VP CHIEF OF STAFF&LEADER. DEV. 1.0 49.0 X 0 291726 45161 STEPHEN VAULT VP STRATEGIC COMMUNITY DEV. 1.0 49.0 X 0 301661 34387 SOPHIA MARSHALL VP ORGANIZATION COMMUNICATIONS 1.0 49.0 X 0 296295 38620 JASON L KELSEY VP REHAB. & SPORTS MED. SRVCS. 1.0 49.0 X 0 247802 81448 SHALIMA PANNIKODE SVP CHIEF INFO. & DIGITAL OFF. 1.0 49.0 X 0 296604 31170 FREDA LYON VP SYSTEM EMERGENCY SERVICES 1.0 49.0 X 0 273157 52870 CAROL TODD VP ASST. GENERAL COUNSEL 1.0 49.0 X 0 275363 43233 LEANNE COOK VP CONSUMER ENGAGEMENT 1.0 49.0 X 0 256658 60258 KIMBERLY TAACA VP OPS SPECIALTY DIVISION 1.0 49.0 X 0 274977 38722 STEVEN HUNT VP HUMAN RESOURCES 1.0 49.0 X 0 252880 58442 IVY SPENCER VP CNO 1.0 49.0 X 0 255306 42581 JUDITH WHITE VP LABORATORY SERVICES SYSTEM 1.0 49.0 X 0 250208 42458 JONATHAN D MAURER VP INFO.SEC.&CISO(END. 12/20) 1.0 49.0 X 0 257259 31523 JOSEPH A REPPERT SVP FINANCE (BEG. 8/20) 1.0 49.0 X 0 253157 34487 ELLEN WRIGHT VP HIM CDI & POLICIES 1.0 49.0 X 0 243645 43226 ROBERT J DECOUX VP CORPORATE MED. STAFF SVCS. 1.0 49.0 X 0 230829 49229 REBECCA L RUHL VP FACILITY COMPLIANCE OPS. 1.0 49.0 X 0 243841 32008 RICHARD S SIEGEL FORMER VP CARDIO.&CVM ADMN 0.0 0.0 X 0 267432 6106 SUSAN JACKSON VP PHARMACY SVCS (BEG. 5/21) 1.0 49.0 X 0 222733 46636 KATHARINE LEONARD VP REAL ESTATE & FACILITY DVLP 1.0 49.0 X 0 247881 21430 SOPHIA L MCINTYRE SVP AMB.CARE DIV.(BEG. 10/20) 1.0 49.0 X 0 213972 10903 THOMAS A DRAPER VP CARDIO. ADMIN.(BEG. 8/20) 1.0 49.0 X 0 185596 19268 NICKOLOS A YAITSKY VP HEAD OF DIGITAL PLATFORMS 1.0 49.0 X 0 164380 35993 JULIE C TEER SVP & WHS FDN PRES(BEG. 10/20) 1.0 49.0 X 0 144979 2314 ARIF AZIZ MD TRUSTEE 1.0 12.0 X 0 86108 0 STEVEN OWEIDA MD FORMER TRUSTEE 0.0 0.0 X 0 46847 0 OTIS A BRUMBY III TRUSTEE 1.0 12.0 X 0 44970 0 T FITZ JOHNSON TRUSTEE 1.0 12.0 X 0 40367 0 R RANDALL BENTLEY SR ESQ TRUSTEE (END. 6/21) 1.0 12.0 X 0 39473 0 W CHARLES BROCK TRUSTEE 1.0 12.0 X 0 39340 0 DAVID HAFNER FORMER TRUSTEE 0.0 0.0 X 0 18643 0 TE RUSTY DURHAM FORMER TRUSTEE 0.0 0.0 X 0 15007 0 CHARLES J JONES TRUSTEE (END. 6/21) 1.0 12.0 X 0 8840 0 MITZI MOORE TRUSTEE 1.0 12.0 X 0 5560 0 O SCOTT SWAYZE MD TRUSTEE 1.0 12.0 X 0 3908 0 FRANK ROS TRUSTEE 1.0 12.0 X 0 3597 0 H SPEER BURDETTE III TRUSTEE 1.0 12.0 X 0 3115 0 EDWARD RICHARDSON TRUSTEE 1.0 12.0 X 0 2872 0 GREG MORGAN TRUSTEE 1.0 12.0 X 0 2595 0 GARY A MILLER TRUSTEE 1.0 12.0 X 0 2555 0 JAMES HOLMES TRUSTEE 1.0 12.0 X 0 2555 0 AMBICA YADAV TRUSTEE 1.0 12.0 X 0 2475 0 JOHN MCKIBBEN TRUSTEE 1.0 12.0 X 0 1885 0 JAY CUNNINGHAM TRUSTEE (BEG. 3/21) 1.0 12.0 X 0 0 0 MATTHEW B TERRY SVP CHIEF STRAT.OFF.(BEG.6/21) 1.0 49.0 X 0 0 0 PRANAV K JAIN VP&CH. MED INFO.OFF.(BEG.5/21) 1.0 49.0 X 0 0 0 RICHARD H CAPPS EVP CH INFO&DIGIT.OFF(BEG1/21) 1.0 49.0 X 0 0 0 SANA B BRUNO VP LAB SRVCS SYSTEM (END.5/21) 1.0 49.0 X 0 0 0 0 19391743 1494846 0 true true false 0 36489 55000 562462 653951 0 477157 477157 0 0 0 0 0 3420564 3420564 3420564 3420564 129132 36489 71711 57421 57421 0 0 0 0 0 0 0 4609093 3955142 15314212 15314212 15610 15610 0 0 0 0 0 0 0 0 0 0 0 0 0 79904 79904 0 0 425 425 0 0 0 0 0 0 0 0 0 0 0 REPAIRS & MAINTENANCE 95316 95316 PATIENT SERVICE EXPENSES 11262 11262 SHUTTLE EXPENSE 104379 104379 EDUCATION 3930 3930 12630 12630 15637668 15557764 79904 0 0 0 0 0 20912 42730 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19621223 8098363 0 0 0 0 0 0 0 0 19642135 8141093 6522 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6522 0 X -50000 -50000 19685613 8191093 19635613 8141093 19642135 8141093 -11028575 -472467 6522 X false true X true false X X 1 WEST GEORGIA MEDICAL CENTER INC 205497506 3 true 15314212 0 1 15314212 true false false false false false false false false false false false false false false true RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 19685613 822150 3345351 528775 15183246 8141093 18958227 570516 483424 90000 236554 19685613 17672892 631904 954755 90000 211324 18958227 16332380 513548 1078160 93050 158146 17672892 14602355 550791 1387967 0 208235 0 16332878 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, 2021 OR 2020." Golf Outing 119739 36489 83250 13770 1700 25344 2363 4097 Poinsetta Sales 42900 42900 114 22119 2 2982 2982 2204 165621 36489 129132 13770 1700 25344 2477 28420 71711 57421 true WEST GEORGIA MEDICAL CENTER INC 1514 VERNON ROAD LAGRANGE GA 30240 205497506 501(C)(3) 15314212 FMV N/A PROGRAM SUPPORT 1 0 HELPING HANDS EMPLOYEE PROGRAM 28 15610 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 R MUSTER MD SVP SPECIALTY DIVISION WMG 0 501746 0 118674 0 132654 0 51200 0 38104 0 842378 0 116927 ANDREW LEE VP CHIEF DIV. OFF.(END. 12/20) 0 251175 0 0 0 73177 0 31804 0 29420 0 385576 0 0 ANDREW W COX VP CHIEF OF STAFF&LEADER. DEV. 0 244291 0 37145 0 10290 0 15380 0 29781 0 336887 0 0 ANTHONY J BUDZINSKI EVP & CFO 0 734356 0 192675 0 22159 0 44161 0 32813 0 1026164 0 0 AVIRAL SINGH VP BRAND & MARKET STRATEGY 0 234114 0 45580 0 10341 0 22967 0 33727 0 346729 0 0 AVRIL P BECKFORD MD TRUSTEE & CHIEF PEDIATRIC OFF. 0 184128 0 270228 0 9101 0 28816 0 4491 0 496764 0 0 BARBARA B COREY SVP MANAGED CARE 0 395474 0 79621 0 16688 0 22750 0 25081 0 539614 0 0 BETH KOST SVP, CHIEF COMPLIANCE OFFICER 0 388908 0 78110 0 135734 0 51200 0 28074 0 682026 0 120112 BRADFORD B NEWTON VP INFO.TECH.ADMIN.(END.12/20) 0 255688 0 39633 0 9950 0 25857 0 24624 0 355752 0 0 CANDICE L SAUNDERS PRESIDENT & CEO 0 1397844 0 714332 0 372126 0 51162 0 32821 0 2568285 0 350539 CAROL TODD VP ASST. GENERAL COUNSEL 0 206003 0 31299 0 38061 0 21710 0 21523 0 318596 0 27665 CARRIE O PLIETZ EVP & COO HOSP DIV (END 10/20) 0 619832 0 850 0 12602 0 43875 0 30227 0 707386 0 0 DANIEL ABAD VP TOTAL & CHIEF TM ENGAGE OFF 0 269833 0 41010 0 10240 0 24811 0 14159 0 360053 0 0 DANYALE ZIGLOR VP HUMAN RESOURCES 0 229803 0 34971 0 37524 0 44700 0 15478 0 362476 0 27495 DAVID HAFNER FORMER TRUSTEE 0 18643 0 0 0 0 0 0 0 0 0 18643 0 0 DAVID JONES EVP CHIEF HR OFFICER 0 492601 0 129943 0 18949 0 6347 0 17945 0 665785 0 0 DAVID W PRESTON SVP BRAND EXP. & COMMUNICATION 0 369593 0 75056 0 14437 0 28570 0 23797 0 511453 0 0 DOUGLAS ARVIN CPA MBA FORMER SVP FINANCE 0 0 0 0 0 699797 0 2119 0 3792 0 705708 0 324433 ELIZABETH H LOUDERMILK VP FINANCIAL PLANNING 0 289137 0 44937 0 10614 0 31700 0 30581 0 406969 0 0 ELIZABETH H PAPETTI VP OPS. HOSPITAL DIVISION 0 240916 0 40737 0 9059 0 25186 0 26605 0 342503 0 0 ELLEN WRIGHT VP HIM CDI & POLICIES 0 202955 0 30929 0 9761 0 23493 0 19733 0 286871 0 0 FREDA LYON VP SYSTEM EMERGENCY SERVICES 0 226332 0 34461 0 12364 0 27069 0 25801 0 326027 0 0 IVY SPENCER VP CNO 0 209486 0 34985 0 10835 0 23897 0 18684 0 297887 0 0 JAMES L HORNSBY JR MD TRUSTEE & PHYSICIAN 0 285896 0 145511 0 1329 0 44394 0 33194 0 510324 0 0 JAMES M SWARTZ VP ACCOUNTING 0 264674 0 40307 0 9326 0 37629 0 25769 0 377705 0 0 JASON D STEVENS SVP DEPUTY GENERAL COUNSEL 0 322059 0 49517 0 14523 0 43953 0 25784 0 455836 0 0 JASON L KELSEY VP REHAB. & SPORTS MED. SRVCS. 0 206183 0 31421 0 10198 0 43501 0 37947 0 329250 0 0 JENNIFER J GIUSTI VP CLINICAL OUTCOMES 0 344432 0 52398 0 11770 0 31700 0 23150 0 463450 0 0 JESSICA KOVALESKY VP CARE COORDINATOR 0 267039 0 31894 0 9523 0 25200 0 17991 0 351647 0 0 JILL M CASE-WIRTH SVP NURSING SERVICES 0 388288 0 77904 0 414330 0 31700 0 11702 0 923924 0 393421 JOHN A BRENNAN EVP CHIEF CLIN. INTEG. OFFICER 0 878121 0 228327 0 308480 0 31700 0 37861 0 1484489 0 291228 JONATHAN D MAURER VP INFO.SEC.&CISO(END. 12/20) 0 191998 0 707 0 64554 0 19124 0 12399 0 288782 0 0 JOSEPH BRAUD VP INFORMATION TECHNOLOGY OPS 0 261651 0 54740 0 10461 0 3409 0 23495 0 353756 0 0 JOSEPH L BRYWCZYNSKI SVP HLT PARKS DEV.(END. 11/20) 0 301758 0 67170 0 98273 0 48275 0 25307 0 540783 0 67443 JOSEPH A REPPERT SVP FINANCE (BEG. 8/20) 0 181734 0 60000 0 11423 0 29150 0 5337 0 287644 0 0 JUDITH WHITE VP LABORATORY SERVICES SYSTEM 0 238853 0 0 0 11355 0 24849 0 17609 0 292666 0 0 KATHARINE LEONARD VP REAL ESTATE & FACILITY DVLP 0 221537 0 19309 0 7035 0 8781 0 12649 0 269311 0 0 KEM M MULLINS EVP AMBULATORY & BUS. DEV. 0 649966 0 181324 0 14424 0 24500 0 36832 0 907046 0 0 KIMBERLY J RYAN SENIOR VP (END. 12/20) 0 451698 0 0 0 431127 0 31700 0 27828 0 942353 0 416211 KIMBERLY TAACA VP OPS SPECIALTY DIVISION 0 234633 0 31285 0 9059 0 24410 0 14312 0 313699 0 0 KRISTEN S TRICE VP DIAGNOSTIC OUTREACH 0 204479 0 61118 0 36850 0 20102 0 30862 0 353411 0 27103 LAURA DANNELS VP & CHIEF TALENT OFFICER 0 264816 0 28756 0 18336 0 19645 0 16211 0 347764 0 0 LEANNE COOK VP CONSUMER ENGAGEMENT 0 213347 0 32460 0 10851 0 22534 0 37724 0 316916 0 0 LEO E REICHERT EVP & GENERAL COUNSEL 0 644855 0 169197 0 387791 0 31700 0 39664 0 1273207 0 364799 LINDA HUFFER VP POST ACUTE SERVICES 0 307336 0 35245 0 95209 0 34620 0 11302 0 483712 0 30499 MARCUS P CHARLSON MD VP SURGERY 0 233824 0 35575 0 37678 0 14909 0 27674 0 349660 0 28330 MARY L TAVERNARO VP HUMAN RESOURCES OPERATIONS 0 289280 0 44005 0 106016 0 50330 0 26584 0 516215 0 93950 MAXWELL S KAGAN VP FINANCE & CFO 0 270182 0 45458 0 9328 0 24035 0 30536 0 379539 0 0 MICHAEL T MCCULLOUGH SVP SUPPLY CHAIN 0 336548 0 48825 0 13550 0 31591 0 27974 0 458488 0 0 NICKOLOS A YAITSKY VP HEAD OF DIGITAL PLATFORMS 0 140005 0 20000 0 4375 0 21722 0 14271 0 200373 0 0 PAUL D MURPHREE VP MEDICAL OUTCOMES 0 385941 0 58627 0 15340 0 30901 0 33488 0 524297 0 0 PAUL DOUGLASS MD TRUSTEE & PHYSICIAN 0 437727 0 310080 0 -38919 0 31700 0 12970 0 753558 0 0 REBECCA L RUHL VP FACILITY COMPLIANCE OPS. 0 179667 0 30425 0 33749 0 3500 0 28508 0 275849 0 23421 RICHARD S SIEGEL FORMER VP CARDIO.&CVM ADMN 0 40526 0 0 0 226906 0 2841 0 3265 0 273538 0 225615 ROB SCHREINER EVP & PRESIDENT MEDICAL GROUP 0 578076 0 151648 0 24159 0 31700 0 13832 0 799415 0 0 ROBERT J DECOUX VP CORPORATE MED. STAFF SVCS. 0 192449 0 28130 0 10250 0 29290 0 19939 0 280058 0 0 SANDRA LUCIUS VP HEAD OF CARE PLATFORMS 0 258633 0 39386 0 181581 0 31180 0 1766 0 512546 0 166392 SEAN P TURNER VP REV. CYC. MGMT. (END. 2/21) 0 336058 0 51074 0 10745 0 11998 0 20753 0 430628 0 0 SHALIMA PANNIKODE SVP CHIEF INFO. & DIGITAL OFF. 0 290774 0 0 0 5830 0 14830 0 16340 0 327774 0 0 SHYROLL MORRIS VP ONC.&DIG.HEALTH (END. 2/21) 0 297276 0 38233 0 9953 0 43875 0 12442 0 401779 0 0 SNEHAL H DOSHI SVP ANCILLARY & SUPPORT SVCS 0 241037 0 34456 0 10419 0 44700 0 31631 0 362243 0 0 SONYA E ALDY VP TALENT ACQUISITION 0 234976 0 35715 0 41769 0 19289 0 24321 0 356070 0 31065 SOPHIA MARSHALL VP ORGANIZATION COMMUNICATIONS 0 249976 0 37260 0 9059 0 23703 0 14917 0 334915 0 0 SOPHIA L MCINTYRE SVP AMB.CARE DIV.(BEG. 10/20) 0 92309 0 75000 0 46663 0 10768 0 135 0 224875 0 0 STEPHEN VAULT VP STRATEGIC COMMUNITY DEV. 0 228710 0 35124 0 37827 0 23741 0 10646 0 336048 0 28415 STEVEN HUNT VP HUMAN RESOURCES 0 208957 0 34485 0 9438 0 24550 0 33892 0 311322 0 0 STEVEN OWEIDA MD FORMER TRUSTEE 0 46847 0 0 0 0 0 0 0 0 0 46847 0 0 STUART DOWNS VP NURSING OPS. (END. 3/21) 0 318825 0 136336 0 9708 0 44625 0 34401 0 543895 0 0 SUSAN JACKSON VP PHARMACY SVCS (BEG. 5/21) 0 208476 0 13760 0 497 0 23945 0 22691 0 269369 0 0 TE RUSTY DURHAM FORMER TRUSTEE 0 15007 0 0 0 0 0 0 0 0 0 15007 0 0 THOMAS A DRAPER VP CARDIO. ADMIN.(BEG. 8/20) 0 105000 0 35000 0 45596 0 9471 0 9797 0 204864 0 0 TIMOTHY HANEY FORMER SVP RE FAC & DVLP SVC 0 0 0 0 0 1015968 0 1144 0 2876 0 1019988 0 647529 VALERY A AKOPOV MD SVP HOSPITAL DIVISION WMG 0 494290 0 107420 0 19870 0 31700 0 28468 0 681748 0 0 VARMA RAMESWAR MD VP PEDIATRIC OPERATIONS 0 213541 0 32564 0 39660 0 38297 0 13419 0 337481 0 28700 PETER R JUNGBLUT MD MBA FORMER SVP & MEDICAL DIRECTOR 0 343752 0 129343 0 1869 0 51200 0 33954 0 560118 0 0 STEPHEN L BADGER FORMER VP STRATEGIC SERVICES 0 446165 0 57606 0 61217 0 51200 0 38020 0 654208 0 42595 SCHEDULE J, PART I, LINE 4A SEVERANCE PAYMENTS: Pursuant to their respective employment agreements, the following groups of officers are entitled to severance payments based on their compensation at that time in the event of certain identified circumstances. The severance payment periods are 24 months for Executive Vice Presidents, 18 months for Senior Vice Presidents, and 12 months for Vice Presidents. The following officers received severance pay during the 2020 CALENDAR YEAR FROM EITHER THE ORGANIZATION OR A RELATED ORGANIZATION: ANDREW LEE 62,696 DOUGLAS ARVIN, CPA, MBA 368,271 JONATHAN D. MAUER 54,946 TIMOTHY HANEY 366,319 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): TIMOTHY HANEY 647,529 KIMBERLY J. RYAN 416,211 JILL M. CASE-WIRTH 393,421 LEO E. REICHERT 364,799 CANDICE L. SAUNDERS 350,539 DOUGLAS ARVIN, CPA, MBA 324,433 JOHN A. BRENNAN 291,228 RICHARD S. SIEGEL 225,615 SANDRA LUCIUS 166,392 BETH KOST 120,112 ALAN R. MUSTER, MD 116,927 MARY L. TAVERNARO 93,950 JOSEPH L. BRYWCZYNSKI 67,443 STEPHEN L. BADGER 42,595 SONYA E. ALDY 31,065 LINDA HUFFER 30,499 VARMA RAMESWAR, MD 28,700 STEPHEN VAULT 28,415 MARCUS P. CHARLSON, MD 28,330 CAROL TODD 27,665 DANYALE ZIGLOR 27,495 KRISTEN S. TRICE 27,103 REBECCA L. RUHL 23,421 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, 2021. 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 ENTITES AS LISTED IN SCHEDULE R. ALL SIGNIFICANT INTERCOMPANY ACCOUNTS AND TRANSACTIONS HAVE BEEN ELIMINATED IN COMBINATION. 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 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 TRANSPARENCY 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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