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ObjectId: 202241439349301274 - Submission: 2022-05-23
TIN: 51-0190238
Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
Attach to Form 990.
Go to
www.irs.gov/Form990
for instructions and the latest information.
OMB No. 1545-0047
20
20
Open to Public Inspection
Name of the organization
WAKE FOREST UNIVERSITY BAPTIST MEDICAL
CENTER
Employer identification number
51-0190238
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
First-class or charter travel
Housing allowance or residence for personal use
Travel for companions
Payments for business use of personal residence
Tax idemnification and gross-up payments
Health or social club dues or initiation fees
Discretionary spending account
Personal services (e.g., maid, chauffeur, chef)
b
If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain
.....
1b
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a?
....
2
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
Compensation committee
Written employment contract
Independent compensation consultant
Compensation survey or study
Form 990 of other organizations
Approval by the board or compensation committee
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment?
.............
4a
Yes
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan?
.........
4b
Yes
c
Participate in, or receive payment from, an equity-based compensation arrangement?
.........
4c
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization?
....................
5a
No
b
Any related organization?
.......................
5b
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization?
..................
6a
No
b
Any related organization?
......................
6b
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III
............
7
Yes
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III
..........................
8
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)?
.........................
9
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2020
Page 2
Schedule J (Form 990) 2020
Page
2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees.
Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note.
The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A)
Name and Title
(B)
Breakdown of W-2 and/or 1099-MISC compensation
(C)
Retirement and other deferred compensation
(D)
Nontaxable
benefits
(E)
Total of columns
(B)(i)-(D)
(F)
Compensation in column (B) reported as deferred on prior Form 990
(i)
Base
compensation
(ii)
Bonus & incentive
compensation
(iii)
Other
reportable compensation
1
JULIE A FREISCHLAG MD
DIRECTOR(EX-OFF), CEO, DEAN
(i)
(ii)
0
-------------
1,456,803
0
-------------
663,750
0
-------------
949,478
0
-------------
412,187
0
-------------
27,949
0
-------------
3,510,167
0
-------------
905,232
2
NATHAN O HATCH PHD
DIRECTOR(EX-OFF) (TO 6/30/21)
(i)
(ii)
0
-------------
870,516
0
-------------
300,000
0
-------------
353,710
0
-------------
144,881
0
-------------
56,346
0
-------------
1,725,453
0
-------------
272,769
3
KEVIN P HIGH MD
PRES, HEALTH SYSTEM
(i)
(ii)
0
-------------
747,328
0
-------------
292,006
0
-------------
119,075
0
-------------
238,046
0
-------------
21,265
0
-------------
1,417,720
0
-------------
95,467
4
CATHLEEN WHEATLEY DNP
PRES WFBMC, SVP CH NURS OF
(i)
(ii)
573,327
-------------
0
65,466
-------------
0
467,099
-------------
0
159,519
-------------
0
9,339
-------------
0
1,274,750
-------------
0
459,891
-------------
0
5
BRADLEY A CLARK
EVP, CFO, TREASURER
(i)
(ii)
704,049
-------------
0
270,236
-------------
0
14,340
-------------
0
213,399
-------------
0
28,405
-------------
0
1,230,429
-------------
0
13,340
-------------
0
6
TERRY G WILLIAMS
EVP, CH STRATEGY OFF
(i)
(ii)
556,354
-------------
0
199,500
-------------
0
126,627
-------------
0
150,778
-------------
0
24,360
-------------
0
1,057,619
-------------
0
119,832
-------------
0
7
J MCLAIN WALLACE JR
SVP, GEN COUNSEL & SEC
(i)
(ii)
493,466
-------------
0
165,720
-------------
0
118,937
-------------
0
145,748
-------------
0
16,331
-------------
0
940,202
-------------
0
0
-------------
0
8
LILICIA BAILEY
SVP, CF PPL OFF (TO 9-25-20)
(i)
(ii)
319,135
-------------
0
150,000
-------------
0
336,265
-------------
0
68,019
-------------
0
16,967
-------------
0
890,386
-------------
0
314,043
-------------
0
9
J REID MORGAN
ASST SECRETARY
(i)
(ii)
0
-------------
489,082
0
-------------
150,000
0
-------------
20,770
0
-------------
104,450
0
-------------
35,751
0
-------------
800,053
0
-------------
0
10
RAMI BADREDDINE MD
PHYSICIAN
(i)
(ii)
712,237
-------------
0
13,690
-------------
0
19,680
-------------
0
21,519
-------------
0
23,528
-------------
0
790,654
-------------
0
0
-------------
0
11
MICHAEL T WAID
SVP, HLTH SYS OPS
(i)
(ii)
418,579
-------------
0
56,313
-------------
0
90,927
-------------
0
121,927
-------------
0
27,702
-------------
0
715,448
-------------
0
43,365
-------------
0
12
CONRAD S EMMERICH
VP, BUSINESS SVC
(i)
(ii)
450,213
-------------
0
46,452
-------------
0
52,709
-------------
0
116,256
-------------
0
16,429
-------------
0
682,059
-------------
0
51,809
-------------
0
13
WILLIAM D SHOWALTER
SVP, CH INFO OFF
(i)
(ii)
459,702
-------------
0
58,496
-------------
0
6,020
-------------
0
122,519
-------------
0
19,236
-------------
0
665,973
-------------
0
0
-------------
0
14
TRI LE MD
SVP, CLIN OPS & PT FIN SVC
(i)
(ii)
547,691
-------------
0
12,859
-------------
0
270
-------------
0
21,278
-------------
0
26,136
-------------
0
608,234
-------------
0
0
-------------
0
15
LISA M MARSHALL
VP, CH PHIL OFF
(i)
(ii)
0
-------------
393,189
0
-------------
41,553
0
-------------
4,454
0
-------------
94,844
0
-------------
13,179
0
-------------
547,219
0
-------------
0
16
JOHN H MCCONNELL MD
FORMER OFF (4-26-17)
(i)
(ii)
0
-------------
444,351
0
-------------
0
0
-------------
45,408
0
-------------
21,519
0
-------------
22,030
0
-------------
533,308
0
-------------
0
17
KAREN H HUEY
VP, FACILITIES
(i)
(ii)
299,071
-------------
0
30,607
-------------
0
41,714
-------------
0
66,710
-------------
0
16,044
-------------
0
454,146
-------------
0
0
-------------
0
18
ROBERT GFELLER
FORMER OFF (12-31-18)
(i)
(ii)
0
-------------
0
0
-------------
0
239,797
-------------
0
0
-------------
0
122
-------------
0
239,919
-------------
0
0
-------------
0
Schedule J (Form 990) 2020
Page 3
Schedule J (Form 990) 2020
Page
3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference
Explanation
PART I, LINE 3
THE GOVERNANCE AND COMPENSATION COMMITTEE OF THE WFUBMC BOARD OF DIRECTORS IS RESPONSIBLE FOR REVIEWING AND APPROVING ALL MEDICAL CENTER OFFICERS' COMPENSATION (INCLUDING THE COMPENSATION OF MOST OF THE OFFICERS OF THE FILING ORGANIZATION). THE COMMITTEE UTILIZES AN INDEPENDENT, EXTERNAL COMPENSATION CONSULTANT FIRM EXPERIENCED IN HEALTH CARE AND HIGHER EDUCATION COMPENSATION THAT BASES RECOMMENDATIONS ON COMPENSATION SURVEYS AND STUDIES TO DETERMINE THE APPROPRIATENESS OF EACH OFFICER'S COMPENSATION. THESE COMPENSATION CONSULTANTS PRESENT TOTAL COMPENSATION COMPARABILITY DATA FOR THE POSITIONS FOR WHICH COMPENSATION IS BEING DETERMINED. THE DATA IS REVIEWED BY THE GOVERNANCE AND COMPENSATION COMMITTEE OF WFUBMC'S GOVERNING BOARD AT ITS MEETING; NONE OF THE MEMBERS OF THAT COMMITTEE ARE EMPLOYEES OF THE FILING ORGANIZATION. MINUTES OF THE DELIBERATIONS OF THE COMMITTEE ARE CONTEMPORANEOUSLY RECORDED. IN THE EVENT THAT ANY MEMBER OF THE GOVERNANCE AND COMPENSATION COMMITTEE HAS A CONFLICT OF INTEREST, THAT COMMITTEE MEMBER DOES NOT PARTICIPATE IN THE DELIBERATION OR APPROVAL PROCESS, AND THEIR ABSTENTION FROM THE PROCESS IS REFLECTED IN THE MINUTES.
PART I, LINES 4A-B
CERTAIN EXECUTIVES PARTICIPATED IN AND/OR RECEIVED PAYMENTS FROM A SUPPLEMENTAL NON QUALIFIED RETIREMENT PLANS (SERP) AND/OR RECEIVED SEVERANCE PAYMENTS. THE DETERMINATION OF THE AMOUNT OF THE NON QUALIFIED RETIREMENT PLANS FOLLOWED THE FILING ORGANIZATION'S COMPENSATION PROCEDURES AS OUTLINED IN PART VI, SECTION B, LINE 15 OF THE FORM 990. THE FOLLOWING CURRENT OR FORMER DIRECTORS, OFFICERS, AND HIGHLY COMPENSATED EMPLOYEES RECEIVED SEVERANCE AND SERP PAYMENTS IN THEIR CALENDAR YEAR 2020 COMPENSATION: SEVERANCE PAYMENTS: ROBERT GFELLER $239,797 SERP PAYMENTS: LILICIA BAILEY $317,482 BRADLEY A. CLARK $13,340 CONRAD EMMERICH $51,809 JULIE A. FREISCHLAG, MD $915,849 KEVIN HIGH, MD $95,467 KAREN HUEY $39,933 MICHAEL T. WAID $69,272 J. MCLAIN WALLACE, JR. $95,467 CATHLEEN WHEATLEY, DNP $461,059 TERRY G. WILLIAMS $124,457 THE COMPENSATION OF DR. NATHAN O. HATCH, PRESIDENT OF WAKE FOREST UNIVERSITY AND AN EX-OFFICIO DIRECTOR OF THE FILING ORGANIZATION, INCLUDES A PAYOUT OF $272,769 WHICH IS INCLUDED IN HIS 2020 FORM W-2 AND IN COLUMN BIII. THIS AMOUNT IS SHOWN IN SCHEDULE J, PART II, COLUMN F AND HAS BEEN PREVIOUSLY REPORTED ON A PRIOR YEAR FORM 990. DR. HATCH PARTICIPATES IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN (SERP). SCHEDULE J, PART II, COLUMN C INCLUDES THE ACTUARIAL VALUE INCREASE OF $144,881. DR. HATCH'S COMPENSATION IS PAID BY WAKE FOREST UNIVERSITY, A RELATED ORGANIZATION.
PART I, LINE 7
CERTAIN OFFICERS, KEY EMPLOYEES AND FACULTY MEMBERS HAVE INCENTIVE COMPENSATION COMPONENTS CONTAINED IN THEIR EMPLOYMENT AGREEMENTS, AND THROUGH MEDICAL CENTER OR APPLICABLE RELATED ORGANIZATIONS' POLICIES. THESE ARE OFTEN GOAL-BASED AND ARE DETERMINED IN THE COURSE OF EVALUATION OF THE INDIVIDUAL'S PERFORMANCE BY HIS/HER DEPARTMENT CHAIR, SUPERVISOR OR THE COMPENSATION COMMITTEE OF THE BOARD, AS APPLICABLE.
Schedule J (Form 990) 2020
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