TY 2010 Form 990

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (check all that apply)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) ROBERT F BURGIN - THROUGH 073110 INT. PRES. &	40.00	X	X	398,362	0
(2) DAVID THOMPSON MD BOARD MEMBER	40.00	X		339,447	8,701
(3) PIERRE ISTFAN MD BOARD MEMBER	40.00	X		322,540	23,654
(4) JULIE P BENNETT SECRETARY	6.00	X	X	0	0
(5) MARVIN CAMERON EX-OFFICIO B	6.00	X		0	0
(6) DAVE CROCKETT CHAIRMAN	6.00	X	X	0	0
(7) WAYNE J KENNEDY EX-OFFICIO B	6.00	X		0	0
(8) E WAYNE KIRK TREASURER	6.00	X	X	0	0
(9) RAVEN KRICKBAUM BOARD MEMBER	6.00	X		0	0
(10) ROGER L LEONARD BOARD MEMBER	6.00	X		0	0
(11) ROGER K MOWEN BOARD MEMBER	6.00	X		0	0
(12) THOMAS F PUGH MD BOARD MEMBER	6.00	X		0	0
(13) T ARTHUR BUDDY SCOTT JR VICE CHAIRMA	6.00	X	X	0	0
(14) GLEN SKIP SKINNER BOARD MEMBER	6.00	X		0	0
(15) DOUGLAS J SPRINGER MD BOARD MEMBER	6.00	X		0	0
(16) JOHN WILLIAMS BOARD MEMBER	6.00	X		0	0
(17) MARGARET DENARVAEZ-080110-PRESENT PRESIDENT &	40.00		X	758,395	1,602

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) ELIZABETH WARD EXECUTIVE VP	40.00	X			576,536	7,876
(19) J DALE SARGENT MD-THROUGH 2611 CHIEF MED. O	40.00	X			347,647	25,077
(20) MICHAEL BUNDY - THROUGH 4811 SR. VP-OPERA	40.00	X			303,798	25,746
(21) GARY D MILLER - THROUGH 122010 SR. VP-GEN C	40.00	X			293,006	25,218
(22) HAMLIN J WILSON SR. VP-HUMAN	40.00	X			292,529	20,888
(23) ALICE POPE SR. VP-FINAN	40.00	X			261,151	23,307
(24) PATRICK KANE - THROUGH 63011 SR. VP-MARKE	40.00	X			260,199	23,018
(25) TODD J DOUGAN SR. VP-FINAN	40.00	X			235,448	22,359
(26) KENT PETTY - 3110 TO PRESENT CHIEF INFORM	40.00	X			183,432	8,242
(27) VIRGINIA FRANK - 9710 TO PRESENT PRESIDENT-HV	40.00	X			117,388	1,595
(28) TRACEY P MOFFATT-4911 TO PRESENT SR. VP-OPERA	40.00	X			0	0
(29) JOHN HOWARD - 040111-PRESENT WPS PRES&GEN	40.00	X			0	0
(30) BARTHOLEMEW A HOVE PRESIDENT-BR	40.00		X		407,011	31,190
(31) RON PREWITT PRESIDENT-LR	40.00		X		308,032	22,028
(32) DAVID L BRASH REGIONAL VP-	40.00		X		292,505	26,276
(33) FRED PELLE PRESIDENT-HC	2.00		X		246,426	22,843
(34) BLAINE DOUGLAS - THROUGH 7910 PRESIDENT-HV	40.00		X		187,071	15,700
(35) JORGE LODEIRO MD	40.00			X	868,851	45,233
(36) EDWIN A MCELROY MD	40.00			X	751,291	40,350
(37) ROBERT HARRIS MD-THROUGH 103110	40.00			X	693,896	7,755
(38) MALCOLM R MATTHEWS MD-TO 5311	40.00			X	658,009	40,434
(39) MARCO DASILVA MD	40.00			X	648,596	40,711

(A) Name and business address	(B) Description of services	(C) Compensation
SPECTRUM LABORATORY 4380 FEDERAL DRIVE GREENSBORO,NC27410	LAB SERVICES	13,180,693
ROBINS & MORTON GROUP 5500 MARYLAND WAY SUITE 100 BRENTWOOD,TN37027	CONTRACTING	10,000,943
HOLSTON ANESTHESIA ASSOCIATION 135 W RAVINE STREET KINGSPORT,TN37662	MEDICAL SERVICE	7,468,099
HIGHLANDS PATHOLOGY CONSULTANTS SPC 10368 WALLACE ALLEY 18 KINGSPORT,TN37663	MEDICAL SERVICE	1,934,507
EMERGENCY COVERAGE CORP PO BOX 634850 CINCINNATI,OH45263	PHYSICIAN SERVI	1,545,498
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization 51

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.	(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21	697,055	697,055
2	Grants and other assistance to individuals in the U.S. See Part IV, line 22
3	Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	6,421,728		6,421,728
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	189,475,107	188,924,404	550,703
8	Pension plan contributions (include section 401(k) and section 403(b) employer contributions) ....	8,496,802	7,815,138	681,664
9	Other employee benefits .......	35,675,815	35,407,720	268,095
10	Payroll taxes ...........	14,510,118	14,051,779	458,339
11	Fees for services (non-employees):
a	Management ......	238,200	238,200
b	Legal .........	1,156,956	1,059,350	97,606
c	Accounting ...........	807,349	787,001	20,348
d	Lobbying ...........	143,581	143,581
e	Professional fundraising. See Part IV, line 17..
f	Investment management fees ......	274,817	274,817
g	Other ..........	108,446,465	98,108,578	10,337,887
12	Advertising and promotion ....	1,000,994	592,665	408,329
13	Office expenses .......	139,711,020	138,276,733	1,434,287
14	Information technology ......	8,371,446	8,361,712	9,734
15	Royalties ..
16	Occupancy ...........	21,945,311	21,898,751	46,560
17	Travel ............	1,384,659	1,146,017	238,642
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....	32,596	30,356	2,240
20	Interest ...........	20,142,495	20,136,901	5,594
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	41,535,435	40,039,838	1,495,597
23	Insurance ..............	4,016,007	4,016,007
24	Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a	PROVISION FOR BAD DEBTS	33,729,806	33,705,914	23,892
b	PHYSICIAN RECRUITMENT	2,330,326	413,222	1,917,104
c	MISC EXPENSE	1,012,708	777,599	235,109
d	DUES AND MEMBERSHIPS	724,101	241,397	482,704
e	BOOKS AND PUBLICATIONS	362,602	333,917	28,685
f	All other expenses
25	Total functional expenses. Add lines 1 through 24f	642,643,499	617,478,652	25,164,847	0
26	Joint costs. Check here if following SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation

Part X Balance Sheet
	1	Cashnon-interest-bearing ..........	19,280	1	17,919
2	Savings and temporary cash investments .......	28,821,001	2	29,872,126
3	Pledges and grants receivable, net .........		3
4	Accounts receivable, net .........	97,840,693	4	100,500,580
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........		5	29,514
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........		6
7	Notes and loans receivable, net .............		7
8	Inventories for sale or use ..............	14,706,814	8	15,064,889
9	Prepaid expenses and deferred charges ............	6,425,709	9	6,525,891
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	886,796,805
b	Less: accumulated depreciation. .....	10b	454,343,156	425,483,782	10c	432,453,649
11	Investments—publicly traded securities ..........	303,622,399	11	321,289,188
12	Investments—other securities. See Part IV, line 11 ......		12
13	Investments—program-related. See Part IV, line 11 ..	20,120,565	13	18,988,817
14	Intangible assets .........	4,778,521	14	8,745,924
15	Other assets. See Part IV, line 11 ...........	4,654,960	15	5,848,620
16	Total assets. Add lines 1 through 15 (must equal line 34)...	906,473,724	16	939,337,117
	17	Accounts payable and accrued expenses .	59,772,029	17	52,916,367
18	Grants payable ..........		18
19	Deferred revenue ..........		19
20	Tax-exempt bond liabilities ..........	430,070,000	20	438,747,592
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ....		24
25	Other liabilities. Complete Part X of Schedule D.....	119,780,477	25	84,957,606
26	Total liabilities. Add lines 17 through 25.....	609,622,506	26	576,621,565
		Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....	296,851,218	27	362,715,552
28	Temporarily restricted net assets .....		28
29	Permanently restricted net assets .....		29
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances .....	296,851,218	33	362,715,552
34	Total liabilities and net assets/fund balances .....	906,473,724	34	939,337,117

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization

WELLMONT HEALTH SYSTEM

Employer identification number

62-1636465

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches. section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in

section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. Seesection 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Other

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

and (iii) below, the governing body of the the supported organization? ................

11g(i)

(ii) a family member of a person described in (i) above? ......................

11g(ii)

(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................

11g(iii)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization in col. (i) listed in your governing document?		(v) Did you notify the organization in col. (i) of your support?		(vi) Is the organization in col. (i) organized in the U.S.?		(vii) Amount of support?
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of support?


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2010

Page 2

Part II

Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3..
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public Support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11	Total support (Add lines 7 through 10).

Gross receipts from related activities, etc. (See instructions.) ..................

First Five Years If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.......................................... right arrow

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f)) .........

Public Support Percentage for 2009 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2010. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ...................... right arrow

33 1/3% support test—2009. If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2010. If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization .................................................. right arrow

10%-facts-and-circumstances test—2009. If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly
supported organization .............................................. right arrow

Private Foundation If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions ................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2010

Page 3

Part III

Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public Support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13	Total support (Add lines 9, 10c, 11 and 12.).

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f)) .........

Public support percentage from 2009 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f)) ......

Investment income percentage from 2009 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2010. If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .......... right arrow

33 1/3% support tests—2009. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private Foundation If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2010

Page 4

Part IV

Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

OMB No. 1545-0047

2010

Name of organization

WELLMONT HEALTH SYSTEM

Employer identification number

62-1636465

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ, that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ, that received from any one contributor,
during the year, aggregate contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ, that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not aggregate to more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year. ......................... Arrow Bullet

Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Name of organization WELLMONT HEALTH SYSTEM
Schedule B (Form 990, 990-EZ, or 990-PF) (2010) Page 1 of 1 of Part I
Part I	Contributors (see Instructions)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Name of organization WELLMONT HEALTH SYSTEM
Schedule B (Form 990, 990-EZ, or 990-PF) (2010) Page 1 of 1 of Part II
Part II	Noncash Property (see Instructions)
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Page 1 of 1 of Part III

Name of organization
WELLMONT HEALTH SYSTEM

Employer identification number

62-1636465

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below.
SchCMd Bullet

Attach to Form 990 or Form 990-EZ. SchCMd Bullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public
Inspection

If the organization answered “Yes,” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes,” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes,” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35a (Proxy Tax), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

WELLMONT HEALTH SYSTEM

Employer identification number

62-1636465

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization's direct and indirect political campaign activities on behalf of or in opposition to candidates for public office in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c) except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt funtion activities .................................... SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b.. SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.

For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2010

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check if the filing organization belongs to an affiliated group.
B Check if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(a) Filing Organization's Totals	(b) Affiliated Group Totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......
b	Total lobbying expenditures to influence a legislative body (direct lobbying) .......	143,581
c	Total lobbying expenditures (add lines 1a and 1b) ...................	143,581
d	Other exempt purpose expenditures ........................	642,499,918
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............	642,643,499
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.	1,000,000
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................	250,000
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ......................................		Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2007	(b) 2008	(c) 2009	(d) 2010	(e) Total

2a	Lobbying non-taxable amount	1,000,000	1,000,000	1,000,000	1,000,000	4,000,000

b	Lobbying ceiling amount (150% of line 2a, column(e))					6,000,000

c	Total lobbying expenditures	91,230	68,925	96,271	143,581	400,007

d	Grassroots non-taxable amount	250,000	250,000	250,000	250,000	1,000,000

e	Grassroots ceiling amount (150% of line 2d, column (e))					1,500,000

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2010

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? If "Yes," describe in Part IV ..........................

Total. lines 1c through 1i ...................................

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.

Dues, assessments and similar amounts from members .....................

Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ...........................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

Part IV

Supplemental Information

Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.

Identifier	Return Reference	Explanation

Schedule C (Form 990 or 990EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

WELLMONT HEALTH SYSTEM

Employer identification number

62-1636465

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .......
2	Aggregate contributions to (during year) ...
3	Aggregate grants from (during year) ...
4	Aggregate value at end of year .......

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or pleasure) Preservation of an historically importantly land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06 ........	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................

Yes No

In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:

(i)

Revenues included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 52283D

Schedule D (Form 990) 2010

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIV and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

If “Yes,” explain the arrangement in Part XIV.

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current Year	(b)Prior Year	(c)Two Years Back	(d)Three Years Back	(e)Four Years Back
1a	Beginning of year balance ....
b	Contributions ........
c	Investment earnings or losses ...
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the year end balance held as:

Board designated or quasi-endowment: SchDMd Bullet

Permanent endowment: SchDMd Bullet

Term endowment: SchDMd Bullet

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIV the intended uses of the organization's endowment funds.

Part VI

InvestmentsLand, Buildings, and Equipment. See Form 990, Part X, line 10.

Description of investment		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	1,307,181	32,663,799		33,970,980
b	Buildings ................		519,444,184	204,694,980	314,749,204
c	Leasehold improvements ............		2,395,334	474,747	1,920,587
d	Equipment ................		330,986,307	249,173,429	81,812,878
e	Other .................
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........					432,453,649

Schedule D (Form 990) 2010

Page 3

Part VII

InvestmentsOther Securities. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)		(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)

Part VIII

InvestmentsProgram Related. See Form 990, Part X, line 13.

(a) Description of investment type		(b) Book value	(c) Method of valuation: Cost or end-of-year market value









Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. See Form 990, Part X, line 15.

(a) Description				(b) Book value









Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. See Form 990, Part X, line 25.

1.(a) Description of Liability		(b) Amount
Federal Income Taxes
OTHER LT LIABILITIES		24,218,069
OTHER CURRENT LIABILITIES		18,760,892
CAPITAL LEASE OBLIGATIONS		16,102,252
SWAP LIABILITY		11,588,215
POST RETIREMENT BENEFITS		7,762,743
DEFINED BENEFITS PENSION LIABILITY		6,525,435
TAXABLE BOND LIABILITIES


Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)		84,957,606
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).

Schedule D (Form 990) 2010

Page 4

Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1	Total revenue (Form 990, Part VIII, column (A), line 12) ....................	1
2	Total expenses (Form 990, Part IX, column (A), line 25) .....................	2
3	Excess or (deficit) for the year. Subtract line 2 from line 1 .............	3
4	Net unrealized gains (losses) on investments ..........................	4
5	Donated services and use of facilities .............................	5
6	Investment expenses ...................................	6
7	Prior period adjustments ..................................	7
8	Other (Describe in Part XIV) .................................	8
9	Total adjustments (net). Add lines 4 - 8 .............................	9
10	Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 .........	10

Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIV): ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIV): ...........	4b
c	Add lines 4a and 4b.......................		4c
5	Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ......		5

Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements .............		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIV): ............	2d
e	Add lines 2a through 2d......................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIV): ............	4b
c	Add lines 4a and 4b.......................		4c
5	Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ......		5

Part XIV

Supplemental Information

Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.

Identifier	Return Reference	Explanation
LIABILITY UNDER FIN 48 FOOTNOTE	SCHEDULE D, PAGE 3, PART X	THE WELLMONT HEALTH SYSTEM ENTITIES ARE PRIMARILY CLASSIFIED AS ORGANIZATIONS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) AS ENTITIES DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN INCLUDED FOR THESE ENTITIES IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE OPERATIONS OF WELLMONT HEALTH SYSTEM ARE SUBJECT TO STATE AND FEDERAL INCOME TAXES WHICH ARE ACCOUNTED FOR IN ACCORDANCE WITH ASC 740, INCOME TAXES; HOWEVER, SUCH AMOUNTS ARE NOT MATERIAL.

Schedule D (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

WELLMONT HEALTH SYSTEM

Employer identification number

62-1636465

Part I

Charity Care and Certain Other Community Benefits at Cost

Yes

Does the organization have a charity care policy? If "No," skip to question 6a...........

Yes

If "Yes," is it a written policy? .......................

Yes

If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.

Applied uniformly to all hospitals Applied uniformly to most hospitals Generally tailored to individual hospitals

Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.

Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low

income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other

Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If

"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....

Yes

200% 250% 300% 350% 400% Other 150.000 %

If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.

Does the organization's policy provide free or discounted care to the "medically indigent"? ......

Yes

Does the organization budget amounts for free or discounted care provided under its charity care policy? ...

Yes

If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............

Does the organization prepare an annual community benefit report?.............

Yes

If "Yes," does the organization make it available to the public? ..............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Charity Care and Certain Other Community Benefits at Cost

	(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a Charity care at cost (from Worksheets 1 and 2) ..			17,239,015		17,239,015	2.680 %
b Unreimbursed Medicaid (from Worksheet 3, column a) .			68,091,287	51,748,934	16,342,353	2.540 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....
dTotal Charity Care and Means-Tested Government Programs .....			85,330,302	51,748,934	33,581,368	5.230 %
Other Benefits e Community health improvement services and community benefit operations (from (Worksheet 4) ....	476	28,811	5,728,028		5,728,028	0.890 %
f Health professions education (from Worksheet 5) ..	18	135	8,731,418	3,556,874	5,174,544	0.810 %
g Subsidized health services (from Worksheet 6) ..
h Research (from Worksheet 7)	11		81,414	15,500	65,914	0.010 %
i Cash and in-kind contributions to community groups (from Worksheet 8) ..	273	2,775	697,055		697,055	0.110 %
jTotal Other Benefits ...	778	31,721	15,237,915	3,572,374	11,665,541	1.820 %
kTotal. Add lines 7d and 7j. ..	778	31,721	100,568,217	55,321,308	45,246,909	7.040 %

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010

Schedule H (Form 990) 2010

Page 2

Part II

Community Building Activities Complete this table if the organization conducted any community building activities.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	6		199		199
3	Community support	122	882	20,317	2,630	17,687
4	Environmental improvements	1		1,025		1,025
5	Leadership development and training for community members	8	36	1,424		1,424
6	Coalition building	30	590	934		934
7	Community health improvement advocacy	38	860	34,755		34,755	0.010 %
8	Workforce development	13		997		997
9	Other
10	Total	218	2,368	59,651	2,630	57,021	0.010 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense (at cost).....

10,025,120

Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..

Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

162,869,585

Enter Medicare allowable costs of care relating to payments on line 5.....

160,898,845

Subtract line 6 from line 5. This is the surplus or (shortfall)........

1,970,740

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Does the organization have a written debt collection policy? ...............

Yes

If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......

Yes

Part IV

Management Companies and Joint Ventures

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1HOLSTON VALLEY IMAG	RADIOLOGY SERVICES	75.000 %	25.000 %
2HOLSTON VALLEY AMB	SURGERY SERVICES	52.000 %	48.000 %
3SAPLING GROVE AMB	SURGICAL SERVICES	65.000 %	35.000 %
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2010

Page 3

Part VFacility Information

Section A. Hospital Facilities (list in order of size, measured by total revenue per facility, from largest to smallest) How many hospital facilities did the organization operate during the tax year?6 Name and address		Other (Describe)
1	BRISTOL REGIONAL MEDICAL CENTER 1 MEDICAL PARK BLVD BRISTOL,TN37620	X	X		X
2	HOLSTON VALLEY MEDICAL CENTER 130 RAVINE ROAD KINGSPORT,TN37660	X	X		X
3	LONESOME PINE HOSPITAL 1990 HOLTON AVENUE BIG STONE GAP,VA24219	X	X		X
4	HANCOCK COUNTY HOSPITAL 1519 MAIN STREET SNEEDVILLE,TN37869	X		X	X
5	MOUNTAIN VIEW REGIONAL MEDICAL CENT 310 3RD STREET NE NORTON,VA24273	X			X
6	LEE REGIONAL MEDICAL CENTER PO BOX 589 127 HEALTH CARE DRIVE PENNINGTON GAP,VA24277	X			X

Schedule H (Form 990) 2010

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)

Name of Hospital Facility:BRISTOL REGIONAL MEDICAL CENTER

Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

				Yes	No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1	During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. .....................		1
	If “Yes,” indicate what the Needs Assessment describes (check all that apply):
	a	A definition of the community served by the hospital facility
	b	Demographics of the community
	c	Existing health care facilities and resources within the community that are available to respond to the health needs of the community
	d	How data was obtained
	e	The health needs of the community
	f	Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
	g	The process for identifying and prioritizing community health needs and services to meet those needs
	h	The process for consulting with persons representing the community’s interests
	i	Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
	j	Other (describe in Part VI)
2	Indicate the tax year the hospital facility last conducted a Needs Assessment: 20
3	In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted.		3
4	Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................		4
5	Did the hospital facility make its Needs Assessment widely available to the public? ...........		5
	If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
	a	Hospital facility’s website
	b	Available upon request from the hospital facility
	c	Other (describe in Part VI)
6	If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
	a	Adoption of an implementation strategy to address the health needs of the hospital facility’s community
	b	Execution of the implementation strategy
	c	Development of a community benefit plan for the facility
	d	Participation in community-wide community benefit plan
	e	Inclusion of a community benefit section in operational plans
	f	Adoption of a budget for provision of services that address the needs identified in the CHNA
	g	Prioritization of health needs in the community
	h	Prioritization of services that the hospital facility will undertake to meet health needs in its community
	i	Other (describe in Part VI)
7	Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs.		7
Financial Assistance Policy
	Did the hospital facility have in place during the tax year a written financial assistance policy that:
8	Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8	Yes
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?..		9	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for free care: 100.0%

Schedule H (Form 990) 2010

Page 5

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care to low income individuals?.........		10	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 150.0%
11	Explained the basis for calculating amounts charged to patients?.................		11	Yes
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
	a	Income level
	b	Asset level
	c	Medical indigency
	d	Insurance status
	e	Uninsured discount
	f	Medicaid/Medicare
	g	State regulation
	h	Other (describe in Part VI)
12	Explained the method for applying for financial assistance?...................		12	Yes
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted at all times on the hospital facility’s web site
	b	The policy was attached to all billing invoices
	c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
	d	The policy was posted in the hospital facility’s admissions offices
	e	The policy was provided, in writing, to patients upon admission to the hospital facility
	f	The policy was available upon request
	g	Other (describe in Part VI)
Billing and Collections
14	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........		14	Yes
15	Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments or arrests
	e	Other (describe in Part VI)
16	Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?...................................		16	Yes
	If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other (describe in Part VI)
17	Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
	a	Notified patients of the financial assistance policy upon admission
	b	Notified patients of the financial assistance policy prior to discharge
	c	Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
	d	Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
	e	Other (describe in Part VI)

Schedule H (Form 990) 2010

Page 6

Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
				Yes	No
18	Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........		18	Yes
	If “No,” indicate the reasons why (check all that apply):
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility did not have a policy relating to emergency medical care
	c	The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
	d	Other (describe in Part VI)
Charges for Medical Care
19	Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
	a	The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
	b	The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
	c	The hospital facility used the Medicare rate for those services
	d	Other (describe in Part VI)
20	Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?.........		20		No
	If “Yes,” explain in Part VI.
21	Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?...................................		21		No
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2010

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)

Name of Hospital Facility:HOLSTON VALLEY MEDICAL CENTER

Line Number of Hospital Facility (from Schedule H, Part V, Section A):2

				Yes	No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1	During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. .....................		1
	If “Yes,” indicate what the Needs Assessment describes (check all that apply):
	a	A definition of the community served by the hospital facility
	b	Demographics of the community
	c	Existing health care facilities and resources within the community that are available to respond to the health needs of the community
	d	How data was obtained
	e	The health needs of the community
	f	Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
	g	The process for identifying and prioritizing community health needs and services to meet those needs
	h	The process for consulting with persons representing the community’s interests
	i	Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
	j	Other (describe in Part VI)
2	Indicate the tax year the hospital facility last conducted a Needs Assessment: 20
3	In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted.		3
4	Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................		4
5	Did the hospital facility make its Needs Assessment widely available to the public? ...........		5
	If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
	a	Hospital facility’s website
	b	Available upon request from the hospital facility
	c	Other (describe in Part VI)
6	If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
	a	Adoption of an implementation strategy to address the health needs of the hospital facility’s community
	b	Execution of the implementation strategy
	c	Development of a community benefit plan for the facility
	d	Participation in community-wide community benefit plan
	e	Inclusion of a community benefit section in operational plans
	f	Adoption of a budget for provision of services that address the needs identified in the CHNA
	g	Prioritization of health needs in the community
	h	Prioritization of services that the hospital facility will undertake to meet health needs in its community
	i	Other (describe in Part VI)
7	Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs.		7
Financial Assistance Policy
	Did the hospital facility have in place during the tax year a written financial assistance policy that:
8	Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8	Yes
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?..		9	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for free care: 100.0%

Schedule H (Form 990) 2010

Page 5

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care to low income individuals?.........		10	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 150.0%
11	Explained the basis for calculating amounts charged to patients?.................		11	Yes
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
	a	Income level
	b	Asset level
	c	Medical indigency
	d	Insurance status
	e	Uninsured discount
	f	Medicaid/Medicare
	g	State regulation
	h	Other (describe in Part VI)
12	Explained the method for applying for financial assistance?...................		12	Yes
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted at all times on the hospital facility’s web site
	b	The policy was attached to all billing invoices
	c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
	d	The policy was posted in the hospital facility’s admissions offices
	e	The policy was provided, in writing, to patients upon admission to the hospital facility
	f	The policy was available upon request
	g	Other (describe in Part VI)
Billing and Collections
14	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........		14	Yes
15	Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments or arrests
	e	Other (describe in Part VI)
16	Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?...................................		16	Yes
	If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other (describe in Part VI)
17	Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
	a	Notified patients of the financial assistance policy upon admission
	b	Notified patients of the financial assistance policy prior to discharge
	c	Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
	d	Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
	e	Other (describe in Part VI)

Schedule H (Form 990) 2010

Page 6

Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
				Yes	No
18	Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........		18	Yes
	If “No,” indicate the reasons why (check all that apply):
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility did not have a policy relating to emergency medical care
	c	The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
	d	Other (describe in Part VI)
Charges for Medical Care
19	Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
	a	The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
	b	The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
	c	The hospital facility used the Medicare rate for those services
	d	Other (describe in Part VI)
20	Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?.........		20		No
	If “Yes,” explain in Part VI.
21	Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?...................................		21		No
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2010

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)

Name of Hospital Facility:LONESOME PINE HOSPITAL

Line Number of Hospital Facility (from Schedule H, Part V, Section A):3

				Yes	No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1	During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. .....................		1
	If “Yes,” indicate what the Needs Assessment describes (check all that apply):
	a	A definition of the community served by the hospital facility
	b	Demographics of the community
	c	Existing health care facilities and resources within the community that are available to respond to the health needs of the community
	d	How data was obtained
	e	The health needs of the community
	f	Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
	g	The process for identifying and prioritizing community health needs and services to meet those needs
	h	The process for consulting with persons representing the community’s interests
	i	Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
	j	Other (describe in Part VI)
2	Indicate the tax year the hospital facility last conducted a Needs Assessment: 20
3	In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted.		3
4	Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................		4
5	Did the hospital facility make its Needs Assessment widely available to the public? ...........		5
	If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
	a	Hospital facility’s website
	b	Available upon request from the hospital facility
	c	Other (describe in Part VI)
6	If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
	a	Adoption of an implementation strategy to address the health needs of the hospital facility’s community
	b	Execution of the implementation strategy
	c	Development of a community benefit plan for the facility
	d	Participation in community-wide community benefit plan
	e	Inclusion of a community benefit section in operational plans
	f	Adoption of a budget for provision of services that address the needs identified in the CHNA
	g	Prioritization of health needs in the community
	h	Prioritization of services that the hospital facility will undertake to meet health needs in its community
	i	Other (describe in Part VI)
7	Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs.		7
Financial Assistance Policy
	Did the hospital facility have in place during the tax year a written financial assistance policy that:
8	Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8	Yes
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?..		9	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for free care: 100.0%

Schedule H (Form 990) 2010

Page 5

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care to low income individuals?.........		10	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 150.0%
11	Explained the basis for calculating amounts charged to patients?.................		11	Yes
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
	a	Income level
	b	Asset level
	c	Medical indigency
	d	Insurance status
	e	Uninsured discount
	f	Medicaid/Medicare
	g	State regulation
	h	Other (describe in Part VI)
12	Explained the method for applying for financial assistance?...................		12	Yes
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted at all times on the hospital facility’s web site
	b	The policy was attached to all billing invoices
	c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
	d	The policy was posted in the hospital facility’s admissions offices
	e	The policy was provided, in writing, to patients upon admission to the hospital facility
	f	The policy was available upon request
	g	Other (describe in Part VI)
Billing and Collections
14	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........		14	Yes
15	Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments or arrests
	e	Other (describe in Part VI)
16	Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?...................................		16	Yes
	If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other (describe in Part VI)
17	Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
	a	Notified patients of the financial assistance policy upon admission
	b	Notified patients of the financial assistance policy prior to discharge
	c	Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
	d	Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
	e	Other (describe in Part VI)

Schedule H (Form 990) 2010

Page 6

Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
				Yes	No
18	Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........		18	Yes
	If “No,” indicate the reasons why (check all that apply):
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility did not have a policy relating to emergency medical care
	c	The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
	d	Other (describe in Part VI)
Charges for Medical Care
19	Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
	a	The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
	b	The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
	c	The hospital facility used the Medicare rate for those services
	d	Other (describe in Part VI)
20	Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?.........		20		No
	If “Yes,” explain in Part VI.
21	Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?...................................		21		No
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2010

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)

Name of Hospital Facility:HANCOCK COUNTY HOSPITAL

Line Number of Hospital Facility (from Schedule H, Part V, Section A):4

				Yes	No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1	During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. .....................		1
	If “Yes,” indicate what the Needs Assessment describes (check all that apply):
	a	A definition of the community served by the hospital facility
	b	Demographics of the community
	c	Existing health care facilities and resources within the community that are available to respond to the health needs of the community
	d	How data was obtained
	e	The health needs of the community
	f	Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
	g	The process for identifying and prioritizing community health needs and services to meet those needs
	h	The process for consulting with persons representing the community’s interests
	i	Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
	j	Other (describe in Part VI)
2	Indicate the tax year the hospital facility last conducted a Needs Assessment: 20
3	In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted.		3
4	Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................		4
5	Did the hospital facility make its Needs Assessment widely available to the public? ...........		5
	If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
	a	Hospital facility’s website
	b	Available upon request from the hospital facility
	c	Other (describe in Part VI)
6	If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
	a	Adoption of an implementation strategy to address the health needs of the hospital facility’s community
	b	Execution of the implementation strategy
	c	Development of a community benefit plan for the facility
	d	Participation in community-wide community benefit plan
	e	Inclusion of a community benefit section in operational plans
	f	Adoption of a budget for provision of services that address the needs identified in the CHNA
	g	Prioritization of health needs in the community
	h	Prioritization of services that the hospital facility will undertake to meet health needs in its community
	i	Other (describe in Part VI)
7	Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs.		7
Financial Assistance Policy
	Did the hospital facility have in place during the tax year a written financial assistance policy that:
8	Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8	Yes
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?..		9	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for free care: 100.0%

Schedule H (Form 990) 2010

Page 5

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care to low income individuals?.........		10	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 150.0%
11	Explained the basis for calculating amounts charged to patients?.................		11	Yes
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
	a	Income level
	b	Asset level
	c	Medical indigency
	d	Insurance status
	e	Uninsured discount
	f	Medicaid/Medicare
	g	State regulation
	h	Other (describe in Part VI)
12	Explained the method for applying for financial assistance?...................		12	Yes
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted at all times on the hospital facility’s web site
	b	The policy was attached to all billing invoices
	c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
	d	The policy was posted in the hospital facility’s admissions offices
	e	The policy was provided, in writing, to patients upon admission to the hospital facility
	f	The policy was available upon request
	g	Other (describe in Part VI)
Billing and Collections
14	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........		14	Yes
15	Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments or arrests
	e	Other (describe in Part VI)
16	Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?...................................		16	Yes
	If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other (describe in Part VI)
17	Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
	a	Notified patients of the financial assistance policy upon admission
	b	Notified patients of the financial assistance policy prior to discharge
	c	Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
	d	Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
	e	Other (describe in Part VI)

Schedule H (Form 990) 2010

Page 6

Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
				Yes	No
18	Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........		18	Yes
	If “No,” indicate the reasons why (check all that apply):
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility did not have a policy relating to emergency medical care
	c	The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
	d	Other (describe in Part VI)
Charges for Medical Care
19	Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
	a	The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
	b	The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
	c	The hospital facility used the Medicare rate for those services
	d	Other (describe in Part VI)
20	Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?.........		20		No
	If “Yes,” explain in Part VI.
21	Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?...................................		21		No
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2010

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)

Name of Hospital Facility:MOUNTAIN VIEW REGIONAL MEDICAL CENT

Line Number of Hospital Facility (from Schedule H, Part V, Section A):5

				Yes	No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1	During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. .....................		1
	If “Yes,” indicate what the Needs Assessment describes (check all that apply):
	a	A definition of the community served by the hospital facility
	b	Demographics of the community
	c	Existing health care facilities and resources within the community that are available to respond to the health needs of the community
	d	How data was obtained
	e	The health needs of the community
	f	Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
	g	The process for identifying and prioritizing community health needs and services to meet those needs
	h	The process for consulting with persons representing the community’s interests
	i	Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
	j	Other (describe in Part VI)
2	Indicate the tax year the hospital facility last conducted a Needs Assessment: 20
3	In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted.		3
4	Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................		4
5	Did the hospital facility make its Needs Assessment widely available to the public? ...........		5
	If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
	a	Hospital facility’s website
	b	Available upon request from the hospital facility
	c	Other (describe in Part VI)
6	If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
	a	Adoption of an implementation strategy to address the health needs of the hospital facility’s community
	b	Execution of the implementation strategy
	c	Development of a community benefit plan for the facility
	d	Participation in community-wide community benefit plan
	e	Inclusion of a community benefit section in operational plans
	f	Adoption of a budget for provision of services that address the needs identified in the CHNA
	g	Prioritization of health needs in the community
	h	Prioritization of services that the hospital facility will undertake to meet health needs in its community
	i	Other (describe in Part VI)
7	Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs.		7
Financial Assistance Policy
	Did the hospital facility have in place during the tax year a written financial assistance policy that:
8	Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8	Yes
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?..		9	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for free care: 100.0%

Schedule H (Form 990) 2010

Page 5

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care to low income individuals?.........		10	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 150.0%
11	Explained the basis for calculating amounts charged to patients?.................		11	Yes
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
	a	Income level
	b	Asset level
	c	Medical indigency
	d	Insurance status
	e	Uninsured discount
	f	Medicaid/Medicare
	g	State regulation
	h	Other (describe in Part VI)
12	Explained the method for applying for financial assistance?...................		12	Yes
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted at all times on the hospital facility’s web site
	b	The policy was attached to all billing invoices
	c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
	d	The policy was posted in the hospital facility’s admissions offices
	e	The policy was provided, in writing, to patients upon admission to the hospital facility
	f	The policy was available upon request
	g	Other (describe in Part VI)
Billing and Collections
14	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........		14	Yes
15	Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments or arrests
	e	Other (describe in Part VI)
16	Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?...................................		16	Yes
	If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other (describe in Part VI)
17	Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
	a	Notified patients of the financial assistance policy upon admission
	b	Notified patients of the financial assistance policy prior to discharge
	c	Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
	d	Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
	e	Other (describe in Part VI)

Schedule H (Form 990) 2010

Page 6

Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
				Yes	No
18	Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........		18	Yes
	If “No,” indicate the reasons why (check all that apply):
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility did not have a policy relating to emergency medical care
	c	The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
	d	Other (describe in Part VI)
Charges for Medical Care
19	Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
	a	The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
	b	The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
	c	The hospital facility used the Medicare rate for those services
	d	Other (describe in Part VI)
20	Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?.........		20		No
	If “Yes,” explain in Part VI.
21	Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?...................................		21		No
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2010

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)

Name of Hospital Facility:LEE REGIONAL MEDICAL CENTER

Line Number of Hospital Facility (from Schedule H, Part V, Section A):6

				Yes	No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1	During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. .....................		1
	If “Yes,” indicate what the Needs Assessment describes (check all that apply):
	a	A definition of the community served by the hospital facility
	b	Demographics of the community
	c	Existing health care facilities and resources within the community that are available to respond to the health needs of the community
	d	How data was obtained
	e	The health needs of the community
	f	Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
	g	The process for identifying and prioritizing community health needs and services to meet those needs
	h	The process for consulting with persons representing the community’s interests
	i	Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
	j	Other (describe in Part VI)
2	Indicate the tax year the hospital facility last conducted a Needs Assessment: 20
3	In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted.		3
4	Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................		4
5	Did the hospital facility make its Needs Assessment widely available to the public? ...........		5
	If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
	a	Hospital facility’s website
	b	Available upon request from the hospital facility
	c	Other (describe in Part VI)
6	If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
	a	Adoption of an implementation strategy to address the health needs of the hospital facility’s community
	b	Execution of the implementation strategy
	c	Development of a community benefit plan for the facility
	d	Participation in community-wide community benefit plan
	e	Inclusion of a community benefit section in operational plans
	f	Adoption of a budget for provision of services that address the needs identified in the CHNA
	g	Prioritization of health needs in the community
	h	Prioritization of services that the hospital facility will undertake to meet health needs in its community
	i	Other (describe in Part VI)
7	Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs.		7
Financial Assistance Policy
	Did the hospital facility have in place during the tax year a written financial assistance policy that:
8	Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8	Yes
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?..		9	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for free care: 100.0%

Schedule H (Form 990) 2010

Page 5

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care to low income individuals?.........		10	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 150.0%
11	Explained the basis for calculating amounts charged to patients?.................		11	Yes
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
	a	Income level
	b	Asset level
	c	Medical indigency
	d	Insurance status
	e	Uninsured discount
	f	Medicaid/Medicare
	g	State regulation
	h	Other (describe in Part VI)
12	Explained the method for applying for financial assistance?...................		12	Yes
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted at all times on the hospital facility’s web site
	b	The policy was attached to all billing invoices
	c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
	d	The policy was posted in the hospital facility’s admissions offices
	e	The policy was provided, in writing, to patients upon admission to the hospital facility
	f	The policy was available upon request
	g	Other (describe in Part VI)
Billing and Collections
14	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........		14	Yes
15	Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments or arrests
	e	Other (describe in Part VI)
16	Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?...................................		16	Yes
	If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other (describe in Part VI)
17	Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
	a	Notified patients of the financial assistance policy upon admission
	b	Notified patients of the financial assistance policy prior to discharge
	c	Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
	d	Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
	e	Other (describe in Part VI)

Schedule H (Form 990) 2010

Page 6

Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
				Yes	No
18	Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........		18	Yes
	If “No,” indicate the reasons why (check all that apply):
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility did not have a policy relating to emergency medical care
	c	The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
	d	Other (describe in Part VI)
Charges for Medical Care
19	Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
	a	The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
	b	The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
	c	The hospital facility used the Medicare rate for those services
	d	Other (describe in Part VI)
20	Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?.........		20		No
	If “Yes,” explain in Part VI.
21	Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?...................................		21		No
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2010

Page 7

Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, measured by total revenue per facility, from largest to smallest) How many non-hospital facilities did the organization operate during the tax year?
Name and address		Type of Facility (Describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2010

Page 8

Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2	Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Identifier	ReturnReference	Explanation
SUBSIDIZED HEALTH SERVICES EXPLANATION	PART I LINE 7G	PART I LINE 6A WELLMONT HEALTH SYSTEM PREPARES A CONSOLIDATED COMMUNITY BENEFIT REPORT WHICH INCLUDES THE ACTIVITIES OF ALL ITS OPERATIONS AND AFFILIATES IN CONTRAST AN IRS FORM 990 IS FILED FOR EACH TAX EXEMPT CORPORATION 7 SEPARATE FORM 990S AND THERE IS NO SUCH IRS FORM FOR THE TAXABLE CORPORATIONS IN ADDITION THE IRS INSTRUCTIONS TO FORM 990 HAVE SPECIFIC DEFINITIONS METHODS AND WORKSHEETS TO CALCULATE THE COMMUNITY BENEFITS TO BE INCLUDED ON THE FORM 990 AS A RESULT THERE ARE SIGNIFICANT DIFFERENCES BETWEEN THE COMMUNITY BENEFITS REPORTED IN THE CONSOLIDATED COMMUNITY BENEFIT REPORT AND THE VARIOUS FORM 990S FOR EXAMPLE THERE ARE SIGNIFICANT LOSSES INCURRED IN THE TAXABLE CORPORATIONS THAT CANNOT BE REFLECTED IN THE VARIOUS FORM 990S THE LARGEST OF WHICH ARE THE COSTS AND REVENUES ASSOCIATED WITH THE PHYSICIANS AND OTHER PROVIDERS WITHIN THESE CORPORATIONS WHO PROVIDE INDISPENSABLE SERVICES TO PATIENTS OF WELLMONT HEALTH SYSTEM THERE ARE ALSO FUNDS AND SERVICES THAT ARE PROVIDED THAT DO NOT MEET THE SPECIFIC DEFINITIONS OF THE IRS INSTRUCTIONS SUCH AS CONTRIBUTIONS TO COMMUNITY ORGANIZATIONS THAT DO NOT MEET THE DEFINITION OF RESTRICTED TO ONE OR MORE OF THE ACTIVITIES DESCRIBED IN THE TABLE IN PART I LINE 7
EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE	PART I LINE 7 COLUMN F	THE BAD DEBT EXPENSE OF 33729806 WAS INCLUDED ON FORM 990 PART IX LINE 25 COL A BUT WAS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN
COSTING METHODOLOGY EXPLANATION	PART I LINE 7	RATIO OF PATIENT CARE COSTTOCHARGES WAS USED TO DETERMINE THE COSTS FOR AMOUNTS IN LINE 7A AND 7B COL C BY FACILITY THE COSTS INCLUDED IN THE COSTTOCHARGE RATIO INCLUDED THE COSTS FROM ALL PATIENT SEGMENTS ACTUAL COSTS FROM THE GENERAL LEDGER WERE USED FOR AMOUNTS IN LINE 7F AND 7I COLC
NEEDS ASSESSMENT	PART VI	WELLMONT HEALTH SYSTEM EXAMINES THE HEALTHCARE NEEDS OF THE COMMUNITIES IT SERVES BY CONDUCTING PHYSICIAN NEEDS ASSESSMENTS FOR ITS HOSPITALS AS PART OF THIS EFFORT WELLMONT REVIEWS ITS SERVICE AREA AND DEMOGRAPHICS EXAMINES PHYSICIAN DEMOGRAPHICS AND CONDUCTS FOCUS GROUPS IT MAKES A DETERMINATION OF PHYSICIAN NEED WHILE CALCULATING ITS PHYSICIAN SURPLUSES AND DEFICITS AND HIGHLIGHTING ITS RECRUITMENT PRIORITIES AND PLANS WELLMONT ANNUALLY DETERMINES ITS PRIMARY SECONDARY AND TERTIARY MARKETS THROUGH THE USE OF COUNTYBYCOUNTY ANALYSIS TO IDENTIFY THE FOLLOWING CUSTOMER GROUPS PATIENTS AND POTENTIAL PATIENTS COMMUNITYEMPLOYER GROUPS AND LOCAL PHYSICIANS THE HEALTH SYSTEM ALSO RELIES ON THE EXPERTISE OF CONSULTANTS TO PERIODICALLY REVIEW ALL FACETS OF OPERATIONS AND MAKE RECOMMENDATIONS FOR CHANGES
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	PART VI	WELLMONT HEALTH SYSTEM PROACTIVELY INFORMS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY BY POSTING THE POLICY ON ITS WEB SITE AS WELL AS POSTING THE POLICY AT POINTS OF REGISTRATION IN THE HOSPITALS WELLMONT HEALTH SYSTEM USES PROGRAM ELIGIBILITY SPECIALISTS WHO CONTACT THE UNINSURED PATIENT POPULATION THESE SPECIALISTS DISCUSS THE VARIOUS GOVERNMENTAL ASSISTANCE PROGRAMS THAT ARE AVAILABLE TO PATIENTS IN ORDER TO DETERMINE IF THE PATIENT WOULD QUALIFY FOR ANY OF THESE PROGRAMS THE SPECIALISTS WILL WORK WITH THE PATIENTS TO COMPLETE ANY NECESSARY APPLICATIONS AND WILL HELP THEM THROUGH THE QUALIFICATION PROCESS
COMMUNITY INFORMATION	PART VI	WELLMONT HEALTH SYSTEMS SERVICE AREA IS DEFINED BY MANAGEMENT AT THE COUNTY LEVEL BASED ON PATIENT ACTIVITY AND LOCATIONS OF OUR CAMPUSES THE PRIMARY SERVICE AREA PSA INCLUDES THE TENNESSEE COUNTIES OF SULLIVAN HAWKINS AND HANCOCK AND THE VIRGINIA COUNTIES OF WASHINGTON WISE LEE AND SCOTT THE SECONDARY SERVICE AREA SSA IS DEFINED AS WASHINGTON GREENE CARTER JOHNSON AND UNICOI COUNTIES OF TENNESSEE AND RUSSELL BUCHANAN SMYTH TAZEWELL DICKENSON AND WYTHE COUNTIES OF VIRGINIA THE DEMOGRAPHICS OF THESE AREAS ARE AS FOLLOWS PSA POPULATION 365567 MEDIAN HOUSEHOLD INCOME 37319 SSA POPULATION 461210 MEDIAN HOUSEHOLD INCOME 35861 APPROXIMATELY 211 OF OUR PATIENTS ARE MEDICAID RECIPIENTS AND 107 ARE UNINSURED AND 2 OF THE PSA COUNTIES ARE DESIGNATED AS MEDICALLY UNDERSERVED AREAS HAWKINS COUNTY TENNESSEE AND LEE COUNTY VIRGINIA
HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE	PART VI	WELLMONT HEALTH SYSTEMS HOSPITALS AND OTHER HEALTHCARE FACILITIES FURTHER THEIR EXEMPT PURPOSE BY PROVIDING MILLIONS IN UNCOMPENSATED CARE AND OTHER CHARITABLE DONATIONS IN FISCAL YEAR 20102011 WELLMONT PROVIDED 74738000 IN UNCOMPENSATED CARE THE HEALTH SYSTEM ALSO DONATED 1023420 TO COMMUNITY ORGANIZATIONS SUCH AS THE AMERICAN HEART ASSOCIATION UNITED WAY SUSAN G KOMEN FOR THE CURE AND THE AMERICAN CANCER SOCIETY WELLMONT PROVIDED NEARLY 5820139 FOR COMMUNITY HEALTH AND OUTREACH AND 5330059 FOR TRAINING AND EDUCATION OF HEALTHCARE PROFESSIONALS EMPLOYEES PHYSICIANS AND VOLUNTEERS DONATED IN EXCESS OF 102900 HOURS OF COMMUNITY SERVICE
AFFILIATED HEALTH CARE INFORMATION	PART VI	WELLMONT HEALTH SYSTEMWELLMONT IS A TENNESSEE NONPROFIT CORPORATION BASED IN KINGSPORT TENNESSEEAND A PREMIER PROVIDER OF HEALTHCARE SERVICES IN NORTHEAST TENNESSEE AND SOUTHWEST VIRGINIA WELLMONT WAS FORMED IN JULY 1996 WITH THE MERGER OF BRISTOL MEMORIAL HOSPITAL IN BRISTOL TENNESSEE AND HOLSTON VALLEY MEDICAL CENTER IN KINGSPORT TENNESSEE OVER THE PAST 15 YEARS WELLMONT HAS GROWN TO INCLUDE SIX ADDITIONAL HOSPITALS AN INTEGRATED PHYSICIAN NETWORK AND SEVERAL AMBULATORY SITES WELLMONT HOSPITALS OFFER A BROAD SCOPE OF SERVICES RANGING FROM COMMUNITY BASED ACUTE CARE TO HIGHLY SPECIALIZED TERTIARY SERVICES INCLUDING TWO TRAUMA CENTERS COMPREHENSIVE HEART CARE AND CANCER CARE WELLMONT OWNS AND OPERATES AN INTEGRATED HEALTH CARE DELIVERY SYSTEM PROVIDING INPATIENT OUTPATIENT AND OTHER HEALTH CARE SERVICES AT MULTIPLE LOCATIONS IN NORTHEAST TENNESSEE AND SOUTHWEST VIRGINIA CURRENTLY WELLMONT OWNS AND OPERATES SIX ACUTE CARE HOSPITAL FACILITIES AND ONE CRITICAL ACCESS HOSPITAL WITH A TOTAL OF 1253 LICENSED BEDS AND THROUGH A JOINT VENTURE PARTNERS TO OPERATE AN ADDITIONAL ACUTE CARE HOSPITAL FACILITY WITH 100 LICENSED BEDS THE ACUTE CARE FACILITIES OWNED BY WELLMONT INCLUDE HOLSTON VALLEY MEDICAL CENTER BRISTOL REGIONAL MEDICAL CENTER MOUNTAIN VIEW REGIONAL MEDICAL CENTER IN NORTON VIRGINIA LEE REGIONAL MEDICAL CENTER IN PENNINGTON GAP VIRGINIA LONESOME PINE HOSPITAL IN BIG STONE GAP VIRGINIA HAWKINS COUNTY MEMORIAL HOSPITAL IN ROGERSVILLE TENNESSEE AND THE CRITICAL ACCESS HOSPITAL HANCOCK COUNTY HOSPITAL IN SNEEDVILLE TENNESSEE WELLMONT IS THE MAJORITY PARTNER WITH ADVENTIST HEALTH SYSTEM AT TAKOMA REGIONAL HOSPITAL AN ACUTE CARE HOSPITAL IN GREENEVILLE TENNESSEE WELLMONT ALSO DIRECTLY OR INDIRECTLY CONTROLS OWNS OR IS AFFILIATED WITH VARIOUS NONPROFIT AND FORPROFIT CORPORATIONS AND OTHER ORGANIZATIONS THAT CURRENTLY PROVIDE HEALTH CARE AND HEALTH CARERELATED SERVICES THROUGHOUT THE SERVICE AREA IN ADDITION TO THE HOSPITAL CAMPUSES AND AMBULATORY CARE CENTERS DESCRIBED ABOVE WELLMONT ALSO OPERATES MEDICAL CLINICS AMBULATORY SURGERY CENTERS COMPREHENSIVE CANCER CARE CENTERS AND IMAGING FACILITIES
LIST OF STATES WHERE COMMUNITY BENEFIT REPORT IS FILED	PART VI	TENNESSEE VIRGINIA
ADDITIONAL INFORMATION	PART VI	PART III LINE 4 THE COST REPORTED ON LINE 2 IS CALCULATED AS THE BAD DEBT EXPENSE FROM THE GENERAL LEDGER TIMES THE RATIO OF COST TO CHARGES AS CALCULATED ON WORKSHEET 2 BY FACILITY THERE ARE NO AMOUNTS REPORTED ON LINE 3 DISCOUNTS ON PATIENT ACCOUNTS ARE NOT INCLUDED IN BAD DEBT EXPENSE PAYMENTS ON PATIENT ACCOUNTS THAT HAVE BEEN PREVIOUSLY WRITTEN OFF AS BAD DEBT ARE USED TO REDUCE BAD DEBT EXPENSE A THIRD PARTY VENDOR IS USED TO HELP DETERMINE THE AMOUNT THAT COULD REASONABLY BE ATTRIBUTABLE TO PATIENTS WHO LIKELY COULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE CHARITY CARE POLICY TEXT OF NOTE TO FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE NET PATIENT SERVICE REVENUE IS REPORTED ON THE ACCRUAL BASIS IN THE PERIOD IN WHICH SERVICES ARE PROVIDED AT THE NET REALIZABLE AMOUNTS EXPECTED TO BE COLLECTED NET PATIENT SERVICE REVENUE INCLUDES AMOUNTS ESTIMATED BY MANAGEMENT TO BE REIMBURSABLE BY PATIENTS AND VARIOUS THIRDPARTY PAYORS UNDER PROVISIONS OF REIMBURSEMENT FORMULAS IN EFFECT INCLUDING RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS ESTIMATED RETROACTIVE ADJUSTMENTS ARE ACCRUED IN THE PERIOD RELATED SERVICES ARE RENDERED AND ADJUSTED IN PERIODS AS FINAL AND OTHER SETTLEMENTS ARE DETERMINED WELLMONT PROVIDES CARE TO PATIENTS WHO MEET CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES BECAUSE WELLMONT DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE THEY ARE NOT INCLUDED IN NET PATIENT SERVICE REVENUE PATIENT ACCOUNTS RECEIVABLE ARE REPORTED NET OF BOTH AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS THE CONTRACTUAL ALLOWANCE REPRESENTS THE DIFFERENCE BETWEEN ESTABLISHED BILLING RATES AND ESTIMATED REIMBURSEMENT FROM MEDICARE TENNCARE MEDICAID AND OTHER THIRDPARTY PAYMENT PROGRAMS WELLMONTS POLICY DOES NOT REQUIRE COLLATERAL OR OTHER SECURITY FOR PATIENT ACCOUNTS RECEIVABLE WELLMONT ROUTINELY OBTAINS ASSIGNMENT OF OR IS OTHERWISE ENTITLED TO RECEIVE PATIENT BENEFITS PAYABLE UNDER HEALTH INSURANCE PROGRAMS PLANS OR POLICIES THE MEDICARE COST REPORT COST FINDING METHODOLOGY AND COST TO CHARGE RATIOS WERE USED TO DETERMINE THE AMOUNT REPORTED ON LINE 6 LINE 7 IS A SURPLUS SO IT IS NOT INCLUDED AS COMMUNITY BENEFIT THE IRS INSTRUCTIONS FOR SCHEDULE H PART III SECTION B LINES 57 SPECIFICALLY INDICATE TO INCLUDE ONLY THOSE APPLICABLE COSTS AND MEDICARE REIMBURSEMENTS THAT ARE REPORTED IN THE ORGANIZATIONS MEDICARE COST REPORT FOR THE YEAR THIS REPORTING DOES NOT TAKE INTO ACCOUNT THOSE COSTS AND REVENUES ASSOCIATED WITH PHYSICIANS WHO ARE TREATING MEDICARE PATIENTS AT HOSPITALOWNED CLINIC AND PHYSICIAN PRACTICE SITES ACCORDINGLY THE RESULT OF TREATING MEDICARE PATIENTS FROM A FINANCIAL PERSPECTIVE MAY DIFFER AS REPORTED FOR FINANCIAL REPORTING PURPOSES AND COMMUNITY BENEFIT REPORTING PURPOSES FROM THE SURPLUS OR SHORTFALL SHOWN ON LINE 7 OF SECTION B OF PART III OF SCHEDULE H PART III LINE 9B A THIRDPARTY VENDOR WAS USED BEGINNING IN FISCAL YEAREND 6302010 TO IDENTIFY PATIENTS WHO HAD BEEN SENT TO A COLLECTION AGENCY BUT WHO LIKELY WOULD QUALIFY FOR CHARITY CARE THESE PATIENTS ACCOUNTS ARE THEN WRITTEN OFF AS CHARITY CARE
BRISTOL REGIONAL MEDICAL CENTER LINE NUMBER 1 PART V LINE 15E	PART V LINE 15E	WELLMONT BRISTOL REGIONAL MEDICAL CENTER S OTHER ACTIONS INCLUDE GARNISHMENT OF WAGES
BRISTOL REGIONAL MEDICAL CENTER LINE NUMBER 1 PART V LINE 16E	PART V LINE 16E	WELLMONT BRISTOL REGIONAL MEDICAL CENTER S OTHER ACTIONS INCLUDE GARNISHMENT OF WAGES
HOLSTON VALLEY MEDICAL CENTER LINE NUMBER 2 PART V LINE 15E	PART V LINE 15E	WELLMONT HOLSTON VALLEY MEDICAL CENTERS OTHER ACTIONS INCLUDE GARNISHMENT OF WAGES
HOLSTON VALLEY MEDICAL CENTER LINE NUMBER 2 PART V LINE 16E	PART V LINE 16E	WELLMONT HOLSTON VALLEY MEDICAL CENTERS OTHER ACTIONS INCLUDE GARNISHMENT OF WAGES
LONESOME PINE HOSPITAL LINE NUMBER 3 PART V LINE 15E	PART V LINE 15E	WELLMONT LONESOME PINE HOSPITAL S OTHER ACTIONS INCLUDE GARNISHMENT OF WAGES
LONESOME PINE HOSPITAL LINE NUMBER 3 PART V LINE 16E	PART V LINE 16E	WELLMONT LONESOME PINE HOSPITAL S OTHER ACTIONS INCLUDE GARNISHMENT OF WAGES
HANCOCK COUNTY HOSPITAL LINE NUMBER 4 PART V LINE 15E	PART V LINE 15E	WELLMONT HANCOCK COUNTY HOSPITALS OTHER ACTIONS INCLUDE GARNISHMENT OF WAGES
HANCOCK COUNTY HOSPITAL LINE NUMBER 4 PART V LINE 16E	PART V LINE 16E	WELLMONT HANCOCK COUNTY HOSPITALS OTHER ACTIONS INCLUDE GARNISHMENT OF WAGES
MOUNTAIN VIEW REGIONAL MEDICAL CENT LINE NUMBER 5 PART V LINE 15E	PART V LINE 15E	WELLMONT MOUNTAIN VIEW REGIONAL MEDICAL CENTERS OTHER ACTIONS INCLUDE GARNISHMENT OF WAGES
MOUNTAIN VIEW REGIONAL MEDICAL CENT LINE NUMBER 5 PART V LINE 16E	PART V LINE 16E	WELLMONT MOUNTAIN VIEW REGIONAL MEDICAL CENTERS OTHER ACTIONS INCLUDE GARNISHMENT OF WAGES
LEE REGIONAL MEDICAL CENTER LINE NUMBER 6 PART V LINE 15E	PART V LINE 15E	WELLMONT LEE REGIONAL MEDICAL CENTERS OTHER ACTIONS INCLUDE GARNISHMENT OF WAGES
LEE REGIONAL MEDICAL CENTER LINE NUMBER 6 PART V LINE 16E	PART V LINE 16E	WELLMONT LEE REGIONAL MEDICAL CENTERS OTHER ACTIONS INCLUDE GARNISHMENT OF WAGES

Schedule H (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization
WELLMONT HEALTH SYSTEM

Employer identification number
62-1636465

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet

(a) Name and address of organization or government	(b) EIN	(c) IRC Code section if applicable	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) APPALACHIAN COLLEGE OF PHARMACY CON1060 DRAGON RD OAKWOOD,VA24631	26-0069167	501	10,000	SPONSORSHIP
(2) AMERICAN CANCER SOCIETY508 PRINCETON RD SUITE 102 JOHNSON CITY,TN37601	64-0329099	501	18,000	RELAY FOR LIFE SPONS
(3) AMERICAN HEART ASSOCIATIONPO BOX 4002900 DES MOINES,IA50340	13-5613797	501	35,000	GO RED FOR WOMEN SPO
(4) BARTER THEATRE FOUNDATIONPO BOX 867 ABINDGON,VA24212	54-6000120	501	20,000	CORPORATE SPONSORSHI
(5) CROSSROADS MEDICAL MISSIONPO BOX 16852 BRISTOL,VA242096852	54-2038877	501	12,500	CORPORATE SPONSOR
(6) FISCHER ROSS GROUP INC2 SOUND VIEW DR SUITE 100 GREENWICH,CT06830	20-5111271	COR	17,500	JOAN LUNDEN TALENT
(7) FRIENDS IN NEED HEALTH CENTER1105 WEST STONE DR KINGSPORT,TN37660	62-1541637	501	151,500	UNINSURED HEALTHCARE
(8) FUN FEST KINGSPORT TN151 EAST MAIN ST KINGSPORT,TN37660	62-0446834	501	12,140	FUN FEST SPONSORSHIP
(9) KINGSPORT CHAMBER OF COMMERCE151 EAST MAIN ST KINGSPORT,TN37662	62-0446834	501	24,655	ANNUAL SPONSORSHIP
(10) KINGSPORT TOMORROW301 LOUIS ST SUITE 303 KINGSPORT,TN37660	58-1941002	501	10,000	ANNUAL HEALTHCARE SY
(11) KOMEN TRI-CITIES AFFILIATEPO BOX 5835 KINGSPORT,TN37663	84-1689067	501	50,000	RACE FOR THE CURE SP
(12) MARCH OF DIMES2313 BROWNS MILL RD SUITE 3 JOHNSON CITY,TN37604	13-1846366	501	9,500	SIGNATURE CHEF ADDIT
(13) RHYTHM & ROOTS REUNIONPO BOX 1927 BRISTOL,VA24203	72-1526206	501	8,000	GOLD SPONSORSHIP FOR
(14) SYMPHONY OF THE MOUNTAINS1200 E CENTER ST KINGSPORT,TN37660	62-0534228	501	35,000	WELLMONT HOLIDAY CON
(15) TENNESSEE CHAMBER OF COMMERCE611 COMMERCE ST SUITE 3030 NASHVILLE,TN37203	62-1236022	501	6,000	ANNUAL SPONSORSHIP
(16) WATAUGA SPORTS MEDICINE FOUNDATIONPO BOX 2267 JOHNSON CITY,TN37605	62-1586264	PLC	40,000	ATHLETE OF THE WEEK
(17) WCYBPO BOX 601063 CHARLOTTE,NC28260	54-0467002	COR	18,084	GO RED FOR WOMEN MED

Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image

Enter total number of other organizations ................................ . Bullet Image

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2010

Page 2

Part III

Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.

(a)Type of grant or assistance	(b)Number of recipients	(c)Amount of cash grant	(d)Amount of non-cash assistance	(e)Method of valuation (book, FMV, appraisal, other)	(f)Description of non-cash assistance

Part IV

Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.

Identifier	Return Reference	Explanation
PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INSIDE THE UNITED STATES	SCHEDULE I, PAGE 1, PART I, LINE 2	ALL REQUESTS FOR CHARITABLE ASSISTANCE ARE REVIEWED BY THE SENIOR VICE PRESIDENT OF MARKETING COMMUNICATIONS. THE REQUEST FOR GRANT FUNDS IS EVALUATED ON THE BASIS OF THE FOLLOWING ITEMS: THE DEGREE TO WHICH THE REQUEST SUPPORTS WELLMONT HEALTH SYSTEM'S MISSION, REPRESENTATION OF WELLMONT HEALTH SYSTEM AS A GOOD CORPORATE CITIZEN, AND THE ANNUAL BUDGET. THE SENIOR VICE PRESIDENT THEN MAKES A DETERMINATION OF APPROVAL FOR ALL REQUESTS AND THE REQUEST IS SENT DIRECTLY TO ACCOUNTS PAYABLE FOR PAYMENT. WELLMONT HEALTH SYSTEM MAKES MINIMAL GRANTS (LESS THAN 5,000 PER ENTITY) THROUGHOUT THE YEAR. THE USE OF THESE GRANT FUNDS IS NOT MONITORED BY WELLMONT HEALTH SYSTEM AS THESE GRANTS ARE MADE IN GENERAL SUPPORT OF THE GRANT RECIPIENT.

Schedule I (Form 990) 2010

Additional Data

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Software Version:

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

WELLMONT HEALTH SYSTEM

Employer identification number

62-1636465

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in 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)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....

Yes

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....

Yes

Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ...............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? ........

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) and 501(c)(4) organizations only must complete lines 5-9.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ...........................

Yes

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

Yes

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

Yes

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 50053T

Schedule J (Form 990) 2010

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.

For each individual whose compensation must be reported in 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) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.

(A) Name		(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)
(A) Name		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
(1) ROBERT F BURGIN - THROUGH 073110	(i) (ii)	380,843		17,519			398,362
(2) DAVID THOMPSON MD	(i) (ii)	285,736	39,316	14,395		8,701	348,148
(3) PIERRE ISTFAN MD	(i) (ii)	274,151	48,118	271	17,147	6,507	346,194
(4) MARGARET DENARVAEZ-080110-PRESENT	(i) (ii)	269,230		489,165		1,602	759,997
(5) ELIZABETH WARD	(i) (ii)	414,980	161,317	239		7,876	584,412
(6) J DALE SARGENT MD-THROUGH 2611	(i) (ii)	286,098	60,775	774	18,989	6,088	372,724
(7) MICHAEL BUNDY - THROUGH 4811	(i) (ii)	252,456	51,180	162	16,363	9,383	329,544
(8) GARY D MILLER - THROUGH 122010	(i) (ii)	240,935	51,180	891	15,715	9,503	318,224
(9) HAMLIN J WILSON	(i) (ii)	240,935	51,180	414	15,715	5,173	313,417
(10) ALICE POPE	(i) (ii)	223,439	37,532	180	14,513	8,794	284,458
(11) PATRICK KANE - THROUGH 63011	(i) (ii)	207,376	43,930	8,893	13,506	9,512	283,217
(12) TODD J DOUGAN	(i) (ii)	192,798	42,650		12,847	9,512	257,807
(13) KENT PETTY - 3110 TO PRESENT	(i) (ii)	177,694		5,738		8,242	191,674
(14) BARTHOLEMEW A HOVE	(i) (ii)	336,293	62,896	7,822	21,678	9,512	438,201
(15) RON PREWITT	(i) (ii)	253,318	53,940	774	16,526	5,502	330,060
(16) DAVID L BRASH	(i) (ii)	240,935	51,300	270	15,995	10,281	318,781
(17) FRED PELLE	(i) (ii)	206,795	38,677	954	13,331	9,512	269,269
(18) BLAINE DOUGLAS - THROUGH 7910	(i) (ii)	186,564		507	9,935	5,765	202,771
(19) JORGE LODEIRO MD	(i) (ii)	712,000	156,002	849	36,083	9,150	914,084
(20) EDWIN A MCELROY MD	(i) (ii)	587,738	163,283	270	30,838	9,512	791,641
(21) ROBERT HARRIS MD-THROUGH 103110	(i) (ii)	693,030		866		7,755	701,651
(22) MALCOLM R MATTHEWS MD-TO 5311	(i) (ii)	476,494	180,207	1,308	30,922	9,512	698,443
(23) MARCO DASILVA MD	(i) (ii)	481,054	166,768	774	30,430	10,281	689,307

Schedule J (Form 990) 2010

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.

Identifier	Return Reference	Explanation
FRINGE OR EXPENSE EXPLANATION	SCHEDULE J, PAGE 1, PART I, LINE 1A	AIRPLANE TRAVEL AND TRAVEL FOR COMPANIONS WELLMONT HEALTH SYSTEM PROVIDED AIRPLANE TRAVEL FOR ITS EXECUTIVES THROUGH A PARTIAL OWNERSHIP OF AN AIRPLANE. ON OCCASION, TRAVEL WAS PROVIDED FOR EXECUTIVES AND THEIR COMPANIONS FOR PERSONAL USE. WELLMONT HEALTH SYSTEM FOLLOWED IRS GUIDELINES AND INCLUDED THE APPROPRIATE AMOUNTS IN THEIR TAXABLE COMPENSATION. HOUSING ALLOWANCE WELLMONT HEALTH SYSTEM OFFERED A HOUSING ALLOWANCE FOR JOHN HOWARD, SR. VP OF LEGAL AFFAIRS, DURING THE FISCAL YEAR ENDED JUNE 30, 2011. THE HOUSING ALLOWANCE PAID TO THE EXECUTIVE WAS INCLUDED IN HIS TAXABLE COMPENSATION. HEALTH OR SOCIAL CLUB DUES DURING THE FISCAL YEAR ENDED JUNE 30, 2011, WELLMONT HEALTH SYSTEM PROVIDED COUNTRY CLUB MEMBERSHIPS TO MARGARET DENARVAEZ, PRESIDENT AND CEO, BART HOVE, PRESIDENT OF BRISTOL REGIONAL MEDICAL CENTER, JOHN HOWARD, SR. VP OF LEGAL AFFAIRS, PATRICK KANE, SR. VP OF MARKETING AND COMMUNICATIONS, AND TRACEY MOFFATT, SR. VP OF OPERATIONS. THESE AMOUNTS ARE INCLUDED IN TAXABLE COMPENSATION.
COMPENSATION CONTINGENT UPON NET EARNINGS OF ORGANIZATION	SCHEDULE J, PAGE 1, PART I, LINE 6A	INCENTIVE COMPENSATION IS PARTIALLY BASED ON MEETING BUDGETED OPERATING MARGIN GOALS.
PURSUANT TO CONTRACT PER REGS. SECTION 53.4958-4(A)(3)	SCHEDULE J, PAGE 1, PART I, LINE 8	ON AUGUST 1, 2010, MARGARET D. DENARVAEZ BECAME THE PRESIDENT AND CEO OF WELLMONT HEALTH SYSTEM. AS PART OF HER EMPLOYMENT CONTRACT, WHICH WAS REVIEWED, APPROVED AND DOCUMENTED BY WELLMONT HEALTH SYSTEM'S PERSONNEL COMMITTEE AND ALSO THE BOARD OF DIRECTORS, NONE OF WHICH HAD A CONFLICT OF INTEREST WITH RESPECT TO THE EMPLOYMENT CONTRACT, HER FORMER RESIDENCE WAS TO BE PURCHASED BY WELLMONT HEALTH SYSTEM FOR THE GREATER OF A FIXED PAYMENT AMOUNT OR ITS APPRAISED VALUE. THREE INDEPENDENT APPRAISALS WERE OBTAINED TO SUBSTANTIATE THE FAIR MARKET VALUE OF THE HOUSE. THE DIFFERENCE BETWEEN THE PURCHASE PRICE OF THE HOUSE AND THE APPRAISED FAIR MARKET VALUE OF THE HOUSE WAS INCLUDED IN THE 2010 FORM W-2 OF MARGARET D. DENARVAEZ. ADDITIONALLY, PRIOR TO DECEMBER 31, 2010, WELLMONT HEALTH SYSTEM RECEIVED AN INTERMEDIATE SANCTION REVIEW CONDUCTED BY AN INDEPENDENT COMPANY FOR THE CEO POSITION WHICH DETERMINED THAT THE COMPENSATION RATE WAS IN THE COMPETITIVE RANGE AND IN COMPLIANCE WITH SECTION 4958 OF THE INTERNAL REVENUE CODE.
OTHER ADDITIONAL INFORMATION	SCHEDULE J, PART III	WELLMONT HEALTH SYSTEM HAS AN EXECUTIVE RETIREMENT PROGRAM THAT INCLUDED MARGARET DENARVAEZ, JOHN HOWARD AND ELIZABETH WARD FOR THE FISCAL YEAR ENDING JUNE 30, 2011. THIS PROGRAM HAS A TARGET BENEFIT OF 60% OF THE HIGHEST THREE YEAR AVERAGE SALARY (LESS EMPLOYER PROVIDER BENEFITS) AND THE EXECUTIVE MUST HAVE TWENTY YEARS OF SERVICE TO RECEIVE THE FULL BENEFIT. THE EXECUTIVE MAY RETIRE EARLY AT AGE 60 AND RECEIVE REDUCED BENEFITS. THERE WERE NO PAYMENTS MADE UNDER THIS PROGRAM FOR THE FISCAL YEAR ENDING JUNE 30, 2011.

Schedule J (Form 990) 2010

Additional Data

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Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization
WELLMONT HEALTH SYSTEM

Employer identification number
62-1636465

Part I

Bond Issues

(a) Issuer Name		(b) Issuer EIN	(c) CUSIP #	(d) Date Issued	(e) Issue Price	(f) Description of Purpose	(g) Defeased		(h) On Behalf of Issuer		(i) Pool financing
(a) Issuer Name		(b) Issuer EIN	(c) CUSIP #	(d) Date Issued	(e) Issue Price	(f) Description of Purpose	Yes	No	Yes	No	Yes	No
A	SULLIVAN CNTY TENN HEALTH EDL & HSG	62-1256662	865293AC8	11-02-2006	200,000,000	RENOVATION/CONSTRUCTION OF HOLSTON VALLEY		X		X		X
B	VIRGINIA SMALL BUSINESS FING AUTH H	54-1300845	928101AC8	07-31-2007	55,000,000	PURCHASE OF HOSPITALS		X		X		X
C	SULLIVAN CNTY TENN HEALTH EDL & HSG	62-1256662	865292DY9	06-01-2003	59,100,000	REFUND OF PREVIOUSLY ISSUED BOND		X		X		X
D	SULLIVAN CNTY TENN HEALTH EDL & HSG	62-1256662	865292DZ6	12-13-2005	70,620,000	REFUND OF PREVIOUSLY ISSUED BOND		X		X		X
	SULLIVAN CNTY TENN HEALTH EDL & HSG	62-1256662	865293AC8	11-02-2006	200,000,000	RENOVATION/CONSTRUCTION OF HOLSTON VALLEY		X		X		X
	VIRGINIA SMALL BUSINESS FING AUTH H	54-1300845	928101AC8	07-31-2007	55,000,000	PURCHASE OF HOSPITALS		X		X		X
	SULLIVAN CNTY TENN HEALTH EDL & HSG	62-1256662	865292DY9	06-01-2003	59,100,000	REFUND OF PREVIOUSLY ISSUED BOND		X		X		X
	SULLIVAN CNTY TENN HEALTH EDL & HSG	62-1256662	865292DZ6	12-13-2005	70,620,000	REFUND OF PREVIOUSLY ISSUED BOND		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired. . . . .
2 Amount of bonds defeased . . . .
3 Total proceeds of issue . . . .	207,055,314		55,658,570		67,546,371		71,923,735
4 Gross proceeds in reserve funds . .	18,977,995		5,464,590		5,300,282
5 Capitalized interest from proceeds.
6 Proceeds in refunding escrow. . . . .
7 Issuance costs from proceeds . . .	2,164,568		1,026,366		2,184,358		266,958
8 Credit enhancement from proceeds.
9 Working capital expenditures from proceeds . .	187,573,513						126,950
10 Capital expenditures from proceeds . .	49,167,614		49,167,614
11 Other spent proceeds . .
12 Other unspent proceeds. . .	12,534,857
13 Year of substantial completion . . .	2011		2007		2003		2005
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue?		X		X	X		X
15 Were the bonds issued as part of an advance refunding issue?		X		X	X		X
16 Has the final allocation of proceeds been made? . .		X	X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .	X		X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . .		X		X		X		X

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2010

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use?		X		X		X		X
b Are there any research agreements that may result in private business use of bond-financed property? . .		X		X		X		X
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? .	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . .
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .
6 Total of lines 4 and 5 . . .. . . . . .
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities?	X		X		X			X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .		X		X		X		X
2 Is the bond issue a variable rate issue?		X		X		X	X
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?		X		X		X	X
b Name of provider .	LEHMAN BROTHERS
c Term of hedge . .	10.8						10.8
d Was the hedge superintegrated? .		X						X
e Was a hedge terminated? .		X						X
4a Were gross proceeds invested in a GIC? .	X			X		X		X
b Name of provider .	MERRILL LYNCH
c Term of GIC . .	4.0
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? .	X
5 Were any gross proceeds invested beyond an available temporary period? .		X		X		X		X
6 Did the bond issue qualify for an exception to rebate? . . .		X		X		X		X

Schedule K (Form 990) 2010

Page 3

Part V

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule K (see instructions).

Identifier	Return Reference	Explanation

Schedule K (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization
WELLMONT HEALTH SYSTEM

Employer identification number
62-1636465

Part I

Bond Issues

(a) Issuer Name		(b) Issuer EIN	(c) CUSIP #	(d) Date Issued	(e) Issue Price	(f) Description of Purpose	(g) Defeased		(h) On Behalf of Issuer		(i) Pool financing
(a) Issuer Name		(b) Issuer EIN	(c) CUSIP #	(d) Date Issued	(e) Issue Price	(f) Description of Purpose	Yes	No	Yes	No	Yes	No
A	SULLIVAN CNTY TENN HEALTH EDL & HSG	62-1256662	865293AC8	11-02-2006	200,000,000	RENOVATION/CONSTRUCTION OF HOLSTON VALLEY		X		X		X
B	VIRGINIA SMALL BUSINESS FING AUTH H	54-1300845	928101AC8	07-31-2007	55,000,000	PURCHASE OF HOSPITALS		X		X		X
C	SULLIVAN CNTY TENN HEALTH EDL & HSG	62-1256662	865292DY9	06-01-2003	59,100,000	REFUND OF PREVIOUSLY ISSUED BOND		X		X		X
D	SULLIVAN CNTY TENN HEALTH EDL & HSG	62-1256662	865292DZ6	12-13-2005	70,620,000	REFUND OF PREVIOUSLY ISSUED BOND		X		X		X
	SULLIVAN CNTY TENN HEALTH EDL & HSG	62-1256662	865293AC8	11-02-2006	200,000,000	RENOVATION/CONSTRUCTION OF HOLSTON VALLEY		X		X		X
	VIRGINIA SMALL BUSINESS FING AUTH H	54-1300845	928101AC8	07-31-2007	55,000,000	PURCHASE OF HOSPITALS		X		X		X
	SULLIVAN CNTY TENN HEALTH EDL & HSG	62-1256662	865292DY9	06-01-2003	59,100,000	REFUND OF PREVIOUSLY ISSUED BOND		X		X		X
	SULLIVAN CNTY TENN HEALTH EDL & HSG	62-1256662	865292DZ6	12-13-2005	70,620,000	REFUND OF PREVIOUSLY ISSUED BOND		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired. . . . .
2 Amount of bonds defeased . . . .
3 Total proceeds of issue . . . .	207,055,314		55,658,570		67,546,371		71,923,735
4 Gross proceeds in reserve funds . .	18,977,995		5,464,590		5,300,282
5 Capitalized interest from proceeds.
6 Proceeds in refunding escrow. . . . .
7 Issuance costs from proceeds . . .	2,164,568		1,026,366		2,184,358		266,958
8 Credit enhancement from proceeds.
9 Working capital expenditures from proceeds . .	187,573,513						126,950
10 Capital expenditures from proceeds . .	49,167,614		49,167,614
11 Other spent proceeds . .
12 Other unspent proceeds. . .	12,534,857
13 Year of substantial completion . . .	2011		2007		2003		2005
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue?		X		X	X		X
15 Were the bonds issued as part of an advance refunding issue?		X		X	X		X
16 Has the final allocation of proceeds been made? . .		X	X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .	X		X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . .		X		X		X		X

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2010

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use?		X		X		X		X
b Are there any research agreements that may result in private business use of bond-financed property? . .		X		X		X		X
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? .	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . .
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .
6 Total of lines 4 and 5 . . .. . . . . .
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities?	X		X		X			X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .		X		X		X		X
2 Is the bond issue a variable rate issue?		X		X		X	X
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?		X		X		X	X
b Name of provider .	LEHMAN BROTHERS
c Term of hedge . .	10.8						10.8
d Was the hedge superintegrated? .		X						X
e Was a hedge terminated? .		X						X
4a Were gross proceeds invested in a GIC? .	X			X		X		X
b Name of provider .	MERRILL LYNCH
c Term of GIC . .	4.0
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? .	X
5 Were any gross proceeds invested beyond an available temporary period? .		X		X		X		X
6 Did the bond issue qualify for an exception to rebate? . . .		X		X		X		X

Schedule K (Form 990) 2010

Page 3

Part V

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule K (see instructions).

Identifier	Return Reference	Explanation

Schedule K (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

WELLMONT HEALTH SYSTEM

Employer identification number

62-1636465

Part I

Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(b) Description of transaction	(c) Corrected?
1(a) Name of disqualified person	(b) Description of transaction	Yes	No

Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.

(a) Name of interested person and purpose	(b) Loan to or from the organization?		(c)Original principal amount	(d)Balance due	(e) In default?		(f) Approved by board or committee?		(g)Written agreement?
(a) Name of interested person and purpose	To	From	(c)Original principal amount	(d)Balance due	Yes	No	Yes	No	Yes	No
(1) JOHN HOWARD RELOCATION ASSISTANCE		X	31,250	29,514		No	Yes		Yes





Total ............... $				29,514

Part III

Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b)Relationship between interested person and the organization	(c)Amount of grant or type of assistance

For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2010

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person	(c) Amount of transaction	(d) Description of transaction	Yes	No

Part V

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule L (see instructions).

Identifier	Return Reference	Explanation
ADDITIONAL INFORMATION	SCHEDULE L PART V	THE TERMS OF MR HOWARDS EMPLOYMENT OFFER INCLUDING RELOCATION ALLOWANCE AND TEMPORARY HOUSING WAS APPROVED BY THE WELLMONT HEALTH SYSTEMS PERSONNEL COMMITTEE OF THE BOARD OF DIRECTORS AT ITS MEETING HELD JANUARY 27 2011

Schedule L (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization

WELLMONT HEALTH SYSTEM

Employer identification number

62-1636465

Identifier	Return Reference	Explanation
ADDITIONAL INFORMATION	FORM 990	FORM 990, PART X, BALANCE SHEET CERTAIN BALANCE SHEET ACCOUNTS HAVE BEEN RECLASSIFIED FOR BETTER COMPARISON TO THE CURRENT YEAR FINANCIAL STATEMENTS.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990	FORM 990, PAGE 6, PART VI, LINE 11B	WELLMONT HEALTH SYSTEM'S FORM 990 IS REVIEWED BY THREE INDIVIDUALS OF WELLMONT HEALTH SYSTEM (THE SENIOR VICE PRESIDENT OF FINANCE, THE CORPORATE CONTROLLER, AND THE MANAGER OF ACCOUNTING) AND THE BOARD OF DIRECTORS OF WELLMONT HEALTH SYSTEM. ANY QUESTIONS OR COMMENTS ARISING FROM THE INITIAL REVIEW ARE ADDRESSED TO ENSURE THE RETURN IS COMPLETE AND ACCURATE.
ENFORCEMENT OF CONFLICTS POLICY	FORM 990, PAGE 6, PART VI, LINE 12C	OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO SIGN A CONFLICT OF INTEREST POLICY ACKNOWLEDGEMENT THAT IS RECEIVED AND REVIEWED BY GENERAL COUNSEL. WELLMONT HEALTH SYSTEM ALSO HAS A POLICY ON BUSINESS PRACTICES THAT DISCUSSES CONFLICT OF INTEREST AND INFORMS THE WORKFORCE TO DISCLOSE ANY ISSUES TO THE SENIOR VICE PRESIDENT, COMPLIANCE AND AUDIT SERVICES, FOR RESOLUTION. WELLMONT HEALTH SYSTEM ALSO USES A HOTLINE THAT ALLOWS ANONYMOUS REPORTING OF POSSIBLE CONFLICT OF INTEREST SITUATIONS FOR INVESTIGATION BY THE SENIOR VICE PRESIDENT, COMPLIANCE AND AUDIT SERVICES.
COMPENSATION PROCESS FOR TOP OFFICIAL	FORM 990, PAGE 6, PART VI, LINE 15A	THE COMPENSATION OF MARGARET DENARVAEZ, THE PRESIDENT AND CEO (08/01/10 TO PRESENT) OF WELLMONT HEALTH SYSTEM IS REVIEWED, APPROVED AND DOCUMENTED BY THE WELLMONT HEALTH SYSTEM PERSONNEL COMMITTEE AND BOARD OF DIRECTORS. THE COMPENSATION OF ROBERT BURGIN, THE PRESIDENT AND CEO (INTERIM - 02/01/10 TO 07/31/10) OF WELLMONT HEALTH SYSTEM, WAS REVIEWED, APPROVED AND DOCUMENTED BY THE WELLMONT HEALTH SYSTEM PERSONNEL COMMITTEE AND THE BOARD OF DIRECTORS. IN ADDITION, THESE BODIES USE COMPARABILITY DATA TO DETERMINE THE APPROPRIATE COMPENSATION. ALL COMPENSATION DELIBERATIONS AND REVIEWS ARE CONTEMPORANEOUSLY DOCUMENTED. THIS PROCESS IS COMPLETED ON AN ANNUAL BASIS. THE HUMAN RESOURCES COMMITTEE OF THE BOARD OF DIRECTORS REVIEWED THE SALARY AND MARKET COMPENSATION DATA FOR MARGARET DENARVAEZ IMMEDIATELY PRIOR TO TENDERING HER OFFER OF EMPLOYMENT. THE LAST COMPENSATION DELIBERATION AND REVIEW PROCESS FOR MARGARET DENARVAEZ WAS COMPLETED MARCH 15, 2011.
COMPENSATION PROCESS FOR OFFICERS	FORM 990, PAGE 6, PART VI, LINE 15B	THE COMPENSATION OF THE OTHER OFFICERS AND KEY EMPLOYEES OF WELLMONT HEALTH SYSTEM ARE REVIEWED, APPROVED AND DOCUMENTED BY THE WELLMONT HEALTH SYSTEM PERSONNEL COMMITTEE AND BOARD OF DIRECTORS. OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION HAVE WRITTEN EMPLOYMENT CONTRACTS AND COMPENSATION IS BASED ON SURVEYS/STUDIES AND THEN APPROVED BY THE WELLMONT HEALTH SYSTEM CEO. IN ADDITION, THESE BODIES USE COMPARABILITY DATA TO DETERMINE THE APPROPRIATE COMPENSATION. ALL COMPENSATION DELIBERATIONS AND REVIEWS ARE CONTEMPORANEOUSLY DOCUMENTED. THIS PROCESS IN COMPLETED ON AN ANNUAL BASIS. THE HUMAN RESOURCES COMMITTEE OF THE BOARD OF DIRECTORS REVIEWED THE SALARY AND MARKET COMPENSATION DATA FOR THE FOLLOWING OTHER OFFICERS AND KEY EMPLOYEES ON AUGUST 26, 2010. WELLMONT HEALTH SYSTEM EXECUTIVE VP AND CFO - ELIZABETH WARD WELLMONT HEALTH SYSTEM SR. VP OF OPERATIONS - MICHAEL BUNDY WELLMONT HEALTH SYSTEM SR. VP OF HUMAN RESOURCES - HAMLIN J. WILSON WELLMONT HEALTH SYSTEM SR. VP GENERAL COUNSEL - GARY D. MILLER WELLMONT HEALTH SYSTEM CHIEF MEDICAL OFFICER - DALE SARGENT, M.D. WELLMONT HEALTH SYSTEM SR. VP OF MARKETING AND COMMUNICATIONS - PATRICK KANE BRISTOL REGIONAL MEDICAL CENTER PRESIDENT - BARTHOLOMEW A. HOVE HOLSTON VALLEY MEDICAL CENTER PRESIDENT - VIRGINIA FRANK HAWKINS COUNTY MEMORIAL HOSPITAL PRESIDENT - FRED PELLE REGIONAL VP VIRGINIA DIVISION - DAVID L. BRASH THE HUMAN RESOURCES COMMITTEE OF THE BOARD OF DIRECTORS REVIEWED THE SALARY AND MARKET COMPENSATION DATA FOR THE FOLLOWING OTHER OFFICERS AND KEY EMPLOYEES, IMMEDIATELY PRIOR TO TENDERING THEIR OFFERS OF EMPLOYMENT. WELLMONT HEALTH SYSTEM SR. VP OF OPERATIONS - TRACEY P. MOFFAT WELLMONT PHYSICIAN SERVICES PRESIDENT AND WELLMONT HEALTH SERVICES GENERAL COUNSEL - JOHN HOWARD WELLMONT HEALTH SYSTEM USES ONE OR MORE OF THE METHODS DESCRIBED TO ESTABLISH THE COMPENSATION OF THE FOLLOWING OTHER OFFICERS AND KEY EMPLOYEES. WELLMONT HEALTH SYSTEM SR. VP OF FINANCE - ALICE POPE WELLMONT HEALTH SYSTEM SR. VP OF FINANCE - TODD J. DOUGAN WELLMONT HEALTH SYSTEM CHIEF INFORMATION OFFICER - KENT PETTY LEE REGIONAL MEDICAL CENTER PRESIDENT - RON PREWITT
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION	FORM 990, PAGE 6, PART VI, LINE 19	WELLMONT HEALTH SYSTEM'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE NOT AVAILABLE TO THE PUBLIC. WELLMONT HEALTH SYSTEM'S AUDITED FINANCIAL STATEMENTS AND QUARTERLY UNAUDITED FINANCIAL STATEMENTS ARE AVAILABLE THROUGH THE ELECTRONIC MUNICIPAL MARKET ACCESS WEBSITE.
GROUP RETURN METHOD	FORM 990, PAGE 7, PART VII	PARENT ORGANIZATION HAS FILED A CONSOLIDATED RETURN

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

WELLMONT HEALTH SYSTEM

Employer identification number

62-1636465

Part I

Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)

(a) Name, address, and EIN of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(f) Direct controlling entity
(1) WELLMONT HEALTH MANAGEMENT SERVICES LLC 1905 AMERICAN WAY KINGSPORT,TN37660 62-1825259	HEALTHCARE	TN	WHS

Part II

Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled organization
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) WELLMONT HAWKINS CO MEMORIAL HOSPI 1905 AMERICAN WAY KINGSPORT,TN37660 62-1816368	HEALTHCARE	TN	501C3	3	NA	Yes
(2) WELLMONT MADISON HOUSE 1905 AMERICAN WAY KINGSPORT,TN37660 62-1308216	HEALTHCARE	TN	501C3	9	WHS	Yes
(3) WELLMONT FOUNDATION 1905 AMERICAN WAY KINGSPORT,TN37660 58-1594191	HEALTHCARE	TN	501C3	7	WHS	Yes
(4) TAKOMA REGIONAL HOSPITAL 401 TAKOMA AVE GREENVILLE,TN37734 51-0603966	HEALTHCARE	TN	501C3	3	WHS	Yes
(5) WELLMONT CARDIOLOGY SERVICES 1905 AMERICAN WAY KINGSPORT,TN37660 26-3557623	HEALTHCARE	TN	501C3	3	WHS	Yes
(6) WELLMONT IMAGING SERVICES INC 1905 AMERICAN WAY KINGSPORT,TN37660 86-1103148	HEALTHCARE	TN	501C3	11A	WHS	Yes
(7) WELLMONT MEDICAL ASSOCIATES 1905 AMERICAN WAY KINGSPORT,TN37660 27-0898372	HEALTHCARE	TN	501C3	3	WHS	Yes
(8) WELLMONT SLEEP SERVICES 1906 AMERICAN WAY KINGSPORT,TN37660	HEALTHCARE	TN	501C3	3	WHS	Yes

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2010

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) HOLSTON VALLEY IMAGING CENTER 103 WEST STONE DRIVE KINGSPORT,TN37660		TN	WHS IMAGING	RELATED				No			No	75.000 %
(2) SAPLING GROVE AMBULATORY SURGERY 220 MEDICAL PARK BOULEVARD BRISTOL,TN37620		TN	WHS	RELATED	615,822	4,532,492		No			No	65.000 %
(3) HOLSTON VALLEY AMBULATORY SURGERY 103 WEST STONE DRIVE KINGSPORT,TN37660		TN	WHS	RELATED	1,098,698	1,895,900		No			No	52.000 %
(4) HOLSTON VALLEY IMAGING CENTER 103 WEST STONE DRIVE KINGSPORT,TN37660		TN	WHS IMAGING	RELATED				No			No	75.000 %
(5) SAPLING GROVE AMBULATORY SURGERY 220 MEDICAL PARK BOULEVARD BRISTOL,TN37620		TN	WHS	RELATED	615,822	4,532,492		No			No	65.000 %
(6) HOLSTON VALLEY AMBULATORY SURGERY 103 WEST STONE DRIVE KINGSPORT,TN37660		TN	WHS	RELATED	1,098,698	1,895,900		No			No	52.000 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership
(1) WELLMONT INC 1905 AMERICAN WAY KINGSPORT,TN37660 62-1320035	PHYS. SVCS	TN	WHS	C CORP	-15,105,870	-50,166,284	100.000 %
(2) MCOT INC 1905 AMERICAN WAY KINGSPORT,TN37660 62-1325938	MED. SVCS.	TN	N/A
(3) MEDICAL LAUNDRY OF TRI-CITIES MEDICAL LAUNDRY OF TRI-CITIES 1905 AMERICAN WAY KINGSPORT,TN37660 62-1482226	MED. SVCS.	TN	N/A
(4) MEDICAL MALL PHARMACY INC 1905 AMERICAN WAY KINGSPORT,TN37660 62-1565006	MED. SVCS.	TN	N/A
(5) WELLMONT PHYSICIAN SERVICES WELLMONT PHYSICIAN SERVICES 1905 AMERICAN WAY KINGSPORT,TN37660 62-1567353	PHYS. SVCS	TN	N/A
(6) WELLMONT HEALTH SERVICES INC 1905 AMERICAN WAY KINGSPORT,TN37660 62-1254373	HEALTHCARE	TN	N/A
(7) WPS PROVIDERS INC 1905 AMERICAN WAY KINGSPORT,TN37660 20-5564642	PHYS. SVCS	TN	N/A
(8) WELLMONT INC 1905 AMERICAN WAY KINGSPORT,TN37660 62-1320035	PHYS. SVCS	TN	WHS	C CORP	-15,105,870	-50,166,284	100.000 %
(9) MCOT INC 1905 AMERICAN WAY KINGSPORT,TN37660 62-1325938	MED. SVCS.	TN	N/A
(10) MEDICAL LAUNDRY OF TRI-CITIES MEDICAL LAUNDRY OF TRI-CITIES 1905 AMERICAN WAY KINGSPORT,TN37660 62-1482226	MED. SVCS.	TN	N/A
(11) MEDICAL MALL PHARMACY INC 1905 AMERICAN WAY KINGSPORT,TN37660 62-1565006	MED. SVCS.	TN	N/A
(12) WELLMONT PHYSICIAN SERVICES WELLMONT PHYSICIAN SERVICES 1905 AMERICAN WAY KINGSPORT,TN37660 62-1567353	PHYS. SVCS	TN	N/A
(13) WELLMONT HEALTH SERVICES INC 1905 AMERICAN WAY KINGSPORT,TN37660 62-1254373	HEALTHCARE	TN	N/A
(14) WPS PROVIDERS INC 1905 AMERICAN WAY KINGSPORT,TN37660 20-5564642	PHYS. SVCS	TN	N/A

Schedule R (Form 990) 2010

Page 3

Part V

Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)

Note. Complete line 1 if any entity is listed in Parts II, III or IV.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .

Yes

l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .

Yes

m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of other organization	(b) Transaction type(a-r)	(c) Amount involved	(d) Method of determining amount involved
(1) HOLSTON VALLEY AMBULATORY SURGERY C	I	854,332	LEASE AGREEMENT
(2) HOLSTON VALLEY IMAGING CENTER INC	I	824,189	LEASE AGREEMENT
(3) HOLSTON VALLEY IMAGING CENTER INC	P	607,651	COST
(4) MCOT INC	L	2,017,149	COLLECTION AGREEMENT
(5) MEDICAL LAUNDRY OF TRI-CITIES INC	I	92,750	LEASE AGREEMENT
(6) MEDICAL LAUNDRY OF TRI-CITIES INC	L	2,020,989	FMV
(7) MEDICAL MALL PHARMACY INC	L	71,996	COST
(8) SAPLING GROVE AMBULATORY SURGE	R	975,000	DISTRIBUTION
(9) WELLMONT CARDIOLOGY SERVICES	L	362,589	MANAGEMENT AGREEMENT
(10) WELLMONT FOUNDATION	C	3,325,105	NEED
(11) WELLMONT HAWKINS COUNTY MEMORIAL HO	B	893,279	INTERCOMPANY TRANSFER
(12) WELLMONT HAWKINS COUNTY MEMORIAL HO	I	190,632	LEASE AGREEMENT
(13) WELLMONT HAWKINS COUNTY MEMORIAL HO	K	2,167,859	SUPPORT SERVICES
(14) WELLMONT MADISON HOUSE	B	122,833	INTERCOMPANY TRANSFER
(15) WELLMONT PHYSICIAN SERVICES INC	I	1,284,739	LEASE AGREEMENT
(16) WELLMONT PHYSICIAN SERVICES INC	L	135,238	SERVICE AGREEMENT
(17) WELLMONT FOUNDATION	B	122,063	NEED
(18) WELLMONT MEDICAL ASSOCIATES	L	285,000	SERVICES AGREEMENT
(19) WELLMONT CARDIOLOGY SERVICES	K	2,896,947	SERVICES AGREEMENT
(20) WELLMONT CARDIOLOGY SERVICES	F	350,850	NET BOOK VALUE
(21) HOLSTON VALLEY AMBULATORY SURGERY C	R	906,360	DISTRIBUTION
(22) HOLSTON VALLEY AMBULATORY SURGERY C	I	854,332	LEASE AGREEMENT
(23) HOLSTON VALLEY IMAGING CENTER INC	I	824,189	LEASE AGREEMENT
(24) HOLSTON VALLEY IMAGING CENTER INC	P	607,651	COST
(25) MCOT INC	L	2,017,149	COLLECTION AGREEMENT
(26) MEDICAL LAUNDRY OF TRI-CITIES INC	I	92,750	LEASE AGREEMENT
(27) MEDICAL LAUNDRY OF TRI-CITIES INC	L	2,020,989	FMV
(28) MEDICAL MALL PHARMACY INC	L	71,996	COST
(29) SAPLING GROVE AMBULATORY SURGE	R	975,000	DISTRIBUTION
(30) WELLMONT CARDIOLOGY SERVICES	L	362,589	MANAGEMENT AGREEMENT
(31) WELLMONT FOUNDATION	C	3,325,105	NEED
(32) WELLMONT HAWKINS COUNTY MEMORIAL HO	B	893,279	INTERCOMPANY TRANSFER
(33) WELLMONT HAWKINS COUNTY MEMORIAL HO	I	190,632	LEASE AGREEMENT
(34) WELLMONT HAWKINS COUNTY MEMORIAL HO	K	2,167,859	SUPPORT SERVICES
(35) WELLMONT MADISON HOUSE	B	122,833	INTERCOMPANY TRANSFER
(36) WELLMONT PHYSICIAN SERVICES INC	I	1,284,739	LEASE AGREEMENT
(37) WELLMONT PHYSICIAN SERVICES INC	L	135,238	SERVICE AGREEMENT
(38) WELLMONT FOUNDATION	B	122,063	NEED
(39) WELLMONT MEDICAL ASSOCIATES	L	285,000	SERVICES AGREEMENT
(40) WELLMONT CARDIOLOGY SERVICES	K	2,896,947	SERVICES AGREEMENT
(41) WELLMONT CARDIOLOGY SERVICES	F	350,850	NET BOOK VALUE
(42) HOLSTON VALLEY AMBULATORY SURGERY C	R	906,360	DISTRIBUTION
(43) HOLSTON VALLEY AMBULATORY SURGERY C	I	854,332	LEASE AGREEMENT
(44) HOLSTON VALLEY IMAGING CENTER INC	I	824,189	LEASE AGREEMENT
(45) HOLSTON VALLEY IMAGING CENTER INC	P	607,651	COST
(46) MCOT INC	L	2,017,149	COLLECTION AGREEMENT
(47) MEDICAL LAUNDRY OF TRI-CITIES INC	I	92,750	LEASE AGREEMENT
(48) MEDICAL LAUNDRY OF TRI-CITIES INC	L	2,020,989	FMV
(49) MEDICAL MALL PHARMACY INC	L	71,996	COST
(50) SAPLING GROVE AMBULATORY SURGE	R	975,000	DISTRIBUTION
(51) WELLMONT CARDIOLOGY SERVICES	L	362,589	MANAGEMENT AGREEMENT
(52) WELLMONT FOUNDATION	C	3,325,105	NEED
(53) WELLMONT HAWKINS COUNTY MEMORIAL HO	B	893,279	INTERCOMPANY TRANSFER
(54) WELLMONT HAWKINS COUNTY MEMORIAL HO	I	190,632	LEASE AGREEMENT
(55) WELLMONT HAWKINS COUNTY MEMORIAL HO	K	2,167,859	SUPPORT SERVICES
(56) WELLMONT MADISON HOUSE	B	122,833	INTERCOMPANY TRANSFER
(57) WELLMONT PHYSICIAN SERVICES INC	I	1,284,739	LEASE AGREEMENT
(58) WELLMONT PHYSICIAN SERVICES INC	L	135,238	SERVICE AGREEMENT
(59) WELLMONT FOUNDATION	B	122,063	NEED
(60) WELLMONT MEDICAL ASSOCIATES	L	285,000	SERVICES AGREEMENT
(61) WELLMONT CARDIOLOGY SERVICES	K	2,896,947	SERVICES AGREEMENT
(62) WELLMONT CARDIOLOGY SERVICES	F	350,850	NET BOOK VALUE
(63) HOLSTON VALLEY AMBULATORY SURGERY C	R	906,360	DISTRIBUTION
(64) HOLSTON VALLEY AMBULATORY SURGERY C	I	854,332	LEASE AGREEMENT
(65) HOLSTON VALLEY IMAGING CENTER INC	I	824,189	LEASE AGREEMENT
(66) HOLSTON VALLEY IMAGING CENTER INC	P	607,651	COST
(67) MCOT INC	L	2,017,149	COLLECTION AGREEMENT
(68) MEDICAL LAUNDRY OF TRI-CITIES INC	I	92,750	LEASE AGREEMENT
(69) MEDICAL LAUNDRY OF TRI-CITIES INC	L	2,020,989	FMV
(70) MEDICAL MALL PHARMACY INC	L	71,996	COST
(71) SAPLING GROVE AMBULATORY SURGE	R	975,000	DISTRIBUTION
(72) WELLMONT CARDIOLOGY SERVICES	L	362,589	MANAGEMENT AGREEMENT
(73) WELLMONT FOUNDATION	C	3,325,105	NEED
(74) WELLMONT HAWKINS COUNTY MEMORIAL HO	B	893,279	INTERCOMPANY TRANSFER
(75) WELLMONT HAWKINS COUNTY MEMORIAL HO	I	190,632	LEASE AGREEMENT
(76) WELLMONT HAWKINS COUNTY MEMORIAL HO	K	2,167,859	SUPPORT SERVICES
(77) WELLMONT MADISON HOUSE	B	122,833	INTERCOMPANY TRANSFER
(78) WELLMONT PHYSICIAN SERVICES INC	I	1,284,739	LEASE AGREEMENT
(79) WELLMONT PHYSICIAN SERVICES INC	L	135,238	SERVICE AGREEMENT
(80) WELLMONT FOUNDATION	B	122,063	NEED
(81) WELLMONT MEDICAL ASSOCIATES	L	285,000	SERVICES AGREEMENT
(82) WELLMONT CARDIOLOGY SERVICES	K	2,896,947	SERVICES AGREEMENT
(83) WELLMONT CARDIOLOGY SERVICES	F	350,850	NET BOOK VALUE
(84) HOLSTON VALLEY AMBULATORY SURGERY C	R	906,360	DISTRIBUTION

Schedule R (Form 990) 2010

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Are all partners section 501(c)(3) organizations?		(e) Share of end-of-year assets	(f) Disproprtionate allocations?		(g) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(h) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(e) Share of end-of-year assets	Yes	No	(g) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2010

Page 5

Part VII

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule R (see instructions).

Identifier	Return Reference	Explanation

Additional Data

Software ID:
Software Version:

- TIN:

TY 2010 ReasonableCauseExplanation

Name:

WELLMONT HEALTH SYSTEM

EIN: 62-1636465

Explanation:

WELLMONT HEALTH SYSTEM REQUESTED THE INTERNAL REVENUE SERVICE'S APPROVAL OF A ONE-TIME EXTENSION TO MAY 15, 2012 FOR OUR FORM 990 RETURN. THE ORIGINAL REQUEST FOR THE FIRST EXTENSION WAS INADVERTENTLY FILED ONE DAY AFTER THE REQUIRED DUE DATE OF NOVEMBER 15, 2011. AS A COST SAVING INITIATIVE, WE BROUGHT THE RETURN PREPARATION IN-HOUSE AND PURCHASED ULTRATAX SOFTWARE TO ASSIST WITH THE FILING. UNFORTUNATELY, WE ATTEMPTED TO FILE THE REQUEST FOR EXTENSION ELECTRONICALLY WITH THE NEW SOFTWARE, BUT WE WERE UNSUCCESSFUL AFTER MUCH EFFORT. THEREFORE, WE HURRIEDLY FILED THE EXTENSION MANUALLY. IN THE MEANTIME, ONE OF OUR RELATED ORGANIZATIONS FILED AN ORIGINAL REQUEST FOR A FIRST EXTENSION ON THE SAME DAY THAT WELLMONT HEALTH SYSTEM FILED AN ORIGINAL REQUEST FOR A FIRST EXTENSION, AND WAS GRANTED AN EXTENSION. WELLMONT HEALTH SYSTEM HAS TAKEN ACTIONS TO ENSURE THAT ALL FUTURE FILINGS WILL BE TIMELY BY PROPERLY INSTALLING AND PROVIDING TRAINING ON THE ULTRATAX SOFTWARE SYSTEM. A CORPORATE ANNU

1	Briefly describe the organization’s mission or most significant activities: WE DELIVER SUPERIOR HEALTH CARE WITH COMPASSION.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ....	3	14
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	11
5	Total number of individuals employed in calendar year 2010 (Part V, line 2a) ...	5	5,470
6	Total number of volunteers (estimate if necessary) ....	6	793
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ..	7a	151,530
b	Net unrelated business taxable income from Form 990-T, line 34 ..	7b	-3,190

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	2,385,595	3,106,229
9	Program service revenue (Part VIII, line 2g) .........	601,472,119	651,047,190
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	7,814,832	9,545,103
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	10,322,525	9,646,203
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	621,995,071	673,344,725
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	1,065,798	697,055
14	Benefits paid to or for members (Part IX, column (A), line 4) ....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	249,808,413	254,579,570
16a	Professional fundraising fees (Part IX, column (A), line 11e)....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....	337,180,801	387,366,874
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	588,055,012	642,643,499
19	Revenue less expenses. Subtract line 18 from line 12......	33,940,059	30,701,226
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16)............	906,473,724	939,337,117
21	Total liabilities (Part X, line 26)............	609,622,506	576,621,565
22	Net assets or fund balances. Subtract line 21 from line 20 .....	296,851,218	362,715,552

Sign Here

	Signature of officer	Date

	Type or print name and title.

Paid Preparer's Use Only	Preparer's signature	Date	Check if self- employed	Preparer’s taxpayer identification number (see instructions)
	Firm’s name (or yours if self-employed), address, and ZIP + 4			EIN
				Phone no.


4a	(Code: ) (Expenses $ 617,478,652 including grants of $ 697,055 ) (Revenue $ 651,047,190 )
	WELLMONT HEALTH SYSTEM PREPARES A CONSOLIDATED COMMUNITY BENEFIT REPORT WHICH INCLUDES THE ACTIVITIES OF ALL ITS OPERATIONS AND AFFILIATES. IN CONTRAST, AN IRS FORM 990 IS FILED FOR EACH TAX-EXEMPT CORPORATION (7 SEPARATE FORM 990S), AND THERE IS NO SUCH IRS FORM FOR THE TAXABLE CORPORATIONS. IN ADDITION, THE IRS INSTRUCTIONS TO FORM 990 HAVE SPECIFIC DEFINITIONS, METHODS, AND WORKSHEETS TO CALCULATE THE COMMUNITY BENEFITS TO BE INCLUDED ON THE FORM 990. AS A RESULT, THERE ARE SIGNIFICANT DIFFERENCES BETWEEN THE COMMUNITY BENEFITS REPORTED IN THE CONSOLIDATED COMMUNITY BENEFIT REPORT AND THE VARIOUS FORM 990S. FOR EXAMPLE, THERE ARE SIGNIFICANT LOSSES INCURRED IN THE TAXABLE CORPORATIONS THAT CANNOT BE REFLECTED IN THE VARIOUS FORM 990S, THE LARGEST OF WHICH ARE THE COSTS AND REVENUES ASSOCIATED WITH THE PHYSICIANS AND OTHER PROVIDERS WITHIN THESE CORPORATIONS WHO PROVIDE INDISPENSIBLE SERVICES TO PATIENTS OF WELLMONT HEALTH SYSTEM. THERE ARE ALSO FUNDS AND SERVICES THAT ARE PROVIDED THAT DO NOT MEET THE SPECIFIC DEFINITIONS OF THE IRS INSTRUCTIONS, SUCH AS CONTRIBUTIONS TO COMMUNITY ORGANIZATIONS THAT DO NOT MEET THE DEFINITION OF "RESTRICTED TO ONE OR MORE OF THE ACTIVITIES DESCRIBED IN THE TABLE IN PART I, LINE 7" OF SCHEDULE H. JIK WELLMONT HEALTH SYSTEM IS A PUBLIC TRUST. FROM KINGSPORT TO BRISTOL, FROM SNEEDVILLE TO NORTON, THE MEMBER HOSPITALS OF OUR ORGANIZATION WERE BORN OF THEIR COMMUNITIES' COMMITMENT TO SUPERIOR HEALTH CARE FOR THEIR CITIZENS. WE OFFER A VAST ARRAY OF MEDICAL SERVICES AND RESOURCES FOR THOUSANDS OF PATIENTS IN NORTHEAST TENNESSEE AND SOUTHWEST VIRGINIA. IN 2011, WE PROVIDED SERVICES TO 52,309 PATIENTS IN A BED, 189,463 EMERGENCY ROOM VISITS, 214,864 OUTPATIENT REGISTRATIONS (EXCLUDING ER), 2,056 NEWBORN DELIVERIES, 23,151 SURGERIES, AND 250,103 PHYSICIAN OFFICE VISITS. WELLMONT IS A TENNESSEE NOT-FOR-PROFIT CORPORATION. SIX TAX-EXEMPT COMMUNITY BASED HOSPITALS - BRISTOL REGIONAL MEDICAL CENTER (BRISTOL, TENN.), HOLSTON VALLEY MEDICAL CENTER (KINGSPORT, TENN.), LONESOME PINE HOSPITAL (BIG STONE GAP, VA.), HANCOCK COUNTY HOSPITAL (SNEEDVILLE, TENN.), MOUNTAIN VIEW REGIONAL MEDICAL CENTER (NORTON, VA.) AND LEE REGIONAL MEDICAL CENTER (PENNINGTON GAP, VA.) - ARE INCLUDED IN THIS CORPORATION. BUT EVEN AS OUR SERVICE AREA SPANS MULTIPLE STATES AND OUR REVENUE IS REPORTED IN THE HUNDREDS OF MILLIONS OF DOLLARS, WE REMAIN A COMMUNITY-OWNED HEALTH SYSTEM. IT IS OUR MISSION TO DELIVER SUPERIOR HEALTH CARE WITH COMPASSION TO THE PEOPLE WE SERVE. IT IS OUR VISION TO DELIVER THE BEST HEALTH CARE ANYWHERE. CONSISTENT WITH THIS MISSION, WE HAVE WORKED TOWARD IMPROVING OUR COMMUNITY'S ACCESS TO QUALITY, AFFORDABLE HEALTH CARE, EDUCATING OUR REGION'S CAREGIVERS, IMPROVING THE HEALTH STATUS OF OUR COMMUNITIES AND CONTRIBUTING TO THE OVERALL QUALITY OF LIFE IN THE AREAS WE SERVE. OVERALL, WE RETURNED MORE THAN 45,246,909 IN BENEFITS TO OUR REGION, INCLUDING 33,581,368 OF COSTS FOR INDIGENT PATIENTS AND UNCOMPENSATED CARE FOR OTHER PATIENTS AND 11,665,541 FOR OTHER COMMUNITY ACTIVITIES OUTLINED BELOW. WELLMONT HEALTH SYSTEM IS IN COMPLIANCE WITH IRS GUIDELINES FOR FORM 990 SCHEDULE H REPORTING PURPOSES AND THE AMOUNTS REFLECTED ABOVE ARE NOT INCLUSIVE OF RESOURCES DESCRIBED IN WELLMONT HEALTH SYSTEM'S COMMUNITY BENEFIT REPORT AS THE ABOVE AMOUNTS ARE REPORTED ON SCHEDULE H. WE ARE MINDFUL OF OUR RESPONSIBILITIES AS ONE OF THE REGION'S LARGEST EMPLOYERS. 5,439 FAMILIES COUNT ON US FOR THEIR LIVELIHOODS. CITIES AND COUNTIES THROUGHOUT OUR SERVICE AREA RELY ON US AS A DRIVER OF ECONOMIC DEVELOPMENT. IT IS OUR DUTY AS A CORPORATE CITIZEN TO SUPPORT THOSE ENDEAVORS AND CAUSES THAT IMPROVE THE QUALITY OF LIFE IN OUR REGION. AND WE ALSO RECOGNIZE IT IS OUR RESPONSIBILITY TO CARE FOR THOSE IN NEED - REGARDLESS OF THEIR ABILITY TO PAY. IT IS OUR COMMITMENT - INDEED, IT IS OUR MISSION - TO SUPPORT THE CAUSES AND DEVELOP THE INITIATIVES THAT WILL PROPEL OUR COMMUNITIES TOWARD A BETTER, BRIGHTER, HEALTHIER AND MORE VIBRANT FUTURE. SERVING THE UNDERSERVED REGARDLESS OF RACE, RELIGION, ETHNICITY OR ABILITY TO PAY, WELLMONT HEALTH SYSTEM'S HOSPITALS TREAT ALL PATIENTS FOR MEDICALLY NECESSARY CONDITIONS. RECOGNIZING THAT SOME PATIENTS CANNOT AFFORD ESSENTIAL MEDICAL SERVICES, WELLMONT PROVIDED CARE FOR INDIGENT PATIENTS, WRITING OFF 33,747,861 OF CHARGES AND INCURRING COST OF 10,025,120. WELLMONT HEALTH SYSTEM IS IN COMPLIANCE WITH IRS GUIDELINES FOR FORM 990 SCHEDULE H REPORTING PURPOSES AND THE AMOUNTS REFLECTED ABOVE ARE NOT INCLUSIVE OF RESOURCES DESCRIBED IN WELLMONT HEALTH SYSTEM'S COMMUNITY BENEFIT REPORT AS THE ABOVE AMOUNTS ARE REPORTED ON SCHEDULE H. OTHER RECENT INITIATIVES INCLUDE: OUR HEALTH SYSTEM, IN CONJUNCTION WITH A GRANT FROM SUSAN G. KOMEN FOR THE CURE TRI-CITIES, WAS ABLE TO FUND THE COST OF MAMMOGRAMS FOR SEVERAL HUNDRED WOMEN WHO WERE UNDERINSURED OR UNINSURED. PROJECT ACCESS TO BREAST CARE IS DESIGNED TO REACH WOMEN WHO LIVE IN HAWKINS, SULLIVAN, WASHINGTON, JOHNSON, UNICOI, HANCOCK, CARTER AND GREENE COUNTIES IN TENNESSEE AND WOMEN IN SCOTT COUNTY, VA. TO QUALIFY, WOMEN MUST BE BETWEEN THE AGES OF 35 AND 49 AND EITHER BE UNINSURED AND FINANCIALLY UNABLE TO PAY FOR A MAMMOGRAM OR INSURED AND HAVE A HIGH DEDUCTIBLE AND/OR CO-PAY THAT MAKES IT FINANCIALLY DIFFICULT TO OBTAIN A MAMMOGRAM. HOLSTON VALLEY MEDICAL CENTER PROVIDED FINANCIAL SUPPORT OF 289,334 TO FRIENDS IN NEED WHICH INCLUDED CASH CONTRIBUTIONS TOTALING 150,000 AND DRUGS AND SUPPLIES AT A DIRECT COST OF 139,334. THE KINGSPORT-BASED CLINIC PROVIDES PRIMARY HEALTH CARE TO THE WORKING POOR AND THOSE WITHOUT INSURANCE COVERAGE. BRISTOL REGIONAL MEDICAL CENTER RECRUITED DR. DAVE ARNOLD TO SERVE AS MEDICAL DIRECTOR OF HEALING HANDS HEALTH CENTER IN BRISTOL, TENN. DR. ARNOLD'S SALARY AND BENEFITS ARE PAID BY WELLMONT PHYSICIAN SERVICES, A TAXABLE SUBSIDIARY OF WELLMONT HEALTH SYSTEM. BRISTOL REGIONAL PROVIDES SUPPLIES AND OTHER VARIOUS ITEMS VALUED AT 15,749 FOR THE HEALTH CENTER, WHICH PROVIDES QUALITY HEALTH CARE TO THE WORKING POOR. THE WELLMONT FOUNDATION FUNDED THE PURCHASE OF SEVERAL HUNDRED INFANT CAR SEATS FOR NEWBORNS WHOSE FAMILIES COULDN'T AFFORD THEM. TRAINING AND EDUCATING OUR HEALTHCARE PROFESSIONALS WELLMONT HEALTH SYSTEM WILL NOT SUCCEED IN OUR MISSION WITHOUT CONTINUALLY REINVESTING IN OUR MOST PRECIOUS RESOURCE - OUR PEOPLE. TO THAT END, WE SUPPORTED THE EDUCATION AND TRAINING OF HEALTH CARE PROFESSIONALS AT A DIRECT COST OF 5,330,059. RECENT INITIATIVES INCLUDE: WELLMONT HEALTH SYSTEM PROVIDED AND PARTICIPATED IN SEVERAL FORMAL TRAINING PROGRAMS FOR HEALTH PROFESSIONALS, INCLUDING EAST TENNESSEE STATE UNIVERSITY'S INTERNSHIP AND RESIDENCY PROGRAMS. OUR CONTRIBUTIONS TOTALED 4,949,763 IN SUPPORT OF THE SCHOOL'S JAMES H. QUILLEN COLLEGE OF MEDICINE RESIDENCY PROGRAM. ADDITIONALLY, OUR HOSPITALS PROVIDE TRAINING FOR 50 PERCENT OF THE PHYSICIAN RESIDENTS IN THIS PROGRAM. WELLMONT HEALTH SYSTEM CONTINUES TO WELCOME OSTEOPATHIC MEDICAL STUDENTS FROM LINCOLN MEMORIAL UNIVERSITY'S DEBUSK COLLEGE OF OSTEOPATHIC MEDICINE. THE STUDENTS PERFORM CLINICAL ROTATIONS IN WELLMONT HOSPITALS AS THEY MOVE TOWARD BECOMING THE NEXT GENERATION OF DOCTORS. THE STUDENTS, WHO RECEIVE FREE HOUSING ON THE CAMPUS OF MOUNTAIN VIEW REGIONAL MEDICAL CENTER, COMPLETE THEIR CORE CLINICAL ROTATIONS IN WELLMONT'S MOUNTAIN REGION HOSPITALS - MOUNTAIN VIEW REGIONAL, LONESOME PINE HOSPITAL AND LEE REGIONAL MEDICAL CENTER. THE STUDENTS PERFORM SUBSPECIALTY ROTATIONS AT HOLSTON VALLEY MEDICAL CENTER AND BRISTOL REGIONAL MEDICAL CENTER AND PRIMARY CORE ROTATIONS AT HAWKINS COUNTY MEMORIAL HOSPITAL. WELLMONT HEALTH SYSTEM AND LINCOLN MEMORIAL UNIVERSITY'S DEBUSK COLLEGE OF OSTEOPATHIC MEDICINE AGAIN PARTNERED IN 2011 TO CREATE THE WELLMONT ORTHOPEDIC RESIDENCY PROGRAM AT HOLSTON VALLEY MEDICAL CENTER, ONE OF JUST 33 SUCH PROGRAMS IN THE COUNTRY TO HELP TRAIN THE NEXT GENERATION OF SPECIALTY PHYSICIANS. CLINICIANS AT WELLMONT'S BRISTOL REGIONAL MEDICAL CENTER CAN NOW ENHANCE THEIR SKILLS IN A STATE-OF-THE-ART SIMULATION LABORATORY. ESTABLISHED IN PARTNERSHIP WITH EAST TENNESSEE STATE UNIVERSITY, THE LAB SIMULATES REAL-LIFE PATIENT CARE SITUATIONS USING A SPECIALLY DESIGNED MANNEQUIN THAT FEATURES A LIFELIKE HEARTBEAT, BREATHING SOUNDS AND A PULSE. WELLMONT HEALTH SYSTEM HAS EXERTED TREMENDOUS EFFORT TO ACHIEVE MEANINGFUL USE OF AN ELECTRONIC HEALTH RECORD. THIS NATIONAL MANDATE CREATES TREMENDOUS EFFICIENCIES FOR CAREGIVERS, ENHANCES PATIENT CARE AND ULTIMATELY IMPROVES PATIENT SAFETY BY REDUCING THE POTENTIAL FOR ERRORS ASSOCIATED WITH PAPER DOCUMENTATION AS WELL AS INCREASING THE SECURITY AND SHARING OF DATA AMONG PROVIDERS. THE COST OF IMPLEMENTATION OF THE ELECTRONIC HEALTH RECORD IN 2011 WAS 2,410,854, IN ADDITION TO SIGNIFICANT TRAINING AND EDUCATION FOR STAFF, AT A DIRECT COST OF 133,049. WELLMONT HEALTH SYSTEM HAS PUBLICLY SUPPORTED THE IDEA OF A MEDICAL SCHOOL AT KING COLLEGE TO PROVIDE ADDITIONAL PHYSICIANS TO OUR REGION. WELLMONT HEALTH SYSTEM HAS MADE AVAILABLE CONTINUING

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services. (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses$ 617,478,652

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	9,751,566	509,803

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d		2,892,953
e	Government grants (contributions)1e		209,350

f	All other contributions, gifts, grants, and similar amounts not included above1f		3,926
g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			3,106,229
			Business Code
2a	NET PATIENT REVENUE		621,990	451,576,370	451,576,370
b	PHARMACY REVENUE		621,990	186,556,496	186,556,496
c	BLOOD REVENUE		621,990	12,076,273	12,076,273
d	ADMINISTRATIVE REVENUE		561,000	838,051	838,051
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			651,047,190
3	Investment income (including dividends, interest
	and other similar amounts).....			7,765,025			7,765,025
4	Income from investment of tax-exempt bond proceeds..
5	Royalties............
		(i) Real	(ii) Personal
6a	Gross Rents	6,553,454
b	Less: rental expenses	2,346,555
c	Rental income or (loss)	4,206,899
d	Net rental income or (loss).......			4,206,899			4,206,899
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	157,265,095	20,609,700
b	Less: cost or other basis and sales expenses	156,173,958	19,920,759
c	Gain or (loss)	1,091,137	688,941
d	Net gain or (loss)..........			1,780,078			1,780,078
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...
10a	Gross sales of inventory, less returns and allowances .
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Miscellaneous Revenue			Business Code
11a	CAFETERIA VENDING		722,210	2,954,366			2,954,366
b	MISCELLANEOUS REVENUE		900,099	1,825,279			1,825,279
c	GIFT SHOP REVENUE		453,220	508,129			508,129
d	All other revenue ....			151,530		151,530
e	Total. Add lines 11a–11d ......			5,439,304
12	Total revenue. See Instructions....			673,344,725	651,047,190	151,530	19,039,776


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........			19,280	1	17,919
2	Savings and temporary cash investments .......			28,821,001	2	29,872,126
3	Pledges and grants receivable, net .........				3
4	Accounts receivable, net .........			97,840,693	4	100,500,580
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........				5	29,514
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........				6
7	Notes and loans receivable, net .............				7
8	Inventories for sale or use ..............			14,706,814	8	15,064,889
9	Prepaid expenses and deferred charges ............			6,425,709	9	6,525,891
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	886,796,805
b	Less: accumulated depreciation. .....	10b	454,343,156	425,483,782	10c	432,453,649
11	Investments—publicly traded securities ..........			303,622,399	11	321,289,188
12	Investments—other securities. See Part IV, line 11 ......				12
13	Investments—program-related. See Part IV, line 11 ..			20,120,565	13	18,988,817
14	Intangible assets .........			4,778,521	14	8,745,924
15	Other assets. See Part IV, line 11 ...........			4,654,960	15	5,848,620
16	Total assets. Add lines 1 through 15 (must equal line 34)...			906,473,724	16	939,337,117
17	Accounts payable and accrued expenses .			59,772,029	17	52,916,367
18	Grants payable ..........				18
19	Deferred revenue ..........				19
20	Tax-exempt bond liabilities ..........			430,070,000	20	438,747,592
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........				22
23	Secured mortgages and notes payable to unrelated third parties ..				23
24	Unsecured notes and loans payable to unrelated third parties ....				24
25	Other liabilities. Complete Part X of Schedule D.....			119,780,477	25	84,957,606
26	Total liabilities. Add lines 17 through 25.....			609,622,506	26	576,621,565
	Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....			296,851,218	27	362,715,552
28	Temporarily restricted net assets .....				28
29	Permanently restricted net assets .....				29
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances .....			296,851,218	33	362,715,552
34	Total liabilities and net assets/fund balances .....			906,473,724	34	939,337,117