2020-05-11T12:10:27-05:00 2019-06-30 PricewaterhouseCoopers LLP 2001 MARKET ST SUITE 1800 PHILADELPHIA PA 19103 990 2018-07-01 200936376 WEST GEORGIA HEALTH FOUNDATION % JAMES M SWARTZ WEST 7709567827 793 SAWYER ROAD Marietta GA 300622222 JAMES M SWARTZ VP ACCOUNTING 7709567827 2020-05-08 true JOANNE KRUEGER P01235586 2673303000 155.201.35.69 23522320201325000029 2020-05-11 P 7C276736B1F8534619D83B6F2AADECD8007A5E58 2719192911BCB3EB586EADDE14073544A58AB321 2018 2020-09-23 17:36:50Z CANDICE L SAUNDERS 793 SAWYER ROAD Marietta GA 300622222 1554796 false X www.wghealth.org X 2004 GA TO SUPPORT THE CHARITABLE ACTIVITIES OF WEST GEORGIA MEDICAL CENTER, INC. AND ITS AFFILIATES. 20 10 0 18 0 0 470933 506597 0 0 806961 931601 71547 48790 1349441 1486988 132716 113303 0 0 0 0 0 0 0 89557 156110 222273 269413 1127168 1217575 17672893 18958728 0 0 17672893 18958728 THE FOUNDATION OPERATES EXCLUSIVELY FOR THE BENEFIT OF THE WEST GEORGIA MEDICAL CENTER, INC. AND ITS AFFILIATED ENTITIES. false false 115461 0 0 TO PROVIDE FUNDS FOR THE SUPPORT OF WEST GEORGIA MEDICAL CENTER, INC. AND ITS AFFILIATES. SUPPORT INCLUDES BEREAVEMENT SERVICES, HOSPITAL VOLUNTEER PROGRAM, AND CAMP DOGWOOD - A GRIEF CAMP FOR CHILDREN. 90940 90940 0 TO PROVIDE FINANCIAL SUPPORT TO WEST GEORGIA MEDICAL CENTER, INC. FOR THE OPERATION OF THE HOSPICE CENTER. 22363 22363 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, 2018 TO JUNE 30, 2019, THE HELPING HANDS PROGRAM ASSISTED 58 WEST GEORGIA HEALTH SERVICES, INC. EMPLOYEES BY PROVIDING $22,363 IN MONETARY ASSISTANCE. 228764 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 true 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 20 10 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 AMBICA YADAV TRUSTEE 1.0 13.0 X 0 5919 0 AVRIL P BECKFORD MD TRUSTEE & CHIEF PEDIATRIC OFF. 1.0 49.0 X X 0 452510 29270 CHARLES J JONES TRUSTEE 1.0 13.0 X 0 9318 0 DAVID H HAFNER MD TRUSTEE 1.0 13.0 X 0 56388 0 EDWARD RICHARDSON TRUSTEE (BEG. 4/19) 1.0 13.0 X 0 0 0 FRANK ROS TRUSTEE 1.0 13.0 X 0 6421 0 GARY A MILLER TRUSTEE 1.0 13.0 X 0 3568 0 GREG MORGAN TRUSTEE 1.0 13.0 X 0 3070 0 H SPEER BURDETTE III TRUSTEE 1.0 13.0 X 0 4610 0 JAMES HOLMES TRUSTEE (BEG. 4/19) 1.0 13.0 X 0 0 0 JAMES L HORNSBY JR MD TRUSTEE & PHYSICIAN 1.0 51.0 X 0 353602 71950 MICHAEL B PATTON TRUSTEE 1.0 13.0 X 0 3737 0 MITZI MOORE TRUSTEE 1.0 13.0 X 0 10871 0 O SCOTT SWAYZE MD TRUSTEE 1.0 13.0 X 0 5895 0 OTIS A BRUMBY III TRUSTEE 1.0 13.0 X 0 49185 0 PAUL DOUGLASS MD TRUSTEE & PHYSICIAN 1.0 49.0 X 0 796091 40795 R RANDALL BENTLEY SR ESQ TRUSTEE 1.0 13.0 X 0 44408 0 ROBERT N CROSS MD TRUSTEE 1.0 13.0 X 0 11001 0 T FITZ JOHNSON TRUSTEE 1.0 13.0 X 0 43397 0 W CHARLES BROCK TRUSTEE 1.0 13.0 X 0 43391 0 WALTER G ROBINSON TRUSTEE (END. 12/18) 1.0 13.0 X 0 8139 0 ALAN R MUSTER MD SVP SPECIALTY DIVISION WMG 1.0 51.0 X 0 665560 83346 ANDREW S ALBERRY VP INFO TECHNOLOGY OPERATIONS 1.0 49.0 X 0 258768 24039 ANDREW LEE VP CHIEF DIVERSITY OFFICER 1.0 49.0 X 0 341507 34030 ANDREW W COX VP CHIEF OF STAFF (BEG. 10/18) 1.0 49.0 X 0 203435 34918 ANTHONY J BUDZINSKI EVP & CFO 1.0 51.0 X 0 939452 78785 ANTHONY M TRUPIANO SVP SUPPLY CHAIN (END. 1/19) 1.0 49.0 X 0 936846 48232 AVIRAL SINGH VP BRAND&MRKT STR.(BEG.3/19) 1.0 49.0 X 0 0 0 BARBARA B COREY SVP MANAGED CARE 1.0 49.0 X 0 463766 50609 BETH KOST SVP, CHIEF COMPLIANCE OFFICER 1.0 49.0 X 0 470653 51220 BRADFORD B NEWTON VP INFO. TECHNOLOGY ADMIN. 1.0 49.0 X 0 349560 50622 CANDICE L SAUNDERS PRESIDENT & CEO 1.0 51.0 X 0 2426944 79353 CARRIE O PLIETZ EVP & COO HOSPITAL DIVISION 1.0 49.0 X 0 951290 66912 DANIEL ABAD VP TOTAL REWARDS (BEG. 3/19) 1.0 49.0 X 0 0 0 DAVID JONES EVP HR&ORG. LEARN.(BEG.1/19) 1.0 49.0 X 0 0 0 DAVID W ANDERSON EVP/HR/OL/CCO 1.0 49.0 X 0 865929 77106 DAVID W PRESTON SVP BRAND EXP&COMM(BEG.10/18) 1.0 49.0 X 0 139442 9989 DOUGLAS ARVIN CPA MBA SVP FINANCE 1.0 49.0 X 0 459531 39837 ELIZABETH H LOUDERMILK VP FINANCIAL PLANNING 1.0 49.0 X 0 321014 50055 ELIZABETH H PAPETTI VP OPS. HOSPITAL DIVISION 1.0 49.0 X 0 260522 36956 ELLEN WRIGHT VP HIM CDI & POLICIES 1.0 49.0 X 0 225933 40773 FREDA LYON VP SYSTEM EMERGENCY SERVICES 1.0 49.0 X 0 267000 55948 IVY SPENCER VP CNO 1.0 49.0 X 0 199226 39496 JAMES M SWARTZ VP ACCOUNTING 1.0 49.0 X 0 302471 46262 JASON D STEVENS VP DEPUTY GENERAL COUNSEL 1.0 49.0 X 0 353892 57948 JASON L KELSEY VP REHAB&SPORTS MED(BEG.11/18) 1.0 49.0 X 0 177401 48079 JENNIFER J GIUSTI VP CLINICAL OUTCOMES 1.0 49.0 X 0 386608 40047 JILL M CASE-WIRTH SVP NURSING SERVICES 1.0 49.0 X 0 474604 60462 JOHN A BRENNAN EVP CHIEF CLIN. INTEG. OFFICER 1.0 49.0 X 0 1161536 83576 JONATHAN D MAURER VP INFO SEC. & CISO(BEG. 8/18) 1.0 49.0 X 0 177852 18662 JOSEPH L BRYWCZYNSKI SVP HEALTH PARKS DEVELOPMENT 1.0 49.0 X 0 471838 73413 JUDITH WHITE VP LAB. SRVS. SYST.(BEG. 4/19) 1.0 49.0 X 0 0 0 KEITH BOWERMASTER VP COMMUNICATIONS (END. 12/18) 1.0 49.0 X 0 288335 58347 KEM M MULLINS EVP AMBULATORY & BUS. DEV. 1.0 49.0 X 0 713886 56723 KEVIN C SCHAEFFER MD VP ONCOLOGY 1.0 49.0 X 0 284484 46728 KIMBERLY TAACA VP OPS SPECIALTY DIVISION 1.0 49.0 X 0 239588 46291 KRISTEN S TRICE VP DIAGNOSTIC OUTREACH 1.0 49.0 X 0 232256 42682 LEANNE COOK VP CONSUMER ENG. (BEG. 3/19) 1.0 49.0 X 0 0 0 LEO E REICHERT EVP & GENERAL COUNSEL 1.0 49.0 X 0 811932 66669 MARCUS P CHARLSON MD VP SURGERY 1.0 49.0 X 0 208957 37257 MARY L TAVERNARO VP HUMAN RESOURCES OPERATIONS 1.0 49.0 X 0 325273 54487 MAXWELL S KAGAN VP FINANCE & CFO 1.0 49.0 X 0 296639 39858 MICHAEL T MCCULLOUGH SVP SUPPLY CHAIN (BEG. 12/18) 1.0 49.0 X 0 66227 0 PAUL D MURPHREE VP MEDICAL OUTCOMES 1.0 49.0 X 0 439670 76901 REBECCA L RUHL VP FACILITY COMPLIANCE OPS 1.0 49.0 X 0 203610 29995 RICHARD S SIEGEL VP CARDIOLOGY & CVM ADMIN 1.0 49.0 X 0 382611 80285 ROB SCHREINER EVP & PRESIDENT MEDICAL GROUP 1.0 49.0 X 0 728722 38899 ROBERT J DECOUX VP CORPORATE MED STAFF SVCS 1.0 49.0 X 0 235358 54917 SANDRA LUCIUS VP INFO TECHNOLOGY APPS 1.0 49.0 X 0 400773 49169 SEAN P TURNER VP REVENUE CYCLE MANAGEMENT 1.0 49.0 X 0 428955 38743 SHALIMA PANNIKODE SVP CHF INFO&DIGITAL(BEG.4/19) 1.0 49.0 X 0 0 0 SNEHAL H DOSHI VP SYSTEM PHARMACIST 1.0 49.0 X 0 253636 60538 SONYA E ALDY VP TALENT ACQUISITION 1.0 49.0 X 0 269707 35130 SOPHIA MARSHALL VP ORG. COMM. (BEG. 3/19) 1.0 49.0 X 0 0 0 STEPHEN L BADGER VP STRATEGIC SERVICES 1.0 49.0 X 0 619283 82985 STEVEN HUNT VP HUMAN RESOURCES (BEG. 2/19) 1.0 49.0 X 0 0 0 STEPHEN VAULT VP BUSINESS DEVELOPMENT 1.0 49.0 X 0 236081 25314 TIMOTHY HANEY SVP R. E. FAC. & DVLP. SVCS. 1.0 49.0 X 0 461540 55544 VALERY A AKOPOV MD SVP HOSPITAL DIVISION WMG 1.0 49.0 X 0 590611 57469 VARMA RAMESWAR MD VP PEDIATRIC OPERATIONS 1.0 49.0 X 0 245526 52474 YVETTE BREWER MD VP PRIMARY CARE & BEHAV HEALTH 1.0 49.0 X 0 246810 54536 BETHANY ROBERTSON FORMER VP/CHIEF LEARNING OFF. 0.0 0.0 X 0 341999 15481 ELLEN LANGFORD FORMER SVP WMG AMB. TRANS. 0.0 0.0 X 0 637673 57967 KIMBERLY W MENEFEE FORMER SVP STRATEGIC COMM. DEV 0.0 0.0 X 0 840489 20595 MICHELLE ROBINSON FORMER VP MARKETING 0.0 0.0 X 0 396371 14122 PETER R JUNGBLUT MD MBA FORMER SVP & MEDICAL DIRECTOR 0.0 50.0 X 0 398300 79163 ROBIN G BOEHRINGER FORMER VP TOTAL REWARDS 0.0 0.0 X 0 241338 11453 0 28230741 2963412 0 true true false 0 57295 65000 384302 50940 506597 0 548394 548394 0 0 0 0 0 383207 383207 383207 383207 116598 57295 67808 48790 48790 0 0 0 0 0 0 0 1486988 980391 X 90940 90940 22363 22363 0 0 0 0 0 0 0 0 0 0 0 0 0 40649 40649 0 11256 11256 0 0 0 0 0 0 0 0 0 0 0 REPAIRS & MAINTENANCE 25797 25797 0 0 PATIENT SERVICE EXPENSES 23481 23481 0 0 CAMP DOGWOOD EXPENSES 14189 14189 0 0 COMMUNITY EXPENSES 10434 10434 0 0 30304 30304 269413 228764 40649 0 0 0 0 0 136970 75657 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17535923 18883071 0 0 0 0 0 0 0 0 17672893 18958728 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X -500 0 16761393 18046728 912000 912000 17672893 18958728 17672893 18958728 X 1217575 59765 8495 X false true X true false X X 1 WEST GEORGIA MEDICAL CENTER INC 205497506 3 true 90940 0 1 90940 0 true false false false false false false false false false false false false false false true RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 17672892 631904 954755 90000 211324 18958227 16332380 513548 1078160 93050 158146 17672892 14602355 550791 1387967 0 208235 0 16332878 11774139 2295910 781178 256371 14594856 10924729 1314581 -148912 316259 11774139 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." GOLF OUTING 122795 57295 65500 13460 19405 10660 5241 POINSETTIA SALE 33977 33977 33 18687 4 17121 17121 322 173893 57295 116598 13460 19405 10660 33 24250 67808 48790 true WEST GEORGIA MEDICAL CENTER INC 1514 VERNON ROAD LAGRANGE GA 30240 205497506 501(C)(3) 90000 940 FMV EQUIPMENT PROGRAM SUPPORT 1 HELPING HANDS EMPLOYEE PROGRAM 58 22363 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 470770 0 170872 0 23918 0 48481 0 34865 0 748906 0 0 ANDREW S ALBERRY VP INFO TECHNOLOGY OPERATIONS 0 215010 0 33497 0 10261 0 0 0 24039 0 282807 0 0 ANDREW LEE VP CHIEF DIVERSITY OFFICER 0 289994 0 42276 0 9237 0 5625 0 28405 0 375537 0 0 ANDREW W COX VP CHIEF OF STAFF (BEG. 10/18) 0 179606 0 21790 0 2039 0 10130 0 24788 0 238353 0 0 ANTHONY J BUDZINSKI EVP & CFO 0 675979 0 237926 0 25547 0 48500 0 30285 0 1018237 0 0 ANTHONY M TRUPIANO SVP SUPPLY CHAIN (END. 1/19) 0 329324 0 82795 0 524727 0 46675 0 1557 0 985078 0 505532 AVRIL P BECKFORD MD TRUSTEE & CHIEF PEDIATRIC OFF. 0 226143 0 219935 0 6432 0 27715 0 1555 0 481780 0 0 BARBARA B COREY SVP MANAGED CARE 0 366640 0 82995 0 14131 0 29498 0 21111 0 514375 0 0 BETH KOST SVP, CHIEF COMPLIANCE OFFICER 0 334014 0 120892 0 15747 0 29500 0 21720 0 521873 0 0 BETHANY ROBERTSON FORMER VP/CHIEF LEARNING OFF. 0 217528 0 30271 0 94200 0 3889 0 11592 0 357480 0 87044 BRADFORD B NEWTON VP INFO. TECHNOLOGY ADMIN. 0 226646 0 113691 0 9223 0 21775 0 28847 0 400182 0 0 CANDICE L SAUNDERS PRESIDENT & CEO 0 1326416 0 750823 0 349705 0 48409 0 30944 0 2506297 0 324125 CARRIE O PLIETZ EVP & COO HOSPITAL DIVISION 0 693547 0 244044 0 13699 0 36125 0 30787 0 1018202 0 0 DAVID W ANDERSON EVP/HR/OL/CCO 0 525885 0 185097 0 154947 0 48413 0 28693 0 943035 0 131690 DOUGLAS ARVIN CPA MBA SVP FINANCE 0 360102 0 85978 0 13451 0 20103 0 19734 0 499368 0 0 ELIZABETH H LOUDERMILK VP FINANCIAL PLANNING 0 264041 0 47803 0 9170 0 22234 0 27821 0 371069 0 0 ELIZABETH H PAPETTI VP OPS. HOSPITAL DIVISION 0 213096 0 38645 0 8781 0 23125 0 13831 0 297478 0 0 ELLEN LANGFORD FORMER SVP WMG AMB. TRANS. 0 93017 0 46247 0 498409 0 44796 0 13171 0 695640 0 300505 ELLEN WRIGHT VP HIM CDI & POLICIES 0 185000 0 30698 0 10235 0 16914 0 23859 0 266706 0 0 FREDA LYON VP SYSTEM EMERGENCY SERVICES 0 211740 0 42564 0 12696 0 26372 0 29576 0 322948 0 0 IVY SPENCER VP CNO 0 178946 0 14635 0 5645 0 22207 0 17289 0 238722 0 0 JAMES L HORNSBY JR MD TRUSTEE & PHYSICIAN 0 244997 0 107479 0 1126 0 41625 0 30325 0 425552 0 0 JAMES M SWARTZ VP ACCOUNTING 0 243883 0 47830 0 10758 0 18776 0 27486 0 348733 0 0 JASON D STEVENS VP DEPUTY GENERAL COUNSEL 0 285390 0 57348 0 11154 0 34055 0 23893 0 411840 0 0 JASON L KELSEY VP REHAB&SPORTS MED(BEG.11/18) 0 156981 0 17161 0 3259 0 14735 0 33344 0 225480 0 0 JENNIFER J GIUSTI VP CLINICAL OUTCOMES 0 316002 0 60528 0 10078 0 29970 0 10077 0 426655 0 0 JILL M CASE-WIRTH SVP NURSING SERVICES 0 364467 0 89300 0 20837 0 47904 0 12558 0 535066 0 0 JOHN A BRENNAN EVP CHIEF CLIN. INTEG. OFFICER 0 850179 0 293276 0 18081 0 48500 0 35076 0 1245112 0 0 JONATHAN D MAURER VP INFO SEC. & CISO(BEG. 8/18) 0 79618 0 73482 0 24752 0 14373 0 4289 0 196514 0 0 JOSEPH L BRYWCZYNSKI SVP HEALTH PARKS DEVELOPMENT 0 311426 0 70459 0 89953 0 47500 0 25913 0 545251 0 62355 KEITH BOWERMASTER VP COMMUNICATIONS (END. 12/18) 0 232266 0 46656 0 9413 0 29425 0 28922 0 346682 0 0 KEM M MULLINS EVP AMBULATORY & BUS. DEV. 0 534612 0 164696 0 14578 0 22750 0 33973 0 770609 0 0 KEVIN C SCHAEFFER MD VP ONCOLOGY 0 228440 0 45897 0 10147 0 35222 0 11506 0 331212 0 0 KIMBERLY W MENEFEE FORMER SVP STRATEGIC COMM. DEV 0 108169 0 65436 0 666884 0 11863 0 8732 0 861084 0 437043 KIMBERLY TAACA VP OPS SPECIALTY DIVISION 0 198952 0 31934 0 8702 0 23125 0 23166 0 285879 0 0 KRISTEN S TRICE VP DIAGNOSTIC OUTREACH 0 185855 0 37370 0 9031 0 14516 0 28166 0 274938 0 0 LEO E REICHERT EVP & GENERAL COUNSEL 0 595083 0 199021 0 17828 0 30000 0 36669 0 878601 0 0 MARCUS P CHARLSON MD VP SURGERY 0 166732 0 33333 0 8892 0 13048 0 24209 0 246214 0 0 MARY L TAVERNARO VP HUMAN RESOURCES OPERATIONS 0 262137 0 52736 0 10400 0 29752 0 24735 0 379760 0 0 MAXWELL S KAGAN VP FINANCE & CFO 0 250016 0 36829 0 9794 0 22951 0 16907 0 336497 0 0 MICHELLE ROBINSON FORMER VP MARKETING 0 226753 0 36209 0 133409 0 4061 0 10061 0 410493 0 126106 PAUL DOUGLASS MD TRUSTEE & PHYSICIAN 0 527447 0 262273 0 6371 0 30000 0 10795 0 836886 0 0 PAUL D MURPHREE VP MEDICAL OUTCOMES 0 359840 0 68279 0 11551 0 47800 0 29101 0 516571 0 0 PETER R JUNGBLUT MD MBA FORMER SVP & MEDICAL DIRECTOR 0 251577 0 141821 0 4902 0 48500 0 30663 0 477463 0 0 REBECCA L RUHL VP FACILITY COMPLIANCE OPS 0 161556 0 32493 0 9561 0 3250 0 26745 0 233605 0 0 RICHARD S SIEGEL VP CARDIOLOGY & CVM ADMIN 0 318274 0 50303 0 14034 0 46488 0 33797 0 462896 0 0 ROB SCHREINER EVP & PRESIDENT MEDICAL GROUP 0 550000 0 163488 0 15234 0 29435 0 9464 0 767621 0 0 ROBERT J DECOUX VP CORPORATE MED STAFF SVCS 0 188285 0 36883 0 10190 0 28453 0 26464 0 290275 0 0 ROBIN G BOEHRINGER FORMER VP TOTAL REWARDS 0 189295 0 0 0 52043 0 6837 0 4616 0 252791 0 44873 SANDRA LUCIUS VP INFO TECHNOLOGY APPS 0 236053 0 118441 0 46279 0 46822 0 2347 0 449942 0 32043 SEAN P TURNER VP REVENUE CYCLE MANAGEMENT 0 310613 0 62439 0 55903 0 8599 0 30144 0 467698 0 41533 SNEHAL H DOSHI VP SYSTEM PHARMACIST 0 203168 0 39835 0 10633 0 28624 0 31914 0 314174 0 0 SONYA E ALDY VP TALENT ACQUISITION 0 216180 0 43457 0 10070 0 9750 0 25380 0 304837 0 0 STEPHEN L BADGER VP STRATEGIC SERVICES 0 460803 0 99466 0 59014 0 47475 0 35510 0 702268 0 41750 STEPHEN VAULT VP BUSINESS DEVELOPMENT 0 189688 0 37320 0 9073 0 14402 0 10912 0 261395 0 0 TIMOTHY HANEY SVP R. E. FAC. & DVLP. SVCS. 0 352261 0 88538 0 20741 0 28730 0 26814 0 517084 0 0 VALERY A AKOPOV MD SVP HOSPITAL DIVISION WMG 0 467530 0 95506 0 27575 0 30000 0 27469 0 648080 0 0 VARMA RAMESWAR MD VP PEDIATRIC OPERATIONS 0 196359 0 39493 0 9674 0 40251 0 12223 0 298000 0 0 YVETTE BREWER MD VP PRIMARY CARE & BEHAV HEALTH 0 197886 0 36817 0 12107 0 32732 0 21804 0 301346 0 0 SCHEDULE J, PART I, LINE 4A SEVERANCE PAYMENTS: Pursuant to their respective employment agreements, the following groups of officers are entitled to severance payments based on their compensation at that time in the event of certain identified circumstances. The severance payment periods are 24 months for Executive Vice Presidents, 18 months for Senior Vice Presidents, and 12 months for Vice Presidents. The following officer received severance pay during the 2018 CALENDAR YEAR FROM EITHER THE ORGANIZATION OR A RELATED ORGANIZATION: ELLEN LANGFORD $188,991 KIMBERLY W. MENEFEE 219,596 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 M. TRUPIANO $505,532 BETHANY ROBERTSON 87,044 CANDICE L. SAUNDERS 324,125 DAVID W. ANDERSON 131,690 ELLEN LANGFORD 300,505 JOSEPH L. BRYWCZYNSKI 62,355 KIMBERLY W. MENEFEE 437,043 MICHELLE ROBINSON 126,106 ROBIN G. BOEHRINGER 44,873 SANDRA LUCIUS 32,043 SEAN P. TURNER 41,533 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. X FLOORING MATERIALS 1 50000 COST false true false 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, 2019. FORM 990, PART IV, LINE 12B AUDITED FINANCIAL STATEMENTS West Georgia Health Foundation is audited on an annual basis by an outside auditing firm, KPMG, and as part of that audit a consolidated financial statement is issued for all of WellStar Health System, Inc. and its CONTROLLED Affiliates. The independent auditors report includes the accounts of Wellstar and its controlled affiliates, WELLSTAR Kennestone Hospital, Inc., WELLSTAR Cobb Hospital, Inc., WELLSTAR Douglas Hospital, Inc., WELLSTAR Paulding Medical Center, Inc., WELLSTAR ATLANTA MEDICAL CENTER, INC., WELLSTAR NORTH FULTON HOSPITAL, INC., WELLSTAR SPALDING REGIONAL HOSPITAL, INC., WELLSTAR SYLVAN GROVE HOSPITAL, INC., WELLSTAR WEST GEORGIA MEDICAL CENTER, INC., VERNON WOODS RETIREMENT COMMUNITY, INC., CHS Foundation, Inc., various Wellstar owned physician practices, a hospice facility, a nursing facility, home health business, and entities for infusion therapy and durable medical equipment. All significant intercompany accounts and transactions have been eliminated in combination. The Board of Trustees of Wellstar HEALTH SYSTEM, INC. has the authority to approve appointments of the members of the board of trustees of all affiliate corporations. 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 ultimate 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 B, 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. 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 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 AS WELL AS THE CEO IN AN ADVISORY ROLE AND NOT A VOTING MEMBER. FURTHER IN COMMITTEE DISCUSSIONS ABOUT THE COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER, THE CEO WILL RECUSE HIM/HERSELF FROM THAT PROCESS AND 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. 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 XI, LINE 9 OTHER CHANGES IN NET ASSETS: $8,495 FORM 990 PART IX LINE 24 - OTHER EXPENSES DESCRIPTION:EDUCATION TOTAL EXPENSES:8524 PROGRAM SERVICES:8524 MANAGEMENT AND GENERAL:FUNDRAISING: FORM 990 PART IX LINE 24 - OTHER EXPENSES DESCRIPTION:VOLUNTEER SERVICES TOTAL EXPENSES:4340 PROGRAM SERVICES:4340 MANAGEMENT AND GENERAL:FUNDRAISING: FORM 990 PART IX LINE 24 - OTHER EXPENSES DESCRIPTION:BEREAVEMENT SERVICES TOTAL EXPENSES:2642 PROGRAM SERVICES:2642 MANAGEMENT AND GENERAL:FUNDRAISING: FORM 990 PART IX LINE 24 - OTHER EXPENSES DESCRIPTION:MISCELLANEOUS EXPENSES TOTAL EXPENSES:14798 PROGRAM SERVICES:14798 MANAGEMENT AND GENERAL:FUNDRAISING: CHS Foundation Inc 793 SAWYER ROAD Marietta GA 30062 581649540 Foundation GA 501(C)(3) 12 II WHS INC true Douglas Hospital Inc 793 SAWYER ROAD MARIETTA GA 30062 582026750 Healthcare GA 501(C)(3) 3 WHS INC true Kennestone Hospital Inc 793 SAWYER ROAD Marietta GA 30062 582032904 Healthcare GA 501(C)(3) 3 WHS INC true Paulding Medical Center Inc 793 SAWYER ROAD MARIETTA GA 30062 582095884 Healthcare GA 501(C)(3) 3 WHS INC true Wellstar Foundation Inc 793 SAWYER ROAD MARIETTA GA 30062 581627413 Foundation GA 501(C)(3) 12 II WHS INC 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 true WELLSTAR NORTH FULTON HOSPTIAL INC 793 SAWYER ROAD MARIETTA GA 30062 810851756 HEALTHCARE GA 501(C)(3) 3 WHS INC true WELLSTAR SPALDING REGIONAL HOSPITALINC 793 SAWYER ROAD MARIETTA GA 30062 810864789 HEALTHCARE GA 501(C)(3) 3 WHS INC true WELLSTAR SYLVAN GROVE HOSPITAL INC 793 SAWYER ROAD MARIETTA GA 30062 810875069 HEALTHCARE GA 501(C)(3) 3 WHS INC true WEST GEORGIA HEALTH SERVICES INC 793 SAWYER ROAD MARIETTA GA 30062 205497622 HEALTHCARE GA 501(C)(3) 12 II WHS INC true WEST GEORGIA MEDICAL CENTER INC 793 SAWYER ROAD MARIETTA GA 30062 205497506 HEALTHCARE GA 501(C)(3) 3 WGHS INC true VERNON WOODS RETIREMENT COMMUNITY INC 793 SAWYER ROAD MARIETTA GA 30062 582575049 HEALTHCARE GA 501(C)(3) 10 WGHS INC true MEDICAL PARK FOUNDATION INC 1514 VERNON ROAD LAGRANGE GA 30062 581303478 FOUNDATION GA 501(C)(3) 7 WGHS INC true COBB HOSPITAL INC 793 SAWYER ROAD MARIETTA GA 30062 580968382 HEALTHCARE GA 501(C)(3) 3 WHS INC true 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 SPALDING EMSSPALDING 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 Community Assurance Co 3rd Fl Barclays Hse Shedden Rd George Town CJ 581649541 INSURANCE CJ WHS INC C CORP WEST GEORGIA HEALTH PHYSICIANS INC 793 SAWYER ROAD MARIETTA GA 300622222 275125341 PHYSICIAN PRAC. GA WGHS INC C CORP false true true false false false false false false false false false true true true true false false false