WEST GEORGIA HEALTH FOUNDATION INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- WEST GEORGIA HEALTH FOUNDATION INC (EIN 20-0936376)
- Tax period
- 2019-07-01 to 2020-06-30
- Filed
- 2021-05-14
- IRS object ID
- 202111349349303316
- Schema version
- 2019v5.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-05-14T11:54:34-05:00 | ReturnTs |
| Tax Period End | 2020-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PricewaterhouseCoopers LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2001 MARKET ST SUITE 1800 | AddressLine1Txt |
| City | PHILADELPHIA | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 19103 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 200936376 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WEST GEORGIA HEALTH FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % JAMES M SWARTZ | InCareOfNm |
| Business Name Control | WEST | BusinessNameControlTxt |
| Phone | 7709567827 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 793 SAWYER ROAD | AddressLine1Txt |
| City | Marietta | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 300622222 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAMES M SWARTZ | PersonNm |
| Person Title | VP ACCOUNTING | PersonTitleTxt |
| Phone | 7709567827 | PhoneNum |
| Signature | 2021-05-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JOANNE KRUEGER | PreparerPersonNm |
| PTIN | P01235586 | PTIN |
| Phone | 2673303000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CANDICE L SAUNDERS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 793 SAWYER ROAD | AddressLine1Txt |
| City | Marietta | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 300622222 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,144,912 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.wghealth.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2004 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | TO SUPPORT THE CHARITABLE ACTIVITIES OF WEST GEORGIA MEDICAL CENTER, INC. AND ITS AFFILIATES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 19 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 12 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $506,597 | PYContributionsGrantsAmt |
| CY Contributions Grants | $431,792 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $931,601 | PYInvestmentIncomeAmt |
| CY Investment Income | $577,861 | CYInvestmentIncomeAmt |
| PY Other Revenue | $48,790 | PYOtherRevenueAmt |
| CY Other Revenue | $64,770 | CYOtherRevenueAmt |
| PY Total Revenue | $1,486,988 | PYTotalRevenueAmt |
| CY Total Revenue | $1,074,423 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $113,303 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $154,511 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $156,110 | PYOtherExpensesAmt |
| CY Other Expenses | $204,867 | CYOtherExpensesAmt |
| PY Total Expenses | $269,413 | PYTotalExpensesAmt |
| CY Total Expenses | $359,378 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,217,575 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $715,045 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $18,958,728 | TotalAssetsBOYAmt |
| Total Assets EOY | $19,642,135 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $6,522 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $18,958,728 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $19,635,613 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE FOUNDATION OPERATES EXCLUSIVELY FOR THE BENEFIT OF THE WEST GEORGIA MEDICAL CENTER, INC. AND ITS AFFILIATED ENTITIES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $195,558 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | 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 | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $90,000 | ExpenseAmt |
| Grant | $90,000 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | TO PROVIDE FINANCIAL SUPPORT TO WEST GEORGIA MEDICAL CENTER, INC. FOR THE OPERATION OF THE HOSPICE CENTER. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $14,511 | ExpenseAmt |
| Grant | $14,511 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | 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, 2019 TO JUNE 30, 2020, THE HELPING HANDS PROGRAM ASSISTED 30 WEST GEORGIA HEALTH SERVICES, INC. EMPLOYEES BY PROVIDING $14,511 IN MONETARY ASSISTANCE. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $300,069 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (true) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (true) | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 19 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | GA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAMES M SWARTZ | PersonNm |
| Phone | 7709567827 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 793 SAWYER ROAD | AddressLine1Txt |
| City | Marietta | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 300622222 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (92 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| CANDICE L SAUNDERS | ||||||||
| PRESIDENT & CEO | 1.0 | 51.0 | Yes (X) | $0 | $2,470,527 | $81,334 | ||
| ANTHONY J BUDZINSKI | ||||||||
| EVP & CFO | 1.0 | 49.0 | Yes (X) | $0 | $1,316,813 | $80,725 | ||
| JOHN A BRENNAN | ||||||||
| EVP CHIEF CLIN. INTEG. OFFICER | 1.0 | 49.0 | Yes (X) | $0 | $1,152,200 | $85,658 | ||
| CARRIE O PLIETZ | ||||||||
| EVP & COO HOSPITAL DIVISION | 1.0 | 49.0 | Yes (X) | $0 | $958,040 | $72,283 | ||
| LEO E REICHERT | ||||||||
| EVP & GENERAL COUNSEL | 1.0 | 49.0 | Yes (X) | $0 | $827,805 | $78,484 | ||
| ROB SCHREINER | ||||||||
| EVP & PRESIDENT MEDICAL GROUP | 1.0 | 49.0 | Yes (X) | $0 | $744,399 | $40,297 | ||
| KEM M MULLINS | ||||||||
| EVP AMBULATORY & BUS. DEV. | 1.0 | 49.0 | Yes (X) | $0 | $722,112 | $57,728 | ||
| ALAN R MUSTER MD | ||||||||
| SVP SPECIALTY DIVISION WMG | 1.0 | 51.0 | Yes (X) | $0 | $668,022 | $84,899 | ||
| DAVID JONES | ||||||||
| EVP CHIEF HR OFFICER | 1.0 | 49.0 | Yes (X) | $0 | $701,279 | $28,471 | ||
| VALERY A AKOPOV MD | ||||||||
| SVP HOSPITAL DIVISION WMG | 1.0 | 49.0 | Yes (X) | $0 | $646,474 | $58,863 | ||
| PAUL DOUGLASS MD | ||||||||
| TRUSTEE & PHYSICIAN | 1.0 | 49.0 | $0 | $661,178 | $43,597 | Yes (X) | ||
| STEPHEN L BADGER | ||||||||
| FORMER VP STRATEGIC SERVICES | 0.0 | 50.0 | $0 | $588,669 | $86,070 | Yes (X) | ||
| JILL M CASE-WIRTH | ||||||||
| SVP NURSING SERVICES | 1.0 | 49.0 | Yes (X) | $0 | $583,296 | $62,394 | ||
| JOSEPH L BRYWCZYNSKI | ||||||||
| SVP HEALTH PARKS DEVELOPMENT | 1.0 | 49.0 | Yes (X) | $0 | $492,843 | $74,240 | ||
| BETH KOST | ||||||||
| SVP, CHIEF COMPLIANCE OFFICER | 1.0 | 49.0 | Yes (X) | $0 | $492,253 | $57,487 | ||
| PETER R JUNGBLUT MD MBA | ||||||||
| FORMER SVP & MEDICAL DIRECTOR | 0.0 | 50.0 | $0 | $450,613 | $81,450 | Yes (X) | ||
| PAUL D MURPHREE | ||||||||
| VP MEDICAL OUTCOMES | 1.0 | 49.0 | Yes (X) | $0 | $448,944 | $82,648 | ||
| BARBARA B COREY | ||||||||
| SVP MANAGED CARE | 1.0 | 49.0 | Yes (X) | $0 | $477,581 | $45,174 | ||
| AVRIL P BECKFORD MD | ||||||||
| TRUSTEE & CHIEF PEDIATRIC OFF. | 1.0 | 49.0 | Yes (X) | $0 | $481,985 | $31,447 | Yes (X) | |
| DOUGLAS ARVIN CPA MBA | ||||||||
| SVP FINANCE (END. 2/20) | 1.0 | 49.0 | Yes (X) | $0 | $471,706 | $35,798 | ||
| KIMBERLY J RYAN | ||||||||
| SENIOR VICE PRESIDENT | 1.0 | 49.0 | Yes (X) | $0 | $448,905 | $52,987 | ||
| SHALIMA PANNIKODE | ||||||||
| SVP CHIEF INFO. & DIGITAL OFF. | 1.0 | 49.0 | Yes (X) | $0 | $460,276 | $31,296 | ||
| RICHARD S SIEGEL | ||||||||
| VP CARDIO.&CVM ADMN(END. 1/20) | 1.0 | 49.0 | Yes (X) | $0 | $396,222 | $81,281 | ||
| DAVID W PRESTON | ||||||||
| SVP BRAND EXP. & COMMUNICATION | 1.0 | 49.0 | Yes (X) | $0 | $431,352 | $44,407 | ||
| ELIZABETH H LOUDERMILK | ||||||||
| VP FINANCIAL PLANNING | 1.0 | 49.0 | Yes (X) | $0 | $419,394 | $54,633 | ||
| MICHAEL T MCCULLOUGH | ||||||||
| SVP SUPPLY CHAIN | 1.0 | 49.0 | Yes (X) | $0 | $409,522 | $52,085 | ||
| JASON D STEVENS | ||||||||
| SVP DEPUTY GENERAL COUNSEL | 1.0 | 49.0 | Yes (X) | $0 | $392,420 | $67,372 | ||
| ANDREW LEE | ||||||||
| VP CHIEF DIVERSITY OFFICER | 1.0 | 49.0 | Yes (X) | $0 | $406,354 | $45,501 | ||
| JENNIFER J GIUSTI | ||||||||
| VP CLINICAL OUTCOMES | 1.0 | 49.0 | Yes (X) | $0 | $398,519 | $53,140 | ||
| JAMES L HORNSBY JR MD | ||||||||
| TRUSTEE & PHYSICIAN | 1.0 | 51.0 | $0 | $373,914 | $74,050 | Yes (X) | ||
| SEAN P TURNER | ||||||||
| VP REVENUE CYCLE MANAGEMENT | 1.0 | 49.0 | Yes (X) | $0 | $390,811 | $37,929 | ||
| MARY L TAVERNARO | ||||||||
| VP HUMAN RESOURCES OPERATIONS | 1.0 | 49.0 | Yes (X) | $0 | $350,907 | $56,108 | ||
| MAXWELL S KAGAN | ||||||||
| VP FINANCE & CFO | 1.0 | 49.0 | Yes (X) | $0 | $327,577 | $41,300 | ||
| FREDA LYON | ||||||||
| VP SYSTEM EMERGENCY SERVICES | 1.0 | 49.0 | Yes (X) | $0 | $300,559 | $56,758 | ||
| SANDRA LUCIUS | ||||||||
| VP INFO. TECHNOLOGY APPS | 1.0 | 49.0 | Yes (X) | $0 | $306,237 | $49,809 | ||
| SNEHAL H DOSHI | ||||||||
| VP SYSTEM PHARMACIST | 1.0 | 49.0 | Yes (X) | $0 | $296,483 | $58,986 | ||
| TIMOTHY HANEY | ||||||||
| SVP RE FAC&DVLP SVC (END.1/20) | 1.0 | 49.0 | Yes (X) | $0 | $286,214 | $57,126 | ||
| BRADFORD B NEWTON | ||||||||
| VP INFO. TECHNOLOGY ADMIN. | 1.0 | 49.0 | Yes (X) | $0 | $289,266 | $51,425 | ||
| ELIZABETH H PAPETTI | ||||||||
| VP OPS. HOSPITAL DIVISION | 1.0 | 49.0 | Yes (X) | $0 | $284,999 | $53,295 | ||
| JONATHAN D MAURER | ||||||||
| VP INFORMATION SECURITY & CISO | 1.0 | 49.0 | Yes (X) | $0 | $273,385 | $54,987 | ||
| ANDREW W COX | ||||||||
| VP CHIEF OF STAFF&LEADER. DEV. | 1.0 | 49.0 | Yes (X) | $0 | $282,060 | $40,633 | ||
| KIMBERLY TAACA | ||||||||
| VP OPS SPECIALTY DIVISION | 1.0 | 49.0 | Yes (X) | $0 | $271,710 | $47,647 | ||
| ROBERT J DECOUX | ||||||||
| VP CORPORATE MED. STAFF SVCS. | 1.0 | 49.0 | Yes (X) | $0 | $259,843 | $57,448 | ||
| VARMA RAMESWAR MD | ||||||||
| VP PEDIATRIC OPERATIONS | 1.0 | 49.0 | Yes (X) | $0 | $251,504 | $60,578 | ||
| JAMES M SWARTZ | ||||||||
| VP ACCOUNTING | 1.0 | 49.0 | Yes (X) | $0 | $277,027 | $32,048 | ||
| SONYA E ALDY | ||||||||
| VP TALENT ACQUISITION | 1.0 | 49.0 | Yes (X) | $0 | $275,400 | $33,218 | ||
| MARCUS P CHARLSON MD | ||||||||
| VP SURGERY | 1.0 | 49.0 | Yes (X) | $0 | $264,441 | $42,244 | ||
| JASON L KELSEY | ||||||||
| VP REHAB. & SPORTS MED. SRVCS. | 1.0 | 49.0 | Yes (X) | $0 | $240,840 | $57,789 | ||
| IVY SPENCER | ||||||||
| VP CNO | 1.0 | 49.0 | Yes (X) | $0 | $254,378 | $41,577 | ||
| DANYALE ZIGLOR | ||||||||
| VP HUMAN RESOURCES (BEG.12/19) | 1.0 | 49.0 | Yes (X) | $0 | $240,986 | $52,827 | ||
| CAROL TODD | ||||||||
| VP ASST. GENERAL COUNSEL | 1.0 | 49.0 | Yes (X) | $0 | $247,822 | $41,104 | ||
| SOPHIA MARSHALL | ||||||||
| VP ORGANIZATION COMMUNICATIONS | 1.0 | 49.0 | Yes (X) | $0 | $256,207 | $28,073 | ||
| KRISTEN S TRICE | ||||||||
| VP DIAGNOSTIC OUTREACH | 1.0 | 49.0 | Yes (X) | $0 | $238,621 | $43,882 | ||
| KEITH BOWERMASTER | ||||||||
| FORMER VP COMMUNICATIONS | 0.0 | 0.0 | $0 | $280,619 | $1,267 | Yes (X) | ||
| DANIEL ABAD | ||||||||
| VP TOTAL REWARDS | 1.0 | 49.0 | Yes (X) | $0 | $256,961 | $24,460 | ||
| STEVEN HUNT | ||||||||
| VP HUMAN RESOURCES | 1.0 | 49.0 | Yes (X) | $0 | $231,668 | $49,685 | ||
| AVIRAL SINGH | ||||||||
| VP BRAND & MARKET STRATEGY | 1.0 | 49.0 | Yes (X) | $0 | $245,822 | $31,144 | ||
| ANDREW S ALBERRY | ||||||||
| VP INFO TECH OPS. (END. 11/19) | 1.0 | 49.0 | Yes (X) | $0 | $251,645 | $23,900 | ||
| KIMBERLY W MENEFEE | ||||||||
| FORMER SVP STRATEGIC COMM. DEV | 0.0 | 0.0 | $0 | $275,126 | $0 | Yes (X) | ||
| STEPHEN VAULT | ||||||||
| VP STRATEGIC COMMUNITY DEV. | 1.0 | 49.0 | Yes (X) | $0 | $238,106 | $34,840 | ||
| ELLEN WRIGHT | ||||||||
| VP HIM CDI & POLICIES | 1.0 | 49.0 | Yes (X) | $0 | $234,370 | $38,568 | ||
| JUDITH WHITE | ||||||||
| VP LABORATORY SERVICES SYSTEM | 1.0 | 49.0 | Yes (X) | $0 | $215,854 | $29,743 | ||
| REBECCA L RUHL | ||||||||
| VP FACILITY COMPLIANCE OPS. | 1.0 | 49.0 | Yes (X) | $0 | $209,269 | $30,575 | ||
| ELLEN LANGFORD | ||||||||
| FORMER SVP WMG AMB. TRANS. | 0.0 | 0.0 | $0 | $236,783 | $0 | Yes (X) | ||
| DAVID W ANDERSON | ||||||||
| FORMER EVP/HR/OL/CCO | 0.0 | 0.0 | $0 | $176,481 | $50,980 | Yes (X) | ||
| LAURA DANNELS | ||||||||
| VP & CHIEF LEARNING OFFICER | 1.0 | 49.0 | Yes (X) | $0 | $192,305 | $26,444 | ||
| LEANNE COOK | ||||||||
| VP CONSUMER ENGAGEMENT | 1.0 | 49.0 | Yes (X) | $0 | $173,953 | $40,414 | ||
| SHYROLL MORRIS | ||||||||
| VP ONC.&DIG.HEALTH (BEG. 9/19) | 1.0 | 49.0 | Yes (X) | $0 | $161,753 | $5,490 | ||
| JESSICA KOVALESKY | ||||||||
| VP CARE COORDINATOR(BEG.10/19) | 1.0 | 49.0 | Yes (X) | $0 | $107,841 | $3,813 | ||
| LINDA HUFFER | ||||||||
| VP POST ACUTE SRVC.(BEG.10/19) | 1.0 | 49.0 | Yes (X) | $0 | $100,348 | $6,233 | ||
| ARIF AZIZ MD | ||||||||
| TRUSTEE | 1.0 | 12.0 | $0 | $51,758 | $0 | Yes (X) | ||
| STEVEN OWEIDA MD | ||||||||
| FORMER TRUSTEE | 0.0 | 0.0 | $0 | $49,802 | $0 | Yes (X) | ||
| OTIS A BRUMBY III | ||||||||
| TRUSTEE | 1.0 | 12.0 | $0 | $48,188 | $0 | Yes (X) | ||
| T FITZ JOHNSON | ||||||||
| TRUSTEE | 1.0 | 12.0 | $0 | $47,229 | $0 | Yes (X) | ||
| R RANDALL BENTLEY SR ESQ | ||||||||
| TRUSTEE | 1.0 | 12.0 | $0 | $41,602 | $0 | Yes (X) | ||
| W CHARLES BROCK | ||||||||
| TRUSTEE | 1.0 | 12.0 | $0 | $41,553 | $0 | Yes (X) | ||
| DAVID HAFNER | ||||||||
| FORMER TRUSTEE | 0.0 | 0.0 | $0 | $20,311 | $0 | Yes (X) | ||
| TE RUSTY DURHAM | ||||||||
| FORMER TRUSTEE | 0.0 | 0.0 | $0 | $15,319 | $0 | Yes (X) | ||
| MITZI MOORE | ||||||||
| TRUSTEE | 1.0 | 12.0 | $0 | $11,203 | $0 | Yes (X) | ||
| CHARLES J JONES | ||||||||
| TRUSTEE | 1.0 | 12.0 | $0 | $10,891 | $0 | Yes (X) | ||
| ROBERT N CROSS MD | ||||||||
| TRUSTEE (END. 7/19) | 1.0 | 12.0 | $0 | $8,132 | $0 | Yes (X) | ||
| FRANK ROS | ||||||||
| TRUSTEE | 1.0 | 12.0 | $0 | $7,085 | $0 | Yes (X) | ||
| O SCOTT SWAYZE MD | ||||||||
| TRUSTEE | 1.0 | 12.0 | $0 | $7,074 | $0 | Yes (X) | ||
| AMBICA YADAV | ||||||||
| TRUSTEE | 1.0 | 12.0 | $0 | $5,692 | $0 | Yes (X) | ||
| GARY A MILLER | ||||||||
| TRUSTEE | 1.0 | 12.0 | $0 | $5,447 | $0 | Yes (X) | ||
| GREG MORGAN | ||||||||
| TRUSTEE | 1.0 | 12.0 | $0 | $5,218 | $0 | Yes (X) | ||
| EDWARD RICHARDSON | ||||||||
| TRUSTEE | 1.0 | 12.0 | $0 | $4,547 | $0 | Yes (X) | ||
| JAMES HOLMES | ||||||||
| TRUSTEE | 1.0 | 12.0 | $0 | $4,401 | $0 | Yes (X) | ||
| H SPEER BURDETTE III | ||||||||
| TRUSTEE | 1.0 | 12.0 | $0 | $4,391 | $0 | Yes (X) | ||
| JOHN MCKIBBEN | ||||||||
| TRUSTEE (BEG. 8/19) | 1.0 | 12.0 | $0 | $643 | $0 | Yes (X) | ||
| JOSEPH BRAUD | ||||||||
| VP INFO. TECH. OPS.(BEG. 1/20) | 1.0 | 49.0 | Yes (X) | $0 | $0 | $0 | ||
| KATHARINE LEONARD | ||||||||
| VP RE & FAC DVLP (BEG. 3/20) | 1.0 | 49.0 | Yes (X) | $0 | $0 | $0 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $17,512,888 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,533,651 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $32,485 | FundraisingAmt |
| Related Organizations | $60,000 | RelatedOrganizationsAmt |
| All Other Contributions | $339,307 | AllOtherContributionsAmt |
| Total Contributions | $431,792 | TotalContributionsAmt |
| Total Program Service Revenue | $0 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $514,734 | TotalRevenueColumnAmt |
| Exclusion | $514,734 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $63,127 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $63,127 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $63,127 | TotalRevenueColumnAmt |
| Exclusion | $63,127 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $135,259 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $32,485 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $70,489 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $64,770 | TotalRevenueColumnAmt |
| Exclusion | $64,770 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,074,423 | TotalRevenueColumnAmt |
| Exclusion | $642,631 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $140,000 | TotalAmt |
| Program Services | $140,000 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,511 | TotalAmt |
| Program Services | $14,511 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,309 | TotalAmt |
| Management And General | $59,309 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $850 | TotalAmt |
| Program Services | $850 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| REPAIRS & MAINTENANCE | $10,764 | $10,764 | $0 | $0 |
| PATIENT SERVICE EXPENSES | $21,387 | $21,387 | $0 | $0 |
| CAMP DOGWOOD EXPENSES | $6,401 | $6,401 | $0 | $0 |
| COMMUNITY EXPENSES | $932 | $932 | $0 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,224 | TotalAmt |
| Program Services | $105,224 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $359,378 | TotalAmt |
| Program Services | $300,069 | ProgramServicesAmt |
| Management And General | $59,309 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,657 | BOYAmt |
| EOY | $20,912 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,883,071 | BOYAmt |
| EOY | $19,621,223 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,958,728 | BOYAmt |
| EOY | $19,642,135 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $6,522 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $6,522 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | -$50,000 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,958,728 | BOYAmt |
| EOY | $19,685,613 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,958,728 | BOYAmt |
| EOY | $19,635,613 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,958,728 | BOYAmt |
| EOY | $19,642,135 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $715,045 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$38,160 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type2 | Yes (X) | SupportingOrgType2Ind |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WEST GEORGIA MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 205497506 | EIN |
| Organization Type | 3 | OrganizationTypeCd |
| Governing Document Listed | Yes (true) | GoverningDocumentListedInd |
| Support | $90,000 | SupportAmt |
| Other Support | $0 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $90,000 | SupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (true) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | false | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | false | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | false | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | false | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | false | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | false | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | false | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | false | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | false | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | false | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | false | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | false | ContributionControllerInd |
| Contribution Family | false | ContributionFamilyInd |
| Contribution35 Controlled | false | Contribution35ControlledInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Majority Dir Trst Supported Org | Yes (true) | MajorityDirTrstSupportedOrgInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $18,958,227 | BeginningYearBalanceAmt |
| Contributions | $570,516 | ContributionsAmt |
| Investment Earnings Or Losses | $483,424 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $90,000 | GrantsOrScholarshipsAmt |
| Other Expenditures | $236,554 | OtherExpendituresAmt |
| End Year Balance | $19,685,613 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $17,672,892 | BeginningYearBalanceAmt |
| Contributions | $631,904 | ContributionsAmt |
| Investment Earnings Or Losses | $954,755 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $90,000 | GrantsOrScholarshipsAmt |
| Other Expenditures | $211,324 | OtherExpendituresAmt |
| End Year Balance | $18,958,227 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $16,332,380 | BeginningYearBalanceAmt |
| Contributions | $513,548 | ContributionsAmt |
| Investment Earnings Or Losses | $1,078,160 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $93,050 | GrantsOrScholarshipsAmt |
| Other Expenditures | $158,146 | OtherExpendituresAmt |
| End Year Balance | $17,672,892 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $14,602,355 | BeginningYearBalanceAmt |
| Contributions | $550,791 | ContributionsAmt |
| Investment Earnings Or Losses | $1,387,967 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $0 | GrantsOrScholarshipsAmt |
| Other Expenditures | $208,235 | OtherExpendituresAmt |
| Administrative Expenses | $0 | AdministrativeExpensesAmt |
| End Year Balance | $16,332,878 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $11,774,139 | BeginningYearBalanceAmt |
| Contributions | $2,295,910 | ContributionsAmt |
| Investment Earnings Or Losses | $781,178 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $256,371 | OtherExpendituresAmt |
| End Year Balance | $14,594,856 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.05000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.95000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
| Land | LandGrp | |
| Buildings | BuildingsGrp | |
| Leasehold Improvements | LeaseholdImprovementsGrp | |
| Equipment | EquipmentGrp | |
| Other Land Buildings | OtherLandBuildingsGrp | |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
| Total Liability | $0 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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." |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF OUTING | Event1Nm |
| Gross Receipts Event1 | $108,235 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $32,485 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $75,750 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $13,060 | CashPrizesEvent1Amt |
| Non Cash Prizes Event1 | $2,735 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $21,600 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $8,450 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $5,854 | OtherDirectExpensesEvent1Amt |
| Event2 | POINSETTA SALE | Event2Nm |
| Gross Receipts Event2 | $50,833 | GrossReceiptsEvent2Amt |
| Gross Revenue Event2 | $50,833 | GrossRevenueEvent2Amt |
| Food And Beverage Event2 | $281 | FoodAndBeverageEvent2Amt |
| Other Direct Expenses Event2 | $17,387 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 4 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $8,676 | GrossReceiptsOtherEventsAmt |
| Gross Revenue Other Events | $8,676 | GrossRevenueOtherEventsAmt |
| Oth Direct Expnss Other Events | $1,122 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $167,744 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $32,485 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $135,259 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $13,060 | CashPrizesTotalEventsAmt |
| Non Cash Prizes Total Events | $2,735 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $21,600 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $8,731 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $24,363 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $70,489 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $64,770 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WEST GEORGIA MEDICAL CENTER INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1514 VERNON ROAD | AddressLine1Txt |
| City | LAGRANGE | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30240 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 205497506 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $58,000 | CashGrantAmt |
| Non Cash Assistance | $82,000 | NonCashAssistanceAmt |
| Valuation Method Used | FMV | ValuationMethodUsedDesc |
| Non Cash Assistance | car/flooring | NonCashAssistanceDesc |
| Purpose Of Grant | PROGRAM SUPPORT | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | HELPING HANDS EMPLOYEE PROGRAM | GrantTypeTxt |
| Recipient | 30 | RecipientCnt |
| Cash Grant | $14,511 | CashGrantAmt |
| Valuation Method Used | FMV | ValuationMethodUsedDesc |
| Non Cash Assistance | N/A | NonCashAssistanceDesc |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | 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. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (71 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ALAN R MUSTER MD | ||||||||||||||
| SVP SPECIALTY DIVISION WMG | $0 | $492,176 | $0 | $153,371 | $0 | $22,475 | $0 | $48,600 | $0 | $36,299 | $0 | $752,921 | $0 | $0 |
| ANDREW LEE | ||||||||||||||
| VP CHIEF DIVERSITY OFFICER | $0 | $300,534 | $0 | $69,143 | $0 | $36,677 | $0 | $16,250 | $0 | $29,251 | $0 | $451,855 | $0 | $0 |
| ANDREW S ALBERRY | ||||||||||||||
| VP INFO TECH OPS. (END. 11/19) | $0 | $211,694 | $0 | $30,192 | $0 | $9,759 | $0 | $0 | $0 | $23,900 | $0 | $275,545 | $0 | $0 |
| ANDREW W COX | ||||||||||||||
| VP CHIEF OF STAFF&LEADER. DEV. | $0 | $239,175 | $0 | $30,725 | $0 | $12,160 | $0 | $13,988 | $0 | $26,645 | $0 | $322,693 | $0 | $0 |
| ANTHONY J BUDZINSKI | ||||||||||||||
| EVP & CFO | $0 | $711,281 | $0 | $189,614 | $0 | $415,918 | $0 | $49,600 | $0 | $31,125 | $0 | $1,397,538 | $0 | $388,946 |
| AVIRAL SINGH | ||||||||||||||
| VP BRAND & MARKET STRATEGY | $0 | $176,928 | $0 | $62,139 | $0 | $6,755 | $0 | $11,654 | $0 | $19,490 | $0 | $276,966 | $0 | $0 |
| AVRIL P BECKFORD MD | ||||||||||||||
| TRUSTEE & CHIEF PEDIATRIC OFF. | $0 | $194,006 | $0 | $277,267 | $0 | $10,712 | $0 | $27,825 | $0 | $3,622 | $0 | $513,432 | $0 | $0 |
| BARBARA B COREY | ||||||||||||||
| SVP MANAGED CARE | $0 | $383,148 | $0 | $77,716 | $0 | $16,717 | $0 | $21,125 | $0 | $24,049 | $0 | $522,755 | $0 | $0 |
| BETH KOST | ||||||||||||||
| SVP, CHIEF COMPLIANCE OFFICER | $0 | $376,783 | $0 | $98,784 | $0 | $16,686 | $0 | $30,600 | $0 | $26,887 | $0 | $549,740 | $0 | $0 |
| BRADFORD B NEWTON | ||||||||||||||
| VP INFO. TECHNOLOGY ADMIN. | $0 | $236,842 | $0 | $43,177 | $0 | $9,247 | $0 | $21,775 | $0 | $29,650 | $0 | $340,691 | $0 | $0 |
| CANDICE L SAUNDERS | ||||||||||||||
| PRESIDENT & CEO | $0 | $1,380,165 | $0 | $719,400 | $0 | $370,962 | $0 | $49,600 | $0 | $31,734 | $0 | $2,551,861 | $0 | $350,539 |
| CAROL TODD | ||||||||||||||
| VP ASST. GENERAL COUNSEL | $0 | $196,522 | $0 | $41,362 | $0 | $9,938 | $0 | $20,517 | $0 | $20,587 | $0 | $288,926 | $0 | $0 |
| CARRIE O PLIETZ | ||||||||||||||
| EVP & COO HOSPITAL DIVISION | $0 | $714,553 | $0 | $228,715 | $0 | $14,772 | $0 | $40,650 | $0 | $31,633 | $0 | $1,030,323 | $0 | $0 |
| DANIEL ABAD | ||||||||||||||
| VP TOTAL REWARDS | $0 | $193,663 | $0 | $56,883 | $0 | $6,415 | $0 | $15,103 | $0 | $9,357 | $0 | $281,421 | $0 | $0 |
| DANYALE ZIGLOR | ||||||||||||||
| VP HUMAN RESOURCES (BEG.12/19) | $0 | $197,389 | $0 | $34,259 | $0 | $9,338 | $0 | $37,200 | $0 | $15,627 | $0 | $293,813 | $0 | $0 |
| DAVID HAFNER | ||||||||||||||
| FORMER TRUSTEE | $0 | $20,311 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $20,311 | $0 | $0 |
| DAVID JONES | ||||||||||||||
| EVP CHIEF HR OFFICER | $0 | $453,078 | $0 | $224,378 | $0 | $23,823 | $0 | $1,924 | $0 | $26,547 | $0 | $729,750 | $0 | $0 |
| DAVID W ANDERSON | ||||||||||||||
| FORMER EVP/HR/OL/CCO | $0 | $0 | $0 | $76,387 | $0 | $100,094 | $0 | $47,492 | $0 | $3,488 | $0 | $227,461 | $0 | $0 |
| DAVID W PRESTON | ||||||||||||||
| SVP BRAND EXP. & COMMUNICATION | $0 | $363,301 | $0 | $53,327 | $0 | $14,724 | $0 | $23,750 | $0 | $20,657 | $0 | $475,759 | $0 | $0 |
| DOUGLAS ARVIN CPA MBA | ||||||||||||||
| SVP FINANCE (END. 2/20) | $0 | $344,734 | $0 | $85,091 | $0 | $41,881 | $0 | $16,038 | $0 | $19,760 | $0 | $507,504 | $0 | $0 |
| ELIZABETH H LOUDERMILK | ||||||||||||||
| VP FINANCIAL PLANNING | $0 | $275,849 | $0 | $48,400 | $0 | $95,145 | $0 | $25,750 | $0 | $28,883 | $0 | $474,027 | $0 | $81,056 |
| ELIZABETH H PAPETTI | ||||||||||||||
| VP OPS. HOSPITAL DIVISION | $0 | $226,303 | $0 | $49,996 | $0 | $8,700 | $0 | $23,750 | $0 | $29,545 | $0 | $338,294 | $0 | $0 |
| ELLEN LANGFORD | ||||||||||||||
| FORMER SVP WMG AMB. TRANS. | $0 | $0 | $0 | $0 | $0 | $236,783 | $0 | $0 | $0 | $0 | $0 | $236,783 | $0 | $0 |
| ELLEN WRIGHT | ||||||||||||||
| VP HIM CDI & POLICIES | $0 | $193,600 | $0 | $31,419 | $0 | $9,351 | $0 | $17,529 | $0 | $21,039 | $0 | $272,938 | $0 | $0 |
| FREDA LYON | ||||||||||||||
| VP SYSTEM EMERGENCY SERVICES | $0 | $217,078 | $0 | $39,545 | $0 | $43,936 | $0 | $26,604 | $0 | $30,154 | $0 | $357,317 | $0 | $28,914 |
| IVY SPENCER | ||||||||||||||
| VP CNO | $0 | $199,800 | $0 | $44,029 | $0 | $10,549 | $0 | $23,750 | $0 | $17,827 | $0 | $295,955 | $0 | $0 |
| JAMES L HORNSBY JR MD | ||||||||||||||
| TRUSTEE & PHYSICIAN | $0 | $258,750 | $0 | $113,904 | $0 | $1,260 | $0 | $42,750 | $0 | $31,300 | $0 | $447,964 | $0 | $0 |
| JAMES M SWARTZ | ||||||||||||||
| VP ACCOUNTING | $0 | $156,679 | $0 | $42,634 | $0 | $77,714 | $0 | $12,917 | $0 | $19,131 | $0 | $309,075 | $0 | $69,963 |
| JASON D STEVENS | ||||||||||||||
| SVP DEPUTY GENERAL COUNSEL | $0 | $300,025 | $0 | $80,584 | $0 | $11,811 | $0 | $42,750 | $0 | $24,622 | $0 | $459,792 | $0 | $0 |
| JASON L KELSEY | ||||||||||||||
| VP REHAB. & SPORTS MED. SRVCS. | $0 | $196,700 | $0 | $29,897 | $0 | $14,243 | $0 | $23,721 | $0 | $34,068 | $0 | $298,629 | $0 | $0 |
| JENNIFER J GIUSTI | ||||||||||||||
| VP CLINICAL OUTCOMES | $0 | $328,682 | $0 | $58,258 | $0 | $11,579 | $0 | $30,600 | $0 | $22,540 | $0 | $451,659 | $0 | $0 |
| JILL M CASE-WIRTH | ||||||||||||||
| SVP NURSING SERVICES | $0 | $378,036 | $0 | $83,757 | $0 | $121,503 | $0 | $49,600 | $0 | $12,794 | $0 | $645,690 | $0 | $98,356 |
| JOHN A BRENNAN | ||||||||||||||
| EVP CHIEF CLIN. INTEG. OFFICER | $0 | $858,700 | $0 | $273,803 | $0 | $19,697 | $0 | $49,600 | $0 | $36,058 | $0 | $1,237,858 | $0 | $0 |
| JONATHAN D MAURER | ||||||||||||||
| VP INFORMATION SECURITY & CISO | $0 | $230,006 | $0 | $33,886 | $0 | $9,493 | $0 | $42,750 | $0 | $12,237 | $0 | $328,372 | $0 | $0 |
| JOSEPH L BRYWCZYNSKI | ||||||||||||||
| SVP HEALTH PARKS DEVELOPMENT | $0 | $325,276 | $0 | $70,050 | $0 | $97,517 | $0 | $47,600 | $0 | $26,640 | $0 | $567,083 | $0 | $65,163 |
| JUDITH WHITE | ||||||||||||||
| VP LABORATORY SERVICES SYSTEM | $0 | $159,235 | $0 | $50,004 | $0 | $6,615 | $0 | $15,690 | $0 | $14,053 | $0 | $245,597 | $0 | $0 |
| KEITH BOWERMASTER | ||||||||||||||
| FORMER VP COMMUNICATIONS | $0 | $8,937 | $0 | $0 | $0 | $271,682 | $0 | $0 | $0 | $1,267 | $0 | $281,886 | $0 | $48,214 |
| KEM M MULLINS | ||||||||||||||
| EVP AMBULATORY & BUS. DEV. | $0 | $554,656 | $0 | $152,604 | $0 | $14,852 | $0 | $22,750 | $0 | $34,978 | $0 | $779,840 | $0 | $0 |
| KIMBERLY J RYAN | ||||||||||||||
| SENIOR VICE PRESIDENT | $0 | $434,560 | $0 | $0 | $0 | $14,345 | $0 | $30,600 | $0 | $22,387 | $0 | $501,892 | $0 | $0 |
| KIMBERLY TAACA | ||||||||||||||
| VP OPS SPECIALTY DIVISION | $0 | $214,863 | $0 | $48,147 | $0 | $8,700 | $0 | $23,750 | $0 | $23,897 | $0 | $319,357 | $0 | $0 |
| KIMBERLY W MENEFEE | ||||||||||||||
| FORMER SVP STRATEGIC COMM. DEV | $0 | $0 | $0 | $0 | $0 | $275,126 | $0 | $0 | $0 | $0 | $0 | $275,126 | $0 | $0 |
| KRISTEN S TRICE | ||||||||||||||
| VP DIAGNOSTIC OUTREACH | $0 | $194,173 | $0 | $35,398 | $0 | $9,050 | $0 | $14,914 | $0 | $28,968 | $0 | $282,503 | $0 | $0 |
| LAURA DANNELS | ||||||||||||||
| VP & CHIEF LEARNING OFFICER | $0 | $98,080 | $0 | $79,817 | $0 | $14,408 | $0 | $22,625 | $0 | $3,819 | $0 | $218,749 | $0 | $0 |
| LEANNE COOK | ||||||||||||||
| VP CONSUMER ENGAGEMENT | $0 | $156,705 | $0 | $10,263 | $0 | $6,985 | $0 | $17,026 | $0 | $23,388 | $0 | $214,367 | $0 | $0 |
| LEO E REICHERT | ||||||||||||||
| EVP & GENERAL COUNSEL | $0 | $621,870 | $0 | $187,493 | $0 | $18,442 | $0 | $40,624 | $0 | $37,860 | $0 | $906,289 | $0 | $0 |
| MARCUS P CHARLSON MD | ||||||||||||||
| VP SURGERY | $0 | $214,819 | $0 | $40,665 | $0 | $8,957 | $0 | $16,511 | $0 | $25,733 | $0 | $306,685 | $0 | $0 |
| MARY L TAVERNARO | ||||||||||||||
| VP HUMAN RESOURCES OPERATIONS | $0 | $275,898 | $0 | $63,460 | $0 | $11,549 | $0 | $30,600 | $0 | $25,508 | $0 | $407,015 | $0 | $0 |
| MAXWELL S KAGAN | ||||||||||||||
| VP FINANCE & CFO | $0 | $259,036 | $0 | $57,927 | $0 | $10,614 | $0 | $23,750 | $0 | $17,550 | $0 | $368,877 | $0 | $0 |
| MICHAEL T MCCULLOUGH | ||||||||||||||
| SVP SUPPLY CHAIN | $0 | $313,000 | $0 | $57,012 | $0 | $39,510 | $0 | $30,600 | $0 | $21,485 | $0 | $461,607 | $0 | $0 |
| PAUL D MURPHREE | ||||||||||||||
| VP MEDICAL OUTCOMES | $0 | $370,120 | $0 | $61,879 | $0 | $16,945 | $0 | $49,600 | $0 | $33,048 | $0 | $531,592 | $0 | $0 |
| PAUL DOUGLASS MD | ||||||||||||||
| TRUSTEE & PHYSICIAN | $0 | $435,988 | $0 | $251,171 | $0 | -$25,981 | $0 | $30,600 | $0 | $12,997 | $0 | $704,775 | $0 | $0 |
| PETER R JUNGBLUT MD MBA | ||||||||||||||
| FORMER SVP & MEDICAL DIRECTOR | $0 | $295,768 | $0 | $151,439 | $0 | $3,406 | $0 | $49,320 | $0 | $32,130 | $0 | $532,063 | $0 | $0 |
| REBECCA L RUHL | ||||||||||||||
| VP FACILITY COMPLIANCE OPS. | $0 | $168,824 | $0 | $30,777 | $0 | $9,668 | $0 | $3,250 | $0 | $27,325 | $0 | $239,844 | $0 | $0 |
| RICHARD S SIEGEL | ||||||||||||||
| VP CARDIO.&CVM ADMN(END. 1/20) | $0 | $318,274 | $0 | $63,363 | $0 | $14,585 | $0 | $47,090 | $0 | $34,191 | $0 | $477,503 | $0 | $0 |
| ROB SCHREINER | ||||||||||||||
| EVP & PRESIDENT MEDICAL GROUP | $0 | $563,080 | $0 | $164,713 | $0 | $16,606 | $0 | $30,600 | $0 | $9,697 | $0 | $784,696 | $0 | $0 |
| ROBERT J DECOUX | ||||||||||||||
| VP CORPORATE MED. STAFF SVCS. | $0 | $190,573 | $0 | $32,513 | $0 | $36,757 | $0 | $30,173 | $0 | $27,275 | $0 | $317,291 | $0 | $26,883 |
| SANDRA LUCIUS | ||||||||||||||
| VP INFO. TECHNOLOGY APPS | $0 | $246,746 | $0 | $44,982 | $0 | $14,509 | $0 | $47,460 | $0 | $2,349 | $0 | $356,046 | $0 | $0 |
| SEAN P TURNER | ||||||||||||||
| VP REVENUE CYCLE MANAGEMENT | $0 | $322,181 | $0 | $58,719 | $0 | $9,911 | $0 | $8,776 | $0 | $29,153 | $0 | $428,740 | $0 | $0 |
| SHALIMA PANNIKODE | ||||||||||||||
| SVP CHIEF INFO. & DIGITAL OFF. | $0 | $342,698 | $0 | $110,000 | $0 | $7,578 | $0 | $14,830 | $0 | $16,466 | $0 | $491,572 | $0 | $0 |
| SHYROLL MORRIS | ||||||||||||||
| VP ONC.&DIG.HEALTH (BEG. 9/19) | $0 | $79,425 | $0 | $60,807 | $0 | $21,521 | $0 | $3,566 | $0 | $1,924 | $0 | $167,243 | $0 | $0 |
| SNEHAL H DOSHI | ||||||||||||||
| VP SYSTEM PHARMACIST | $0 | $210,792 | $0 | $38,860 | $0 | $46,831 | $0 | $26,030 | $0 | $32,956 | $0 | $355,469 | $0 | $30,664 |
| SONYA E ALDY | ||||||||||||||
| VP TALENT ACQUISITION | $0 | $224,227 | $0 | $40,866 | $0 | $10,307 | $0 | $9,750 | $0 | $23,468 | $0 | $308,618 | $0 | $0 |
| SOPHIA MARSHALL | ||||||||||||||
| VP ORGANIZATION COMMUNICATIONS | $0 | $188,464 | $0 | $61,051 | $0 | $6,692 | $0 | $23,750 | $0 | $4,323 | $0 | $284,280 | $0 | $0 |
| STEPHEN L BADGER | ||||||||||||||
| FORMER VP STRATEGIC SERVICES | $0 | $433,162 | $0 | $93,913 | $0 | $61,594 | $0 | $49,600 | $0 | $36,470 | $0 | $674,739 | $0 | $41,750 |
| STEPHEN VAULT | ||||||||||||||
| VP STRATEGIC COMMUNITY DEV. | $0 | $192,564 | $0 | $35,095 | $0 | $10,447 | $0 | $23,636 | $0 | $11,204 | $0 | $272,946 | $0 | $0 |
| STEVEN HUNT | ||||||||||||||
| VP HUMAN RESOURCES | $0 | $194,384 | $0 | $29,809 | $0 | $7,475 | $0 | $18,589 | $0 | $31,096 | $0 | $281,353 | $0 | $0 |
| STEVEN OWEIDA MD | ||||||||||||||
| FORMER TRUSTEE | $0 | $49,802 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $49,802 | $0 | $0 |
| TE RUSTY DURHAM | ||||||||||||||
| FORMER TRUSTEE | $0 | $15,319 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $15,319 | $0 | $0 |
| TIMOTHY HANEY | ||||||||||||||
| SVP RE FAC&DVLP SVC (END.1/20) | $0 | $312,049 | $0 | -$88,138 | $0 | $62,303 | $0 | $29,610 | $0 | $27,516 | $0 | $343,340 | $0 | $0 |
| VALERY A AKOPOV MD | ||||||||||||||
| SVP HOSPITAL DIVISION WMG | $0 | $488,724 | $0 | $132,489 | $0 | $25,261 | $0 | $30,600 | $0 | $28,263 | $0 | $705,337 | $0 | $0 |
| VARMA RAMESWAR MD | ||||||||||||||
| VP PEDIATRIC OPERATIONS | $0 | $203,785 | $0 | $36,120 | $0 | $11,599 | $0 | $47,260 | $0 | $13,318 | $0 | $312,082 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PART I, LINE 1A | FormAndLineReferenceDesc |
| Explanation | THE ITEMS, AS INDICATED IN LINE 1A, WERE PROVIDED, IN SOME INSTANCES, TO BOARD MEMEBERS AND TO CERTAIN EMPLOYED INDIVIDUALS LISTED IN FORM 990, PART VII BY THE ORGANIZATION. THE ORGANIZATION FOLLOWS IRS GUIDELINES AND THESE ITEMS WERE ADDED AS TAXABLE INCOME AS APPROPRIATE. SCHEDULE J, PART I, LINE 1B REIMBURSEMENT POLICY: WHILE WELLSTAR HEALTH SYSTEM AND ITS AFFILIATES DO NOT HAVE A WRITTEN POLICY REGARDING PAYMENT OR REIMBURSEMENT OF THE ITEMS LISTED IN SCHEDULE J, PART I, LINE 1A, THE ORGANIZATION FOLLOWS IRS GUIDELINES IN THE PAYMENT OF ANY OF THESE ITEMS TO INDIVIDUALS LISTED IN FORM 990, PART VII, SECTION A. THESE ITEMS ARE ADDED AS TAXABLE WAGES ON THE INDIVIDUAL'S FORM W-2 AS APPROPRIATE. SCHEDULE J, PART 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 2019 CALENDAR YEAR FROM EITHER THE ORGANIZATION OR A RELATED ORGANIZATION: DAVID W. ANDERSON 96,194 DOUGLAS ARVIN, CPA, MBA 28,771 ELLEN LANGFORD 263,783 KEITH BOWERMASTER 223,420 KIMBERLY W. MENEFEE 275,126 TIMOTHY HANEY 40,702 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): ANTHONY J. BUDZINSKI 388,946 CANDICE L. SAUNDERS 350,539 ELIZABETH H. LOUDERMILK 81,056 FREDA LYON 28,914 JAMES M. SWARTZ 69,963 JILL M. CASE-WIRTH 98,356 JOSEPH L. BRYWCZYNSKI 65,163 KEITH BOWERMASTER 48,214 LINDA HUFFER 30,499 ROBERT J. DECOUX 26,883 SNEHAL H. DOSHI 30,664 STEPHEN L. BADGER 41,750 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. ANNUAL EXTERNAL AUDIT PROCESS AND APPROVED BY THE BOARD OF TRUSTEES AT THAT TIME. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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, 2020. 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 OFFICER, 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 CEO 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 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 AT A PREDETERMINED TARGETED 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 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. UNDER ITS CONTINUING DISCLOSURE AGREEMENTS FOR PUBLIC BONDS OUTSTANGINS 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 V, PART VII, AND PART IX AS WELL AS SCHEDULE J REPRESENT COMPENSATION PROVIDED TO INDIVIDUALS THAT PROVIDE SERVICES TO THE ORGANIZATION. LIKEWISE, THE NUMBER OF EMPLOYEES REPORTED ON FORM 990 REPRESENT THE NUMBER OF INDIVIDUALS PROVIDING SERVICES TO THE ORGANIZATION. ALL FEDERAL EMPLOYMENT TAX RESPONSIBILITIES FOR THESE INDIVIDUALS (INCLUDING FEDERAL EMPLOYMENT TAX REPORTING RESPONSIBILITIES) ARE HANDLED BY WELLSTAR HEALTH SYSTEM, INC.(EIN 58-1649541). |
| FORM 990 PART IX LINE 24 - OTHER EXPENSES | DESCRIPTION:EDUCATION TOTAL EXPENSES:18523 PROGRAM SERVICES:18523 FUNDRAISING: |
| FORM 990 PART IX LINE 24 - OTHER EXPENSES | DESCRIPTION:VOLUNTEER SERVICES TOTAL EXPENSES:5563 PROGRAM SERVICES:5563 FUNDRAISING: |
| FORM 990 PART IX LINE 24 - OTHER EXPENSES | DESCRIPTION:BEREAVEMENT SERVICES TOTAL EXPENSES:392 PROGRAM SERVICES:392 FUNDRAISING: |
| FORM 990 PART IX LINE 24 - OTHER EXPENSES | DESCRIPTION:MISCELLANEOUS EXPENSES TOTAL EXPENSES:9795 PROGRAM SERVICES:9795 FUNDRAISING: |
| FORM 990 PART IX LINE 24 - OTHER EXPENSES | DESCRIPTION:FOOD PANTRY EXPENSE TOTAL EXPENSES:330 PROGRAM SERVICES:330 FUNDRAISING: |
| FORM 990 PART IX LINE 24 - OTHER EXPENSES | DESCRIPTION:SHUTTLE EXPENSE TOTAL EXPENSES:70621 PROGRAM SERVICES:70621 FUNDRAISING: |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (14 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Douglas Hospital Inc | ||||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 30062 | 582026750 | Healthcare | GA | 501(C)(3) | 3 | WHS INC | Yes (true) |
| Kennestone Hospital Inc | ||||||||||
| 793 SAWYER ROAD | Marietta | GA | 30062 | 582032904 | Healthcare | GA | 501(C)(3) | 3 | WHS INC | Yes (true) |
| Paulding Medical Center Inc | ||||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 30062 | 582095884 | Healthcare | GA | 501(C)(3) | 3 | WHS INC | Yes (true) |
| Wellstar Foundation Inc | ||||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 30062 | 581627413 | Foundation | GA | 501(C)(3) | 12 II | WHS INC | Yes (true) |
| Wellstar Health System Inc | ||||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 30062 | 581649541 | Healthcare | GA | 501(C)(3) | 12 II | NA | false |
| WELLSTAR ATLANTA MEDICAL CENTER INC | ||||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 30062 | 810837031 | HEALTHCARE | GA | 501(C)(3) | 3 | WHS INC | Yes (true) |
| WELLSTAR NORTH FULTON HOSPTIAL INC | ||||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 30062 | 810851756 | HEALTHCARE | GA | 501(C)(3) | 3 | WHS INC | Yes (true) |
| WELLSTAR SPALDING REGIONAL HOSPITALINC | ||||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 30062 | 810864789 | HEALTHCARE | GA | 501(C)(3) | 3 | WHS INC | Yes (true) |
| WELLSTAR SYLVAN GROVE HOSPITAL INC | ||||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 30062 | 810875069 | HEALTHCARE | GA | 501(C)(3) | 3 | WHS INC | Yes (true) |
| WEST GEORGIA HEALTH SERVICES INC | ||||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 30062 | 205497622 | HEALTHCARE | GA | 501(C)(3) | 12 II | WHS INC | Yes (true) |
| WEST GEORGIA MEDICAL CENTER INC | ||||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 30062 | 205497506 | HEALTHCARE | GA | 501(C)(3) | 3 | WGHS INC | Yes (true) |
| VERNON WOODS RETIREMENT COMMUNITY INC | ||||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 30062 | 582575049 | HEALTHCARE | GA | 501(C)(3) | 10 | WGHS INC | Yes (true) |
| MEDICAL PARK FOUNDATION INC | ||||||||||
| 1514 VERNON ROAD | LAGRANGE | GA | 30062 | 581303478 | FOUNDATION | GA | 501(C)(3) | 7 | WGHS INC | Yes (true) |
| COBB HOSPITAL INC | ||||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 30062 | 580968382 | HEALTHCARE | GA | 501(C)(3) | 3 | WHS INC | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|
| COBB SOUTH PARKING DECK | |||||||
| 793 SAWYER ROAD | MARIETTA | GA | 300622222 | 752999669 | PARKING | GA | NA |
| KENNESTONE EAST PARKING DECK LLC | |||||||
| 793 SAWYER ROAD | MARIETTA | GA | 300622222 | 200537100 | PARKING | GA | NA |
| GRIFFIN IMAGING LLC | |||||||
| 793 SAWYER ROAD | MARIETTA | GA | 300622222 | IMAGING CENTER | GA | NA | |
| WELLSTAR SPALD EMSSPALD 911 LLC | |||||||
| 793 SAWYER ROAD | MARIETTA | GA | 300622222 | OFF. BLDG/EMS CTR | GA | NA | |
| NORTH FULTON PARKING DECK LP | |||||||
| 793 SAWYER ROAD | MARIETTA | GA | 300622222 | PARKING | GA | NA | |
| WELLSTAR COBB HOSPITAL CANCER CENTER | |||||||
| 793 SAWYER ROAD | MARIETTA | GA | 30062 | 464323565 | HEALTH SERVICES | GA | NA |
| SPALDING HEALTH SYSTEM LLC | |||||||
| 793 SAWYER ROAD | MARIETTA | GA | 30062 | 582148398 | PHYS. HOSP. ORG. | GA | NA |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Legal Domicile StateLegalDomicileStateCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Community Assurance Co | ||||||||||||
| 3rd Fl Barclays Hse Shedden Rd | George Town | CJ | 581649541 | INSURANCE | CJ | WHS INC | C CORP | |||||
| WEST GEORGIA HEALTH PHYSICIANS INC | ||||||||||||
| 275125341 | PHYSICIAN PRAC. | WGHS INC | C CORP | 793 SAWYER ROAD | MARIETTA | GA | 300622222 | GA | ||||
| WELLSTAR HELATH PLAN INC | ||||||||||||
| 461922499 | HEALTH INSURANCE | WHS INC | C CORP | 793 SAWYER ROAD | MARIETTA | GA | 300622222 | GA | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Comments