TY 2012 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)
(1) PIERRE ISTFAN MD........................................................................ BOARD MEMBER	40.00 .......................	X	576,762	39,934
(2) JULIE P BENNETT........................................................................ SECRETARY	6.00 .......................	X	0	0
(3) MARVIN CAMERON........................................................................ EX-OFFICIO B	6.00 .......................	X	0	0
(4) DAVE CROCKETT........................................................................ BOARD MEMBER	6.00 .......................	X	0	0
(5) WAYNE J KENNEDY........................................................................ VICE CHAIR	6.00 .......................	X	0	0
(6) RAVEN KRICKBAUM........................................................................ BOARD MEMBER	6.00 .......................	X	0	0
(7) ROGER L LEONARD........................................................................ BOARD MEMBER	6.00 .......................	X	0	0
(8) T ARTHUR BUDDY SCOTT JR........................................................................ CHAIRMAN	6.00 .......................	X	0	0
(9) GLEN SKIP SKINNER........................................................................ BOARD MEMBER	6.00 .......................	X	0	0
(10) DOUGLAS J SPRINGER MD........................................................................ BOARD MEMBER	6.00 .......................	X	0	0
(11) JOHN WILLIAMS........................................................................ BOARD MEMBER	6.00 .......................	X	0	0
(12) JACK BUTTERWORTH MD........................................................................ BOARD MEMBER	6.00 .......................	X	0	0
(13) DAVID LESTER........................................................................ ASST SECT/TR	6.00 .......................	X	0	0
(14) WILLIAM SMITH MD........................................................................ BOARD MEMBER	6.00 .......................	X	0	0
(15) DAVID SPARKS MD........................................................................ BOARD MEMBER	6.00 .......................	X	0	0
(16) MARY HALL........................................................................ BOARD MEMBER	6.00 .......................	X	0	0
(17) CHARLIE FLOYD........................................................................ BOARD MEMBER	6.00 .......................	X	0	0

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) MARGARET DENARVAEZ........................................................................ PRESIDENT &	40.00 .......................	X			1,031,881	0	47,176
(19) JOHN HOWARD........................................................................ EVP-LEGAL &	40.00 .......................	X			532,845	0	13,270
(20) TRACEY P MOFFATT........................................................................ SR.VP & WHS	40.00 .......................	X			455,389	0	25,885
(21) ALICE POPE........................................................................ EVP & CFO	40.00 .......................	X			339,958	0	27,519
(22) HAMLIN J WILSON........................................................................ SR. VP-HUMAN	40.00 .......................	X			323,035	0	22,753
(23) KENT PETTY........................................................................ CHIEF INFORM	40.00 .......................	X			308,767	0	30,528
(24) TODD J DOUGAN........................................................................ SR. VP-FINAN	40.00 .......................	X			271,725	0	26,356
(25) LOWELL TODD NORRIS........................................................................ SYSTEM VP-MA	8.00 .......................32.00	X			48,885	195,538	24,848
(26) BARTHOLEMEW A HOVE........................................................................ PRESIDENT-BR	40.00 .......................		X		497,375	0	37,534
(27) VIRGINIA FRANK........................................................................ PRESIDENT-HV	40.00 .......................		X		406,608	0	31,727
(28) GREG NEAL........................................................................ PRESIDENT/CE	32.00 .......................8.00		X		282,637	70,659	27,618
(29) DAVID L BRASH........................................................................ SR. VP OF BU	40.00 .......................		X		299,749	0	29,484
(30) SUSAN LINDENBUSCH........................................................................ VP WHS ONCOL	40.00 .......................			X	343,679	0	22,424
(31) DANIEL CARLSON........................................................................ CHIEF MEDICA	40.00 .......................			X	340,118	0	5,620
(32) TROY SYBERT........................................................................ CHIEF QUALIT	40.00 .......................			X	303,601	0	29,543
(33) WILLIAM TROY CLARK........................................................................ VP/HV CHIEF	40.00 .......................			X	289,403	0	25,553
(34) MARTHA CHILL........................................................................ SYSTEM VP/EM	40.00 .......................			X	277,264	0	21,873

(A) Name and business address	(B) Description of services	(C) Compensation
SOLSTAS LAB PARTNERS4380 FEDERAL DRIVEGREENSBORONC27410	LAB SERVICES	13,684,325
HOLSTON ANESTHESIA ASSOCIATION135 W RAVINE STREET SUITE 5BPO BOX 1308KINGSPORTTN37662	MEDICAL SERVICE	7,837,121
NORTHEAST TN EMERGENCY PHYSICIANS415 BROAD STREETKINGSPORTTN37660	PHYSICIAN SVS	3,115,540
HTA - MOUNTAIN EMPIRE LLCDEPT 2046PO BOX 11407BIRMINGHAMAL35246	LEASE	2,794,656
HIGHLANDS PATHOLOGY CONSULTANTS SPC10368 WALLACE ALLEYKINGSPORTTN37663	MEDICAL SERVICE	2,133,342
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 53

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 United States. See Part IV, line 21	364,038	364,038
2	Grants and other assistance to individuals in the United States. See Part IV, line 22
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	5,733,811		5,733,811
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	201,887,470	184,456,132	17,431,338
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	10,798,205	7,487,914	3,310,291
9	Other employee benefits .......	34,813,891	32,413,172	2,400,719
10	Payroll taxes ...........	14,569,999	13,242,278	1,327,721
11	Fees for services (non-employees):
a	Management ......	1,217,609	61,229	1,156,380
b	Legal .........	815,827	790,008	25,819
c	Accounting ...........	957,405	919,405	38,000
d	Lobbying ...........	64,174	64,174
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	413,832	413,832
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	85,261,121	82,206,050	3,055,071
12	Advertising and promotion ....	1,236,682	1,226,377	10,305
13	Office expenses .......	29,276,516	26,470,484	2,806,032
14	Information technology ......	11,165,931	10,653,939	511,992
15	Royalties ..
16	Occupancy ...........	19,184,534	15,738,168	3,446,366
17	Travel ............	1,339,695	637,558	702,137
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....	11,397	11,397
20	Interest ...........	21,431,105	21,429,438	1,667
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	45,202,544	42,957,448	2,245,096
23	Insurance ..............	4,598,691	4,598,691
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	DRUGS & MEDICAL SUPPLIES	119,083,741	119,083,741
b	PROVISION FOR BAD DEBTS	51,183,441	51,082,419	101,022
c	MISC EXPENSE	2,069,213	1,483,432	585,781
d	PHYSICIAN RECRUITMENT	1,425,230	210,680	1,214,550
e	All other expenses	1,117,079	520,852	596,227
25	Total functional expenses. Add lines 1 through 24e	665,223,181	618,522,856	46,700,325	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet Check if Schedule O contains a response to any question in this Part X ...............
	1	Cashnon-interest-bearing .............	948,014	1	321,617
2	Savings and temporary cash investments .........	35,772,409	2	49,779,799
3	Pledges and grants receivable, net ...........		3
4	Accounts receivable, net .............	118,465,911	4	115,810,678
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
		8,681	5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
			6
7	Notes and loans receivable, net .............		7
8	Inventories for sale or use ..............	15,281,656	8	16,664,616
9	Prepaid expenses and deferred charges ..........	6,897,997	9	8,333,651
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	987,960,886
b	Less: accumulated depreciation .....	10b	539,626,200	429,068,956	10c	448,334,686
11	Investments—publicly traded securities ..........	343,401,965	11	380,769,767
12	Investments—other securities. See Part IV, line 11 .....		12
13	Investments—program-related. See Part IV, line 11 .....	20,328,086	13	20,038,518
14	Intangible assets ...............	11,618,870	14	8,745,924
15	Other assets. See Part IV, line 11 ...........	5,420,624	15	8,052,583
16	Total assets. Add lines 1 through 15 (must equal line 34)......	987,213,169	16	1,056,851,839
	17	Accounts payable and accrued expenses .........	60,100,983	17	67,473,674
18	Grants payable .................		18
19	Deferred revenue ................		19
20	Tax-exempt bond liabilities .............	442,481,059	20	450,196,234
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Loans and other 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 ..	950,645	23	10,955,180
24	Unsecured notes and loans payable to unrelated third parties ....		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................	97,277,820	25	81,033,005
26	Total liabilities. Add lines 17 through 25.........	600,810,507	26	609,658,093
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	386,402,662	27	447,193,746
28	Temporarily restricted net assets ...........		28
29	Permanently restricted net assets ...........		29
	Organizations that do not follow SFAS 117 (ASC 958), 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 ...........	386,402,662	33	447,193,746
34	Total liabilities and net assets/fund balances ........	987,213,169	34	1,056,851,839

- 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

2012

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 described in 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. See section 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 - Non-functionally integrated

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 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 monetary support
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of monetary support


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2012

Page 2

Part II

Support Schedule for Organizations Described in Sections 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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
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 2012 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2011 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2012. 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—2011. If the organization did not check a 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—2012. 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—2011. 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) 2012

Page 3

Part III

Support Schedule for Organizations Described in Section 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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(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.)..

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 2012 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2011 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2011 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2012. 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—2011. 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) 2012

Page 4

Part IV

Supplemental Information. Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2012

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

2012

Name of the 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, total 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 total 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 on line H of its
Form 990-EZ or on Part I, 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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 2

Name of organization WELLMONT HEALTH SYSTEM

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total 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) Total 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) Total 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) Total 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) Total 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) Total 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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 3

Name of organization WELLMONT HEALTH SYSTEM

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 4

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
that total 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

$
Use duplicate copies of Part III if additional space is needed.

(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) (2012)

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

2012

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 35c (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 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 function 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 Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2012

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 SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

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) .......	64,174
c	Total lobbying expenditures (add lines 1a and 1b) ...................	64,174
d	Other exempt purpose expenditures ........................	665,159,007
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............	665,223,181
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) 2009	(b) 2010	(c) 2011	(d) 2012	(e) Total

2a	Lobbying nontaxable 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	96,271	143,581	63,081	64,174	367,107

d	Grassroots nontaxable 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) 2012

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)).

For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(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? ..........................

Total. Add 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 carry over 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) and if either (a) BOTH Part III-A, lines 1 and 2, are answered “No” OR (b) Part III-A, line 3, is answered “Yes."

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

Section 162(e) nondeductible 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; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.

Identifier	Return Reference	Explanation

Schedule C (Form 990 or 990EZ) 2012

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, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2012

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 can 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 education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 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, and not on a historic structure listed in the National Register ....................	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax 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 section 170(h)(4)(B)(ii)? .......................................

Yes No

In Part XIII, 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 (ASC 958), 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 XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), 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 (ASC 958) 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 Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2012

Page 2

Part III

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

Using the organization’s acquisition, 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 XIII.

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 XIII 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 XIII. Check here if the explanation has been provided in Part XIII ........

Part V

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

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....
b	Contributions ........
c	Net investment earnings, gains, and 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 current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages in lines 2a, 2b, and 2c should equal 100%.

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 XIII the intended uses of the organization's endowment funds.

Part VI

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

Description of property		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	107,181	32,684,199		32,791,380
b	Buildings ................		534,273,701	239,583,667	294,690,034
c	Leasehold improvements ............		6,670,029	1,050,329	5,619,700
d	Equipment ................		326,585,985	260,501,663	66,084,322
e	Other .................		87,639,791	38,490,541	49,149,250
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......					448,334,686

Schedule D (Form 990) 2012

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) must 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) must 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) must 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) Book value
Federal income taxes
OTHER LT LIABILITIES		25,664,648
CAPITAL LEASE OBLIGATIONS		21,340,839
OTHER CURRENT LIABILITIES		11,626,519
DEFINED BENEFITS PENSION LIABILITY		10,392,912
SWAP LIABILITY		7,425,743
POST RETIREMENT BENEFITS		4,582,344



Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		81,033,005
2. Fin 48 (ASC 740) Footnote. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII .....................................................

Schedule D (Form 990) 2012

Page 4

Part XI 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 XIII.) ............	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 XIII.) ...........	4b
c	Add lines 4a and 4b.......................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII 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 XIII.) ............	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 XIII.) ............	4b
c	Add lines 4a and 4b.......................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

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, line 2; Part XI, lines 2d and 4b; and Part XII, 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) 2012

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

2012

Open to Public Inspection

Name of the organization

WELLMONT HEALTH SYSTEM

Employer identification number

62-1636465

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...

Yes

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

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

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

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: .........

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

If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......

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

Did the organization prepare a community benefit report during the tax year? ..........

Yes

If "Yes," did 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.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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	Financial Assistance at cost (from Worksheet 1) ..			15,364,503		15,364,503	2.310 %
b	Medicaid (from Worksheet 3, column a) ....			100,347,494	76,913,030	23,434,464	3.520 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .
d	Total Financial Assistance and Means-Tested Government Programs .			115,711,997	76,913,030	38,798,967	5.830 %
Other Benefits		272	94,067	5,172,124		5,172,124	0.780 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	272	94,067	5,172,124		5,172,124	0.780 %
f	Health professions education (from Worksheet 5) ..	62	3,232	6,716,405		6,716,405	1.010 %
g	Subsidized health services (from Worksheet 6) ..
h	Research (from Worksheet 7)	76	1,606	96,143	37	96,106	0.010 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	88	2,400	258,585		258,585	0.040 %
j	Total. Other Benefits ..	498	101,305	12,243,257	37	12,243,220	1.840 %
k	Total. Add lines 7d and 7j .	498	101,305	127,955,254	76,913,067	51,042,187	7.670 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2012

Schedule H (Form 990) 2012

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(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
1	Physical improvements and housing
2	Economic development
3	Community support	12	6,290	13,464	3,500	9,964
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building	12		342		342
7	Community health improvement advocacy	15	1,091	2,002		2,002
8	Workforce development	2	1,005	1,281		1,281
9	Other
10	Total	41	8,386	17,089	3,500	13,589

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did 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. Explain in Part VI the methodology used by the organization to estimate this amount. ......

13,585,633

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

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

150,503,719

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

144,346,758

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

6,156,961

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

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(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	SURGICAL 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) 2012

Page

Part VFacility Information

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

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	HOLSTON VALLEY MEDICAL CENTER
Name of hospital facility or facility reporting group

For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9....................

Yes

If “Yes,” indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

In conducting its most recent CHNA, did the hospital facility take into account input from representatives of the community served by the hospital facility, including those with special knowledge of or expertise in public health? 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 ....................

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If “Yes,” indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Financial Assistance Policy			Yes	No
9	Did the hospital facility have in place during the tax year a written financial assistance policy that:
	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?	9	Yes
10	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........	10	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 200.0% If "No," explain in Part VI the criteria the hospital facility used.
11	Used FPG to determine eligibility for providing discounted care?.................	11		No
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: % If "No," explain in Part VI the criteria the hospital facility used.
12	Explained the basis for calculating amounts charged to patients?.................	12	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)
13	Explained the method for applying for financial assistance?...................	13	Yes
14	Included measures to publicize the policy within the community served by the hospital facility?.......	14	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a	The policy was posted on the hospital facility’s website
b	The policy was attached to 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 on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
Billing and Collections
15	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?.......	15	Yes
16	Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)
17	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?..........	17	Yes
	If “Yes,” check all actions in which the hospital facility or a third party engaged:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the patients regarding the patients’ bills

Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Part VI)

Policy Relating to Emergency Medical Care

Yes

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?..........

Yes

If “No,” indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

During the tax year, did the hospital facility charge any FAP-eligible individuals 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? ............................

If “Yes,” explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? .........................

If “Yes,” explain in Part VI.

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	BRISTOL REGIONAL MEDICAL CENTER
Name of hospital facility or facility reporting group

For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9....................

Yes

If “Yes,” indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If “Yes,” indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Financial Assistance Policy			Yes	No
9	Did the hospital facility have in place during the tax year a written financial assistance policy that:
	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?	9	Yes
10	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........	10	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 200.0% If "No," explain in Part VI the criteria the hospital facility used.
11	Used FPG to determine eligibility for providing discounted care?.................	11		No
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: % If "No," explain in Part VI the criteria the hospital facility used.
12	Explained the basis for calculating amounts charged to patients?.................	12	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)
13	Explained the method for applying for financial assistance?...................	13	Yes
14	Included measures to publicize the policy within the community served by the hospital facility?.......	14	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a	The policy was posted on the hospital facility’s website
b	The policy was attached to 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 on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
Billing and Collections
15	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?.......	15	Yes
16	Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)
17	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?..........	17	Yes
	If “Yes,” check all actions in which the hospital facility or a third party engaged:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the patients regarding the patients’ bills

Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Part VI)

Policy Relating to Emergency Medical Care

Yes

If “No,” indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If “Yes,” explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? .........................

If “Yes,” explain in Part VI.

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	LONESOME PINE HOSPITAL
Name of hospital facility or facility reporting group

For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9....................

Yes

If “Yes,” indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If “Yes,” indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Financial Assistance Policy			Yes	No
9	Did the hospital facility have in place during the tax year a written financial assistance policy that:
	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?	9	Yes
10	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........	10	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 200.0% If "No," explain in Part VI the criteria the hospital facility used.
11	Used FPG to determine eligibility for providing discounted care?.................	11		No
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: % If "No," explain in Part VI the criteria the hospital facility used.
12	Explained the basis for calculating amounts charged to patients?.................	12	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)
13	Explained the method for applying for financial assistance?...................	13	Yes
14	Included measures to publicize the policy within the community served by the hospital facility?.......	14	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a	The policy was posted on the hospital facility’s website
b	The policy was attached to 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 on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
Billing and Collections
15	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?.......	15	Yes
16	Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)
17	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?..........	17	Yes
	If “Yes,” check all actions in which the hospital facility or a third party engaged:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the patients regarding the patients’ bills

Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Part VI)

Policy Relating to Emergency Medical Care

Yes

If “No,” indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If “Yes,” explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? .........................

If “Yes,” explain in Part VI.

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	MOUNTAIN VIEW REGIONAL MEDICAL CENT
Name of hospital facility or facility reporting group

For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9....................

Yes

If “Yes,” indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If “Yes,” indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Financial Assistance Policy			Yes	No
9	Did the hospital facility have in place during the tax year a written financial assistance policy that:
	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?	9	Yes
10	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........	10	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 200.0% If "No," explain in Part VI the criteria the hospital facility used.
11	Used FPG to determine eligibility for providing discounted care?.................	11		No
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: % If "No," explain in Part VI the criteria the hospital facility used.
12	Explained the basis for calculating amounts charged to patients?.................	12	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)
13	Explained the method for applying for financial assistance?...................	13	Yes
14	Included measures to publicize the policy within the community served by the hospital facility?.......	14	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a	The policy was posted on the hospital facility’s website
b	The policy was attached to 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 on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
Billing and Collections
15	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?.......	15	Yes
16	Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)
17	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?..........	17	Yes
	If “Yes,” check all actions in which the hospital facility or a third party engaged:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the patients regarding the patients’ bills

Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Part VI)

Policy Relating to Emergency Medical Care

Yes

If “No,” indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If “Yes,” explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? .........................

If “Yes,” explain in Part VI.

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	LEE REGIONAL MEDICAL CENTER
Name of hospital facility or facility reporting group

For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9....................

Yes

If “Yes,” indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If “Yes,” indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Financial Assistance Policy			Yes	No
9	Did the hospital facility have in place during the tax year a written financial assistance policy that:
	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?	9	Yes
10	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........	10	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 200.0% If "No," explain in Part VI the criteria the hospital facility used.
11	Used FPG to determine eligibility for providing discounted care?.................	11		No
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: % If "No," explain in Part VI the criteria the hospital facility used.
12	Explained the basis for calculating amounts charged to patients?.................	12	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)
13	Explained the method for applying for financial assistance?...................	13	Yes
14	Included measures to publicize the policy within the community served by the hospital facility?.......	14	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a	The policy was posted on the hospital facility’s website
b	The policy was attached to 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 on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
Billing and Collections
15	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?.......	15	Yes
16	Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)
17	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?..........	17	Yes
	If “Yes,” check all actions in which the hospital facility or a third party engaged:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the patients regarding the patients’ bills

Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Part VI)

Policy Relating to Emergency Medical Care

Yes

If “No,” indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If “Yes,” explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? .........................

If “Yes,” explain in Part VI.

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	HANCOCK COUNTY HOSPITAL
Name of hospital facility or facility reporting group

For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9....................

Yes

If “Yes,” indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If “Yes,” indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Financial Assistance Policy			Yes	No
9	Did the hospital facility have in place during the tax year a written financial assistance policy that:
	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?	9	Yes
10	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........	10	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 200.0% If "No," explain in Part VI the criteria the hospital facility used.
11	Used FPG to determine eligibility for providing discounted care?.................	11		No
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: % If "No," explain in Part VI the criteria the hospital facility used.
12	Explained the basis for calculating amounts charged to patients?.................	12	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)
13	Explained the method for applying for financial assistance?...................	13	Yes
14	Included measures to publicize the policy within the community served by the hospital facility?.......	14	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a	The policy was posted on the hospital facility’s website
b	The policy was attached to 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 on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
Billing and Collections
15	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?.......	15	Yes
16	Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)
17	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?..........	17	Yes
	If “Yes,” check all actions in which the hospital facility or a third party engaged:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the patients regarding the patients’ bills

Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Part VI)

Policy Relating to Emergency Medical Care

Yes

If “No,” indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If “Yes,” explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? .........................

If “Yes,” explain in Part VI.

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care 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) 2012

Page

Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; Part V, Section A; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any 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.
8	Facility reporting group(s). If applicable, for each hospital facility in a facility reporting group provide the descriptions required for Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.

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 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 51183441 WAS INCLUDED ON FORM 990 PART IX LINE 25 COLUMN 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
COMMUNITY BUILDING ACTIVITIES	PART II	WELLMONT HEALTH SYSTEM PROMOTED THE HEALTH OF THE COMMUNITIES IT SERVES IN A VARIETY OF WAYS COMMUNITY SUPPORT SEVERAL EMPLOYEES OF HOLSTON VALLEY MEDICAL CENTER HVMCSERVE AS BOARD MEMBERS FOR SUSAN G KOMEN AND RONALD MCDONALD HOUSE COALITION BUILDING STAFF FROM HOLSTON VALLEY MEDICAL CENTER HVMC PARTICIPATED IN SEVERAL COMMUNITY GROUPS TO INCLUDE INTEGRATED EMERGENCY PLANNING COMMITTEE REGIONAL MEDICAL COMMUNICATION COMMITTEE KINGSPORT AREA SAFETY COUNCIL AND NORTHEAST TENNESSEE REGIONAL HOSPITAL EMERGENCY PREPAREDNESS COMMITTEE THE CHIEF ADMINISTRATIVE OFFICER FOR THE COMMUNITY HOSPITALS SERVED ON THE REMOTE AREA MEDICAL RAM EVENT PLANNING COMMITTEE THE RAM CLINIC BRINGS FREE HEALTH DENTAL AND VISION CARE TO UNINSURED AND UNDERINSURED PEOPLE THE WISE VA CLINIC HELD ON JULY 1921 2013 WAS THE 648TH RAM EXPEDITION SINCE 1985 AND DREW 3459 PATIENT ENCOUNTERS FOR VARIOUS MEDICAL EYE AND DENTAL NEEDS COMMUNITY HEALTH IMPROVEMENT ADVOCACY TO PROMOTE COMMUNITY HEALTH IMPROVEMENTS AND SAFETY HOLSTON VALLEY MEDICAL CENTER HVMC PROVIDED RESOURCES TO CONDUCT VARIOUS PRESENTATIONS SUCH AS TRAUMA NURSE TALK TOUGH TN GOVERNORS COMMISSION ON INJURY PREVENTION AND HEARING CONSERVATION WORKFORCE DEVELOPMENT BRISTOL REGIONAL MEDICAL CENTER BRMC ORGANIZED A DISCUSSION WITH BRISTOL TENNESSEE CITY SCHOOL SYSTEM TEACHERS REGARDING SKILLS THEIR STUDENTS NEED TO BE TAUGHT IN ORDER TO WORK AT BRMC IN VARIOUS DEPARTMENTS
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 363395 MEDIAN HOUSEHOLD INCOME 38282 SSA POPULATION 459656 MEDIAN HOUSEHOLD INCOME 36763 APPROXIMATELY 1949 OF OUR PATIENTS ARE MEDICAID RECIPIENTS AND 1058 ARE UNINSURED AND TWO 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 2013 WELLMONT PROVIDED 70 050546 IN UNCOMPENSATED CARE THE HEALTH SYSTEM ALSO DONATED 758810 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 5966504 FOR COMMUNITY HEALTH AND OUTREACH 47093 FOR COMMUNITY BENEFIT OPERATIONS 21332 FOR COMMUNITY BUILDING ACTIVITIES 6782638 FOR TRAINING AND EDUCATION OF HEALTHCARE PROFESSIONALS AND 96106 FOR CLINICAL TRIALS AND RESEARCH EMPLOYEESPHYSICIANS AND VOLUNTEERS DONATED IN EXCESS OF 88446 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 17 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
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 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
HOLSTON VALLEY MEDICAL CENTER LINE NUMBER 1 PART V LINE 3	PART V LINE 3	INFORMATION FOR THE CHNA ASSESSMENT WAS GATHERED FROM A VARIETY OF SOURCES INCLUDING INTERVIEWS WITH PATIENTS INTERVIEWS WITH KEY COMMUNITY LEADERS AND STAKEHOLDERS INCLUDING REPRESENTATIVE OF UNDERSERVED POPULATIONS AND AREAS WITH HEALTHCARE DISPARITIES INTERVIEWS WITH LEADERS AND STAFF IN OTHER HEALTHCARE ORGANIZATIONS OR CIVIC ORGANIZATIONS WITH A SHARED MISSION TO POSITIVELY IMPACT THE HEALTH STATUS OF THE COMMUNITY PHYSICIAN NEEDS ASSESSMENT COMMUNITY HEALTH FACILITY ASSESSMENT MENTAL HEALTH NEEDS ASSESSMENT DIALYSIS AND DENTAL NEEDS ASSESSMENT PUBLICLY AVAILABLE POPULATION AND DEMOGRAPHIC INFORMATION PUBLICLY AVAILABLE POPULATION HEALTH INFORMATION THE INFORMATION WAS THEN COLLATED AND ASSESSED TO DETERMINE THE GREATEST UNMET HEALTH NEEDS FACING OUR REGION STRATEGIES TO ADDRESS THESE NEEDS WERE THEN DEVELOPED UTILIZING INTERNAL RESOURCES AND PARTNERSHIPS WITH OTHER HEALTHCARE ORGANIZATIONS AND PHYSICIANS SEVERAL COMMUNITY LEADERS PARTICIPATED IN THE CHNA THROUGH PERSONAL INTERVIEWS SURVEYS AND OTHER MEANS THEIR FEEDBACK WAS INVALUABLE IN ASSESSING THE HEALTH NEEDS OF THE COMMUNITIES WE SERVE AND DEVELOPING ACTIONS PLANS TO ENSURE THOSE NEEDS WERE MET THE TIME TALENT AND INSIGHT OF ELECTED REPRESENTATIVES AND LEADERS OF BUSINESSES MUNICIPALITIES AND ORGANIZATIONS LISTED BELOW WERE GREATLY APPRECIATED ADVANCED HOME CARE BELIEVE IN BRISTOL BILL GATTON AUTOMOTIVE GROUP BRISTOL COMPRESSORS INTERNATIONAL BRISTOL TENNESEE CITY SCHOOLS VIRGINIA STATE SENATOR BILL CARRICO CHILTERN INTERNATIONAL CITY OF BRISTOL TN CITY OF BRISTOL VA CITY OF KINGSPORT TN CITY OF NORTON VA CITY OF NORTON SCHOOL SYSTEM CITY OF ROGERSVILLE TN CITY OF SNEEDVILLE TN DICKENSON COUNTY CHAMBER OF COMMERCE DOMTAR DR GLENN E VANCE JR DDS ELECTROMECHANICAL CORPORATION FIRST TENNESSEE BANK FRIENDS IN NEED HEALTHCARE INC FRONTIER HEALTH US REPRESENTATIVE MORGAN GRIFFITH HANCOCK MANOR NURSING HOME HAWKINS COUNTY GAS UTILITY HAWKINS AND HANCOCK COUNTY HEALTH DEPARTMENTS HEALING HANDS HEALTH CENTER THE HEALTH WAGON HUNTER SMITH DAVIS ATTORNEYS AT LAW INDUSTRIAL DEVELOPMENT AUTHORITY OF DICKENSON COUNTY KVAT FOOD STORES KAVANAUGH CALL CENTER GROUP VIRGINIA STATE DELEGATE TERRY KILGORE KINGSPORT AREA CHAMBER OF COMMERCE KINGSPORT OFFICE OF SMALL BUSINESS DEVELOPMENT ENTREPRENEURSHIP LANDMARK REALTY INC LEE COUNTY VA MEADOWVIEW CONFERENCE RESORT CONVENTION CENTER VIRGINIA STATE DELEGATE JAMES WILL MOREFIELD MOUNTAIN EMPIRE OLDER CITIZENS INC NASH AND POWERS INSURANCE SERVICES NORTON INDUSTRIAL DEVELOPMENT AUTHORITY OAK HILL CEMETERY VIRGINIA STATE DELEGATE ISRAEL OQUINN PHARMACEUTICAL PRODUCT DEVELOPMENT VIRGINIA STATE SENATOR PHILLIP PUCKETT TENNESSEE LT GOVERNOR RON RAMSEY THE REGIONAL EYE CENTER THE ROBINETTE COMPANY RURAL HEALTH SERVICES CONSORTIUM SOUTHWEST VIRGINIA COMMUNITY HEALTH SYSTEMS INC STRONGWELL CORPORATION SULLIVAN COUNTY TN SULLIVAN COUNTY REGIONAL HEALTH DEPARTMENT SULLIVAN COUNTY SCHOOL SYSTEM TELEOPTICS INC TOWN OF ABINGDON VA TOWN OF BIG STONE GAP VA TOWN OF PENNINGTON GAP VA TOWN OF JONESVILLE VA TRISUMMIT BANK UNIVERSAL FIBERS UNIVERSITY OF VIRGINIAS COLLEGE AT WISE VIRGINIA CITY HYBRID ENERGY CENTER VIRGINIA DEPARTMENT OF HEALTH CUMBERLAND PLATEAU HEALTH DISTRICT VIRGINIA DEPARTMENT OF HEALTH LENOWISCO DISTRICT WCYBTV WELLMONT MEDICAL ASSOCIATES WISE COUNTY CHAMBER OF COMMERCE WISE COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY WISE COUNTY VA YWCA BRISTOL
HOLSTON VALLEY MEDICAL CENTER LINE NUMBER 1 PART V LINE 4	PART V LINE 4	BRISTOL REGIONAL MEDICAL CENTER LONESOME PINE HOSPITAL HAWKINS COUNTY MEMORIAL HOSPITAL HANCOCK COUNTY HOSPITAL MOUNTAIN VIEW REGIONAL MEDICAL CENTER LEE REGIONAL MEDICAL CENTER TAKOMA REGIONAL MEDICAL CENTER
HOLSTON VALLEY MEDICAL CENTER LINE NUMBER 1 PART V LINE 7	PART V LINE 7	KEY FINDINGS NOTED DURING THE CHNA WERE LACK OF SUFFICIENT PSYCHIATRIC HEALTH AND DENTAL CARE THESE FINDINGS FALL OUTSIDE THE CORE BUSINESS AND MISSON OF WELLMONT HEALTH SYSTEM TO HELP MEET THESE NEEDS WELLMONT HEALTH SYSTEM WILL CONTINUE TO STRENGTHEN OUR PARTNERSHIPS AND CONTINUUM OF CARE OPPORTUNITIES WITH AREA HEALTH DEPARTMENTS FEDERALLY QUALIFIED HEALTH CENTERS AND FRONTIER HEALTH THE REGIONS LEADING PROVIDER OF BEHAVIORAL HEALTH SERVICES
HOLSTON VALLEY MEDICAL CENTER LINE NUMBER 1 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 1 PART V LINE 16E	PART V LINE 16E	WELLMONT HOLSTON VALLEY MEDICAL CENTERS OTHER ACTIONS INCLUDE GARNISHMENT OF WAGES
HOLSTON VALLEY MEDICAL CENTER LINE NUMBER 1 PART V LINE 19D	PART V LINE 19D	WELLMONT LEE REGIONAL MEDICAL CENTER FOLLOWS TENNESSEE STATUTE WHICH IS 175 OF AVERAGE COST FOR ITS HOSPITALS
BRISTOL REGIONAL MEDICAL CENTER LINE NUMBER 2 PART V LINE 3	PART V LINE 3	INFORMATION FOR THE CHNA ASSESSMENT WAS GATHERED FROM A VARIETY OF SOURCES INCLUDING INTERVIEWS WITH PATIENTS INTERVIEWS WITH KEY COMMUNITY LEADERS AND STAKEHOLDERS INCLUDING REPRESENTATIVE OF UNDERSERVED POPULATIONS AND AREAS WITH HEALTHCARE DISPARITIES INTERVIEWS WITH LEADERS AND STAFF IN OTHER HEALTHCARE ORGANIZATIONS OR CIVIC ORGANIZATIONS WITH A SHARED MISSION TO POSITIVELY IMPACT THE HEALTH STATUS OF THE COMMUNITY PHYSICIAN NEEDS ASSESSMENT COMMUNITY HEALTH FACILITY ASSESSMENT MENTAL HEALTH NEEDS ASSESSMENT DIALYSIS AND DENTAL NEEDS ASSESSMENT PUBLICLY AVAILABLE POPULATION AND DEMOGRAPHIC INFORMATION PUBLICLY AVAILABLE POPULATION HEALTH INFORMATION THE INFORMATION WAS THEN COLLATED AND ASSESSED TO DETERMINE THE GREATEST UNMET HEALTH NEEDS FACING OUR REGION STRATEGIES TO ADDRESS THESE NEEDS WERE THEN DEVELOPED UTILIZING INTERNAL RESOURCES AND PARTNERSHIPS WITH OTHER HEALTHCARE ORGANIZATIONS AND PHYSICIANS SEVERAL COMMUNITY LEADERS PARTICIPATED IN THE CHNA THROUGH PERSONAL INTERVIEWS SURVEYS AND OTHER MEANS THEIR FEEDBACK WAS INVALUABLE IN ASSESSING THE HEALTH NEEDS OF THE COMMUNITIES WE SERVE AND DEVELOPING ACTIONS PLANS TO ENSURE THOSE NEEDS WERE MET THE TIME TALENT AND INSIGHT OF ELECTED REPRESENTATIVES AND LEADERS OF BUSINESSES MUNICIPALITIES AND ORGANIZATIONS LISTED BELOW WERE GREATLY APPRECIATED ADVANCED HOME CARE BELIEVE IN BRISTOL BILL GATTON AUTOMOTIVE GROUP BRISTOL COMPRESSORS INTERNATIONAL BRISTOL TENNESEE CITY SCHOOLS VIRGINIA STATE SENATOR BILL CARRICO CHILTERN INTERNATIONAL CITY OF BRISTOL TN CITY OF BRISTOL VA CITY OF KINGSPORT TN CITY OF NORTON VA CITY OF NORTON SCHOOL SYSTEM CITY OF ROGERSVILLE TN CITY OF SNEEDVILLE TN DICKENSON COUNTY CHAMBER OF COMMERCE DOMTAR DR GLENN E VANCE JR DDS ELECTROMECHANICAL CORPORATION FIRST TENNESSEE BANK FRIENDS IN NEED HEALTHCARE INC FRONTIER HEALTH US REPRESENTATIVE MORGAN GRIFFITH HANCOCK MANOR NURSING HOME HAWKINS COUNTY GAS UTILITY HAWKINS AND HANCOCK COUNTY HEALTH DEPARTMENTS HEALING HANDS HEALTH CENTER THE HEALTH WAGON HUNTER SMITH DAVIS ATTORNEYS AT LAW INDUSTRIAL DEVELOPMENT AUTHORITY OF DICKENSON COUNTY KVAT FOOD STORES KAVANAUGH CALL CENTER GROUP VIRGINIA STATE DELEGATE TERRY KILGORE KINGSPORT AREA CHAMBER OF COMMERCE KINGSPORT OFFICE OF SMALL BUSINESS DEVELOPMENT ENTREPRENEURSHIP LANDMARK REALTY INC LEE COUNTY VA MEADOWVIEW CONFERENCE RESORT CONVENTION CENTER VIRGINIA STATE DELEGATE JAMES WILL MOREFIELD MOUNTAIN EMPIRE OLDER CITIZENS INC NASH AND POWERS INSURANCE SERVICES NORTON INDUSTRIAL DEVELOPMENT AUTHORITY OAK HILL CEMETERY VIRGINIA STATE DELEGATE ISRAEL OQUINN PHARMACEUTICAL PRODUCT DEVELOPMENT VIRGINIA STATE SENATOR PHILLIP PUCKETT TENNESSEE LT GOVERNOR RON RAMSEY THE REGIONAL EYE CENTER THE ROBINETTE COMPANY RURAL HEALTH SERVICES CONSORTIUM SOUTHWEST VIRGINIA COMMUNITY HEALTH SYSTEMS INC STRONGWELL CORPORATION SULLIVAN COUNTY TN SULLIVAN COUNTY REGIONAL HEALTH DEPARTMENT SULLIVAN COUNTY SCHOOL SYSTEM TELEOPTICS INC TOWN OF ABINGDON VA TOWN OF BIG STONE GAP VA TOWN OF PENNINGTON GAP VA TOWN OF JONESVILLE VA TRISUMMIT BANK UNIVERSAL FIBERS UNIVERSITY OF VIRGINIAS COLLEGE AT WISE VIRGINIA CITY HYBRID ENERGY CENTER VIRGINIA DEPARTMENT OF HEALTH CUMBERLAND PLATEAU HEALTH DISTRICT VIRGINIA DEPARTMENT OF HEALTH LENOWISCO DISTRICT WCYBTV WELLMONT MEDICAL ASSOCIATES WISE COUNTY CHAMBER OF COMMERCE WISE COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY WISE COUNTY VA YWCA BRISTOL
BRISTOL REGIONAL MEDICAL CENTER LINE NUMBER 2 PART V LINE 4	PART V LINE 4	HOLSTON VALLEY MEDICAL CENTER LONESOME PINE HOSPITAL HAWKINS COUNTY MEMORIAL HOSPITAL HANCOCK COUNTY HOSPITAL MOUNTAIN VIEW REGIONAL MEDICAL CENTER LEE REGIONAL MEDICAL CENTER TAKOMA REGIONAL MEDICAL CENTER
BRISTOL REGIONAL MEDICAL CENTER LINE NUMBER 2 PART V LINE 7	PART V LINE 7	KEY FINDINGS NOTED DURING THE CHNA WERE LACK OF SUFFICIENT PSYCHIATRIC HEALTH AND DENTAL CARE THESE FINDINGS FALL OUTSIDE THE CORE BUSINESS AND MISSON OF WELLMONT HEALTH SYSTEM TO HELP MEET THESE NEEDS WELLMONT HEALTH SYSTEM WILL CONTINUE TO STRENGTHEN OUR PARTNERSHIPS AND CONTINUUM OF CARE OPPORTUNITIES WITH AREA HEALTH DEPARTMENTS FEDERALLY QUALIFIED HEALTH CENTERS AND FRONTIER HEALTH THE REGIONS LEADING PROVIDER OF BEHAVIORAL HEALTH SERVICES
BRISTOL REGIONAL MEDICAL CENTER LINE NUMBER 2 PART V LINE 15E	PART V LINE 15E	WELLMONT BRISTOL REGIONAL MEDICAL CENTERS OTHER ACTIONS INCLUDE GARNISHMENT OF WAGES
BRISTOL REGIONAL MEDICAL CENTER LINE NUMBER 2 PART V LINE 16E	PART V LINE 16E	WELLMONT BRISTOL REGIONAL MEDICAL CENTERS OTHER ACTIONS INCLUDE GARNISHMENT OF WAGES
BRISTOL REGIONAL MEDICAL CENTER LINE NUMBER 2 PART V LINE 19D	PART V LINE 19D	WELLMONT HOLSTON VALLEY MEDICAL CENTER FOLLOWS TENNESSEE STATUTE WHICH IS 175 OF AVERAGE COST FOR ITS HOSPITALS
LONESOME PINE HOSPITAL LINE NUMBER 3 PART V LINE 3	PART V LINE 3	INFORMATION FOR THE CHNA ASSESSMENT WAS GATHERED FROM A VARIETY OF SOURCES INCLUDING INTERVIEWS WITH PATIENTS INTERVIEWS WITH KEY COMMUNITY LEADERS AND STAKEHOLDERS INCLUDING REPRESENTATIVE OF UNDERSERVED POPULATIONS AND AREAS WITH HEALTHCARE DISPARITIES INTERVIEWS WITH LEADERS AND STAFF IN OTHER HEALTHCARE ORGANIZATIONS OR CIVIC ORGANIZATIONS WITH A SHARED MISSION TO POSITIVELY IMPACT THE HEALTH STATUS OF THE COMMUNITY PHYSICIAN NEEDS ASSESSMENT COMMUNITY HEALTH FACILITY ASSESSMENT MENTAL HEALTH NEEDS ASSESSMENT DIALYSIS AND DENTAL NEEDS ASSESSMENT PUBLICLY AVAILABLE POPULATION AND DEMOGRAPHIC INFORMATION PUBLICLY AVAILABLE POPULATION HEALTH INFORMATION THE INFORMATION WAS THEN COLLATED AND ASSESSED TO DETERMINE THE GREATEST UNMET HEALTH NEEDS FACING OUR REGION STRATEGIES TO ADDRESS THESE NEEDS WERE THEN DEVELOPED UTILIZING INTERNAL RESOURCES AND PARTNERSHIPS WITH OTHER HEALTHCARE ORGANIZATIONS AND PHYSICIANS SEVERAL COMMUNITY LEADERS PARTICIPATED IN THE CHNA THROUGH PERSONAL INTERVIEWS SURVEYS AND OTHER MEANS THEIR FEEDBACK WAS INVALUABLE IN ASSESSING THE HEALTH NEEDS OF THE COMMUNITIES WE SERVE AND DEVELOPING ACTIONS PLANS TO ENSURE THOSE NEEDS WERE MET THE TIME TALENT AND INSIGHT OF ELECTED REPRESENTATIVES AND LEADERS OF BUSINESSES MUNICIPALITIES AND ORGANIZATIONS LISTED BELOW WERE GREATLY APPRECIATED ADVANCED HOME CARE BELIEVE IN BRISTOL BILL GATTON AUTOMOTIVE GROUP BRISTOL COMPRESSORS INTERNATIONAL BRISTOL TENNESEE CITY SCHOOLS VIRGINIA STATE SENATOR BILL CARRICO CHILTERN INTERNATIONAL CITY OF BRISTOL TN CITY OF BRISTOL VA CITY OF KINGSPORT TN CITY OF NORTON VA CITY OF NORTON SCHOOL SYSTEM CITY OF ROGERSVILLE TN CITY OF SNEEDVILLE TN DICKENSON COUNTY CHAMBER OF COMMERCE DOMTAR DR GLENN E VANCE JR DDS ELECTROMECHANICAL CORPORATION FIRST TENNESSEE BANK FRIENDS IN NEED HEALTHCARE INC FRONTIER HEALTH US REPRESENTATIVE MORGAN GRIFFITH HANCOCK MANOR NURSING HOME HAWKINS COUNTY GAS UTILITY HAWKINS AND HANCOCK COUNTY HEALTH DEPARTMENTS HEALING HANDS HEALTH CENTER THE HEALTH WAGON HUNTER SMITH DAVIS ATTORNEYS AT LAW INDUSTRIAL DEVELOPMENT AUTHORITY OF DICKENSON COUNTY KVAT FOOD STORES KAVANAUGH CALL CENTER GROUP VIRGINIA STATE DELEGATE TERRY KILGORE KINGSPORT AREA CHAMBER OF COMMERCE KINGSPORT OFFICE OF SMALL BUSINESS DEVELOPMENT ENTREPRENEURSHIP LANDMARK REALTY INC LEE COUNTY VA MEADOWVIEW CONFERENCE RESORT CONVENTION CENTER VIRGINIA STATE DELEGATE JAMES WILL MOREFIELD MOUNTAIN EMPIRE OLDER CITIZENS INC NASH AND POWERS INSURANCE SERVICES NORTON INDUSTRIAL DEVELOPMENT AUTHORITY OAK HILL CEMETERY VIRGINIA STATE DELEGATE ISRAEL OQUINN PHARMACEUTICAL PRODUCT DEVELOPMENT VIRGINIA STATE SENATOR PHILLIP PUCKETT TENNESSEE LT GOVERNOR RON RAMSEY THE REGIONAL EYE CENTER THE ROBINETTE COMPANY RURAL HEALTH SERVICES CONSORTIUM SOUTHWEST VIRGINIA COMMUNITY HEALTH SYSTEMS INC STRONGWELL CORPORATION SULLIVAN COUNTY TN SULLIVAN COUNTY REGIONAL HEALTH DEPARTMENT SULLIVAN COUNTY SCHOOL SYSTEM TELEOPTICS INC TOWN OF ABINGDON VA TOWN OF BIG STONE GAP VA TOWN OF PENNINGTON GAP VA TOWN OF JONESVILLE VA TRISUMMIT BANK UNIVERSAL FIBERS UNIVERSITY OF VIRGINIAS COLLEGE AT WISE VIRGINIA CITY HYBRID ENERGY CENTER VIRGINIA DEPARTMENT OF HEALTH CUMBERLAND PLATEAU HEALTH DISTRICT VIRGINIA DEPARTMENT OF HEALTH LENOWISCO DISTRICT WCYBTV WELLMONT MEDICAL ASSOCIATES WISE COUNTY CHAMBER OF COMMERCE WISE COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY WISE COUNTY VA YWCA BRISTOL
LONESOME PINE HOSPITAL LINE NUMBER 3 PART V LINE 4	PART V LINE 4	BRISTOL REGIONAL MEDICAL CENTER HOLSTON VALLEY MEDICAL CENTER HAWKINS COUNTY MEMORIAL HOSPITAL HANCOCK COUNTY HOSPITAL MOUNTAIN VIEW REGIONAL MEDICAL CENTER LEE REGIONAL MEDICAL CENTER TAKOMA REGIONAL MEDICAL CENTER
LONESOME PINE HOSPITAL LINE NUMBER 3 PART V LINE 7	PART V LINE 7	KEY FINDINGS NOTED DURING THE CHNA WERE LACK OF SUFFICIENT PSYCHIATRIC HEALTH AND DENTAL CARE THESE FINDINGS FALL OUTSIDE THE CORE BUSINESS AND MISSON OF WELLMONT HEALTH SYSTEM TO HELP MEET THESE NEEDS WELLMONT HEALTH SYSTEM WILL CONTINUE TO STRENGTHEN OUR PARTNERSHIPS AND CONTINUUM OF CARE OPPORTUNITIES WITH AREA HEALTH DEPARTMENTS FEDERALLY QUALIFIED HEALTH CENTERS AND FRONTIER HEALTH THE REGIONS LEADING PROVIDER OF BEHAVIORAL HEALTH SERVICES
LONESOME PINE HOSPITAL LINE NUMBER 3 PART V LINE 15E	PART V LINE 15E	WELLMONT LONESOME PINE HOSPITALS OTHER ACTIONS INCLUDE GARNISHMENT OF WAGES
LONESOME PINE HOSPITAL LINE NUMBER 3 PART V LINE 16E	PART V LINE 16E	WELLMONT LONESOME PINE HOSPITALS OTHER ACTIONS INCLUDE GARNISHMENT OF WAGES
LONESOME PINE HOSPITAL LINE NUMBER 3 PART V LINE 19D	PART V LINE 19D	WELLMONT BRISTOL REGIONAL MEDICAL CENTER FOLLOWS TENNESSEE STATUTE WHICH IS 175 OF AVERAGE COST FOR ITS HOSPITALS
MOUNTAIN VIEW REGIONAL MEDICAL CENT LINE NUMBER 4 PART V LINE 3	PART V LINE 3	INFORMATION FOR THE CHNA ASSESSMENT WAS GATHERED FROM A VARIETY OF SOURCES INCLUDING INTERVIEWS WITH PATIENTS INTERVIEWS WITH KEY COMMUNITY LEADERS AND STAKEHOLDERS INCLUDING REPRESENTATIVE OF UNDERSERVED POPULATIONS AND AREAS WITH HEALTHCARE DISPARITIES INTERVIEWS WITH LEADERS AND STAFF IN OTHER HEALTHCARE ORGANIZATIONS OR CIVIC ORGANIZATIONS WITH A SHARED MISSION TO POSITIVELY IMPACT THE HEALTH STATUS OF THE COMMUNITY PHYSICIAN NEEDS ASSESSMENT COMMUNITY HEALTH FACILITY ASSESSMENT MENTAL HEALTH NEEDS ASSESSMENT DIALYSIS AND DENTAL NEEDS ASSESSMENT PUBLICLY AVAILABLE POPULATION AND DEMOGRAPHIC INFORMATION PUBLICLY AVAILABLE POPULATION HEALTH INFORMATION THE INFORMATION WAS THEN COLLATED AND ASSESSED TO DETERMINE THE GREATEST UNMET HEALTH NEEDS FACING OUR REGION STRATEGIES TO ADDRESS THESE NEEDS WERE THEN DEVELOPED UTILIZING INTERNAL RESOURCES AND PARTNERSHIPS WITH OTHER HEALTHCARE ORGANIZATIONS AND PHYSICIANS SEVERAL COMMUNITY LEADERS PARTICIPATED IN THE CHNA THROUGH PERSONAL INTERVIEWS SURVEYS AND OTHER MEANS THEIR FEEDBACK WAS INVALUABLE IN ASSESSING THE HEALTH NEEDS OF THE COMMUNITIES WE SERVE AND DEVELOPING ACTIONS PLANS TO ENSURE THOSE NEEDS WERE MET THE TIME TALENT AND INSIGHT OF ELECTED REPRESENTATIVES AND LEADERS OF BUSINESSES MUNICIPALITIES AND ORGANIZATIONS LISTED BELOW WERE GREATLY APPRECIATED ADVANCED HOME CARE BELIEVE IN BRISTOL BILL GATTON AUTOMOTIVE GROUP BRISTOL COMPRESSORS INTERNATIONAL BRISTOL TENNESEE CITY SCHOOLS VIRGINIA STATE SENATOR BILL CARRICO CHILTERN INTERNATIONAL CITY OF BRISTOL TN CITY OF BRISTOL VA CITY OF KINGSPORT TN CITY OF NORTON VA CITY OF NORTON SCHOOL SYSTEM CITY OF ROGERSVILLE TN CITY OF SNEEDVILLE TN DICKENSON COUNTY CHAMBER OF COMMERCE DOMTAR DR GLENN E VANCE JR DDS ELECTROMECHANICAL CORPORATION FIRST TENNESSEE BANK FRIENDS IN NEED HEALTHCARE INC FRONTIER HEALTH US REPRESENTATIVE MORGAN GRIFFITH HANCOCK MANOR NURSING HOME HAWKINS COUNTY GAS UTILITY HAWKINS AND HANCOCK COUNTY HEALTH DEPARTMENTS HEALING HANDS HEALTH CENTER THE HEALTH WAGON HUNTER SMITH DAVIS ATTORNEYS AT LAW INDUSTRIAL DEVELOPMENT AUTHORITY OF DICKENSON COUNTY KVAT FOOD STORES KAVANAUGH CALL CENTER GROUP VIRGINIA STATE DELEGATE TERRY KILGORE KINGSPORT AREA CHAMBER OF COMMERCE KINGSPORT OFFICE OF SMALL BUSINESS DEVELOPMENT ENTREPRENEURSHIP LANDMARK REALTY INC LEE COUNTY VA MEADOWVIEW CONFERENCE RESORT CONVENTION CENTER VIRGINIA STATE DELEGATE JAMES WILL MOREFIELD MOUNTAIN EMPIRE OLDER CITIZENS INC NASH AND POWERS INSURANCE SERVICES NORTON INDUSTRIAL DEVELOPMENT AUTHORITY OAK HILL CEMETERY VIRGINIA STATE DELEGATE ISRAEL OQUINN PHARMACEUTICAL PRODUCT DEVELOPMENT VIRGINIA STATE SENATOR PHILLIP PUCKETT TENNESSEE LT GOVERNOR RON RAMSEY THE REGIONAL EYE CENTER THE ROBINETTE COMPANY RURAL HEALTH SERVICES CONSORTIUM SOUTHWEST VIRGINIA COMMUNITY HEALTH SYSTEMS INC STRONGWELL CORPORATION SULLIVAN COUNTY TN SULLIVAN COUNTY REGIONAL HEALTH DEPARTMENT SULLIVAN COUNTY SCHOOL SYSTEM TELEOPTICS INC TOWN OF ABINGDON VA TOWN OF BIG STONE GAP VA TOWN OF PENNINGTON GAP VA TOWN OF JONESVILLE VA TRISUMMIT BANK UNIVERSAL FIBERS UNIVERSITY OF VIRGINIAS COLLEGE AT WISE VIRGINIA CITY HYBRID ENERGY CENTER VIRGINIA DEPARTMENT OF HEALTH CUMBERLAND PLATEAU HEALTH DISTRICT VIRGINIA DEPARTMENT OF HEALTH LENOWISCO DISTRICT WCYBTV WELLMONT MEDICAL ASSOCIATES WISE COUNTY CHAMBER OF COMMERCE WISE COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY WISE COUNTY VA YWCA BRISTOL
MOUNTAIN VIEW REGIONAL MEDICAL CENT LINE NUMBER 4 PART V LINE 4	PART V LINE 4	BRISTOL REGIONAL MEDICAL CENTER HOLSTON VALLEY MEDICAL CENTER LONESOME PINE HOSPITAL HAWKINS COUNTY MEMORIAL HOSPITAL HANCOCK COUNTY HOSPITAL LEE REGIONAL MEDICAL CENTER TAKOMA REGIONAL MEDICAL CENTER
MOUNTAIN VIEW REGIONAL MEDICAL CENT LINE NUMBER 4 PART V LINE 7	PART V LINE 7	KEY FINDINGS NOTED DURING THE CHNA WERE LACK OF SUFFICIENT PSYCHIATRIC HEALTH AND DENTAL CARE THESE FINDINGS FALL OUTSIDE THE CORE BUSINESS AND MISSON OF WELLMONT HEALTH SYSTEM TO HELP MEET THESE NEEDS WELLMONT HEALTH SYSTEM WILL CONTINUE TO STRENGTHEN OUR PARTNERSHIPS AND CONTINUUM OF CARE OPPORTUNITIES WITH AREA HEALTH DEPARTMENTS FEDERALLY QUALIFIED HEALTH CENTERS AND FRONTIER HEALTH THE REGIONS LEADING PROVIDER OF BEHAVIORAL HEALTH SERVICES
MOUNTAIN VIEW REGIONAL MEDICAL CENT LINE NUMBER 4 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 4 PART V LINE 16E	PART V LINE 16E	WELLMONT MOUNTAIN VIEW REGIONAL MEDICAL CENTERS OTHER ACTIONS INCLUDE GARNISHMENT OF WAGES
MOUNTAIN VIEW REGIONAL MEDICAL CENT LINE NUMBER 4 PART V LINE 19D	PART V LINE 19D	WELLMONT LONESOME PINE HOSPITAL FOLLOWS TENNESSEE STATUTE WHICH IS 175 OF AVERAGE COST FOR ITS HOSPITALS IN THE ABSENCE OF VIRGINIA STATUTE
LEE REGIONAL MEDICAL CENTER LINE NUMBER 5 PART V LINE 1J	PART V LINE 1J	LEE REGIONAL MEDICAL CENTER CEASED OPERATIONS EFFECTIVE OCTOBER 1 2013 DUE TO THE COMMUNITYS LOW USE OF THE HOSPITAL AND A LACK OF CONSISTENT PHYSICIAN COVERAGE IN ADDITION THE CLOSURE IS DUE IN PART TO MAJOR CUTS IN MEDICARE REIMBURSEMENTS BY THE FEDERAL GOVERNMENT ASSOCIATED WITH THE AFFORDABLE CARE ACT AND A LACK OF MEDICAID EXPANSION BY THE COMMONWEALTH OF VIRGINIA
LEE REGIONAL MEDICAL CENTER LINE NUMBER 5 PART V LINE 3	PART V LINE 3	INFORMATION FOR THE CHNA ASSESSMENT WAS GATHERED FROM A VARIETY OF SOURCES INCLUDING INTERVIEWS WITH PATIENTS INTERVIEWS WITH KEY COMMUNITY LEADERS AND STAKEHOLDERS INCLUDING REPRESENTATIVE OF UNDERSERVED POPULATIONS AND AREAS WITH HEALTHCARE DISPARITIES INTERVIEWS WITH LEADERS AND STAFF IN OTHER HEALTHCARE ORGANIZATIONS OR CIVIC ORGANIZATIONS WITH A SHARED MISSION TO POSITIVELY IMPACT THE HEALTH STATUS OF THE COMMUNITY PHYSICIAN NEEDS ASSESSMENT COMMUNITY HEALTH FACILITY ASSESSMENT MENTAL HEALTH NEEDS ASSESSMENT DIALYSIS AND DENTAL NEEDS ASSESSMENT PUBLICLY AVAILABLE POPULATION AND DEMOGRAPHIC INFORMATION PUBLICLY AVAILABLE POPULATION HEALTH INFORMATION THE INFORMATION WAS THEN COLLATED AND ASSESSED TO DETERMINE THE GREATEST UNMET HEALTH NEEDS FACING OUR REGION STRATEGIES TO ADDRESS THESE NEEDS WERE THEN DEVELOPED UTILIZING INTERNAL RESOURCES AND PARTNERSHIPS WITH OTHER HEALTHCARE ORGANIZATIONS AND PHYSICIANS SEVERAL COMMUNITY LEADERS PARTICIPATED IN THE CHNA THROUGH PERSONAL INTERVIEWS SURVEYS AND OTHER MEANS THEIR FEEDBACK WAS INVALUABLE IN ASSESSING THE HEALTH NEEDS OF THE COMMUNITIES WE SERVE AND DEVELOPING ACTIONS PLANS TO ENSURE THOSE NEEDS WERE MET THE TIME TALENT AND INSIGHT OF ELECTED REPRESENTATIVES AND LEADERS OF BUSINESSES MUNICIPALITIES AND ORGANIZATIONS LISTED BELOW WERE GREATLY APPRECIATED ADVANCED HOME CARE BELIEVE IN BRISTOL BILL GATTON AUTOMOTIVE GROUP BRISTOL COMPRESSORS INTERNATIONAL BRISTOL TENNESEE CITY SCHOOLS VIRGINIA STATE SENATOR BILL CARRICO CHILTERN INTERNATIONAL CITY OF BRISTOL TN CITY OF BRISTOL VA CITY OF KINGSPORT TN CITY OF NORTON VA CITY OF NORTON SCHOOL SYSTEM CITY OF ROGERSVILLE TN CITY OF SNEEDVILLE TN DICKENSON COUNTY CHAMBER OF COMMERCE DOMTAR DR GLENN E VANCE JR DDS ELECTROMECHANICAL CORPORATION FIRST TENNESSEE BANK FRIENDS IN NEED HEALTHCARE INC FRONTIER HEALTH US REPRESENTATIVE MORGAN GRIFFITH HANCOCK MANOR NURSING HOME HAWKINS COUNTY GAS UTILITY HAWKINS AND HANCOCK COUNTY HEALTH DEPARTMENTS HEALING HANDS HEALTH CENTER THE HEALTH WAGON HUNTER SMITH DAVIS ATTORNEYS AT LAW INDUSTRIAL DEVELOPMENT AUTHORITY OF DICKENSON COUNTY KVAT FOOD STORES KAVANAUGH CALL CENTER GROUP VIRGINIA STATE DELEGATE TERRY KILGORE KINGSPORT AREA CHAMBER OF COMMERCE KINGSPORT OFFICE OF SMALL BUSINESS DEVELOPMENT ENTREPRENEURSHIP LANDMARK REALTY INC LEE COUNTY VA MEADOWVIEW CONFERENCE RESORT CONVENTION CENTER VIRGINIA STATE DELEGATE JAMES WILL MOREFIELD MOUNTAIN EMPIRE OLDER CITIZENS INC NASH AND POWERS INSURANCE SERVICES NORTON INDUSTRIAL DEVELOPMENT AUTHORITY OAK HILL CEMETERY VIRGINIA STATE DELEGATE ISRAEL OQUINN PHARMACEUTICAL PRODUCT DEVELOPMENT VIRGINIA STATE SENATOR PHILLIP PUCKETT TENNESSEE LT GOVERNOR RON RAMSEY THE REGIONAL EYE CENTER THE ROBINETTE COMPANY RURAL HEALTH SERVICES CONSORTIUM SOUTHWEST VIRGINIA COMMUNITY HEALTH SYSTEMS INC STRONGWELL CORPORATION SULLIVAN COUNTY TN SULLIVAN COUNTY REGIONAL HEALTH DEPARTMENT SULLIVAN COUNTY SCHOOL SYSTEM TELEOPTICS INC TOWN OF ABINGDON VA TOWN OF BIG STONE GAP VA TOWN OF PENNINGTON GAP VA TOWN OF JONESVILLE VA TRISUMMIT BANK UNIVERSAL FIBERS UNIVERSITY OF VIRGINIAS COLLEGE AT WISE VIRGINIA CITY HYBRID ENERGY CENTER VIRGINIA DEPARTMENT OF HEALTH CUMBERLAND PLATEAU HEALTH DISTRICT VIRGINIA DEPARTMENT OF HEALTH LENOWISCO DISTRICT WCYBTV WELLMONT MEDICAL ASSOCIATES WISE COUNTY CHAMBER OF COMMERCE WISE COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY WISE COUNTY VA YWCA BRISTOL
LEE REGIONAL MEDICAL CENTER LINE NUMBER 5 PART V LINE 4	PART V LINE 4	BRISTOL REGIONAL MEDICAL CENTER HOLSTON VALLEY MEDICAL CENTER LONESOME PINE HOSPITAL HAWKINS COUNTY MEMORIAL HOSPITAL HANCOCK COUNTY HOSPITAL MOUNTAIN VIEW REGIONAL MEDICAL CENTER TAKOMA REGIONAL MEDICAL CENTER
LEE REGIONAL MEDICAL CENTER LINE NUMBER 5 PART V LINE 7	PART V LINE 7	KEY FINDINGS NOTED DURING THE CHNA WERE LACK OF SUFFICIENT PSYCHIATRIC HEALTH AND DENTAL CARE THESE FINDINGS FALL OUTSIDE THE CORE BUSINESS AND MISSON OF WELLMONT HEALTH SYSTEM TO HELP MEET THESE NEEDS WELLMONT HEALTH SYSTEM WILL CONTINUE TO STRENGTHEN OUR PARTNERSHIPS AND CONTINUUM OF CARE OPPORTUNITIES WITH AREA HEALTH DEPARTMENTS FEDERALLY QUALIFIED HEALTH CENTERS AND FRONTIER HEALTH THE REGIONS LEADING PROVIDER OF BEHAVIORAL HEALTH SERVICES
LEE REGIONAL MEDICAL CENTER LINE NUMBER 5 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 5 PART V LINE 16E	PART V LINE 16E	WELLMONT LEE REGIONAL MEDICAL CENTERS OTHER ACTIONS INCLUDE GARNISHMENT OF WAGES
LEE REGIONAL MEDICAL CENTER LINE NUMBER 5 PART V LINE 19D	PART V LINE 19D	WELLMONT MOUNTAIN VIEW REGIONAL MEDICAL CENTER FOLLOWS TENNESSEE STATUTE WHICH IS 175 OF AVERAGE COST FOR ITS HOSPITALS IN THE ABSENCE OF VIRGINIA STATUTE
HANCOCK COUNTY HOSPITAL LINE NUMBER 6 PART V LINE 3	PART V LINE 3	INFORMATION FOR THE CHNA ASSESSMENT WAS GATHERED FROM A VARIETY OF SOURCES INCLUDING INTERVIEWS WITH PATIENTS INTERVIEWS WITH KEY COMMUNITY LEADERS AND STAKEHOLDERS INCLUDING REPRESENTATIVE OF UNDERSERVED POPULATIONS AND AREAS WITH HEALTHCARE DISPARITIES INTERVIEWS WITH LEADERS AND STAFF IN OTHER HEALTHCARE ORGANIZATIONS OR CIVIC ORGANIZATIONS WITH A SHARED MISSION TO POSITIVELY IMPACT THE HEALTH STATUS OF THE COMMUNITY PHYSICIAN NEEDS ASSESSMENT COMMUNITY HEALTH FACILITY ASSESSMENT MENTAL HEALTH NEEDS ASSESSMENT DIALYSIS AND DENTAL NEEDS ASSESSMENT PUBLICLY AVAILABLE POPULATION AND DEMOGRAPHIC INFORMATION PUBLICLY AVAILABLE POPULATION HEALTH INFORMATION THE INFORMATION WAS THEN COLLATED AND ASSESSED TO DETERMINE THE GREATEST UNMET HEALTH NEEDS FACING OUR REGION STRATEGIES TO ADDRESS THESE NEEDS WERE THEN DEVELOPED UTILIZING INTERNAL RESOURCES AND PARTNERSHIPS WITH OTHER HEALTHCARE ORGANIZATIONS AND PHYSICIANS SEVERAL COMMUNITY LEADERS PARTICIPATED IN THE CHNA THROUGH PERSONAL INTERVIEWS SURVEYS AND OTHER MEANS THEIR FEEDBACK WAS INVALUABLE IN ASSESSING THE HEALTH NEEDS OF THE COMMUNITIES WE SERVE AND DEVELOPING ACTIONS PLANS TO ENSURE THOSE NEEDS WERE MET THE TIME TALENT AND INSIGHT OF ELECTED REPRESENTATIVES AND LEADERS OF BUSINESSES MUNICIPALITIES AND ORGANIZATIONS LISTED BELOW WERE GREATLY APPRECIATED ADVANCED HOME CARE BELIEVE IN BRISTOL BILL GATTON AUTOMOTIVE GROUP BRISTOL COMPRESSORS INTERNATIONAL BRISTOL TENNESEE CITY SCHOOLS VIRGINIA STATE SENATOR BILL CARRICO CHILTERN INTERNATIONAL CITY OF BRISTOL TN CITY OF BRISTOL VA CITY OF KINGSPORT TN CITY OF NORTON VA CITY OF NORTON SCHOOL SYSTEM CITY OF ROGERSVILLE TN CITY OF SNEEDVILLE TN DICKENSON COUNTY CHAMBER OF COMMERCE DOMTAR DR GLENN E VANCE JR DDS ELECTROMECHANICAL CORPORATION FIRST TENNESSEE BANK FRIENDS IN NEED HEALTHCARE INC FRONTIER HEALTH US REPRESENTATIVE MORGAN GRIFFITH HANCOCK MANOR NURSING HOME HAWKINS COUNTY GAS UTILITY HAWKINS AND HANCOCK COUNTY HEALTH DEPARTMENTS HEALING HANDS HEALTH CENTER THE HEALTH WAGON HUNTER SMITH DAVIS ATTORNEYS AT LAW INDUSTRIAL DEVELOPMENT AUTHORITY OF DICKENSON COUNTY KVAT FOOD STORES KAVANAUGH CALL CENTER GROUP VIRGINIA STATE DELEGATE TERRY KILGORE KINGSPORT AREA CHAMBER OF COMMERCE KINGSPORT OFFICE OF SMALL BUSINESS DEVELOPMENT ENTREPRENEURSHIP LANDMARK REALTY INC LEE COUNTY VA MEADOWVIEW CONFERENCE RESORT CONVENTION CENTER VIRGINIA STATE DELEGATE JAMES WILL MOREFIELD MOUNTAIN EMPIRE OLDER CITIZENS INC NASH AND POWERS INSURANCE SERVICES NORTON INDUSTRIAL DEVELOPMENT AUTHORITY OAK HILL CEMETERY VIRGINIA STATE DELEGATE ISRAEL OQUINN PHARMACEUTICAL PRODUCT DEVELOPMENT VIRGINIA STATE SENATOR PHILLIP PUCKETT TENNESSEE LT GOVERNOR RON RAMSEY THE REGIONAL EYE CENTER THE ROBINETTE COMPANY RURAL HEALTH SERVICES CONSORTIUM SOUTHWEST VIRGINIA COMMUNITY HEALTH SYSTEMS INC STRONGWELL CORPORATION SULLIVAN COUNTY TN SULLIVAN COUNTY REGIONAL HEALTH DEPARTMENT SULLIVAN COUNTY SCHOOL SYSTEM TELEOPTICS INC TOWN OF ABINGDON VA TOWN OF BIG STONE GAP VA TOWN OF PENNINGTON GAP VA TOWN OF JONESVILLE VA TRISUMMIT BANK UNIVERSAL FIBERS UNIVERSITY OF VIRGINIAS COLLEGE AT WISE VIRGINIA CITY HYBRID ENERGY CENTER VIRGINIA DEPARTMENT OF HEALTH CUMBERLAND PLATEAU HEALTH DISTRICT VIRGINIA DEPARTMENT OF HEALTH LENOWISCO DISTRICT WCYBTV WELLMONT MEDICAL ASSOCIATES WISE COUNTY CHAMBER OF COMMERCE WISE COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY WISE COUNTY VA YWCA BRISTOL
HANCOCK COUNTY HOSPITAL LINE NUMBER 6 PART V LINE 4	PART V LINE 4	BRISTOL REGIONAL MEDICAL CENTER HOLSTON VALLEY MEDICAL CENTER LONESOME PINE HOSPITAL HAWKINS COUNTY MEMORIAL HOSPITAL MOUNTAIN VIEW REGIONAL MEDICAL CENTER LEE REGIONAL MEDICAL CENTER TAKOMA REGIONAL MEDICAL CENTER
HANCOCK COUNTY HOSPITAL LINE NUMBER 6 PART V LINE 7	PART V LINE 7	KEY FINDINGS NOTED DURING THE CHNA WERE LACK OF SUFFICIENT PSYCHIATRIC HEALTH AND DENTAL CARE THESE FINDINGS FALL OUTSIDE THE CORE BUSINESS AND MISSON OF WELLMONT HEALTH SYSTEM TO HELP MEET THESE NEEDS WELLMONT HEALTH SYSTEM WILL CONTINUE TO STRENGTHEN OUR PARTNERSHIPS AND CONTINUUM OF CARE OPPORTUNITIES WITH AREA HEALTH DEPARTMENTS FEDERALLY QUALIFIED HEALTH CENTERS AND FRONTIER HEALTH THE REGIONS LEADING PROVIDER OF BEHAVIORAL HEALTH SERVICES
HANCOCK COUNTY HOSPITAL LINE NUMBER 6 PART V LINE 15E	PART V LINE 15E	WELLMONT HANCOCK COUNTY HOSPITALS OTHER ACTIONS INCLUDE GARNISHMENT OF WAGES
HANCOCK COUNTY HOSPITAL LINE NUMBER 6 PART V LINE 16E	PART V LINE 16E	WELLMONT HANCOCK COUNTY HOSPITALS OTHER ACTIONS INCLUDE GARNISHMENT OF WAGES
HANCOCK COUNTY HOSPITAL LINE NUMBER 6 PART V LINE 19D	PART V LINE 19D	WELLMONT LEE REGIONAL MEDICAL CENTER FOLLOWS TENNESSEE STATUTE WHICH IS 175 OF AVERAGE COST FOR ITS HOSPITALS IN THE ABSENCE OF VIRGINIA STATUTE

Schedule H (Form 990) 2012

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

2012

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. Part II can be duplicated if additional space is needed.

(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) AMERICAN CANCER SOCIETY 508 PRINCETON RD SUITE 102 JOHNSON CITY,TN37601	64-0329099	501(C)	19,000	RELAY FOR LIFE SPONS
(2) APPALACHIAN MOUNTAIN PROJECT ACCESS 1060 DRAGON RD OAKWOOD,VA24631	26-0069167	501(C)	40,000	SPONSORSHIP
(3) BARTER THEATRE PO BOX 867 ABINDGON,VA24212	54-6000120	501(C)	15,000	SPONSORSHIP
(4) BRISTOL MOTOR SPEEDWAY PO BOX 3966 BRISTOL,TN37625	62-1016760		10,000	CHILDREN'S CHARITIES
(5) BRISTOL CONVENTION & VISITORS BUREA PO BOX 519 BRISTOL,VA24203	54-0150315	501(C)	25,000	SPONSOR PICK PINK
(6) EAST TENNESSEE STATE UNIVERSITY PO BOX 70732 JOHNSON CITY,TN37614	23-7092731	501(C)	20,000	ATHLETIC SPONSORSHIP
(7) FUN FEST KINGSPORT TN 151 EAST MAIN ST KINGSPORT,TN37660	62-0446834	501(C)	17,750	SPONSORSHIP
(8) KINGSPORT CHAMBER OF COMMERCE 151 EAST MAIN ST KINGSPORT,TN37662	62-0446834	501(C)	25,835	ANNUAL SPONSORSHIP
(9) KINGSPORT TOMORROW 301 LOUIS ST SUITE 303 KINGSPORT,TN37660	58-1941002	501(C)	10,000	HEALTHCARE SYMPOSIUM
(10) OTHERS 5000			116,351	SPONSORSHIPS
(11) RHYTHM & ROOTS REUNION PO BOX 1927 BRISTOL,VA24203	72-1526206	501(C)	10,000	SPONSORSHIP
(12) SUSAN G KOMEN FOR THE CURE PO BOX 5835 KINGSPORT,TN37663	84-1689067	501(C)	55,102	SPONSORSHIP

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

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

Cat. No. 50055P

Schedule I (Form 990) 2012

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.
Part III can be duplicated 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, Part III, column (b), 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 SYSTEM ADVANCEMENT. 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) 2012

Additional Data

Software ID:
Software Version:

- TIN:

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

2012

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 or provision of all of 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 filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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 Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

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

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

Cat. No. 50053T

Schedule J (Form 990) 2012

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(A) Name and Title		(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)	(F) Compensation reported as deferred in prior Form 990
(1)PIERRE ISTFAN MDBOARD MEMBER	(i) (ii)	453,995	122,353	414	27,630	12,304	616,696
(2)MARGARET DENARVAEZPRESIDENT & CEO	(i) (ii)	762,876	247,353	21,652	40,877	6,299	1,079,057
(3)JOHN HOWARDEVP-LEGAL & CORP AFF	(i) (ii)	385,821	80,476	66,548		13,270	546,115
(4)TRACEY P MOFFATTSRVP & WHS COO	(i) (ii)	369,216	72,923	13,250	17,400	8,485	481,274
(5)ALICE POPEEVP & CFO	(i) (ii)	292,230	47,458	270	17,216	10,303	367,477
(6)HAMLIN J WILSONSR VP-HUMAN RESOURC	(i) (ii)	270,848	51,773	414	16,454	6,299	345,788
(7)KENT PETTYCHIEF INFORM OFF	(i) (ii)	266,827	41,670	270	16,250	14,278	339,295
(8)TODD J DOUGANSR VP-FINANCE	(i) (ii)	228,588	43,137		13,662	12,694	298,081
(9)LOWELL TODD NORRISSYSTEM VP-MARKETING	(i) (ii)	40,767 163,069	8,066 32,262	52 207	2,431 9,723	2,539 10,155	53,855 215,416
(10)BARTHOLEMEW A HOVEPRESIDENT-BRMC	(i) (ii)	415,032	73,573	8,770	24,840	12,694	534,909
(11)VIRGINIA FRANKPRESIDENT-HVMC	(i) (ii)	337,495	63,983	5,130	18,258	13,469	438,335
(12)GREG NEALPRESIDENTCEO WHCMH	(i) (ii)	237,175 59,294	38,526 9,631	6,936 1,734	13,507 3,377	8,587 2,147	304,731 76,183
(13)DAVID L BRASHSR VP OF BUS DEV	(i) (ii)	264,964	34,515	270	15,936	13,548	329,233
(14)SUSAN LINDENBUSCHVP WHS ONCOLOGY SVS	(i) (ii)	262,501	50,004	31,174	8,146	14,278	366,103
(15)DANIEL CARLSONCHIEF MEDICAL OFFICE	(i) (ii)	243,523	38,610	57,985		5,620	345,738
(16)TROY SYBERTCHIEF QUALITY OFF	(i) (ii)	261,661	41,670	270	16,055	13,488	333,144
(17)WILLIAM TROY CLARKVPHV CHIEF OPER OFF	(i) (ii)	251,866	37,375	162	15,213	10,340	314,956
(18)MARTHA CHILLSYSTEM VPEMR DIR	(i) (ii)	238,967	37,109	1,188	11,175	10,698	299,137

Schedule J (Form 990) 2012

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.

Identifier	Return Reference	Explanation
FRINGE OR EXPENSE EXPLANATION	SCHEDULE J, PAGE 1, PART I, LINE 1A	CHARTER 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, KIM ONESKO, CHIEF ADMINISTRATIVE OFFICER FOR WELLMONT MEDICAL ASSOCIATES, SUSAN LINDENBUSCH, VP OF ONCOLOGY SERVICES, DURING THE FISCAL YEAR ENDED JUNE 30, 2013. THE HOUSING ALLOWANCES PAID TO THE EXECUTIVES WERE INCLUDED IN THEIR TAXABLE COMPENSATION. HEALTH OR SOCIAL CLUB DUES DURING THE FISCAL YEAR ENDED JUNE 30, 2013, WELLMONT HEALTH SYSTEM PROVIDED COUNTRY CLUB MEMBERSHIPS TO MARGARET DENARVAEZ, VIRGINIA FRANK, JOHN HOWARD, BARTON A. HOVE, AND TRACEY MOFFATT. 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.
OTHER ADDITIONAL INFORMATION	SCHEDULE J, PART III	WELLMONT HEALTH SYSTEM HAS AN EXECUTIVE RETIREMENT PROGRAM THAT INCLUDED MARGARET DENARVAEZ, JOHN HOWARD AND ALICE POPE FOR THE FISCAL YEAR ENDING JUNE 30, 2013. 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, 2013.

Schedule J (Form 990) 2012

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 Part VI.
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.

OMB No. 1545-0047

2012

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	CONSTRUCTION AT HVMC		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 1993 BOND		X		X		X
D	SULLIVAN CNTY TENN HEALTH EDL & HSG	62-1256662	865292DZ6	12-13-2005	70,620,000	REFUND 2002 BOND		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .
2 Amount of bonds legally 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 escrows . . . . . . . . . . . .	60,061,731				60,061,731		71,529,827
7 Issuance costs from proceeds . . . . . . . . . . . .	2,164,568		1,026,366		699,922		266,958
8 Credit enhancement from proceeds . . . . . . . . . . .	1,541,817				1,541,817
9 Working capital expenditures from proceeds . . . . . . . . .	126,950						126,950
10 Capital expenditures from proceeds . . . . . . . . . . .	182,892,682		49,167,614
11 Other spent proceeds . . . . . . . . . . . . . .
12 Other unspent proceeds . . . . . . . . . . . . . .	69
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 Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2012

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 of bond-financed property? . . . . . . . . . . . .		X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . . . . . . . . . . . . .
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .		X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .
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 Does the bond issue meet the private security or payment test? . . . . .		X		X		X		X
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X		X		X		X
b If “Yes” to line 8a, enter the percentage of bond-financed property sold or disposed of.	%		%		%		%
c If “Yes” to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .		X		X		X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2?	X		X		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T? . . . . .		X		X		X		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .		X		X		X		X
b Exception to rebate? . . . . . . . .		X		X		X		X
c No rebate due? . . . . . . . . . .	X		X		X		X
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .		X		X		X	X
4a Has the organization or the governmental issuer entered into a qualified 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

Schedule K (Form 990) 2012

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (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
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .		X		X		X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?		X

Part VI

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

Identifier	Return Reference	Explanation
DIFFERENCES IN ISSUE PRICE EXPLANATION	SCHEDULE K	SULLIVAN CNTY TENN HEALTH EDL HSG ADDITIONAL PROCEEDS ON PART II LINE 3 WERE FROM PREMIUMS ON BOND ISSUES ACCRUED INTEREST AND INITIAL RESERVE FUNDS
DATE REBATE COMPUTATION PERFORMED	SCHEDULE K	SULLIVAN CNTY TENN HEALTH EDL HSG 103111 VIRGINIA SMALL BUSINESS FING AUTH H 073112 SULLIVAN CNTY TENN HEALTH EDL HSG 053113 SULLIVAN CNTY TENN HEALTH EDL HSG 090112
ADDITIONAL INFORMATION	SCHEDULE K	SULLIVAN CNTY TENN HEALTH EDL HSG DIFFERENCE IN PROCEEDS VERSUS ISSUE PRICE EXPLANATION FOR 2012 TAXEXEMPT MASTER LEASESUBLEASE PROCEEDS ON PART II LINE 3 DIFFER FROM THE ISSUE PRICE ON PART I E BECAUSE AS OF FY 2013 ONLY TWO DRAWS WERE MADE AGAINST THE BOND TOTALING 16150175

Schedule K (Form 990) 2012

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, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ. MediumBullet

See separate instructions.

OMB No. 1545-0047

2012

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

Enter the amount of tax incurred by 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-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No






Total ...... $

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 assistance	(d) Type of assistance	(e) Purpose of assistance

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2012

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	(b) Relationship between interested person and the organization	(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
(1) BRISTOL ANESTHESIA SERVICES PC	VENDOR	101,421	ANESTHESIA SERVICES		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	WILLIAM SMITH MD PRACTICES WITH BRISTOL ANESTHESIA SERVICES PC WHO PROVIDES ANESTHESIA SERVICES TO BRISTOL REGIONAL MEDICAL CENTER

Schedule L (Form 990 or 990-EZ) 2012

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

2012

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.
FIRST ACCOMPLISHMENT DESCRIPTION	FORM 990, PAGE 2, PART III, LINE 4A	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. WELLMONT 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 2013, WE PROVIDED SERVICES TO 51,462 PATIENTS IN A BED, 307,654 EMERGENCY ROOM VISITS, 217,125 OUTPATIENT REGISTRATIONS (EXCLUDING ER), 2,309 NEWBORN DELIVERIES, 21,324 SURGERIES AND 418,924 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 PINEHOSPITAL (BIG STONE GAP, VA.), HANCOCK COUNTY HOSPITAL (SNEEDVILLE, TENN.),MOUNTAIN VIEW REGIONAL MEDICAL CENTER (NORTON, VA.) AND LEE REGIONALMEDICAL 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 51,042,187 IN BENEFITS TO OUR REGION, INCLUDING 38,798,967 OF COSTS FOR INDIGENT PATIENTS AND UNCOMPENSATED CARE FOR OTHER PATIENTS AND 51,042,187 FOR OTHER COMMUNITY ACTIVITIES OUTLINED BELOW. WELLMONT 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'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. 5,740 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'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 58,057,581 OF CHARGES AND INCURRING COST OF 15,364,503. WELLMONT IS INCOMPLIANCE WITH IRS GUIDELINES FOR FORM 990 SCHEDULE H REPORTING PURPOSES AND THE AMOUNTS REFLECTED ABOVE ARE NOT INCLUSIVE OF RESOURCES DESCRIBED IN WELLMONT'S COMMUNITY BENEFIT REPORT AS THE ABOVE AMOUNTS ARE REPORTED ON SCHEDULE H. OTHER RECENT INITIATIVES INCLUDE: THE WELLMONT HEALTH COACH IS PART OF WELLMONT'S ONGOING EFFORTS TO IMPROVE THE HEALTH OF OUR COMMUNITIES AND ENCOURAGE WELLNESS IN THE MOUNTAINS OF NORTHEAST TENNESSEE AND SOUTHWEST VIRGINIA. FUNDED BY COMMUNITY SUPPORT THROUGH THE WELLMONT FOUNDATION, THE COACH OFFERS A HOST OF COMPREHENSIVE SCREENINGS THAT HELP IDENTIFY POTENTIAL HEALTH PROBLEMS. 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 BREASTCARE 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. BRISTOL REGIONAL MEDICAL CENTER PROVIDES SUPPLIES AND OTHER VARIOUS ITEMS VALUED AT 24,151 TO HEALING HANDS HEALTH CENTER IN BRISTOL, TENN., WHICH PROVIDES QUALITY HEALTH CARE TO THE WORKING POOR. DR. DAVE ARNOLD SERVES AS THE MEDICAL DIRECTOR OF HEALING HANDS HEALTH CENTER IN BRISTOL, TENN. AND HIS SALARY AND BENEFITS ARE PAID BY WELLMONT PHYSICIANS SERVICES, A TAXABLE SUBSIDIARY OF WELLMONT. TRAINING AND EDUCATING OUR HEALTHCARE PROFESSIONALS WELLMONT 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 6,782,638. RECENT INITIATIVES INCLUDE: WELLMONT PROVIDED AND PARTICIPATED IN SEVERAL FORMAL TRAINING PROGRAMS FOR HEALTH PROFESSIONALS, INCLUDING EAST TENNESSEE STATE UNIVERSITY'S INTERNSHIP AND RESIDENCY PROGRAMS. OUR CONTRIBUTIONS TOTALED 620,041 IN SUPPORT OF THE SCHOOL'S JAMES H. QUILLEN COLLEGE OF MEDICINE RESIDENCY PROGRAM. WELLMONT 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 AND LEE REGIONAL MEDICAL CENTER. THE STUDENTS PERFORM SUB-SPECIALTY ROTATIONS AT HOLSTON VALLEY MEDICAL CENTER AND BRISTOL REGIONAL MEDICAL CENTER AND PRIMARY CORE ROTATIONS AT HAWKINS COUNTY MEMORIAL HOSPITAL. OUR CONTRIBUTIONS TOTALED 1,029,041 IN SUPPORT OF THE DEBUSK COLLEGE OF OSTEOPATHIC MEDICINE. WELLMONT AND LINCOLN MEMORIAL UNIVERSITY'S DEBUSK COLLEGE OF OSTEOPATHIC MEDICINE ALSO PARTNER TO PROVIDE 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. OUR CONTRIBUTIONS TOTALED 864,989 IN SUPPORT OF THE LINCOLN MEMORIAL UNIVERSITY'S DEBUSK COLLEGE OF OSTEOPATHIC MEDICINE ORTHOPEDIC RESIDENCY PROGRAM. WELLMONT CONTINUES TO EXERT 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. WELLMONT STARTED THE IMPLEMENTATION OF MYWELLMONT, WHICH IS AN ONLINE PORTAL THAT ALLOWS WELLMONT PATIENTS TO SECURELY ACCESS THEIR HEALTH INFORMATION FROM VIRTUALLY ANYWHERE. PATIENTS CAN ELECTRONICALLY REQUEST APPOINTMENTS, VIEW TEST RESULTS, RENEW PRESCRIPTIONS, PAY BILLS AND PERFORM MANY OTHER ROUTINE ACTIVITIES. MOST IMPORTANTLY, PATIENTS AND PROVIDERS CAN CONNECT IN MORE WAYS THAN EVER BEFORE, ENHANCING RELATIONSHIPS AND BUILDING A TEAM-BASED APPROACH TO CARE. WELLMONT HAS MADE AVAILABLE CONTINUING EDUCATION AND TRAINING TO EMPLOYEES, MEDICAL STAFF, MEMBERS OF AFFILIATED HEALTH CAREORGANIZATIONS AND SCHOOLS AND INTERESTED MEMBERS OF THE PUBLIC. SOME OF THOSE OPPORTUNITIES INCLUDED: -ANNUAL STROKE SYMPOSIUM; OPEN TO WELLMONT PHYSICIANS AND STAFF AND THE COMMUNITY; -ANNUAL CRITICAL CARE AND TRAUMA CONFERENCE; OPEN TO WELLMONT PHYSICIANS AND STAFF AND THE COMMUNITY; -ANNUAL CARDIOVASCULAR SUMMIT; OPEN TO WELLMONT PHYSICIANS AND STAFFAND THE COMMUNITY; -REGULAR EDUCATION FOR CLINICAL STAFF ON TOPICS INCLUDING CPR PROGRAMS, ADVANCED CARDIOVASCULAR LIFE SUPPORT, PEDIATRIC ADVANCED LIFE SUPPORT, ADVANCED TRAUMA LIFE SUPPORT AND ADVANCED TRAUMA COURSE FOR NURSING. WELLMONT SUPPORTS A NURSE EXTERN PROGRAM THAT UTILIZES NURSING STAFF THAT HAVE COMPLETED A DEGREE BUT NOT YET PASSED BOARD CERTIFICATION. THIS PROVIDES INVALUABLE EXPERIENCE FOR NEW NURSES, WHO ARE SUPERVISED BY BOARD CERTIFIED NURSES DURING THIS TIME. THE EXTERNS ARE NOT REQUIRED TO WORK FOR WELLMONT AFTER EARNING THEIR CERTIFICATION. AT A DIRECT COST OF 385,158, OUR ORGANIZATION STAFFED AND MAINTAINED A MEDICAL LIBRARY PROGRAM FOR EMPLOYEES, MEDICAL STAFF AND MEMBERS OF AFFILIATED HEALTHCARE ORGANIZATIONS TO HELP ENHANCE KNOWLEDGE WITH THE LATEST RESEARCH FINDING AND THINKING. WELLMONT AND NORTHEAST STATE TECHNICAL COMMUNITY COLLEGE HAVE PARTNERED TO ESTABLISH A NURSING SCHOOL THAT WILL ENHANCE CAREER OPPORTUNITIES FOR STUDENTS AND BOLSTER THE SUPPLY OF NURSES THROUGHOUT THE REGION. PROVIDING
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. ANY CHANGES OR CORRECTIONS ARE IDENTIFIED, REVISED IN THE RETURN, AND REVIEWED BY THE INDIVIDUALS LISTED ABOVE PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE.
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. ANY POTENTIAL CONFLICTS ARE DISCUSSED WITH THE COMPLIANCE AND AUDIT SERVICES DEPARTMENT AS THEY ARISE. 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 COMPLIANCE AND AUDIT SERVICES DEPARTMENT, FOR RESOLUTION. WELLMONT HEALTH SYSTEM ALSO USES A HOTLINE THAT ALLOWS ANONYMOUS REPORTING OF POSSIBLE CONFLICT OF INTEREST SITUATIONS FOR INVESTIGATION BY THE COMPLIANCE AND AUDIT SERVICES DEPARTMENT.
COMPENSATION PROCESS FOR TOP OFFICIAL	FORM 990, PAGE 6, PART VI, LINE 15A	THE COMPENSATION OF MARGARET DENARVAEZ, THE PRESIDENT AND CEO OF WELLMONT HEALTH SYSTEM, IS REVIEWED, APPROVED AND DOCUMENTED BY THE WELLMONT HEALTH SYSTEM HUMAN RESOURCES 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 LAST COMPENSATION DELIBERATION AND REVIEW PROCESS FOR MARGARET DENARVAEZ WAS COMPLETED NOVEMBER 29, 2012 AND APPROVED BY THE BOARD OF DIRECTORS OF WELLMONT HEALTH SYSTEM ON DECEMBER 4, 2012.
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 HUMAN RESOURCES COMMITTEE OF THE 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 NOVEMBER 29, 2012. WELLMONT HEALTH SYSTEM CHIEF OPERATIONS OFFICER - TRACEY P. MOFFAT EXECUTIVE VP OF LEGAL AND CORPORATE AFFAIRS - JOHN HOWARD WELLMONT HEALTH SYSTEM EXECUTIVE VP AND CHIEF FINANCIAL OFFICER - ALICE POPE WELLMONT HEALTH SYSTEM SR. VP OF HUMAN RESOURCES - HAMLIN J. WILSON WELLMONT HEALTH SYSTEM VP OF MARKETING AND COMMUNICATIONS - LOWELL TODD NORRIS BRISTOL REGIONAL MEDICAL CENTER PRESIDENT - BARTHOLOMEW A. HOVE COMMUNITY HOSPITAL PRESIDENT AND CEO AND INTERIM BRISTOL REGIONAL MEDICAL CENTER PRESIDENT - GREG NEAL HOLSTON VALLEY MEDICAL CENTER PRESIDENT - VIRGINIA FRANK 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 - TODD J. DOUGAN WELLMONT HEALTH SYSTEM CHIEF INFORMATION OFFICER - KENT PETTY REGIONAL VP VIRGINIA DIVISION - DAVID L. BRASH
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
OTHER FEES FOR SERVICES	FORM 990, PART IX, LINE 11G	OTHER FEES FOR SERVICES 75,083,339 2,958,005 0 TN COVERAGE FEE 11,807,524 0 0 WHS ALLOCATION -4,712,066 0 0 JV 27,253 97,066 0
OTHER CHANGES IN NET ASSETS EXPLANATION	FORM 990, PART XI, LINE 9	UNREALIZED SWAP GAIN 2,355,796 INTERCOMPANY RESOLUTION 1,214,203 UNREALIZED GAIN ON INVESTMENTS 5,735,177 CHANGE IN PENSION LIABILITY 7,358,624 ROUNDING 74

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2012

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

2012

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" to Form 990, Part IV, line 33.)

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(f) Direct controlling entity
(1) WELLMONT HEALTH MANAGEMENT WELLMONT HEALTH MANAGEMENT 1905 AMERICAN WAY KINGSPORT,TN37660 62-1825259	HEALTHCARE	TN	WHS
(2) WELLMONT INTEGRATED NETWORK LLC WELLMONT INTEGRATED NETWORK LLC 1905 AMERICAN WAY KINGSPORT,TN37660 45-5443060	HEALTHCARE	TN	WHS

Part II

Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" to 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 entity?
(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	9	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	7	WHS	Yes
(8) WELLMONT SLEEP SERVICES 1906 AMERICAN WAY KINGSPORT,TN37660	HEALTHCARE	TN	501C3	3	WHS	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2012

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to 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	360,471	3,869,364		No			No
(3) HOLSTON VALLEY AMBULATORY SURGERY 103 WEST STONE DRIVE KINGSPORT,TN37660		TN	WHS	RELATED	1,119,634	1,479,413		No			No
(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	360,471	3,869,364		No			No
(6) HOLSTON VALLEY AMBULATORY SURGERY 103 WEST STONE DRIVE KINGSPORT,TN37660		TN	WHS	RELATED	1,119,634	1,479,413		No			No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" to 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	(i) Section 512(b)(13) controlled entity?
(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		Yes	No
(1) WELLMONT INC 1905 AMERICAN WAY KINGSPORT,TN37660 62-1320035	PHYS. SVCS	TN	WHS	C CORP	-6,854,420	-87,271,683	100.000 %		No
(2) MCOT INC 1905 AMERICAN WAY KINGSPORT,TN37660 62-1325938	MED. SVCS.	TN	N/A						No
(3) MEDICAL LAUNDRY OF TRI-CITIES MEDICAL LAUNDRY OF TRI-CITIES 1905 AMERICAN WAY KINGSPORT,TN37660 62-1482226	MED. SVCS.	TN	N/A						No
(4) MEDICAL MALL PHARMACY INC 1905 AMERICAN WAY KINGSPORT,TN37660 62-1565006	MED. SVCS.	TN	N/A						No
(5) WELLMONT PHYSICIAN SERVICES WELLMONT PHYSICIAN SERVICES 1905 AMERICAN WAY KINGSPORT,TN37660 62-1567353	PHYS. SVCS	TN	N/A						No
(6) WELLMONT HEALTH SERVICES INC 1905 AMERICAN WAY KINGSPORT,TN37660 62-1254373	HEALTHCARE	TN	N/A						No
(7) WPS PROVIDERS INC 1905 AMERICAN WAY KINGSPORT,TN37660 20-5564642	PHYS. SVCS	TN	N/A						No
(8) WELLMONT INC 1905 AMERICAN WAY KINGSPORT,TN37660 62-1320035	PHYS. SVCS	TN	WHS	C CORP	-6,854,420	-87,271,683	100.000 %		No
(9) MCOT INC 1905 AMERICAN WAY KINGSPORT,TN37660 62-1325938	MED. SVCS.	TN	N/A						No
(10) MEDICAL LAUNDRY OF TRI-CITIES MEDICAL LAUNDRY OF TRI-CITIES 1905 AMERICAN WAY KINGSPORT,TN37660 62-1482226	MED. SVCS.	TN	N/A						No
(11) MEDICAL MALL PHARMACY INC 1905 AMERICAN WAY KINGSPORT,TN37660 62-1565006	MED. SVCS.	TN	N/A						No
(12) WELLMONT PHYSICIAN SERVICES WELLMONT PHYSICIAN SERVICES 1905 AMERICAN WAY KINGSPORT,TN37660 62-1567353	PHYS. SVCS	TN	N/A						No
(13) WELLMONT HEALTH SERVICES INC 1905 AMERICAN WAY KINGSPORT,TN37660 62-1254373	HEALTHCARE	TN	N/A						No
(14) WPS PROVIDERS INC 1905 AMERICAN WAY KINGSPORT,TN37660 20-5564642	PHYS. SVCS	TN	N/A						No

Schedule R (Form 990) 2012

Page 3

Part V

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

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

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 or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

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

Yes

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

Yes

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

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

f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

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

Yes

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

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

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

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-s)	(c) Amount involved	(d) Method of determining amount involved
(1) WELLMONT CARDIOLOGY SERVICES	B	4,968,647	CAPITAL CONTRIBUTIONS
(2) WELLMONT HAWKINS COUNTY MEMORIAL HO	B	2,359,040	CAPITAL CONTRIBUTIONS
(3) WELLMONT FOUNDATION	C	1,810,746	NEED
(4) HOLSTON VALLEY IMAGING CENTER INC	I	2,396,248	INTERCOMPANY SETTLEMENT
(5) HOLSTON VALLEY AMBULATORY SURGERY C	J	906,361	LEASE AGREEMENT
(6) MEDICAL LAUNDRY OF TRI-CITIES INC	J	92,750	LEASE AGREEMENT
(7) WELLMONT CARDIOLOGY SERVICES	J	360,343	COST INVOICES
(8) WELLMONT MEDICAL ASSOCIATES	J	1,230,862	LEASE AGREEMENT
(9) WELLMONT HAWKINS COUNTY MEMORIAL HO	J	198,436	LEASE AGREEMENT
(10) WELLMONT MEDICAL ASSOCIATES	K	57,906	LEASE AGREEMENT
(11) WELLMONT HAWKINS COUNTY MEMORIAL HO	L	4,853,098	SUPPORT SERVICES
(12) MCOT INC	M	2,167,950	COLLECTION AGREEMENT
(13) MEDICAL LAUNDRY OF TRI-CITIES INC	M	2,071,808	FMV
(14) WELLMONT CARDIOLOGY SERVICES	M	3,223,371	COST INVOICES
(15) WELLMONT MEDICAL ASSOCIATES	M	582,250	SERVICE AGREEMENT
(16) HOLSTON VALLEY AMBULATORY SURGERY C	R	968,760	DISTRIBUTION
(17) SAPLING GROVE AMBULATORY SURGE	R	604,500	DISTRIBUTION
(18) WELLMONT MEDICAL ASSOCIATES	G	829,136	ASSET TRANSFER
(19) WELLMONT FOUNDATION	M	667,811	INVOICES
(20) WELLMONT CARDIOLOGY SERVICES	B	4,968,647	CAPITAL CONTRIBUTIONS
(21) WELLMONT HAWKINS COUNTY MEMORIAL HO	B	2,359,040	CAPITAL CONTRIBUTIONS
(22) WELLMONT FOUNDATION	C	1,810,746	NEED
(23) HOLSTON VALLEY IMAGING CENTER INC	I	2,396,248	INTERCOMPANY SETTLEMENT
(24) HOLSTON VALLEY AMBULATORY SURGERY C	J	906,361	LEASE AGREEMENT
(25) MEDICAL LAUNDRY OF TRI-CITIES INC	J	92,750	LEASE AGREEMENT
(26) WELLMONT CARDIOLOGY SERVICES	J	360,343	COST INVOICES
(27) WELLMONT MEDICAL ASSOCIATES	J	1,230,862	LEASE AGREEMENT
(28) WELLMONT HAWKINS COUNTY MEMORIAL HO	J	198,436	LEASE AGREEMENT
(29) WELLMONT MEDICAL ASSOCIATES	K	57,906	LEASE AGREEMENT
(30) WELLMONT HAWKINS COUNTY MEMORIAL HO	L	4,853,098	SUPPORT SERVICES
(31) MCOT INC	M	2,167,950	COLLECTION AGREEMENT
(32) MEDICAL LAUNDRY OF TRI-CITIES INC	M	2,071,808	FMV
(33) WELLMONT CARDIOLOGY SERVICES	M	3,223,371	COST INVOICES
(34) WELLMONT MEDICAL ASSOCIATES	M	582,250	SERVICE AGREEMENT
(35) HOLSTON VALLEY AMBULATORY SURGERY C	R	968,760	DISTRIBUTION
(36) SAPLING GROVE AMBULATORY SURGE	R	604,500	DISTRIBUTION
(37) WELLMONT MEDICAL ASSOCIATES	G	829,136	ASSET TRANSFER
(38) WELLMONT FOUNDATION	M	667,811	INVOICES
(39) WELLMONT CARDIOLOGY SERVICES	B	4,968,647	CAPITAL CONTRIBUTIONS
(40) WELLMONT HAWKINS COUNTY MEMORIAL HO	B	2,359,040	CAPITAL CONTRIBUTIONS
(41) WELLMONT FOUNDATION	C	1,810,746	NEED
(42) HOLSTON VALLEY IMAGING CENTER INC	I	2,396,248	INTERCOMPANY SETTLEMENT
(43) HOLSTON VALLEY AMBULATORY SURGERY C	J	906,361	LEASE AGREEMENT
(44) MEDICAL LAUNDRY OF TRI-CITIES INC	J	92,750	LEASE AGREEMENT
(45) WELLMONT CARDIOLOGY SERVICES	J	360,343	COST INVOICES
(46) WELLMONT MEDICAL ASSOCIATES	J	1,230,862	LEASE AGREEMENT
(47) WELLMONT HAWKINS COUNTY MEMORIAL HO	J	198,436	LEASE AGREEMENT
(48) WELLMONT MEDICAL ASSOCIATES	K	57,906	LEASE AGREEMENT
(49) WELLMONT HAWKINS COUNTY MEMORIAL HO	L	4,853,098	SUPPORT SERVICES
(50) MCOT INC	M	2,167,950	COLLECTION AGREEMENT
(51) MEDICAL LAUNDRY OF TRI-CITIES INC	M	2,071,808	FMV
(52) WELLMONT CARDIOLOGY SERVICES	M	3,223,371	COST INVOICES
(53) WELLMONT MEDICAL ASSOCIATES	M	582,250	SERVICE AGREEMENT
(54) HOLSTON VALLEY AMBULATORY SURGERY C	R	968,760	DISTRIBUTION
(55) SAPLING GROVE AMBULATORY SURGE	R	604,500	DISTRIBUTION
(56) WELLMONT MEDICAL ASSOCIATES	G	829,136	ASSET TRANSFER
(57) WELLMONT FOUNDATION	M	667,811	INVOICES
(58) WELLMONT CARDIOLOGY SERVICES	B	4,968,647	CAPITAL CONTRIBUTIONS
(59) WELLMONT HAWKINS COUNTY MEMORIAL HO	B	2,359,040	CAPITAL CONTRIBUTIONS
(60) WELLMONT FOUNDATION	C	1,810,746	NEED
(61) HOLSTON VALLEY IMAGING CENTER INC	I	2,396,248	INTERCOMPANY SETTLEMENT
(62) HOLSTON VALLEY AMBULATORY SURGERY C	J	906,361	LEASE AGREEMENT
(63) MEDICAL LAUNDRY OF TRI-CITIES INC	J	92,750	LEASE AGREEMENT
(64) WELLMONT CARDIOLOGY SERVICES	J	360,343	COST INVOICES
(65) WELLMONT MEDICAL ASSOCIATES	J	1,230,862	LEASE AGREEMENT
(66) WELLMONT HAWKINS COUNTY MEMORIAL HO	J	198,436	LEASE AGREEMENT
(67) WELLMONT MEDICAL ASSOCIATES	K	57,906	LEASE AGREEMENT
(68) WELLMONT HAWKINS COUNTY MEMORIAL HO	L	4,853,098	SUPPORT SERVICES
(69) MCOT INC	M	2,167,950	COLLECTION AGREEMENT
(70) MEDICAL LAUNDRY OF TRI-CITIES INC	M	2,071,808	FMV
(71) WELLMONT CARDIOLOGY SERVICES	M	3,223,371	COST INVOICES
(72) WELLMONT MEDICAL ASSOCIATES	M	582,250	SERVICE AGREEMENT
(73) HOLSTON VALLEY AMBULATORY SURGERY C	R	968,760	DISTRIBUTION
(74) SAPLING GROVE AMBULATORY SURGE	R	604,500	DISTRIBUTION
(75) WELLMONT MEDICAL ASSOCIATES	G	829,136	ASSET TRANSFER
(76) WELLMONT FOUNDATION	M	667,811	INVOICES

Schedule R (Form 990) 2012

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to 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)	(e) Are all partners section 501(c)(3) organizations?		(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?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(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

Schedule R (Form 990) 2012

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 INFORMATION	SCHEDULE R	PART V LINE 2 WELLMONT FOUNDATION PERFORMS FUNDRAISING SERVICES FOR WELLMONT HEALTH SYSTEM AND ITS RELATED 501C3 ENTITIES THE COST OF THESE SERVICES IS 667811 AND CANNOT BE DETERMINED BY ENTITY

Additional Data

Software ID:
Software Version:

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	17
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	14
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ......	5	6,543
6	Total number of volunteers (estimate if necessary) .............	6	2,773
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	102,751
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	-8,369

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	4,400,625	1,467,930
9	Program service revenue (Part VIII, line 2g) .........	691,289,550	664,198,681
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	18,826,444	18,508,931
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	21,721,215	25,174,849
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	736,237,834	709,350,391
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	321,497	364,038
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)	265,319,622	267,803,376
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–24e)....	409,648,889	397,055,767
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	675,290,008	665,223,181
19	Revenue less expenses. Subtract line 18 from line 12.......	60,947,826	44,127,210
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	987,213,169	1,056,851,839
21	Total liabilities (Part X, line 26).............	600,810,507	609,658,093
22	Net assets or fund balances. Subtract line 21 from line 20.....	386,402,662	447,193,746

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 618,522,856 including grants of $ 364,038 ) (Revenue $ )
	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. 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. WELLMONT 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 2013, WE PROVIDED SERVICES TO 51,462 PATIENTS IN A BED, 307,654 EMERGENCY ROOM VISITS, 217,125 OUTPATIENT REGISTRATIONS (EXCLUDING ER), 2,309 NEWBORN DELIVERIES, 21,324 SURGERIES AND 418,924 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 PINEHOSPITAL (BIG STONE GAP, VA.), HANCOCK COUNTY HOSPITAL (SNEEDVILLE, TENN.),MOUNTAIN VIEW REGIONAL MEDICAL CENTER (NORTON, VA.) AND LEE REGIONALMEDICAL 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 51,042,187 IN BENEFITS TO OUR REGION, INCLUDING 38,798,967 OF COSTS FOR INDIGENT PATIENTS AND UNCOMPENSATED CARE FOR OTHER PATIENTS AND 51,042,187 FOR OTHER COMMUNITY ACTIVITIES OUTLINED BELOW. WELLMONT 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'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. 5,740 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'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 58,057,581 OF CHARGES AND INCURRING COST OF 15,364,503. WELLMONT IS INCOMPLIANCE WITH IRS GUIDELINES FOR FORM 990 SCHEDULE H REPORTING PURPOSES AND THE AMOUNTS REFLECTED ABOVE ARE NOT INCLUSIVE OF RESOURCES DESCRIBED IN WELLMONT'S COMMUNITY BENEFIT REPORT AS THE ABOVE AMOUNTS ARE REPORTED ON SCHEDULE H. OTHER RECENT INITIATIVES INCLUDE: THE WELLMONT HEALTH COACH IS PART OF WELLMONT'S ONGOING EFFORTS TO IMPROVE THE HEALTH OF OUR COMMUNITIES AND ENCOURAGE WELLNESS IN THE MOUNTAINS OF NORTHEAST TENNESSEE AND SOUTHWEST VIRGINIA. FUNDED BY COMMUNITY SUPPORT THROUGH THE WELLMONT FOUNDATION, THE COACH OFFERS A HOST OF COMPREHENSIVE SCREENINGS THAT HELP IDENTIFY POTENTIAL HEALTH PROBLEMS. 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 BREASTCARE 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. BRISTOL REGIONAL MEDICAL CENTER PROVIDES SUPPLIES AND OTHER VARIOUS ITEMS VALUED AT 24,151 TO HEALING HANDS HEALTH CENTER IN BRISTOL, TENN., WHICH PROVIDES QUALITY HEALTH CARE TO THE WORKING POOR. DR. DAVE ARNOLD SERVES AS THE MEDICAL DIRECTOR OF HEALING HANDS HEALTH CENTER IN BRISTOL, TENN. AND HIS SALARY AND BENEFITS ARE PAID BY WELLMONT PHYSICIANS SERVICES, A TAXABLE SUBSIDIARY OF WELLMONT. TRAINING AND EDUCATING OUR HEALTHCARE PROFESSIONALS WELLMONT 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 6,782,638. RECENT INITIATIVES INCLUDE: WELLMONT PROVIDED AND PARTICIPATED IN SEVERAL FORMAL TRAINING PROGRAMS FOR HEALTH PROFESSIONALS, INCLUDING EAST TENNESSEE STATE UNIVERSITY'S INTERNSHIP AND RESIDENCY PROGRAMS. OUR CONTRIBUTIONS TOTALED 620,041 IN SUPPORT OF THE SCHOOL'S JAMES H. QUILLEN COLLEGE OF MEDICINE RESIDENCY PROGRAM. WELLMONT 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 AND LEE REGIONAL MEDICAL CENTER. THE STUDENTS PERFORM SUB-SPECIALTY ROTATIONS AT HOLSTON VALLEY MEDICAL CENTER AND BRISTOL REGIONAL MEDICAL CENTER AND PRIMARY CORE ROTATIONS AT HAWKINS COUNTY MEMORIAL HOSPITAL. OUR CONTRIBUTIONS TOTALED 1,029,041 IN SUPPORT OF THE DEBUSK COLLEGE OF OSTEOPATHIC MEDICINE. WELLMONT AND LINCOLN MEMORIAL UNIVERSITY'S DEBUSK COLLEGE OF OSTEOPATHIC MEDICINE ALSO PARTNER TO PROVIDE 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. OUR CONTRIBUTIONS TOTALED 864,989 IN SUPPORT OF THE LINCOLN MEMORIAL UNIVERSITY'S DEBUSK COLLEGE OF OSTEOPATHIC MEDICINE ORTHOPEDIC RESIDENCY PROGRAM. WELLMONT CONTINUES TO EXERT 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. WELLMONT STARTED THE IMPLEMENTATION OF MYWELLMONT, WHICH IS AN ONLINE PORTAL THAT ALLOWS WELLMONT PATIENTS TO SECURELY ACCESS THEIR HEALTH INFORMATION FROM VIRTUALLY ANYWHERE. PATIENTS CAN ELECTRONICALLY REQUEST APPOINTMENTS, VIEW TEST RESULTS, RENEW PRESCRIPTIONS, PAY BILLS AND PERFORM MANY OTHER ROUTINE ACTIVITIES. MOST IMPORTANTLY, PATIENTS AND PROVIDERS CAN CONNECT IN MORE WAYS THAN EVER BEFORE, ENHANCING RELATIONSHIPS AND BUILDING A TEAM-BASED APPROACH TO CARE. WELLMONT HAS MADE AVAILABLE CONTINUING EDUCATION AND TRAINING TO EMPLOYEES, MEDICAL STAFF, MEMBERS OF AFFILIATED HEALTH CAREORGANIZATIONS AND SCHOOLS AND INTERESTED MEMBERS OF THE PUBLIC. SOME OF THOSE OPPORTUNITIES INCLUDED: -ANNUAL STROKE SYMPOSIUM; OPEN TO WELLMONT PHYSICIANS AND STAFF AND THE COMMUNITY; -ANNUAL CRITICAL CARE AND TRAUMA CONFERENCE; OPEN TO WELLMONT PHYSICIANS AND STAFF AND THE COMMUNITY; -ANNUAL CARDIOVASCULAR SUMMIT; OPEN TO WELLMONT PHYSICIANS AND STAFFAND THE COMMUNITY; -REGULAR EDUCATION FOR CLINICAL STAFF ON TOPICS INCLUDING CPR PROGRAMS, ADVANCED CARDIOVASCULAR LIFE SUPPORT, PEDIATRIC ADVANCED LIFE SUPPORT, ADVANCED TRAUMA LIFE SUPPORT AND ADVANCED TRAUMA COURSE FOR NURSING. WELLMONT SU

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 expenses618,522,856

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	6,352,919	842,959	489,645

				(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		1,101,725
e	Government grants (contributions)1e		259,736

f	All other contributions, gifts, grants, and similar amounts not included above1f		106,469

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			1,467,930
			Business Code
2a	NET PATIENT REVENUE		621990	436,136,617	436,136,617
b	PHARMACY REVENUE		621990	215,687,439	215,687,439
c	BLOOD REVENUE		621990	11,536,558	11,536,558
d	ADMINISTRATIVE REVENUE		561000	838,067	838,067
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			664,198,681
3	Investment income (including dividends, interest, and other similar amounts).......			15,719,801			15,719,801
4	Income from investment of tax-exempt bond proceeds..
5	Royalties...........
		(i) Real	(ii) Personal
6a	Gross rents	6,552,896
b	Less: rental expenses	1,963,950
c	Rental income or (loss)	4,588,946
d	Net rental income or (loss).......			4,588,946			4,588,946
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	90,603,404	4,927,450
b	Less: cost or other basis and sales expenses	87,817,247	4,924,477
c	Gain or (loss)	2,786,157	2,973
d	Net gain or (loss)..........			2,789,130		1,606	2,787,524
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	MEANINGFUL USE FUNDS		621990	11,541,076	11,541,076
b	MISCELLANEOUS REVENUE		453220	5,207,727			5,207,727
c	CAFETERIA VENDING		900099	3,260,828			3,260,828
d	All other revenue ....			576,272		101,145	475,127
e	Total. Add lines 11a–11d ......			20,585,903
12	Total revenue. See Instructions......			709,350,391	675,739,757	102,751	32,039,953


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing .............			948,014	1	321,617
2	Savings and temporary cash investments .........			35,772,409	2	49,779,799
3	Pledges and grants receivable, net ...........				3
4	Accounts receivable, net .............			118,465,911	4	115,810,678
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
				8,681	5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6
7	Notes and loans receivable, net .............				7
8	Inventories for sale or use ..............			15,281,656	8	16,664,616
9	Prepaid expenses and deferred charges ..........			6,897,997	9	8,333,651
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	987,960,886
b	Less: accumulated depreciation .....	10b	539,626,200	429,068,956	10c	448,334,686
11	Investments—publicly traded securities ..........			343,401,965	11	380,769,767
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 .....			20,328,086	13	20,038,518
14	Intangible assets ...............			11,618,870	14	8,745,924
15	Other assets. See Part IV, line 11 ...........			5,420,624	15	8,052,583
16	Total assets. Add lines 1 through 15 (must equal line 34)......			987,213,169	16	1,056,851,839
17	Accounts payable and accrued expenses .........			60,100,983	17	67,473,674
18	Grants payable .................				18
19	Deferred revenue ................				19
20	Tax-exempt bond liabilities .............			442,481,059	20	450,196,234
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Loans and other 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 ..			950,645	23	10,955,180
24	Unsecured notes and loans payable to unrelated third parties ....				24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................			97,277,820	25	81,033,005
26	Total liabilities. Add lines 17 through 25.........			600,810,507	26	609,658,093
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			386,402,662	27	447,193,746
28	Temporarily restricted net assets ...........				28
29	Permanently restricted net assets ...........				29
	Organizations that do not follow SFAS 117 (ASC 958), 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 ...........			386,402,662	33	447,193,746
34	Total liabilities and net assets/fund balances ........			987,213,169	34	1,056,851,839