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Nonprofiteer
← FORSYTH MEDICAL CENTER FOUNDATION

Form 990 for tax year 2024

Filed by FORSYTH MEDICAL CENTER FOUNDATION.

Totals

Total revenue
$5,125,851
Total expenses
$4,621,721
Contributions and grants received
$1,875,396
Grants paid
$3,622,380
Program services expenses (Part IX)
$3,836,951
Management and general expenses
$512,939
Fundraising expenses
$271,831
Program service expenses (Part III)
$3,836,951

Program services were 83.0% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • ANDREA GENDRACHI

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.2

  • ANDREW SCHNEIDER MD

    TRUSTEE (TO 12/31/24)/CHIEF OF STAFF

    Total calculated
    $6,105
    From this org
    $0
    From related orgs
    $6,105
    Other
    $0
    Hours/week
    0.2 + 1 related

  • BONNIE DONAHUE

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.2

  • CHARLES BLIXT

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.2

  • DAMON SANDERS-PRATT

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.2

  • DAVID BAILEY

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.2

  • ELIZABETH MADDEN

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.2

  • EVA WU

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.2

  • GARY ORTIZ

    TRUSTEE (TO 12/31/24)

    Total calculated
    $0
    Hours/week
    0.2

  • GREGORY BREWER

    TRUSTEE (FR 1/1/24)

    Total calculated
    $0
    Hours/week
    0.2

  • GWENDOLYN CLEMENTS

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.2

  • HENRI CANCIO-FITZGERALD

    TRUSTEE (FR 1/1/24)

    Total calculated
    $0
    Hours/week
    0.2

  • JALEEMA SPEAKS MD

    TRUSTEE/OBGYN

    Total calculated
    $530,026
    From this org
    $0
    From related orgs
    $472,760
    Other
    $57,266
    Hours/week
    0.2 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $326,559 related
    Bonus
    $0 + $85,955 related
    Other
    $0 + $60,246 related
    Deferred
    $0 + $20,700 related
    Nontaxable benefits
    $0 + $36,566 related
    Filer's total
    $0 + $530,026 related

  • JOHN CARD MD

    CHAIR/INTERNIST

    Total calculated
    $488,264
    From this org
    $0
    From related orgs
    $451,509
    Other
    $36,755
    Hours/week
    0.5 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $357,158 related
    Bonus
    $0 + $28,860 related
    Other
    $0 + $65,491 related
    Deferred
    $0 + $20,700 related
    Nontaxable benefits
    $0 + $16,055 related
    Filer's total
    $0 + $488,264 related

  • JOHN WOLFE

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.2

  • JOHN-MARK MITCHELL

    TRUSTEE (TO 4/30/24)

    Total calculated
    $0
    Hours/week
    0.2

  • JOSEPH ELY

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.2

  • JOSEPH LOGAN

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    0.5

  • LARRY PULLIAM

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.2

  • MARY FOWLER

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.2

  • ROLLAND BARRETT MD

    TRUSTEE/CLIN ETHICS MED ED CONSULT

    Total calculated
    $1,534
    From this org
    $0
    From related orgs
    $1,534
    Other
    $0
    Hours/week
    0.2 + 0.2 related

  • RONNIE WILLARD

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.2

  • SHERRY POLONSKY

    TREASURER

    Total calculated
    $0
    Hours/week
    0.5

  • STEPHANIE FLORES DE VALGAZ

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.2

  • SUZANNE JABBOUR

    TRUSTEE (FR 1/1/24)

    Total calculated
    $0
    Hours/week
    0.2

  • TADELRO BROWN

    SECRETARY

    Total calculated
    $0
    Hours/week
    0.5

  • THOMAS GROTE MD

    TRUSTEE/ONCOLOGIST

    Total calculated
    $209,723
    From this org
    $0
    From related orgs
    $199,116
    Other
    $10,607
    Hours/week
    0.2 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $160,442 related
    Bonus
    $0 + $37,388 related
    Other
    $0 + $1,286 related
    Deferred
    $0 + $9,638 related
    Nontaxable benefits
    $0 + $969 related
    Filer's total
    $0 + $209,723 related

  • THOMAS MCDANIEL

    TRUSTEE (FR 1/1/24)

    Total calculated
    $0
    Hours/week
    0.2

  • ALICE POPE

    EVP/CFO (FR 4/29/24)

    Total calculated
    $1,175,156
    From this org
    $0
    From related orgs
    $991,687
    Other
    $183,469
    Hours/week
    0.2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $824,247 related
    Bonus
    $0
    Other
    $0 + $167,440 related
    Deferred
    $0 + $173,333 related
    Nontaxable benefits
    $0 + $10,136 related
    Filer's total
    $0 + $1,175,156 related

  • DOROTHY ANN CAULKINS

    SVP FDN (TO 6/1/24)

    Total calculated
    $842,395
    From this org
    $0
    From related orgs
    $803,158
    Other
    $39,237
    Hours/week
    8 + 42 related

    Schedule J breakdown matched by us

    Base
    $0 + $160,279 related
    Bonus
    $0 + $335,344 related
    Other
    $0 + $307,535 related
    Deferred
    $0 + $10,620 related
    Nontaxable benefits
    $0 + $28,617 related
    Filer's total
    $0 + $842,395 related

  • GEOFFREY GARDNER

    CFO (TO 4/28/24)

    Total calculated
    $1,299,330
    From this org
    $0
    From related orgs
    $1,254,252
    Other
    $45,078
    Hours/week
    0.2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $457,268 related
    Bonus
    $0 + $732,220 related
    Other
    $0 + $64,764 related
    Deferred
    $0 + $20,700 related
    Nontaxable benefits
    $0 + $24,378 related
    Filer's total
    $0 + $1,299,330 related

  • HEATHER EGAN

    EXEC DIRECTOR

    Total calculated
    $218,583
    From this org
    $171,588
    From related orgs
    $0
    Other
    $46,995
    Hours/week
    25 + 25 related

    Schedule J breakdown matched by us

    Base
    $157,547
    Bonus
    $13,009
    Other
    $1,032
    Deferred
    $9,992
    Nontaxable benefits
    $37,003
    Filer's total
    $218,583

  • SHARON HARRINGTON

    VP CHIEF PHILANTHROPY OFF(FR 6/2/24)

    Total calculated
    $305,826
    From this org
    $0
    From related orgs
    $290,978
    Other
    $14,848
    Hours/week
    8 + 42 related

    Schedule J breakdown matched by us

    Base
    $0 + $227,170 related
    Bonus
    $0 + $41,184 related
    Other
    $0 + $22,624 related
    Deferred
    $0 + $14,319 related
    Nontaxable benefits
    $0 + $529 related
    Filer's total
    $0 + $305,826 related

  • KIMBERLY HENDERSON

    FMR OFFICER (12/31/19)

    Total calculated
    $1,620,829
    From this org
    $0
    From related orgs
    $1,421,376
    Other
    $199,453
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $807,422 related
    Bonus
    $0 + $498,449 related
    Other
    $0 + $115,505 related
    Deferred
    $0 + $168,921 related
    Nontaxable benefits
    $0 + $30,532 related
    Filer's total
    $0 + $1,620,829 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 1a · First-class or charter travel
  • 1a · Travel for companions
  • 1a · Discretionary spending account
  • 1a · Housing allowance or residence for personal use
  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 1A
PART I, LINE 1A: FRINGE OR EXPENSE EXPLANATION FIRST-CLASS OR CHARTER TRAVEL: EXECUTIVES ARE LIMITED TO BUSINESS OR COACH CLASS FOR COMMERCIAL FLIGHTS. HOWEVER, CHARTER TRAVEL IS AVAILABLE FOR CERTAIN EXECUTIVES, BOARD MEMBERS, AND APPROVED BUSINESS PERSONNEL WHO MEET POLICY CRITERIA AND OBTAIN APPROPRIATE APPROVALS. TRAVEL FOR COMPANIONS: COMPANIONS ARE ALLOWED AS PASSENGERS ON CERTAIN CHARTER FLIGHTS PAID BY THE ORGANIZATION. THE VALUE OF THE COMPANION'S FLIGHT IS CALCULATED USING APPLICABLE TAX LAW. THE CALCULATED AMOUNT IS INCLUDED IN THE EXECUTIVES TAXABLE COMPENSATION INCOME AS PRESCRIBED BY APPLICABLE TAX LAW. DISCRETIONARY SPENDING ACCOUNT: CERTAIN EXECUTIVES RECEIVE A DISCRETIONARY SPENDING ACCOUNT. THE DOLLAR AMOUNT IN THE ACCOUNT IS PRE-APPROVED BY THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE NOVANT HEALTH BOARD OF TRUSTEES. THE EXECUTIVE MAY DEFER THE AMOUNT TO A RETIREMENT ACCOUNT OR THE AMOUNT IS TREATED AS COMPENSATION AND IS SPREAD OUT OVER THE COURSE OF THE YEAR IN THE EXECUTIVE'S PAYCHECKS AS TAXABLE INCOME. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE: TEMPORARY HOUSING ALLOWANCES ARE INCLUDED IN CERTAIN EXECUTIVE RECRUITMENT AND RELOCATION PACKAGES. THE TAXABLE VALUE OF THESE ARRANGEMENTS IS CALCULATED AND INCLUDED IN THE EXECUTIVE'S TAXABLE COMPENSATION IN ACCORDANCE WITH APPLICABLE FEDERAL LAW AND REGULATIONS.
PART I, LINE 3
THE FILING ORGANIZATION IS AN INTEGRAL PART OF NOVANT HEALTH, AN INTEGRATED HEALTHCARE SYSTEM AND RELIES UPON NOVANT HEALTH, INC., THE PARENT ORGANIZATION, TO USE THE PROCESS DESCRIBED IN PART VI, LINE 15A/15B OF THIS RETURN TO ESTABLISH COMPENSATION FOR CERTAIN EXECUTIVES. THIS PROCESS ADHERES TO THE REQUIREMENTS SET FORTH TO SECURE THE REBUTTABLE PRESUMPTION OF REASONABLENESS AND INCLUDES A REVIEW AND APPROVAL BY INDEPENDENT AND DISINTERESTED MEMBERS OF A COMPENSATION COMMITTEE, CONSULTATION WITH INDEPENDENT COMPENSATION CONSULTANTS, THE UTILIZATION OF THIRD-PARTY COMPARABILITY DATA SUCH AS PUBLISHED COMPENSATION SURVEYS, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION.
PART I, LINES 4A-B
PART I, LINES 4A-C: SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SEVERANCE DOROTHY ANN CAULKINS $218,478 NONQUALIFIED KIMBERLY HENDERSON $62,883 DOROTHY ANN CAULKINS $55,503 GEOFFREY GARDNER $22,093 EQUITY-BASED NONE
PART I, LINE 4A - SEVERANCE PLAN:
ELIGIBLE EXECUTIVES MAY RECEIVE SEVERANCE PAY THAT IS BASED ON ANNUAL COMPENSATION FOR A SPECIFIED PERIOD OF TIME. THE SEVERANCE PAY WOULD BE PAID ONLY IN THE EVENT OF CERTAIN TYPES OF EMPLOYMENT TERMINATION, AND IS FURTHER CONTINGENT ON THE SATISFACTION OF OTHER CONDITIONS SUCH AS COMPLIANCE WITH A NON-COMPETITION COVENANT. ANY CURRENT YEAR PAYMENTS HAVE BEEN INCLUDED IN THE COMPENSATION AMOUNTS REPORTED IN PART VII AND IN COLUMN (B)(III) OF SCHEDULE J. THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE NOVANT HEALTH BOARD REVIEWS, APPROVES, AND OVERSEES ALL ASPECTS AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS, INCLUDING THE AMOUNTS AWARDED UNDER THIS SEVERANCE PLAN.
PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS:
THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") IS INTENDED TO SUPPORT RETENTION OF KEY EXECUTIVES, AND TO OFFER COMPETITIVE TOTAL COMPENSATION. GENERALLY, ANNUAL CONTRIBUTIONS TO THE PLAN OR PAYMENTS TO PARTICIPANTS WILL BE BASED ON A PERCENTAGE OF THE PARTICIPANT'S BASE SALARY AS OF JANUARY 1ST OF THE PREVIOUS PLAN YEAR AND ARE REPORTED IN COLUMN (C) OF SCHEDULE J. PRIOR TO MAKING THE CONTRIBUTIONS OR PAYMENTS, THE NOVANT HEALTH COMPENSATION AND LEADERSHIP COMMITTEE ("COMMITTEE") WILL APPROVE THE AMOUNTS AS TO REASONABLENESS, WHEN COMBINED WITH ALL OTHER ANNUAL COMPENSATION. A 3 YEAR CLASS-YEAR VESTING PERIOD WILL APPLY UP TO AGE 62, WHEN ALL MONEY WOULD BE VESTED AND PAID OUT TO THE PARTICIPANT. OTHERWISE, VESTING WILL OCCUR ON JANUARY 1ST OF EACH YEAR FOR THE APPROPRIATE CLASS-YEAR VESTING PERIOD. THE COMMITTEE REVIEWS, APPROVES, AND OVERSEES ALL ASPECTS AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS, INCLUDING THE AMOUNTS AWARDED UNDER THIS SERP.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Provenance

Return type
form_990
Tax year
2024
Filed
14 November 2025
IRS schema version
2024v5.2
Source object
202533189349307173

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