TY 2015 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)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) GERALD G BLACKWELL MD...................................................................... PRES/SEC/PHY	40.00 .................	X	X		802,762	0	33,867
(2) HERBERT LADLEY MD...................................................................... BOARD MEM/PH	40.00 .................	X			783,447	0	32,895
(3) DAVID BECKNER MD...................................................................... BOARD MEM/PH	40.00 .................	X			776,973	0	31,993
(4) JONATHAN BURRESS MD...................................................................... BOARD MEM/PH	40.00 .................	X			768,493	0	30,773
(5) MARK CHANG MD...................................................................... BOARD MEM/PH	40.00 .................	X			764,707	0	30,022
(6) FREDDIE M WILLIAMS...................................................................... BOARD MEM/PH	40.00 .................	X			758,381	0	26,268
(7) MATTHEW LUFF...................................................................... BOARD MEM/PH	40.00 .................	X			649,324	0	29,453
(8) ALICE POPE TERM 42216...................................................................... BOARD MEM/WH	.................	X			0	622,401	30,564
(9) THOMAS M BULLE MD...................................................................... BOARD MEM/PH	40.00 .................	X			576,494	0	29,786
(10) RICHARD NEAL CARTER...................................................................... BOARD MEM/PH	40.00 .................	X			460,894	0	18,937
(11) TIMOTHY W ATTEBERY...................................................................... BOARD MEMBER	1.00 ................. 39.00	X			0	457,547	24,744
(12) GREG NEAL...................................................................... BOARD MEM/PR	1.00 ................. 39.00	X			0	450,645	24,978
(13) BRAD PRICE...................................................................... SENIOR VP RE	1.00 ................. 39.00	X			0	389,490	12,941
(14) TODD J DOUGAN...................................................................... BOARD MEM/CF	1.00 ................. 39.00	X			0	372,338	20,628
(15) VYVYAN DEROUEN...................................................................... EXECUTIVE DI	.................	X	X		93,248	0	9,107
(16) DAVID CROCKETT...................................................................... BOARD MEMBER	.................	X			0	0	0
(17) ROBERT K KRAMER MD...................................................................... BOARD MEM/PH	40.00 .................			X	783,003	0	33,022

(A) Name and business address	(B) Description of services	(C) Compensation
HOLSTON MEDICAL GROUP, P O BOX 9 KINGSPORT,TN37662	PROFESSIONAL SV	698,588
NORTHEAST TN EMERGENCY PHYSICIANS, 415 BROAD STREET SUITE 410 KINGSPORT,TN37660	PROFESSIONAL SV	266,580
CLINCH PROFESSIONAL PHYSICIAN LLC, 67919 GOV GC PEERY HWY SUITE 3650 RICHLANDS,VA24641	PROFESSIONAL SV	245,809
HIGHLANDS PHYSICIANS INC, 2004 AMERICAN WAY SUITE 201 KINGSPORT,TN37660		127,526

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 4

- 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.
right arrow

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

Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

WELLMONT CARDIOLOGY SERVICES

Employer identification number

26-3557623

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 (Form 990 or 990-EZ))

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 in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ..............

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

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2015

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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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 VI.)..
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 section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2014 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2015. 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—2014. 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—2015. 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 VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2014. 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 VI 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) 2015

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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .	8,484	55,917	180,267	13,419	357,291	615,378
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......	26,231,600	29,385,201	29,812,960	27,339,461	27,271,502	140,040,724
3	Gross receipts from activities that are not an unrelated trade or business under section 513...	1,305,501	1,512,362	1,595,206	1,178,413	1,132,091	6,723,573
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.	27,545,585	30,953,480	31,588,433	28,531,293	28,760,884	147,379,675
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.)						147,379,675

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
9	Amounts from line 6...	27,545,585	30,953,480	31,588,433	28,531,293	28,760,884	147,379,675
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..		135		106,845	45,806	152,786
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.		135		106,845	45,806	152,786
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.			2,325			2,325
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..	27,545,585	30,953,615	31,590,758	28,638,138	28,806,690	147,534,786

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

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 8, column (f) divided by line 13, column (f)) .........

99.890 %

Public support percentage from 2014 Schedule A, Part III, line 15 ...............

99.930 %

Section D. Computation of Investment Income Percentage

Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (f)) ......

0 %

Investment income percentage from 2014 Schedule A, Part III, line 17 .............

0 %

19a

331/3% support tests—2015. 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—2014. 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) 2015

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2015

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2015

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2015

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2015 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2015	(iii) Distributable Amount for 2015
1 Distributable amount for 2015 from Section C, line 6
2 Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......
e From 2014.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2015 distributable amount
i Carryover from 2010 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2015 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2015 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2016. Add lines 3j and 4c.
8 Breakdown of line 7:
a
b
c Excess from 2013.......
d From 2014.......
e From 2015.......

Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2015

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.

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Name of the organization

WELLMONT CARDIOLOGY SERVICES

Employer identification number

26-3557623

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, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) 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), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions 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 an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled 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 totaling $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 its Form 990PF, Part I, line 2, 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) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2

Name of organization WELLMONT CARDIOLOGY SERVICES

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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 3

Name of organization WELLMONT CARDIOLOGY SERVICES		Employer identification number 26-3557623

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) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 4


Name of organization WELLMONT CARDIOLOGY SERVICES			Employer identification number 26-3557623
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. 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.) $ 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) (2015)

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," on 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.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

WELLMONT CARDIOLOGY SERVICES

Employer identification number

26-3557623

Part I

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

			(a) Donor advised funds	(b) Funds and other accounts

1	Total number at end of year ....
2	Aggregate value of contributions to (during year)
3	Aggregate value of 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" on 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, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, 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" on 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)

Revenue included on 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:

Revenue included on 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) 2015

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" on 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


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
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, for escrow or custodial account liability?

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" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	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 on 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" on 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.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11a. 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 ...
b	Buildings
c	Leasehold improvements	2,527,538	581,594	1,945,944
d	Equipment ...	2,881,582	1,875,257	1,006,325
e	Other ...	92,323	41,954	50,369
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				3,002,638

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11b. 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
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

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

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) GOODWILL				381,577
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				381,577

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)
2. Liability for uncertain tax positions. 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) 2015

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
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 (losses) 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. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
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

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.

Return Reference	Explanation

Schedule D (Form 990) 2015

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" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

WELLMONT CARDIOLOGY SERVICES

Employer identification number

26-3557623

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 on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

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
directors, trustees, officers, including 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 on 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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

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

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

Any related organization?

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

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

The organization?

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

Yes

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

For persons listed on 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 on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" on 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) 2015

Page 2

Part II

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

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column(B) reported as deferred on prior Form 990
(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)
1GERALD G BLACKWELL MDPRES/SEC/PHYSICIAN	(i) (ii)	554,434 -------------	227,739 -------------	20,589 -------------	23,877 -------------	9,990 -------------	836,629 -------------	-------------
2HERBERT LADLEY MDBOARD MEM/PHYSICIAN	(i) (ii)	554,434 -------------	227,739 -------------	1,274 -------------	23,877 -------------	9,018 -------------	816,342 -------------	-------------
3DAVID BECKNER MDBOARD MEM/PHYSICIAN	(i) (ii)	548,434 -------------	227,739 -------------	800 -------------	22,003 -------------	9,990 -------------	808,966 -------------	-------------
4JONATHAN BURRESS MDBOARD MEM/PHYSICIAN	(i) (ii)	530,434 -------------	232,739 -------------	5,320 -------------	22,104 -------------	8,669 -------------	799,266 -------------	-------------
5MARK CHANG MDBOARD MEM/PHYSICIAN	(i) (ii)	554,434 -------------	187,696 -------------	22,577 -------------	21,857 -------------	8,165 -------------	794,729 -------------	-------------
6FREDDIE M WILLIAMSBOARD MEM/PHYSICIAN	(i) (ii)	530,434 -------------	227,739 -------------	208 -------------	22,003 -------------	4,265 -------------	784,649 -------------	-------------
7MATTHEW LUFFBOARD MEM/PHYSICIAN	(i) (ii)	548,434 -------------	100,682 -------------	208 -------------	19,463 -------------	9,990 -------------	678,777 -------------	-------------
8ALICE POPE TERM 42216BOARD MEM/WHS CFO	(i) (ii)	------------- 429,481	------------- 184,100	------------- 8,820	------------- 18,549	------------- 12,015	------------- 652,965	-------------
9THOMAS M BULLE MDBOARD MEM/PHYSICIAN	(i) (ii)	400,709 -------------	174,511 -------------	1,274 -------------	20,264 -------------	9,522 -------------	606,280 -------------	-------------
10RICHARD NEAL CARTERBOARD MEM/PHYSICIAN	(i) (ii)	447,327 -------------	-------------	13,567 -------------	8,947 -------------	9,990 -------------	479,831 -------------	-------------
11TIMOTHY W ATTEBERYBOARD MEMBER/HV CEO	(i) (ii)	------------- 393,955	------------- 62,751	------------- 841	------------- 15,438	------------- 9,306	------------- 482,291	-------------
12GREG NEALBOARD MEM/PRES BRMC	(i) (ii)	------------- 373,693	------------- 75,832	------------- 1,120	------------- 14,988	------------- 9,990	------------- 475,623	-------------
13BRAD PRICESENIOR VP RESOURCE M	(i) (ii)	------------- 279,371	------------- 109,764	------------- 355	------------- 12,941	-------------	------------- 402,431	-------------
14TODD J DOUGANBOARD MEM/CFO	(i) (ii)	------------- 262,307	------------- 109,891	------------- 140	------------- 10,638	------------- 9,990	------------- 392,966	-------------
15ROBERT K KRAMER MDBOARD MEM/PHYSICIAN	(i) (ii)	554,434 -------------	227,739 -------------	830 -------------	23,877 -------------	9,145 -------------	816,025 -------------	-------------
16PABITRA SAHA MDPHYSICIAN	(i) (ii)	554,434 -------------	227,739 -------------	691 -------------	23,784 -------------	11,035 -------------	817,683 -------------	-------------
17DANIEL SIMPSONPHYSICIAN	(i) (ii)	548,434 -------------	227,739 -------------	409 -------------	21,938 -------------	9,990 -------------	808,510 -------------	-------------
18JOHN R BERTUSOPHYSICIAN	(i) (ii)	536,405 -------------	227,739 -------------	1,099 -------------	23,927 -------------	9,990 -------------	799,160 -------------	-------------
19JOHN F BERRYPHYSICIAN	(i) (ii)	530,434 -------------	227,739 -------------	320 -------------	22,003 -------------	9,990 -------------	790,486 -------------	-------------
20BARTON A HOVEPRESIDENT/WHS CEO	(i) (ii)	------------- 798,729	------------- 520,000	------------- 63,863	------------- 28,581	------------- 9,990	------------- 1,421,163	-------------
21JAMES MERRILL MDBOARD MEM/PHYSICIAN	(i) (ii)	554,434 -------------	227,739 -------------	844 -------------	17,669 -------------	10,567 -------------	811,253 -------------	-------------
22MARK MAYHEW MDBOARD MEM/PHYSICIAN	(i) (ii)	548,434 -------------	227,739 -------------	347 -------------	22,003 -------------	9,990 -------------	808,513 -------------	-------------
23HARRISON D TURNER MD TM 7116BOARD MEM/PHYSICIAN	(i) (ii)	431,840 -------------	227,739 -------------	2,023 -------------	19,737 -------------	9,790 -------------	691,129 -------------	-------------
24MARGARET D DENARVAEZ TERM 91614WHS PRESIDENT & CEO	(i) (ii)	-------------	------------- 136,339	------------- 9,872	-------------	-------------	------------- 146,211	-------------
25TRACEY P MOFFATT TERM 10314BOARD MEM/WHS COO	(i) (ii)	-------------	------------- 45,000	------------- 420	------------- 900	-------------	------------- 46,320	-------------

Schedule J (Form 990) 2015

Page 3

Part III

Supplemental Information

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

Return Reference	Explanation
SCHEDULE J, PAGE 1, PART I, LINE 1A	HEALTH OR SOCIAL CLUB DUES DURING THE FISCAL YEAR ENDED JUNE 30, 2016, WELLMONT HEALTH SYSTEM PROVIDED A COUNTRY CLUB MEMBERSHIP TO BARTON A. HOVE. THESE AMOUNTS ARE INCLUDED IN TAXABLE COMPENSATION.
SCHEDULE J, PAGE 1, PART I, LINE 6B	INCENTIVE COMPENSATION IS BASED ON MEETING BUDGETED OPERATING MARGIN GOALS.
SCHEDULE J, PART III	PART I, LINE 4A - SEVERANCE PAYMENT MARGARET DENARVAEZ, FORMER CEO OF WELLMONT HEALTH SYSTEM, ENTERED INTO A CONFIDENTIAL SEPARATION AGREEMENT AND GENERAL RELEASE (THE "AGREEMENT") AS OF SEPTEMBER 16, 2014. THERE WERE OTHER PAYMENTS FOR EARNED INCENTIVE COMPENSATION AND REIMBURSEMENT OF RELOCATION COSTS THAT ARE NOT CONSIDERED "SEVERANCE". PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN ALICE POPE TERMINATED EMPLOYMENT WITH WELLMONT HEALTH SYSTEM IN APRIL 2016. WELLMONT HEALTH SYSTEM HAS AN EXECUTIVE RETIREMENT PROGRAM THAT INCLUDED ALICE POPE UNTIL APRIL 2016. THERE WERE NO PAYMENTS MADE AND THERE ARE NO CURRENT PARTICIPANTS IN THIS PROGRAM.

Schedule J (Form 990) 2015

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

Information about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

WELLMONT CARDIOLOGY SERVICES

Employer identification number

26-3557623

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) 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 Benefiting 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) 2015

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) THE HEART CENTER PARTNERSHIP	BOARD OVERLAP	1,543,742	LEASE AGREEMENT		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference

Explanation

SCHEDULE L, PART V

SCHEDULE L, PART IV, LINE 1, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: WELLMONT HEALTH SYSTEM (LESSEE), WHICH IS THE SOLE MEMBER OF THE CORPORATION, WELLMONT CARDIOLOGY SERVICES, ENTERED INTO A LEASE AGREEMENT WITH THE HEART CENTER PARTNERSHIP (LESSOR) ON APRIL 30, 2010 TO LEASE 49,481 RENTABLE SQUARE FEET IN THE BUILDING KNOWN AS THE HEART CENTER, LOCATED AT 2050 MEADOWVIEW PARKWAY, KINGSPORT, TENNESSEE 37660 FOR A TEN YEAR TERM WITH RENEWABLE TERMS IN SIX MONTH INCREMENTS. THE AGREEMENT PROVIDES FOR THE LESSEE'S PURCHASE RIGHT OF FIRST REFUSAL AND A MULTI-LESSEE RIGHT OF FIRST OFFER. A SECOND AMMENDMENT DATED JANUARY 1, 2016 INCREASED THE RENTABLE SQUARE FEET TO A TOTAL OF 50,099 AND EXTENDED THE TERM FIVE YEARS. THERE ARE CURRENTLY 38 PHYSICIANS EMPLOYED BY WELLMONT CARDIOLOGY SERVICES OF WHICH, 23 ARE PHYSICIANS THAT ARE THE CURRENT PARTNERS OF THE HEART CENTER PARTNERSHIP, AS IS TIM ATTEBERY, PRESIDENT OF HOLSTON VALLEY MEDICAL CENTER WHICH IS WELLMONT HEALTH SYSTEM'S LARGEST HOSPITAL. THE HEART CENTER PARTNERSHIP IS NOT OWNED BY WELLMONT HEALTH SYSTEM, WELLMONT CARDIOLOGY SERVICES, OR ANY AFFILIATED ENTITIES. THE 23 PHYSICIAN PARTNERS MENTIONED IN THE LEASE AGREEMENT ARE AS FOLLOWS: DAVID C. BECKNER, M.D. JOHN F. BERRY, M.D. JOHN R. BERTUSO, M.D. GERALD G. BLACKWELL, M.D. MARK A. BORSCH, M.D. THOMAS M. BULLE, M.D. JONATHAN W. BURRESS, M.D. LARRY H. COX, M.D. STANLEY A. GALL, JR., M.D. TYLER GREENFIELD, M.D. PIERRE ISTFAN, M.D. CHRISTOPHER J. KENNEDY, M.D. ROBERT KEITH KRAMER, M.D. HERBERT D. LADLEY, M.D. MARC W. MAYHEW, M.D. JAMES J. MERRILL, M.D. WILLIAM M. MESSERSCHMIDT, M.D. DAVID CHRISTOPHER METZGER, M.D. ARUN RAO, M.D. PABITRA K. SAHA, M.D. DANIEL E. SIMPSON, M.D. FREDDIE M. WILLIAMS, M.D. MARCUS WILLIAMS, M.D.

Schedule L (Form 990 or 990-EZ) 2015

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 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

WELLMONT CARDIOLOGY SERVICES

Employer identification number

26-3557623

Return Reference	Explanation
FORM 990, PAGE 2, PART III, LINE 4A	IN 2013, HOLSTON VALLEY MEDICAL CENTER AND BRISTOL REGIONAL MEDICAL CENTER WERE TWO OF ONLY 197 HOSPITALS NATIONWIDE TO RECEIVE THE AMERICAN COLLEGE OF CARDIOLOGY'S PLATINUM PERFORMANCE ACHIEVEMENT AWARD. THIS AWARD RECOGNIZES THE HOSPITALS' COMMITMENT TO AND SUCCESS IN IMPLEMENTING A HIGHER STANDARD OF CARE FOR HEART ATTACK PATIENTS AND SIGNIFIES THEY HAVE REACHED AN AGGRESSIVE GOAL OF TREATING THESE PATIENTS TO STANDARD LEVELS OF CARE OUTLINED BY THE AMERICAN COLLEGE OF CARDIOLOGY. OUR MISSION IS TO IMPROVE THE CARDIOVASCULAR HEALTH OF OUR REGION. IT IS OUR VISION TO DELIVER HIGH QUALITY, COST-EFFECTIVE HEART AND VASCULAR CARE WITH COMPASSION. WELLMONT CARDIOLOGY SERVICES CONSISTS OF 38 BOARD-CERTIFIED CARDIOLOGISTS AND CARDIOVASCULAR AND THORACIC SURGEONS SERVING 13 COMMUNITY OFFICES AND THE SEVEN MEMBER HOSPITALS OF WELLMONT HEALTH SYSTEM. WE DIAGNOSE, TREAT AND MANAGE ALL ASPECTS OF ADULT CARDIOVASCULAR DISEASE. OUR SERVICES INCLUDE GENERAL CARDIOLOGY, PREVENTIVE CARDIOLOGY, ELECTROPHYSIOLOGY, INTERVENTIONAL CARDIOLOGY, VASCULAR MEDICINE, STRUCTURAL HEART DISEASE, HEART FAILURE MANAGEMENT, CARDIOVASCULAR AND THORACIC SURGERY AND ADVANCED CARDIOVASCULAR IMAGING. WE ALSO SERVE AS A LEADER IN CLINICAL RESEARCH AND TEACHING INSTITUTION THROUGH THE CARDIOVASCULAR UNIVERSITY. WE ARE DEDICATED TO 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 QUALITY OF LIFE IN THE AREAS WE SERVE. OVERALL, WE RETURNED MORE THAN 22,637,063 IN BENEFITS TO OUR COMMUNITY. FOR FISCAL YEAR 2016, WE HAD 97,389 OUTPATIENT ENCOUNTERS AND PERFORMED 1,532 INPATIENT SURGICAL PROCEDURES. REGARDLESS OF RACE, RELIGION, ETHNICITY OR ABILITY TO PAY, WELLMONT CARDIOVASCULAR SERVICES TREATS ALL PATIENTS FOR MEDICALLY NECESSARY CONDITIONS. RECOGNIZING THAT SOME PATIENTS CANNOT AFFORD ESSENTIAL MEDICAL SERVICES, WE PROVIDED CARE FOR INDIGENT PATIENTS, WRITING OFF 2,441,063 OF CHARGES AND INCURRING COSTS OF 1,261,098. ADDITIONALLY, WE PROVIDED CARE TO PERSONS COVERED BY MEDICARE, MEDICAID, TENNCARE AND CHAMPUS AT LESS THAN COST. DUE TO MANDATED REDUCTIONS IN MEDICARE FUNDING FROM THE BALANCED BUDGET ACT AND DECLINING REIMBURSEMENT FROM TENNCARE, THE SHORTFALL BETWEEN RECEIPTS AND THE COST OF PROVIDING CARE TO THESE PATIENTS TOTALED 18,934,902. IT IS OUR OBLIGATION TO SUPPORT THE CAUSES THAT IMPROVE THE QUALITY OF LIFE IN OUR REGION. WE SPONSORED OR PARTICIPATED IN EDUCATIONAL, COMMUNITY- BASED PROGRAMS ON HEALTHY LIFESTYLES, RISK FACTOR IDENTIFICATION, DIAGNOSING AND TREATMENT OPTIONS, INCLUDING CONTINUING EDUCATION PROGRAMS FOR PHYSICIANS, NURSES AND ALLIED HEALTH PROFESSIONALS. SUCH INITIATIVES INCLUDED: -9TH ANNUAL HEART TALK -REGIONAL HEALTHCARE SYMPOSIUM -DIABETES EXPO -DIABETES SYMPOSIUM -PRESENTATION TO MEDICAL SOCIETIES -COMMUNITY OUTREACH WITH AREA CHURCHES -PARTICIPATION WITH LOCAL SUPPORT GROUPS -PRESENTATIONS TO AREA CIVIC ORGANIZATIONS WE PARTICIPATED IN THE FOLLOWING EMPLOYER-BASED EVENTS: -ROBINETTE COMPANY HEALTH FAIR, WHICH INCLUDED BLOOD PRESSURE SCREENINGS -BRISTOL COMPRESSORS HEART HEALTHY LUNCH AND LEARNS ADDITIONALLY, DONATIONS TOTALING 11,500 WERE MADE TO LAUGHLIN MEMORIAL HOSPITAL, FUNFEST 3K MOON WALK, WYTHE ARTS COUNCIL AND THE AMERICAN HEART ASSOCATION. THE LEVEL ONE HEART ATTACK NETWORK IS A PARTNERSHIP WITH LOCAL COMMUNITIES, EMERGENCY MEDICAL SERVICE PROVIDERS, AREA EMERGENCY DEPARTMENTS AND WELLMONT CARDIOLOGY SERVICES. THE CONTINUED DEVELOPMENT OF THE NETWORK HAS IMPROVED OUR ABILITY TO PROVIDE PROMPT AND EFFECTIVE HEART ATTACK TREATMENT FOR PATIENTS EXPERIENCING A CARDIAC EMERGENCY. BRISTOL REGIONAL MEDICAL CENTER WAS THE ONLY HOSPITAL IN TENNESSEE AND VIRGINIA TO RECEIVE GOLD RECOGNITION BY THE AMERICAN HEART ASSOCIATION FOR THE 2013 MISSION: LIFELINE STEMI-RECEIVING AWARD FOR RAPID AND EFFECTIVE HEART ATTACK TREATMENT TIMES. AND THIS YEAR, BRISTOL REGIONAL RECEIVED MISSION: LIFELINE GOLD, GOLD PLUS AND GOLD PLUS ACHIEVEMENT AWARDS FOR FOLLOWING THE AMERICAN HEART ASSOCIATION'S RECOMMENDED GUIDELINES FOR HEART ATTACK TREATMENT. OUR HEARTSHAPE PROGRAM, WHICH FOCUSED ON THIS EARLY IDENTIFICATION OF CORONARY ARTERY DISEASE THROUGH CALCIUM SCORING TESTING, REMAINS A PRIORITY FOR OUR PHYSICIANS AND STAFF. NUMEROUS COMMUNITY GROUPS AND LOCAL EMPLOYERS PARTICIPATED IN PRESENTATIONS ABOUT THE IMPORTANCE OF EARLY IDENTIFICATION AND KNOWLEDGE OF RISK FACTORS. HUNDREDS OF DISCOUNTED OR COMPLIMENTARY HEART SCREENINGS WERE DISTRIBUTED TO ENCOURAGE EARLY IDENTIFICATION OF CORONARY ARTERY DISEASE. EMPLOYEES GAVE THEIR TIME TO AREA NONPROFIT ORGANIZATIONS, WHICH INCLUDED THE PROVIDENCE MEDICAL CLINIC AND SUSAN G. KOMEN FOR THE CURE. IN MARCH 2016, BRISTOL REGIONAL AND WELLMONT CARDIOVASCULAR SERVICES HOSTED THE FIRST-EVER NEED FOR SPEED HEART AND STROKE EXPO AND SECONDS COUNT 5K, WHICH RAISED AWARENESS FOR QUICK INTERVENTION DURING EMERGENCY CARDIAC EVENTS AND ALSO GAVE PARTICIPANTS A CHANCE TO IMPROVE THEIR HEALTH BY BEING MORE ACTIVE.
FORM 990, PAGE 6, PART VI, LINE 6	THE BUSINESS AND AFFAIRS OF WELLMONT CARDIOLOGY SERVICES (THE CORPORATION) SHALL BE GOVERNED EXCLUSIVELY BY THE BOARD OF DIRECTORS. THE CORPORATION'S BOARD OF DIRECTORS IS DESIGNATED BY WELLMONT HEALTH SYSTEM, THE SOLE MEMBER OF THE CORPORATION. IN ADDITION TO SUCH RIGHTS OF APPROVAL AND CONSENT AS MAY BE RESERVED TO THE SOLE MEMBER OF THE CORPORATION PURSUANT TO APPLICABLE LAW, TRANSACTIONS OF THE FOLLOWING MATTERS BY THE CORPORATION SHALL REQUIRE THE PRIOR APPROVAL OF WELLMONT HEALTH SYSTEM, THE SOLE MEMBER OF THE CORPORATION: (A) IMPLEMENTATION OF CORPORATION'S ANNUAL BUDGET, (B) INCURRING ANY LOAN OR OTHER INDEBTEDNESS FOR BORROWED MONEY, (C) ACQUISITION OF ANY EQUIPMENT OR PERSONAL PROPERTY FOR A PURCHASE PRICE IN EXCESS OF 50,000 OR THE ACQUISITION OF ANY REAL ESTATE, REGARDLESS OF PURCHASE PRICE, (D) THE UNDERTAKING OF CERTAIN CONTRACTUAL COMMITMENTS, (E) ENTERING INTO ANY PLAN OF MERGER OR CONSOLIDATION, (F) ACQUISITION OF SUBSTANTIALLY ALL OF THE ASSETS OF ANY OTHER LEGAL ENTITY, AND (G) INSTITUTION OF ANY LITIGATION BY OR ON BEHALF OF CORPORATION.
FORM 990, PAGE 6, PART VI, LINE 7A	SEE FORM 990, PART VI, SECTION A, LINE 6 FOR EXPLANATION.
FORM 990, PAGE 6, PART VI, LINE 7B	SEE FORM 990, PART VI, SECTION A, LINE 6 FOR EXPLANATION.
FORM 990, PAGE 6, PART VI, LINE 9	ALICE POPE (TERM 4/22/16) 1905 AMERICAN WAY KINGSPORT, TN 37660 MARGARET D. DENARVAEZ (TERM 9/16/14) 1905 AMERICAN WAY KINGSPORT, TN 37660 GREGORY JONES, M.D. (TERM 7/31/15) 1905 AMERICAN WAY KINGSPORT, TN 37660 TRACEY P. MOFFATT (TERM 10/3/14) 1905 AMERICAN WAY KINGSPORT, TN 37660
FORM 990, PAGE 6, PART VI, LINE 11B	WELLMONT CARDIOLOGY SERVICES' FORM 990 IS REVIEWED BY THE CHIEF FINANCIAL OFFICER, THE CORPORATE CONTROLLER, AND THE MANAGER OF ACCOUNTING FOR WELLMONT HEALTH SYSTEM AND THE BOARD OF DIRECTORS OF WELLMONT CARDIOLOGY SERVICES PRIOR TO FILING. 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.
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 CARDIOLOGY SERVICES' OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE GOVERNED BY WELLMONT HEALTH SYSTEM'S CONFLICT OF INTEREST POLICY. 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.
FORM 990, PAGE 6, PART VI, LINE 15A	GERALD G. BLACKWELL, M.D. RECEIVES NO COMPENSATION FOR SERVING AS PRESIDENT OF THE BOARD OF DIRECTORS OF WELLMONT CARDIOLOGY SERVICES. THE COMPENSATION THAT GERALD G. BLACKWELL, M.D. RECEIVES AS A PHYSICIAN OF WELLMONT CARDIOLOGY SERVICES IS REVIEWED, APPROVED AND DOCUMENTED BY THE WELLMONT HEALTH SYSTEM BOARD OF DIRECTORS. WELLMONT HEALTH SYSTEM USES ONE OR MORE OF THE METHODS DESCRIBED TO ESTABLISH THE COMPENSATION OF GERALD G. BLACKWELL, M.D. THE COMPENSATION OF BARTON A. HOVE, THE PRESIDENT AND CEO OF WELLMONT HEALTH SYSTEM, IS REVIEWED, APPROVED AND DOCUMENTED BY THE WELLMONT HEALTH SYSTEM HUMAN RESOURCES COMMITTEE AND BOARD OF DIRECTORS. BARTON A. HOVE IS ALSO A BOARD MEMBER OF WELLMONT CARDIOLOGY SERVICES. IN ADDITION, THESE BODIES USE COMPARABILITY DATA TO DETERMINE THE APPROPRIATE COMPENSATION. ALL COMPENSATION DELIBERATIONS AND REVIEWS ARE CONTEMPORANEOUSLY DOCUMENTED. THE LAST COMPENSATION DELIBERATION AND REVIEW PROCESS FOR BARTON A. HOVE WAS COMPLETED AND APPROVED BY THE BOARD OF DIRECTORS OF WELLMONT HEALTH SYSTEM ON MARCH 20, 2015.
FORM 990, PAGE 6, PART VI, LINE 15B	THE COMPENSATION OF THE OTHER OFFICERS AND KEY EMPLOYEES OF WELLMONT CARDIOLOGY SERVICES 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 IS COMPLETED ON AN ANNUAL BASIS. WELLMONT HEALTH SYSTEM USES ONE OR MORE OF THE METHODS DESCRIBED TO ESTABLISH THE COMPENSATION OF THE FOLLOWING OTHER OFFICERS AND KEY EMPLOYEES. - BRISTOL REGIONAL MEDICAL CENTER PRESIDENT - GREG NEAL - HOLSTON VALLEY MEDICAL CENTER PRESIDENT - TIM ATTEBERY - WELLMONT HEALTH CHIEF FINANCIAL OFFICER - TODD DOUGAN
FORM 990, PAGE 6, PART VI, LINE 19	WELLMONT CARDIOLOGY SERVICES' GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY 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.
FORM 990, PAGE 7, PART VII	AVERAGE HOURS PER WEEK THE SECRETARY AND VARIOUS BOARD MEMBERS SERVE IN A DIFFERENT CAPACITY FOR SEVERAL RELATED ORGANIZATIONS. THE MAJORITY OF THEIR TIME IS DEVOTED TO A RELATED ORGANIZATION (GREATER THAN 38 HOURS PER WEEK). HOWEVER, BOARD MEMBERS WHO ARE PHYSICIANS HAVE DEDICATED AN AVERAGE OF 40 HOURS PER WEEK TO WELLMONT CARDIOLOGY SERVICES.
FORM 990, PART XI, LINE 9	INTERCOMPANY RESOLUTION 56,234 INTERCOMPANY - HOSPITAL ALLOCATIONS 14,518,632 TOTAL 14,574,866

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

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" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

WELLMONT CARDIOLOGY SERVICES

Employer identification number

26-3557623

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on 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)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled 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 HEALTH SYSTEM 1905 AMERICAN WAY KINGSPORT,TN37660 62-1636465	HEALTHCARE	TN	501C3	3	NA		No
(2)WELLMONT HAWKINS CO MEMORIAL HOSPI 1905 AMERICAN WAY KINGSPORT,TN37660 62-1816368	HEALTHCARE	TN	501C3	3	WHS		No
(3)WELLMONT MEDICAL ASSOCIATES INC 1905 AMERICAN WAY KINGSPORT,TN37660 27-0898372	HEALTHCARE	TN	501C3	7	WHS		No
(4)WELLMONT FOUNDATION INC 1905 AMERICAN WAY KINGSPORT,TN37660 58-1594191	HEALTHCARE	TN	501C3	7	WHS		No
(5)WELLMONT MADISON HOUSE 1905 AMERICAN WAY KINGSPORT,TN37660 62-1308216	HEALTHCARE	TN	501C3	9	WHS		No
(6)WELLMONT WEXFORD HOUSE 1905 AMERICAN WAY KINGSPORT,TN37660 58-1859039	HEALTHCARE	TN	501C3	9	WHS		No
(7)WELLMONT IMAGING SERVICES INC 1905 AMERICAN WAY KINGSPORT,TN37660 86-1103148	HEALTHCARE	TN	501C3	11A	WHS		No
(8)WELLMONT SLEEP SERVICES 1905 AMERICAN WAY KINGSPORT,TN37660 27-3777167	HEALTHCARE	TN	501C3	3	WHS		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2015

Page 2

Part III

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(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 V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) SAPLING GROVE AMBULATORY SURGERY 220 MEDICAL PARK BLVD BRISTOL,TN37620 20-4450153	HEALTHCARE	TN	N/A				No			No
(2) HOLSTON VALLEY AMBULATORY SURGERY 103 WEST STONE DRIVE KINGSPORT,TN37660 62-1816864	HEALTHCARE	TN	N/A				No			No
(3) HOLSTON VALLEY IMAGING CENTER 103 WEST STONE DRIVE KINGSPORT,TN37660 20-2043285	HEALTHCARE	TN	N/A				No			No

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(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	N/A					No
(2) MCOT INC 1905 AMERICAN WAY KINGSPORT,TN37660 62-1325938	MED SVCS	TN	N/A					No
(3) MEDICAL MALL PHARMACY INC 1905 AMERICAN WAY KINGSPORT,TN37660 62-1565006	MED SVCS	TN	N/A					No
(4) WELLMONT PHYSICIAN SERVICES INC 1905 AMERICAN WAY KINGSPORT,TN37660 62-1567353	PHYS SVCS	TN	N/A					No
(5) WELLMONT HEALTH SERVICES INC 1905 AMERICAN WAY KINGSPORT,TN37660 62-1254373	HEALTHCARE	TN	N/A					No
(6) WPS PROVIDERS INC 1905 AMERICAN WAY KINGSPORT,TN37660 20-5564642	PHYS SVCS	TN	N/A					No

Schedule R (Form 990) 2015

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on 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) ............................

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) ............................

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

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

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

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) .....................

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 ............................

Yes

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

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 related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) WELLMONT HEALTH SYSTEM	C	56,234	CAPITAL CONTRIBUTION
(2) WELLMONT HEALTH SYSTEM	K	383,698	LEASE AGREEMENT
(3) WELLMONT HEALTH SYSTEM	M	2,035,874	SERVICE AGREEMENTS
(4) WELLMONT HEALTH SYSTEM	Q	168,010	INVOICES

Schedule R (Form 990) 2015

Page 4

Part VI

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

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

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(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 V-UBI 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 V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2015

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference

Explanation

SCHEDULE R

PART V, LINE 2 RELATED ORGANIZATION TRANSACTIONS WITH WELLMONT HEALTH SYSTEM AND WELLMONT FOUNDATION, DURING THE FISCAL YEAR ENDED JUNE 30, 2016, AND DID NOT MEET THE 50,000 THRESHOLD AMOUNT FOR SEPARATE DISCLOSURE. ORGANIZATION TRANS TYPE AMOUNT METHOD DETERMINATION WELLMONT HEALTH SYSTEM J 25,225 LEASE AGREEMENT WELLMONT MEDICAL ASSOCIATES J 18,810 LEASE AGREEMENT WELLMONT HEALTH SYSTEM L 31,542 INVOICES

Schedule R (Form 990) 2015

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	12
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	0
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	303
6	Total number of volunteers (estimate if necessary) .............	6
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	152,670
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	-9,129

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	13,419	357,291
9	Program service revenue (Part VIII, line 2g) .........	27,069,316	27,211,526
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	-812	-388,330
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	1,679,755	1,383,977
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	28,761,678	28,564,464
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	9,400	11,500
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)	40,054,893	33,394,535
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)....	9,875,441	9,221,306
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	49,939,734	42,627,341
19	Revenue less expenses. Subtract line 18 from line 12.......	-21,178,056	-14,062,877
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	5,460,864	7,287,711
21	Total liabilities (Part X, line 26).............	5,517,098	6,831,956
22	Net assets or fund balances. Subtract line 21 from line 20.....	-56,234	455,755

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 41,593,176 including grants of $ 11,500 ) (Revenue $ 27,211,526 )
	CARDIOVASCULAR ASSOCIATES WAS ESTABLISHED IN 1978 TO PROVIDE COMPREHENSIVE CARDIOVASCULAR SERVICES TO THE NORTHEAST TENNESSEE/SOUTHWEST VIRGINIA REGION. IN MAY 2010, WELLMONT CARDIOLOGY SERVICES ACQUIRED SUBSTANTIALLY ALL OF THE ASSETS OF CARDIOVASCULAR ASSOCIATES TO BECOME THE REGION'S LARGEST PROVIDER OF COMPREHENSIVE CARDIOVASCULAR SERVICES. THIS PHYSICIAN GROUP PROVIDES TOP-QUALITY CARDIOVASCULAR SERVICES TO NORTHEAST TENNESSEE, SOUTHWEST VIRGINIA, SOUTHEAST KENTUCKY AND NORTHWEST NORTH CAROLINA, AS WELL AS AREAS OF WEST VIRGINIA. (CON'T ON SCHEDULE O) IN 2013, HOLSTON VALLEY MEDICAL CENTER AND BRISTOL REGIONAL MEDICAL CENTER WERE TWO OF ONLY 197 HOSPITALS NATIONWIDE TO RECEIVE THE AMERICAN COLLEGE OF CARDIOLOGY'S PLATINUM PERFORMANCE ACHIEVEMENT AWARD. THIS AWARD RECOGNIZES THE HOSPITALS' COMMITMENT TO AND SUCCESS IN IMPLEMENTING A HIGHER STANDARD OF CARE FOR HEART ATTACK PATIENTS AND SIGNIFIES THEY HAVE REACHED AN AGGRESSIVE GOAL OF TREATING THESE PATIENTS TO STANDARD LEVELS OF CARE OUTLINED BY THE AMERICAN COLLEGE OF CARDIOLOGY. OUR MISSION IS TO IMPROVE THE CARDIOVASCULAR HEALTH OF OUR REGION. IT IS OUR VISION TO DELIVER HIGH QUALITY, COST-EFFECTIVE HEART AND VASCULAR CARE WITH COMPASSION. WELLMONT CARDIOLOGY SERVICES CONSISTS OF 38 BOARD-CERTIFIED CARDIOLOGISTS AND CARDIOVASCULAR AND THORACIC SURGEONS SERVING 13 COMMUNITY OFFICES AND THE SEVEN MEMBER HOSPITALS OF WELLMONT HEALTH SYSTEM. WE DIAGNOSE, TREAT AND MANAGE ALL ASPECTS OF ADULT CARDIOVASCULAR DISEASE. OUR SERVICES INCLUDE GENERAL CARDIOLOGY, PREVENTIVE CARDIOLOGY, ELECTROPHYSIOLOGY, INTERVENTIONAL CARDIOLOGY, VASCULAR MEDICINE, STRUCTURAL HEART DISEASE, HEART FAILURE MANAGEMENT, CARDIOVASCULAR AND THORACIC SURGERY AND ADVANCED CARDIOVASCULAR IMAGING. WE ALSO SERVE AS A LEADER IN CLINICAL RESEARCH AND TEACHING INSTITUTION THROUGH THE CARDIOVASCULAR UNIVERSITY. WE ARE DEDICATED TO 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 QUALITY OF LIFE IN THE AREAS WE SERVE. OVERALL, WE RETURNED MORE THAN 22,637,063 IN BENEFITS TO OUR COMMUNITY. FOR FISCAL YEAR 2016, WE HAD 97,389 OUTPATIENT ENCOUNTERS AND PERFORMED 1,532 INPATIENT SURGICAL PROCEDURES. REGARDLESS OF RACE, RELIGION, ETHNICITY OR ABILITY TO PAY, WELLMONT CARDIOVASCULAR SERVICES TREATS ALL PATIENTS FOR MEDICALLY NECESSARY CONDITIONS. RECOGNIZING THAT SOME PATIENTS CANNOT AFFORD ESSENTIAL MEDICAL SERVICES, WE PROVIDED CARE FOR INDIGENT PATIENTS, WRITING OFF 2,441,063 OF CHARGES AND INCURRING COSTS OF 1,261,098. ADDITIONALLY, WE PROVIDED CARE TO PERSONS COVERED BY MEDICARE, MEDICAID, TENNCARE AND CHAMPUS AT LESS THAN COST. DUE TO MANDATED REDUCTIONS IN MEDICARE FUNDING FROM THE BALANCED BUDGET ACT AND DECLINING REIMBURSEMENT FROM TENNCARE, THE SHORTFALL BETWEEN RECEIPTS AND THE COST OF PROVIDING CARE TO THESE PATIENTS TOTALED 18,934,902. IT IS OUR OBLIGATION TO SUPPORT THE CAUSES THAT IMPROVE THE QUALITY OF LIFE IN OUR REGION. WE SPONSORED OR PARTICIPATED IN EDUCATIONAL, COMMUNITY- BASED PROGRAMS ON HEALTHY LIFESTYLES, RISK FACTOR IDENTIFICATION, DIAGNOSING AND TREATMENT OPTIONS, INCLUDING CONTINUING EDUCATION PROGRAMS FOR PHYSICIANS, NURSES AND ALLIED HEALTH PROFESSIONALS. SUCH INITIATIVES INCLUDED: -9TH ANNUAL HEART TALK -REGIONAL HEALTHCARE SYMPOSIUM -DIABETES EXPO -DIABETES SYMPOSIUM -PRESENTATION TO MEDICAL SOCIETIES -COMMUNITY OUTREACH WITH AREA CHURCHES -PARTICIPATION WITH LOCAL SUPPORT GROUPS -PRESENTATIONS TO AREA CIVIC ORGANIZATIONS WE PARTICIPATED IN THE FOLLOWING EMPLOYER-BASED EVENTS: -ROBINETTE COMPANY HEALTH FAIR, WHICH INCLUDED BLOOD PRESSURE SCREENINGS -BRISTOL COMPRESSORS HEART HEALTHY LUNCH AND LEARNS ADDITIONALLY, DONATIONS TOTALING 11,500 WERE MADE TO LAUGHLIN MEMORIAL HOSPITAL, FUNFEST 3K MOON WALK, WYTHE ARTS COUNCIL AND THE AMERICAN HEART ASSOCATION. THE LEVEL ONE HEART ATTACK NETWORK IS A PARTNERSHIP WITH LOCAL COMMUNITIES, EMERGENCY MEDICAL SERVICE PROVIDERS, AREA EMERGENCY DEPARTMENTS AND WELLMONT CARDIOLOGY SERVICES. THE CONTINUED DEVELOPMENT OF THE NETWORK HAS IMPROVED OUR ABILITY TO PROVIDE PROMPT AND EFFECTIVE HEART ATTACK TREATMENT FOR PATIENTS EXPERIENCING A CARDIAC EMERGENCY. BRISTOL REGIONAL MEDICAL CENTER WAS THE ONLY HOSPITAL IN TENNESSEE AND VIRGINIA TO RECEIVE GOLD RECOGNITION BY THE AMERICAN HEART ASSOCIATION FOR THE 2013 MISSION: LIFELINE STEMI-RECEIVING AWARD FOR RAPID AND EFFECTIVE HEART ATTACK TREATMENT TIMES. AND THIS YEAR, BRISTOL REGIONAL RECEIVED MISSION: LIFELINE GOLD, GOLD PLUS AND GOLD PLUS ACHIEVEMENT AWARDS FOR FOLLOWING THE AMERICAN HEART ASSOCIATION'S RECOMMENDED GUIDELINES FOR HEART ATTACK TREATMENT. OUR HEARTSHAPE PROGRAM, WHICH FOCUSED ON THIS EARLY IDENTIFICATION OF CORONARY ARTERY DISEASE THROUGH CALCIUM SCORING TESTING, REMAINS A PRIORITY FOR OUR PHYSICIANS AND STAFF. NUMEROUS COMMUNITY GROUPS AND LOCAL EMPLOYERS PARTICIPATED IN PRESENTATIONS ABOUT THE IMPORTANCE OF EARLY IDENTIFICATION AND KNOWLEDGE OF RISK FACTORS. HUNDREDS OF DISCOUNTED OR COMPLIMENTARY HEART SCREENINGS WERE DISTRIBUTED TO ENCOURAGE EARLY IDENTIFICATION OF CORONARY ARTERY DISEASE. EMPLOYEES GAVE THEIR TIME TO AREA NONPROFIT ORGANIZATIONS, WHICH INCLUDED THE PROVIDENCE MEDICAL CLINIC AND SUSAN G. KOMEN FOR THE CURE. IN MARCH 2016, BRISTOL REGIONAL AND WELLMONT CARDIOVASCULAR SERVICES HOSTED THE FIRST-EVER NEED FOR SPEED HEART AND STROKE EXPO AND SECONDS COUNT 5K, WHICH RAISED AWARENESS FOR QUICK INTERVENTION DURING EMERGENCY CARDIAC EVENTS AND ALSO GAVE PARTICIPANTS A CHANCE TO IMPROVE THEIR HEALTH BY BEING MORE ACTIVE.

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 expenses41,593,176

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)			(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) PABITRA SAHA MD........................................................................ PHYSICIAN	40.00 .......................	X		782,864	0	34,819
(19) DANIEL SIMPSON........................................................................ PHYSICIAN	40.00 .......................	X		776,582	0	31,928
(20) JOHN R BERTUSO........................................................................ PHYSICIAN	40.00 .......................	X		765,243	0	33,917
(21) JOHN F BERRY........................................................................ PHYSICIAN	40.00 .......................	X		758,493	0	31,993
(22) BARTON A HOVE........................................................................ PRESIDENT/WH	.......................40.00		X	0	1,382,592	38,571
(23) JAMES MERRILL MD........................................................................ BOARD MEM/PH	40.00 .......................		X	783,017	0	28,236
(24) MARK MAYHEW MD........................................................................ BOARD MEM/PH	40.00 .......................		X	776,520	0	31,993
(25) HARRISON D TURNER MD TM 7116........................................................................ BOARD MEM/PH	.......................		X	661,602	0	29,527
(26) MARGARET D DENARVAEZ TERM 91614........................................................................ WHS PRESIDEN	.......................		X	0	146,211	0
(27) TRACEY P MOFFATT TERM 10314........................................................................ BOARD MEM/WH	.......................		X	0	45,420	900

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	12,522,047	3,866,644	681,862

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	357,291
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a-1f:$
h Total.Add lines 1a-1f.......		357,291

		Business Code
2a	PATIENT SERVICE REVENUE-NET	621990	24,711,764	24,711,764
b	ON-CALL SERVICES REVENUE	541700	1,203,384	1,203,384
c	RESEARCH REVENUE	621110	1,132,091			1,132,091
d	CARDIAC DIAGNOSTIC INTERPRETA	621110	152,670		152,670
e	MEDICAL RECORDS REVENUE	611600	17,617	17,617
f	All other program service revenue.			-6,000	-6,000
g Total.Add lines 2a–2f.....			27,211,526

3 Investment income (including dividends, interest, and othersimilar amounts) ..........
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		45,806
b	Less: rental expenses		6,566
c	Rental income or (loss)		39,240
d	Net rental income or (loss)......			39,240			39,240
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory
b	Less: cost or other basis and sales expenses		388,330
c	Gain or (loss)		-388,330
d	Net gain or (loss).....			-388,330	-388,330
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..
Business Code			Miscellaneous Revenue
11a	MANAGEMENT FEES		561000	1,225,490	1,225,490
b	RESIDENCY FEES		621990	90,780	90,780
c	MARKETING		561000	28,337	28,337
d	All other revenue ....			130	130
e	Total. Add lines 11a–11d ......			1,344,737
12	Total revenue. See Instructions......			28,564,464	26,883,172	152,670	1,171,331

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	11,500	11,500
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 ....	5,206,992	4,915,941	291,051
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	24,051,325	23,758,283	293,042
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	533,178	548,680	-15,502
9	Other employee benefits .......	2,350,869	2,233,687	117,182
10	Payroll taxes ...........	1,252,171	1,194,798	57,373
11	Fees for services (non-employees):
a	Management ......	842,057	842,057
b	Legal .........	3,000	3,000
c	Accounting ...........
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	965,236	931,488	33,748
12	Advertising and promotion ....	38,540	38,540
13	Office expenses .......	589,295	513,831	75,464
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	2,459,963	2,453,774	6,189
17	Travel ............	312,999	301,590	11,409
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	553,783	553,783
23	Insurance ...	206,814	110,599	96,215
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	MSO ALLOCATION	2,251,898	2,251,898
b	DRUGS & MEDICAL SUPPLIES	493,771	493,229	542
c	RESEARCH FOR PROTOCOLS	207,827	207,827
d	DUES & MEMBERSHIPS	172,858	162,565	10,293
e	All other expenses	123,265	66,106	57,159
25	Total functional expenses. Add lines 1 through 24e	42,627,341	41,593,176	1,034,165	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).

1	Cash–non-interest-bearing ........			204,780	1	-38,519
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			1,216,361	4	3,794,090
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
					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 ........			51,468	8	82,364
9	Prepaid expenses and deferred charges ......			19,513	9	61,146
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	5,501,443
b	Less: accumulated depreciation	10b	2,498,805	3,580,342	10c	3,002,638
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............			6,823	14	4,415
15	Other assets. See Part IV, line 11 ...........			381,577	15	381,577
16	Total assets. Add lines 1 through 15 (must equal line 34)...			5,460,864	16	7,287,711

17	Accounts payable and accrued expenses .....	5,517,098	17	6,831,956
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
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 ..		23
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		25
26	Total liabilities. Add lines 17 through 25..	5,517,098	26	6,831,956

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	-56,234	27	455,755
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 ...........	-56,234	33	455,755
34	Total liabilities and net assets/fund balances ........	5,460,864	34	7,287,711