Form990
Click to see attachment: AMENDED
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private
foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
A For the 2014 calendar year, or tax year beginning 07-01-2014 , and ending 06-30-2015
BCheck if applicable:
CName of organization
WELLMONT HEALTH SYSTEM
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
1905 AMERICAN WAY
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
KINGSPORT, TN37660
D Employer identification number

62-1636465
E Telephone number

G Gross receipts $ 778,307,404
F Name and address of principal officer:
TODD J DOUGAN
1905 AMERICAN WAY
KINGSPORT,TN37660
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.WELLMONT.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1996
M State of legal domicile: TN
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: WE DELIVER SUPERIOR HEALTH CARE WITH COMPASSION.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 18
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 16
5 Total number of individuals employed in calendar year 2014 (Part V, line 2a) ...... 5 6,429
6 Total number of volunteers (estimate if necessary) ............. 6 665
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 240,009
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b  
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 948,195 2,719,815
9 Program service revenue (Part VIII, line 2g) ......... 639,948,563 660,586,840
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 13,654,803 13,688,779
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 20,920,473 17,178,806
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 675,472,034 694,174,240
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 217,972 236,312
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) 257,742,877 263,568,679
16a Professional fundraising fees (Part IX, column (A), line 11e).....   0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 395,430,883 378,942,408
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 653,391,732 642,747,399
19 Revenue less expenses. Subtract line 18 from line 12....... 22,080,302 51,426,841
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 1,136,872,750 1,107,547,852
21 Total liabilities (Part X, line 26)............. 633,182,238 619,863,728
22 Net assets or fund balances. Subtract line 21 from line 20..... 503,690,512 487,684,124
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet
Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2014)
Form 990 (2014)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: WE DELIVER SUPERIOR HEALTH CARE WITH COMPASSION.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 582,652,477 including grants of $ 236,312 ) (Revenue $ 661,974,457 )
WELLMONT HEALTH SYSTEM PREPARES A CONSOLIDATED COMMUNITY BENEFIT REPORT WHICH INCLUDES THE ACTIVITIES OF ALL ITS OPERATIONS AND AFFILIATES. IN CONTRAST, AN IRS FORM 990 IS FILED FOR EACH TAX-EXEMPT CORPORATION (7 SEPARATE FORM 990S), AND THERE IS NO SUCH IRS FORM FOR THE TAXABLE CORPORATIONS. IN ADDITION, THE IRS INSTRUCTIONS TO FORM 990 HAVE SPECIFIC DEFINITIONS, METHODS, AND WORKSHEETS TO CALCULATE THE COMMUNITY BENEFITS TO BE INCLUDED ON THE FORM 990. AS A RESULT, THERE ARE SIGNIFICANT DIFFERENCES BETWEEN THE COMMUNITY BENEFITS REPORTED IN THE CONSOLIDATED COMMUNITY BENEFIT REPORT AND THE VARIOUS FORM 990S. THERE ARE ALSO FUNDS AND SERVICES THAT ARE PROVIDED THAT DO NOT MEET THE SPECIFIC DEFINITIONS OF THE IRS INSTRUCTIONS, SUCH AS CONTRIBUTIONS TO COMMUNITY (CON'T ON SCHEDULE O) ORGANIZATIONS THAT DO NOT MEET THE DEFINITION OF "RESTRICTED TO ONE OR MORE OF THE ACTIVITIES DESCRIBED IN THE TABLE IN PART I, LINE 7" OF SCHEDULE H. WELLMONT IS A PUBLIC TRUST. FROM KINGSPORT TO BRISTOL, FROM SNEEDVILLE TO NORTON, THE MEMBER HOSPITALS OF OUR ORGANIZATION WERE BORN OF THEIR COMMUNITIES' COMMITMENT TO SUPERIOR HEALTH CARE FOR THEIR CITIZENS. WE OFFER A VAST ARRAY OF MEDICAL SERVICES AND RESOURCES FOR THOUSANDS OF PATIENTS IN NORTHEAST TENNESSEE AND SOUTHWEST VIRGINIA. IN 2015, WE PROVIDED SERVICES TO 47,949 PATIENTS IN A BED, 161,995 EMERGENCY ROOM VISITS, 2,246 NEWBORN DELIVERIES, AND 22,175 SURGERIES. WELLMONT IS A TENNESSEE NOT-FOR-PROFIT CORPORATION. FIVE TAX-EXEMPT COMMUNITY BASED HOSPITALS - BRISTOL REGIONAL MEDICAL CENTER (BRISTOL, TENN.), HOLSTON VALLEY MEDICAL CENTER (KINGSPORT, TENN.), LONESOME PINE HOSPITAL (BIG STONE GAP, VA.), HANCOCK COUNTY HOSPITAL (SNEEDVILLE, TENN.), AND MOUNTAIN VIEW REGIONAL MEDICAL CENTER (NORTON, VA.)- ARE INCLUDED IN THIS CORPORATION. BUT EVEN AS OUR SERVICE AREA SPANS MULTIPLE STATES AND OUR REVENUE IS REPORTED IN THE HUNDREDS OF MILLIONS OF DOLLARS, WE REMAIN A COMMUNITY- OWNED HEALTH SYSTEM. IT IS OUR MISSION TO DELIVER SUPERIOR HEALTH CARE WITH COMPASSION TO THE PEOPLE WE SERVE. IT IS OUR VISION TO DELIVER THE BEST HEALTH CARE ANYWHERE. CONSISTENT WITH THIS MISSION, WE HAVE WORKED TOWARD IMPROVING OUR COMMUNITY'S ACCESS TO QUALITY, AFFORDABLE HEALTH CARE, EDUCATING OUR REGION'S CAREGIVERS, IMPROVING THE HEALTH STATUS OF OUR COMMUNITIES AND CONTRIBUTING TO THE OVERALL QUALITY OF LIFE IN THE AREAS WE SERVE. OVERALL, WE RETURNED MORE THAN 44,497,460 IN BENEFITS TO OUR REGION, INCLUDING 34,447,475 OF COSTS FOR INDIGENT PATIENTS AND UNCOMPENSATED CARE FOR OTHER PATIENTS AND 10,049,985 FOR OTHER COMMUNITY ACTIVITIES OUTLINED BELOW. WELLMONT IS IN COMPLIANCE WITH IRS GUIDELINES FOR FORM 990 SCHEDULE H REPORTING PURPOSES AND THE AMOUNTS REFLECTED ABOVE ARE NOT INCLUSIVE OF RESOURCES DESCRIBED IN WELLMONT'S COMMUNITY BENEFIT REPORT AS THE ABOVE AMOUNTS ARE REPORTED ON SCHEDULE H. WE ARE MINDFUL OF OUR RESPONSIBILITIES AS ONE OF THE REGION'S LARGEST EMPLOYERS. 6,429 FAMILIES COUNT ON US FOR THEIR LIVELIHOODS. CITIES AND COUNTIES THROUGHOUT OUR SERVICE AREA RELY ON US AS A DRIVER OF ECONOMIC DEVELOPMENT. IT IS OUR DUTY AS A CORPORATE CITIZEN TO SUPPORT THOSE ENDEAVORS AND CAUSES THAT IMPROVE THE QUALITY OF LIFE IN OUR REGION. AND WE ALSO RECOGNIZE IT IS OUR RESPONSIBILITY TO CARE FOR THOSE IN NEED - REGARDLESS OF THEIR ABILITY TO PAY. IT IS OUR COMMITMENT - INDEED, IT IS OUR MISSION - TO SUPPORT THE CAUSES AND DEVELOP THE INITIATIVES THAT WILL PROPEL OUR COMMUNITIES TOWARD A BETTER, BRIGHTER, HEALTHIER AND MORE VIBRANT FUTURE. SERVING THE UNDERSERVED REGARDLESS OF RACE, RELIGION, ETHNICITY OR ABILITY TO PAY, WELLMONT'S HOSPITALS TREAT ALL PATIENTS FOR MEDICALLY NECESSARY CONDITIONS. RECOGNIZING THAT SOME PATIENTS CANNOT AFFORD ESSENTIAL MEDICAL SERVICES, WELLMONT PROVIDED CARE FOR INDIGENT PATIENTS, WRITING OFF 58,016,379 OF CHARGES AND INCURRING COST OF 13,427,105. WELLMONT IS IN COMPLIANCE WITH IRS GUIDELINES FOR FORM 990 SCHEDULE H REPORTING PURPOSES AND THE AMOUNTS REFLECTED ABOVE ARE NOT INCLUSIVE OF RESOURCES DESCRIBED IN WELLMONT'S COMMUNITY BENEFIT REPORT AS THE ABOVE AMOUNTS ARE REPORTED ON SCHEDULE H. OTHER RECENT INITIATIVES INCLUDE: THE WELLMONT HEALTH COACH IS PART OF WELLMONT'S ONGOING EFFORTS TO IMPROVE THE HEALTH OF OUR COMMUNITIES AND ENCOURAGE WELLNESS IN THE MOUNTAINS OF NORTHEAST TENNESSEE AND SOUTHWEST VIRGINIA. FUNDED BY COMMUNITY SUPPORT THROUGH THE WELLMONT FOUNDATION, THE COACH OFFERS A HOST OF COMPREHENSIVE SCREENINGS THAT HELP IDENTIFY POTENTIAL HEALTH PROBLEMS. OUR HEALTH SYSTEM, IN CONJUNCTION WITH A GRANT FROM SUSAN G. KOMEN FOR THE CURE TRI-CITIES, WAS ABLE TO FUND THE COST OF MAMMOGRAMS FOR SEVERAL HUNDRED WOMEN WHO WERE UNDERINSURED OR UNINSURED. PROJECT ACCESS TO BREAST CARE IS DESIGNED TO REACH WOMEN WHO LIVE IN HAWKINS, SULLIVAN, WASHINGTON, JOHNSON, UNICOI, HANCOCK, CARTER AND GREENE COUNTIES IN TENNESSEE AND WOMEN IN SCOTT COUNTY, VA. TO QUALIFY, WOMEN MUST BE BETWEEN THE AGES OF 35 AND 49 AND EITHER BE UNINSURED AND FINANCIALLY UNABLE TO PAY FOR A MAMMOGRAM OR INSURED AND HAVE A HIGH DEDUCTIBLE AND/OR CO-PAY THAT MAKES IT FINANCIALLY DIFFICULT TO OBTAIN A MAMMOGRAM. BRISTOL REGIONAL MEDICAL CENTER PROVIDES SUPPLIES AND OTHER VARIOUS ITEMS VALUED AT 20,406 TO HEALING HANDS HEALTH CENTER IN BRISTOL, TENN., WHICH PROVIDES QUALITY HEALTH CARE TO THE WORKING POOR. DR. DAVE ARNOLD SERVES AS THE MEDICAL DIRECTOR OF HEALING HANDS HEALTH CENTER IN BRISTOL, TENN. AND HIS SALARY AND BENEFITS ARE PAID BY HEALING HANDS HEALTH CENTER. TRAINING AND EDUCATING OUR HEALTHCARE PROFESSIONALS WELLMONT WILL NOT SUCCEED IN OUR MISSION WITHOUT CONTINUALLY REINVESTING IN OUR MOST PRECIOUS RESOURCE - OUR PEOPLE. TO THAT END, WE SUPPORTED THE EDUCATION AND TRAINING OF HEALTH CARE PROFESSIONALS AT A DIRECT COST OF 5,748,416. RECENT INITIATIVES INCLUDE: WELLMONT PROVIDED AND PARTICIPATED IN SEVERAL FORMAL TRAINING PROGRAMS FOR HEALTH PROFESSIONALS, INCLUDING EAST TENNESSEE STATE UNIVERSITY'S INTERNSHIP AND RESIDENCY PROGRAMS. OUR CONTRIBUTIONS TOTALED 991,864 IN SUPPORT OF THE SCHOOL'S JAMES H. QUILLEN COLLEGE OF MEDICINE RESIDENCY PROGRAM. WELLMONT CONTINUES TO WELCOME OSTEOPATHIC MEDICAL STUDENTS FROM LINCOLN MEMORIAL UNIVERSITY'S DEBUSK COLLEGE OF OSTEOPATHIC MEDICINE. THE STUDENTS PERFORM CLINICAL ROTATIONS IN WELLMONT HOSPITALS AS THEY MOVE TOWARD BECOMING THE NEXT GENERATION OF DOCTORS. THE STUDENTS, WHO RECEIVE FREE HOUSING ON THE CAMPUS OF MOUNTAIN VIEW REGIONAL MEDICAL CENTER, COMPLETE THEIR CORE CLINICAL ROTATIONS AT MOUNTAIN VIEW REGIONAL. THE STUDENTS PERFORM SUB-SPECIALTY ROTATIONS AT HOLSTON VALLEY MEDICAL CENTER AND BRISTOL REGIONAL MEDICAL CENTER AND PRIMARY CORE ROTATIONS AT HAWKINS COUNTY MEMORIAL HOSPITAL. FREE HOUSING IS AVAILABLE ON THE MOUNTAIN VIEW REGIONAL MEDICAL CENTER AND HOLSTON VALLEY MEDICAL CENTER CAMPUSES FOR OUR MOUNTAIN REGION CORE SITE MEDICAL STUDENTS. OUR CONTRIBUTIONS TOTALED 730,534 IN SUPPORT OF THE DEBUSK COLLEGE OF OSTEOPATHIC MEDICINE. WELLMONT AND LINCOLN MEMORIAL UNIVERSITY'S DEBUSK COLLEGE OF OSTEOPATHIC MEDICINE ALSO PARTNER TO PROVIDE THE WELLMONT ORTHOPEDIC RESIDENCY PROGRAM AT HOLSTON VALLEY MEDICAL CENTER, ONE OF JUST 41 SUCH PROGRAMS IN THE COUNTRY TO HELP TRAIN THE NEXT GENERATION OF SPECIALTY PHYSICIANS. OUR CONTRIBUTIONS TOTALED 20,738 IN SUPPORT OF THE LINCOLN MEMORIAL UNIVERSITY'S DEBUSK COLLEGE OF OSTEOPATHIC MEDICINE ORTHOPEDIC RESIDENCY PROGRAM. WELLMONT CONTINUES TO EXERT TREMENDOUS EFFORT TO ACHIEVE MEANINGFUL USE OF AN ELECTRONIC HEALTH RECORD. THIS NATIONAL MANDATE CREATES TREMENDOUS EFFICIENCIES FOR CAREGIVERS, ENHANCES PATIENT CARE AND ULTIMATELY IMPROVES PATIENT SAFETY BY REDUCING THE POTENTIAL FOR ERRORS ASSOCIATED WITH PAPER DOCUMENTATION AS WELL AS INCREASING THE SECURITY AND SHARING OF DATA AMONG PROVIDERS. WELLMONT COMPLETED THE IMPLEMENTATION OF MYWELLMONT, WHICH IS AN ONLINE PORTAL THAT ALLOWS WELLMONT PATIENTS TO SECURELY ACCESS THEIR HEALTH INFORMATION FROM VIRTUALLY ANYWHERE. PATIENTS CAN ELECTRONICALLY REQUEST APPOINTMENTS, VIEW TEST RESULTS, RENEW PRESCRIPTIONS, PAY BILLS AND PERFORM MANY OTHER ROUTINE ACTIVITIES. MOST IMPORTANTLY, PATIENTS AND PROVIDERS CAN CONNECT IN MORE WAYS THAN EVER BEFORE, ENHANCING RELATIONSHIPS AND BUILDING A TEAM-BASED APPROACH TO CARE. WELLMONT HAS MADE AVAILABLE CONTINUING EDUCATION AND TRAINING TO EMPLOYEES, MEDICAL STAFF, MEMBERS OF AFFILIATED HEALTH CAREORGANIZATIONS AND SCHOOLS AND INTERESTED MEMBERS OF THE PUBLIC. SOME OF THOSE OPPORTUNITIES INCLUDED: -ANNUAL STROKE SYMPOSIUM; OPEN TO WELLMONT PHYSICIANS AND STAFF AND THE COMMUNITY; -ANNUAL CRITICAL CARE AND TRAUMA CONFERENCE; OPEN TO WELLMONT PHYSICIANS AND STAFF AND THE COMMUNITY; -ANNUAL CARDIOVASCULAR SUMMIT; OPEN TO WELLMONT PHYSICIANS AND STAFFAND THE COMMUNITY; -ANNUAL WOMEN AND CHILDREN'S EXPOSITION, OPEN TO WELLMONT PHYSICIANS AND STAFF AND THE COMMUNITY; -ANNUAL DIABETES EXPOSITION, OPEN TO WELLMONT PHYSICIANS AND STAFF AND THE COMMUNITY; -A PRESCRIPTION DRUG ABUSE CONFERENCE -REGULAR EDUCATION FOR CLINICAL STAFF ON TOPIC
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 expensesMediumBullet582,652,477
Form 990 (2014)
Form 990 (2014)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part III
Click to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment
...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment
...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment.........................
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H.... Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?
......................
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I.... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I................... Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II................ Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV .......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV
..................... Click to see attachment
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I
...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
358
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
6,429
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
Yes
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
No
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
No
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?
.........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note.
See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2014)
Form 990 (2014)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
18
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
16
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
 
No
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
 
No
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
Yes
 
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
No
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletTODD J DOUGAN
1905 AMERICAN WAY
KINGSPORT,TN37660 (423) 230-8200
Form 990 (2014)
Form 990 (2014)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(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)
(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
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) STANLEY GALL MD........................................................................
BOARD MEMBER
 
.......................40.00
X           0 564,321 29,544
(2) DAVID THOMPSON MD........................................................................
BOARD MEMBER
 
.......................40.00
X           0 433,561 8,407
(3) JULIE P BENNETT........................................................................
VICE CHAIR
6.00
.......................  
X           0 0 0
(4) R DAVID CROCKETT SR........................................................................
BOARD MEMBER
6.00
.......................  
X           0 0 0
(5) WAYNE J KENNEDY........................................................................
SECRETARY
6.00
.......................  
X           0 0 0
(6) RAVEN KRICKBAUM........................................................................
BOARD MEMBER
6.00
.......................  
X           0 0 0
(7) ROGER L LEONARD........................................................................
CHAIRMAN
6.00
.......................  
X           0 0 0
(8) ROGER K MOWEN........................................................................
TREASURER/AS
6.00
.......................  
X           0 0 0
(9) GLEN SKIP SKINNER........................................................................
BOARD MEMBER
6.00
.......................  
X           0 0 0
(10) DOUGLAS J SPRINGER MD........................................................................
BOARD MEMBER
6.00
.......................  
X           0 0 0
(11) DAVID LESTER........................................................................
BOARD MEMBER
6.00
.......................  
X           0 0 0
(12) WILLIAM SMITH MD........................................................................
BOARD MEMBER
6.00
.......................  
X           0 0 0
(13) DAVID SPARKS MD........................................................................
BOARD MEMBER
6.00
.......................  
X           0 0 0
(14) MARY HALL........................................................................
BOARD MEMBER
6.00
.......................  
X           0 0 0
(15) TERRY BEGLEY........................................................................
BOARD MEMBER
6.00
.......................  
X           0 0 0
(16) NELSON GWALTNEY MD........................................................................
BOARD MEMBER
6.00
.......................  
X           0 0 0
(17) KEITH WILSON........................................................................
BOARD MEMBER
6.00
.......................  
X           0 0 0
Form 990 (2014)
Form 990 (2014)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(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)
(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
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) TED WOOD........................................................................
BOARD MEMBER
6.00
.......................  
X           0 0 0
(19) MARGARET DENARVAEZ TERMED 91614........................................................................
PRESIDENT/CE
40.00
.......................0.00
    X       2,554,461 0 65,341
(20) TRACEY P MOFFATT TERMED 10314........................................................................
SR VP & WHS
40.00
.......................  
    X       575,375 0 21,418
(21) ALICE POPE........................................................................
EVP & CFO
40.00
.......................  
    X       479,861 0 27,467
(22) BARTON A HOVE........................................................................
WHS PRESIDEN
40.00
.......................  
    X       394,913 0 16,374
(23) WILLIAM SHOWALTER TERMED 41715........................................................................
SR VP - INFO
40.00
.......................  
    X       393,336 0 8,697
(24) HAMLIN J WILSON........................................................................
SR VP-HUMAN
40.00
.......................  
    X       347,552 0 16,364
(25) GARY D MILLER........................................................................
SR VP & GEN
40.00
.......................  
    X       346,188 0 16,104
(26) TODD J DOUGAN........................................................................
SR VP-FINANC
40.00
.......................  
    X       292,465 0 19,822
(27) LOWELL TODD NORRIS........................................................................
SR VP INST &
8.00
.......................32.00
    X       55,653 222,610 19,670
(28) BUFORD E DEATON........................................................................
EXEC VP & WH
40.00
.......................  
    X       66,293 0 370
(29) TIMOTHY ATTEBERY........................................................................
PRESIDENT/CE
40.00
.......................  
      X     446,896 0 25,151
(30) GREG NEAL........................................................................
PRESIDENT/CE
40.00
.......................  
      X     409,637 0 24,122
(31) FRED PELLE........................................................................
PRESIDENT &
40.00
.......................  
      X     68,173 265,643 21,490
(32) DAVID L BRASH........................................................................
SR VP OF BUS
40.00
.......................  
      X     319,658 0 21,654
(33) MARTHA CHILL........................................................................
SYSTEM VP/EM
40.00
.......................  
      X     310,170 0 21,720
(34) VIRGINIA FRANK TERMED 8814........................................................................
PRESIDENT-HV
40.00
.......................  
      X     231,607 0 6,440
(35) DANIEL CARLSON TERMED 5815........................................................................
CHIEF MEDICA
40.00
.......................  
        X   415,496 0 25,648
(36) SUSAN LINDENBUSCH........................................................................
VP WHS ONCOL
40.00
.......................  
        X   325,826 0 15,619
(37) WILLIAM TROY CLARK TERMED 121214........................................................................
VP/HV CHIEF
40.00
.......................  
        X   316,207 0 21,301
(38) DAVID ARROWOOD........................................................................
CRNA
40.00
.......................  
        X   285,795 0 18,803
(39) BRAD PRICE........................................................................
SR VP-RESOUR
40.00
.......................  
        X   285,597 0 11,032
(40) PIERRE ISTFAN MD........................................................................
BOARD MEMBER
 
.......................40.00
          X 0 567,736 29,881
(41) KENT PETTY TERMED 4114........................................................................
CHIEF INFORM
40.00
.......................  
          X 304,577 0 6,000
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 9,225,736 2,053,871 498,439
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet147
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
EPIC SYSTEMS CORPORATION

P O BOX 88314
MILWAUKEE,WI532880314
SOFTWARE 11,979,650
SOLSTAS LAB PARTNERS

P O BOX 751337
CHARLOTTE,NC28275
LAB SERVICES 9,225,937
SPENCER THOMAS GROUP

1931 WOODBURY AVE 125
PORTSMOUTH,NH03801
SOFTWARE CONSUL 8,188,867
SODEXO INC & AFFILIATES

P O BOX 536922
ATLANTA,GA303536922
MGMT SERVICES 5,978,650
ESD LLC

4352 WEST SYLVANIA AVE SUITE M
TOLEDO,OH43623
SOFTWARE CONSUL 5,518,456
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 MediumBullet139
Form 990 (2014)
Form 990 (2014)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 2,700,214
e Government grants (contributions)1e 19,601
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.......MediumBullet 2,719,815
 Program Service RevenueAmt Business Code
2a PHARMACY REVENUE 621990 334,559,482 334,559,482    
b NET PATIENT REVENUE 621990 319,523,794 319,523,794    
c BLOOD REVENUE 621990 6,417,164 6,417,164    
d ADMINISTRATIVE REVENUE 561000 86,400 86,400    
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 660,586,840
 OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 12,314,497     12,314,497
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties...........MediumBullet        
(i) Real (ii) Personal
6a Gross rents 6,249,636  
b Less: rental expenses 1,913,944  
c Rental income or (loss) 4,335,692  
d Net rental income or (loss).......MediumBullet 4,335,692     4,335,692
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 74,876,753 8,716,749
b Less: cost or other basis and sales expenses 73,943,213 8,276,007
c Gain or (loss) 933,540 440,742
d Net gain or (loss)..........MediumBullet 1,374,282   24,169 1,350,113
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..MediumBullet      
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...MediumBullet        
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..MediumBullet        
Miscellaneous Revenue Business Code
11a MISCELLANEOUS REVENUE 900099 5,012,393     5,012,393
b CAFETERIA VENDING 900099 3,373,493     3,373,493
c MEDICAL LAUNDRY REVENUE 900099 2,453,984     2,453,984
d All other revenue .... 2,003,244 1,387,617 215,840 399,787
e Total. Add lines 11a–11d ...... MediumBullet 12,843,114
12 Total revenue. See Instructions......MediumBullet 694,174,240 661,974,457 240,009 29,239,959
Form 990 (2014)
Form 990 (2014)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ...............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 236,312 236,312
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ....    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............    
4 Benefits paid to or for members ....    
5 Compensation of current officers, directors, trustees, and key employees .... 7,343,761   7,343,761  
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 .... 205,086,337 177,219,235 27,867,102  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 6,084,075 4,976,820 1,107,255  
9 Other employee benefits ....... 30,331,070 26,363,705 3,967,365  
10 Payroll taxes ........... 14,723,436 12,594,408 2,129,028  
11 Fees for services (non-employees):        
a Management ...... 840,922   840,922  
b Legal ......... 1,585,502   1,585,502  
c Accounting ........... 1,718,814   1,718,814  
d Lobbying ........... 146,182 146,182    
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 362,237 362,237    
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) .... 63,676,400 60,709,938 2,966,462  
12 Advertising and promotion .... 1,338,101 1,338,101    
13 Office expenses ....... 34,158,387 31,295,244 2,863,143  
14 Information technology ...... 10,769,216 10,764,359 4,857  
15 Royalties ..        
16 Occupancy ........... 15,322,874 13,124,699 2,198,175  
17 Travel ............ 1,750,451 1,454,310 296,141  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 44,473 43,310 1,163  
20 Interest ........... 18,589,181 18,589,181    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 54,132,186 51,437,210 2,694,976  
23 Insurance .............. 3,430,190 3,430,190    
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a DRUGS & MEDICAL SUPPLIES 124,783,498 124,783,348 150  
b PROVISION FOR BAD DEBTS 41,655,746 41,655,746    
c MISCELLANEOUS EXPENSE 3,463,821 1,705,884 1,757,937  
d PHYSICIAN RECRUITMENT 932,528 188,471 744,057  
e All other expenses 241,699 233,587 8,112  
25 Total functional expenses. Add lines 1 through 24e 642,747,399 582,652,477 60,094,922 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 MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2014)
Form 990 (2014)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 553,847 1 305,060
2 Savings and temporary cash investments ......... 25,886,422 2 45,263,215
3 Pledges and grants receivable, net ...........   3  
4 Accounts receivable, net ............. 175,220,510 4 116,357,945
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 .............. 17,170,337 8 18,417,121
9 Prepaid expenses and deferred charges .......... 9,662,119 9 9,676,575
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,089,340,217
b Less: accumulated depreciation ..... 10b 635,247,983 462,143,813 10c 454,092,234
11 Investments—publicly traded securities .......... 412,922,328 11 411,522,813
12 Investments—other securities. See Part IV, line 11 .....   12  
13 Investments—program-related. See Part IV, line 11 ..... 18,220,889 13 7,213,553
14 Intangible assets ............... 7,993,380 14 37,609,295
15 Other assets. See Part IV, line 11 ........... 7,099,105 15 7,090,041
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 1,136,872,750 16 1,107,547,852
Liabilities 17 Accounts payable and accrued expenses ......... 84,562,491 17 81,970,064
18 Grants payable .................   18  
19 Deferred revenue ................   19  
20 Tax-exempt bond liabilities ............. 471,816,681 20 459,668,669
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 .. 9,564,971 23 9,297,968
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.................... 67,238,095 25 68,927,027
26 Total liabilities. Add lines 17 through 25......... 633,182,238 26 619,863,728
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 503,690,512 27 487,684,124
28 Temporarily restricted net assets ...........   28  
29 Permanently restricted net assets ...........   29  
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet 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 ........... 503,690,512 33 487,684,124
34 Total liabilities and net assets/fund balances ........ 1,136,872,750 34 1,107,547,852
Form 990 (2014)
Form 990 (2014)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
694,174,240
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
642,747,399
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
51,426,841
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
503,690,512
5
Net unrealized gains (losses) on investments ...............
5
 
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-67,433,229
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
487,684,124
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? .................
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2014)
Form 990 (2014)
Page 13
Form 990, Special Condition Description:
Special Condition Description
AMENDED
Form 990 (2014)
Form 990 (2014)
Page 14
Additional Data


Software ID:  
Software Version:  
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
2014
Open to Public
Inspection
Name of the organization
WELLMONT HEALTH SYSTEM
 
Employer identification number

62-1636465
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
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.)
10
11
a
b
c
d
e
f
Enter the number of supported organizations .............................  
g
Provide the following information about the supported organization(s).
(i)Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total    

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
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) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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.  
12
12
 
13
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
14
14
 
15
15
 
16a
b
17a
b
18
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) 2014
Schedule A (Form 990 or 990-EZ) 2014
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) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
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
No
1
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.
1
 
 
2
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).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
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.
3b
 
 
c
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.
3c
 
 
4a
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.
4a
 
 
b
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....
4b
 
 
c
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.
4c
 
 
5a
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).
5a
 
 
b
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?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (a) its supported organizations; (b) individuals that are part of the charitable class benefited by one or more of its supported organizations; or (c) 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.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in IRC 4958(c)(3)(C)), a family member of a substantial contributor, or a 35-percent controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part II of Schedule L (Form 990).
8
 
 
9a
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.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9(a)) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9(a)) 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.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer b below.
10a
 
 
b
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
 
 
11
Has the organization accepted a gift or contribution from any of the following persons?
a
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
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
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
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 5
Part IV
Supporting Organizations (continued)

Section B. Type I Supporting Organizations
Yes
No
1
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.
1
 
 
2
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.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
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).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (1) a written notice describing the type and amount of support provided during the prior tax year, (2) a copy of the Form 990 that was most recently filed as of the date of notification, and (3) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
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).
2
 
 
3
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.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
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.
2a
 
 
b
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.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
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.
3a
 
 
b
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.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 6
Part V – Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

1.   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  
7   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) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 7
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 2014 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-2014
(iii)
Distributable
Amount for 2014
1 Distributable amount for 2014 from Section C, line
6
 
2 Underdistributions, if any, for years prior to 2014
(reasonable cause required--see instructions)
 
3 Excess distributions carryover, if any, to 2014:
a From 2009.......X
b From 2010.......X
c From 2011.......X
d From 2012.......X
e From 2013.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2014 distributable amount  
i Carryover from 2009 not applied (see
instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2014 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2014 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2014, if any. Subtract lines 3g and 4a from line 2
(if amount greater than zero, see instructions)
 
6 Remaining underdistributions for 2014. Subtract
lines 3h and 4b from line 1 (if amount greater than
zero, see instructions)
 
7 Excess distributions carryover to 2015. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a From 2010.......X
b From 2011.......X
c From 2012.......X
d From 2013.......  
e From 2014.......  
Schedule A (Form 990 or 990-EZ) (2014)
Schedule A (Form 990 or 990-EZ) 2014
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) 2014

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Name of the organization
WELLMONT HEALTH SYSTEM
 
Employer identification number

62-1636465
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




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
Special Rules
......... 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) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 2
Name of organization
WELLMONT HEALTH SYSTEM
 
Employer identification number

62-1636465
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


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 3
Name of organization
WELLMONT HEALTH SYSTEM
 
Employer identification number

62-1636465
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) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 4
Name of organization
WELLMONT HEALTH SYSTEM
 
Employer identification number

62-1636465
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 $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a) No.
from
Part I
(b) Purpose of gift (c) Use 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 (c) Use 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 (c) Use 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 (c) Use 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) (2014)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd Bullet Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
If the organization answered "Yes" to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" to Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
WELLMONT HEALTH SYSTEM
 
Employer identification number

62-1636465
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ...................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2014

Schedule C (Form 990 or 990-EZ) 2014
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ....... 146,182  
c Total lobbying expenditures (add lines 1a and 1b) ................... 146,182  
d Other exempt purpose expenditures ........................ 642,601,217  
e Total exempt purpose expenditures (add lines 1c and 1d) ............... 642,747,399  
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
1,000,000  
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) ................. 250,000  
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) Total
2a Lobbying nontaxable amount 1,000,000 1,000,000 1,000,000 1,000,000 4,000,000
b Lobbying ceiling amount
(150% of line 2a, column(e))
6,000,000
c Total lobbying expenditures 63,081 64,174 169,101 146,182 442,538
d Grassroots nontaxable amount 250,000 250,000 250,000 250,000 1,000,000
e Grassroots ceiling amount
(150% of line 2d, column (e))
1,500,000
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2014


Schedule C (Form 990 or 990-EZ) 2014
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
 
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
 
c
Media advertisements? ....................................
 
 
 
d
Mailings to members, legislators, or the public? .........................
 
 
 
e
Publications, or published or broadcast statements? .......................
 
 
 
f
Grants to other organizations for lobbying purposes? .......................
 
 
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
 
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
 
 
i
Other activities? ..........................
 
 
 
j
Total. Add lines 1c through 1i ...............................
 
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
 
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
Schedule C (Form 990 or 990EZ) 2014

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
WELLMONT HEALTH SYSTEM
 
Employer identification number

62-1636465
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
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? ............
6
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? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
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.
Held at the End of the 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  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
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)? .......................................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
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.
b
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 in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
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:
a
Revenue included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
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) 2014

Schedule D (Form 990) 2014
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
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):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
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?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
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  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII .......
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance ....          
b Contributions ........          
c Net investment earnings, gains, and losses          
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........
         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
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' to 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 ................. 107,181 31,544,344 31,651,525
b Buildings ................   521,877,129 267,122,794 254,754,335
c Leasehold improvements ............   8,357,291 1,925,145 6,432,146
d Equipment ................   373,376,522 299,554,384 73,822,138
e Other .................   154,077,750 66,645,660 87,432,090
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 454,092,234
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to 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    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' to 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








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes  
CAPITAL LEASE OBLIGATIONS 23,831,644
OTHER LONG-TERM LIABILITIES 17,410,747
OTHER CURRENT LIABILITIES 13,266,789
DEFINED BENEFITS PENSION LIABILITY 12,020,255
POST RETIREMENT BENEFITS 2,487,290
SWAP LIABILITY -89,698



Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 68,927,027
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) 2014

Schedule D (Form 990) 2014
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to 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' to 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, PAGE 3, PART X THE WELLMONT HEALTH SYSTEM ENTITIES ARE PRIMARILY CLASSIFIED AS ORGANIZATIONS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) AS ENTITIES DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN INCLUDED FOR THESE ENTITIES IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE OPERATIONS OF WELLMONT HEALTH SYSTEM ARE SUBJECT TO STATE AND FEDERAL INCOME TAXES WHICH ARE ACCOUNTED FOR IN ACCORDANCE WITH ASC 740, INCOME TAXES; HOWEVER, SUCH AMOUNTS ARE NOT MATERIAL.
Schedule D (Form 990) 2014

Additional Data


Software ID:  
Software Version:  




SCHEDULE H (Form 990)
Department of the TreasuryInternal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
WELLMONT HEALTH SYSTEM
 
Employer identification number

62-1636465
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: .........
3b
 
No
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) ..
    13,427,105   13,427,105 2.090 %
b Medicaid (from Worksheet 3,
column a) ....
    75,090,879 54,070,509 21,020,370 3.270 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) .
           
d Total Financial Assistance
and Means-Tested
Government Programs .
    88,517,984 54,070,509 34,447,475 5.360 %
Other Benefits
230 175,745 4,226,815   4,226,815 0.660 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) ..
72 5,646 5,555,001   5,555,001 0.860 %
g Subsidized health services
(from Worksheet 6) ..
           
h Research (from Worksheet 7) 202 32 135,640   135,640 0.020 %
i Cash and in-kind
contributions for community
benefit (from Worksheet 8)
62   132,529   132,529 0.020 %
j Total. Other Benefits .. 566 181,423 10,049,985   10,049,985 1.560 %
k Total. Add lines 7d and 7j . 566 181,423 98,567,969 54,070,509 44,497,460 6.920 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support 4 280 9,306   9,306  
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy 69 4,102 15,668   15,668  
8 Workforce development            
9 Other            
10 Total 73 4,382 24,974   24,974  
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
10,621,284
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
145,042,286
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
141,633,052
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
3,409,234
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
1HOLSTON VALLEY AMBUL
 
SURGICAL SERVICES 52.000 %   48.000 %
2SAPLING GROVE AMBULA
 
SURGICAL SERVICES 65.000 %   35.000 %
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?5
Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 HOLSTON VALLEY MEDICAL CENTER
130 RAVINE STREET
KINGSPORT,TN37660
X X   X     X     A
2 BRISTOL REGIONAL MEDICAL CENTER
1 MEDICAL PARK BLVD
BRISTOL,TN37620
X X   X     X     A
3 LONESOME PINE HOSPITAL
1990 HOLTON AVENUE
BIG STONE GAP,VA24219
X X   X     X     A
4 MOUNTAIN VIEW REGIONAL MEDICAL CTR
310 3RD STREET NE
NORTON,VA24273
X X         X     A
5 HANCOCK COUNTY HOSPITAL
1519 MAIN STREET
SNEEDVILLE,TN37869
X       X   X     A
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
A
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
 
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): WWW.WELLMONT.ORG
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

A
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14   No
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

A
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?......... 19 Yes  
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ................................ 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
GROUP A, FACILITY 1, HOLSTON VALLEY MEDICAL CENTER - PART V, LINE 5 INFORMATION FOR THE CHNA ASSESSMENT WAS GATHERED FROM A VARIETY OF SOURCES, INCLUDING: - INTERVIEWS WITH PATIENTS - INTERVIEWS WITH KEY COMMUNITY LEADERS AND STAKEHOLDERS, INCLUDING REPRESENTATIVE OF UNDERSERVED POPULATIONS AND AREAS WITH HEALTHCARE DISPARITIES - INTERVIEWS WITH LEADERS AND STAFF IN OTHER HEALTHCARE ORGANIZATIONS OR CIVIC ORGANIZATIONS WITH A SHARED MISSION TO POSITIVELY IMPACT THE HEALTH STATUS OF THE COMMUNITY - PHYSICIAN NEEDS ASSESSMENT - COMMUNITY HEALTH FACILITY ASSESSMENT - MENTAL HEALTH NEEDS ASSESSMENT - DIALYSIS AND DENTAL NEEDS ASSESSMENT - PUBLICLY AVAILABLE POPULATION AND DEMOGRAPHIC INFORMATION - PUBLICLY AVAILABLE POPULATION HEALTH INFORMATION THE INFORMATION WAS THEN COLLATED AND ASSESSED TO DETERMINE THE GREATEST UNMET HEALTH NEEDS FACING OUR REGION. STRATEGIES TO ADDRESS THESE NEEDS WERE THEN DEVELOPED, UTILIZING INTERNAL RESOURCES AND PARTNERSHIPS WITH OTHER HEALTHCARE ORGANIZATIONS AND PHYSICIANS. SEVERAL COMMUNITY LEADERS PARTICIPATED IN THE CHNA THROUGH PERSONAL INTERVIEWS, SURVEYS AND OTHER MEANS. THEIR FEEDBACK WAS INVALUABLE IN ASSESSING THE HEALTH NEEDS OF THE COMMUNITIES WE SERVE AND DEVELOPING ACTIONS PLANS TO ENSURE THOSE NEEDS WERE MET. THE TIME, TALENT AND INSIGHT OF ELECTED REPRESENTATIVES AND LEADERS OF BUSINESSES, MUNICIPALITIES AND ORGANIZATIONS LISTED BELOW WERE GREATLY APPRECIATED. - ADVANCED HOME CARE - BELIEVE IN BRISTOL - BILL GATTON AUTOMOTIVE GROUP - BRISTOL COMPRESSORS INTERNATIONAL - BRISTOL TENNESEE CITY SCHOOLS - VIRGINIA STATE SENATOR BILL CARRICO - CHILTERN INTERNATIONAL - CITY OF BRISTOL, TN - CITY OF BRISTOL, VA - CITY OF KINGSPORT, TN - CITY OF NORTON, VA - CITY OF NORTON SCHOOL SYSTEM - CITY OF ROGERSVILLE, TN - CITY OF SNEEDVILLE, TN - DICKENSON COUNTY CHAMBER OF COMMERCE - DOMTAR - DR. GLENN E. VANCE, JR., DDS - ELECTRO-MECHANICAL CORPORATION - FIRST TENNESSEE BANK - FRIENDS IN NEED HEALTHCARE, INC. - FRONTIER HEALTH - US REPRESENTATIVE MORGAN GRIFFITH - HANCOCK MANOR NURSING HOME - HAWKINS COUNTY GAS UTILITY - HAWKINS AND HANCOCK COUNTY HEALTH DEPARTMENTS - HEALING HANDS HEALTH CENTER - THE HEALTH WAGON - HUNTER, SMITH & DAVIS, ATTORNEYS AT LAW - INDUSTRIAL DEVELOPMENT AUTHORITY OF DICKENSON COUNTY - KVAT FOOD STORES - KAVANAUGH CALL CENTER GROUP - VIRGINIA STATE DELEGATE TERRY KILGORE - KINGSPORT AREA CHAMBER OF COMMERCE - KINGSPORT OFFICE OF SMALL BUSINESS DEVELOPMENT & ENTREPRENEURSHIP - LANDMARK REALTY, INC. - LEE COUNTY, VA. - MEADOWVIEW CONFERENCE RESORT & CONVENTION CENTER - VIRGINIA STATE DELEGATE JAMES "WILL" MOREFIELD - MOUNTAIN EMPIRE OLDER CITIZENS, INC. - NASH AND POWERS INSURANCE SERVICES - NORTON INDUSTRIAL DEVELOPMENT AUTHORITY - OAK HILL CEMETERY - VIRGINIA STATE DELEGATE ISRAEL O'QUINN - PHARMACEUTICAL PRODUCT DEVELOPMENT - VIRGINIA STATE SENATOR PHILLIP PUCKETT - TENNESSEE LT. GOVERNOR RON RAMSEY - THE REGIONAL EYE CENTER - THE ROBINETTE COMPANY - RURAL HEALTH SERVICES CONSORTIUM - SOUTHWEST VIRGINIA COMMUNITY HEALTH SYSTEMS, INC. - STRONGWELL CORPORATION - SULLIVAN COUNTY, TN - SULLIVAN COUNTY REGIONAL HEALTH DEPARTMENT - SULLIVAN COUNTY SCHOOL SYSTEM - TELE-OPTICS, INC. - TOWN OF ABINGDON, VA - TOWN OF BIG STONE GAP, VA - TOWN OF PENNINGTON GAP, VA - TOWN OF JONESVILLE, VA - TRISUMMIT BANK - UNIVERSAL FIBERS - UNIVERSITY OF VIRGINIA'S COLLEGE AT WISE - VIRGINIA CITY HYBRID ENERGY CENTER - VIRGINIA DEPARTMENT OF HEALTH - CUMBERLAND PLATEAU HEALTH DISTRICT - VIRGINIA DEPARTMENT OF HEALTH - LENOWISCO DISTRICT - WCYB-TV - WELLMONT MEDICAL ASSOCIATES - WISE COUNTY CHAMBER OF COMMERCE - WISE COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY - WISE COUNTY, VA - YWCA BRISTOL
GROUP A, FACILITY 1, HOLSTON VALLEY MEDICAL CENTER - PART V, LINE 6A - BRISTOL REGIONAL MEDICAL CENTER - LONESOME PINE HOSPITAL - HAWKINS COUNTY MEMORIAL HOSPITAL - HANCOCK COUNTY HOSPITAL - MOUNTAIN VIEW REGIONAL MEDICAL CENTER
GROUP A, FACILITY 1, HOLSTON VALLEY MEDICAL CENTER - PART V, LINE 11 KEY FINDINGS NOTED DURING THE CHNA WERE LACK OF SUFFICIENT PSYCHIATRIC HEALTH AND DENTAL CARE. THESE FINDINGS FALL OUTSIDE THE CORE BUSINESS AND MISSON OF WELLMONT HEALTH SYSTEM. TO HELP MEET THESE NEEDS, WELLMONT HEALTH SYSTEM WILL CONTINUE TO STRENGTHEN OUR PARTNERSHIPS AND CONTINUUM OF CARE OPPORTUNITIES WITH AREA HEALTH DEPARTMENTS, FEDERALLY QUALIFIED HEALTH CENTERS AND FRONTIER HEALTH, THE REGION'S LEADING PROVIDER OF BEHAVIORAL HEALTH SERVICES.
GROUP A, FACILITY 1, HOLSTON VALLEY MEDICAL CENTER - PART V, LINE 22D HOLSTON VALLEY MEDICAL CENTER FOLLOWS TENNESSEE STATUTE WHICH IS 175% OF AVERAGE COST FOR ITS HOSPITAL.
GROUP A, FACILITY 2, BRISTOL REGIONAL MEDICAL CENTER - PART V, LINE 5 INFORMATION FOR THE CHNA ASSESSMENT WAS GATHERED FROM A VARIETY OF SOURCES, INCLUDING: - INTERVIEWS WITH PATIENTS - INTERVIEWS WITH KEY COMMUNITY LEADERS AND STAKEHOLDERS, INCLUDING REPRESENTATIVE OF UNDERSERVED POPULATIONS AND AREAS WITH HEALTHCARE DISPARITIES - INTERVIEWS WITH LEADERS AND STAFF IN OTHER HEALTHCARE ORGANIZATIONS OR CIVIC ORGANIZATIONS WITH A SHARED MISSION TO POSITIVELY IMPACT THE HEALTH STATUS OF THE COMMUNITY - PHYSICIAN NEEDS ASSESSMENT - COMMUNITY HEALTH FACILITY ASSESSMENT - MENTAL HEALTH NEEDS ASSESSMENT - DIALYSIS AND DENTAL NEEDS ASSESSMENT - PUBLICLY AVAILABLE POPULATION AND DEMOGRAPHIC INFORMATION - PUBLICLY AVAILABLE POPULATION HEALTH INFORMATION THE INFORMATION WAS THEN COLLATED AND ASSESSED TO DETERMINE THE GREATEST UNMET HEALTH NEEDS FACING OUR REGION. STRATEGIES TO ADDRESS THESE NEEDS WERE THEN DEVELOPED, UTILIZING INTERNAL RESOURCES AND PARTNERSHIPS WITH OTHER HEALTHCARE ORGANIZATIONS AND PHYSICIANS. SEVERAL COMMUNITY LEADERS PARTICIPATED IN THE CHNA THROUGH PERSONAL INTERVIEWS, SURVEYS AND OTHER MEANS. THEIR FEEDBACK WAS INVALUABLE IN ASSESSING THE HEALTH NEEDS OF THE COMMUNITIES WE SERVE AND DEVELOPING ACTIONS PLANS TO ENSURE THOSE NEEDS WERE MET. THE TIME, TALENT AND INSIGHT OF ELECTED REPRESENTATIVES AND LEADERS OF BUSINESSES, MUNICIPALITIES AND ORGANIZATIONS LISTED BELOW WERE GREATLY APPRECIATED. - ADVANCED HOME CARE - BELIEVE IN BRISTOL - BILL GATTON AUTOMOTIVE GROUP - BRISTOL COMPRESSORS INTERNATIONAL - BRISTOL TENNESEE CITY SCHOOLS - VIRGINIA STATE SENATOR BILL CARRICO - CHILTERN INTERNATIONAL - CITY OF BRISTOL, TN - CITY OF BRISTOL, VA - CITY OF KINGSPORT, TN - CITY OF NORTON, VA - CITY OF NORTON SCHOOL SYSTEM - CITY OF ROGERSVILLE, TN - CITY OF SNEEDVILLE, TN - DICKENSON COUNTY CHAMBER OF COMMERCE - DOMTAR - DR. GLENN E. VANCE, JR., DDS - ELECTRO-MECHANICAL CORPORATION - FIRST TENNESSEE BANK - FRIENDS IN NEED HEALTHCARE, INC. - FRONTIER HEALTH - US REPRESENTATIVE MORGAN GRIFFITH - HANCOCK MANOR NURSING HOME - HAWKINS COUNTY GAS UTILITY - HAWKINS AND HANCOCK COUNTY HEALTH DEPARTMENTS - HEALING HANDS HEALTH CENTER - THE HEALTH WAGON - HUNTER, SMITH & DAVIS, ATTORNEYS AT LAW - INDUSTRIAL DEVELOPMENT AUTHORITY OF DICKENSON COUNTY - KVAT FOOD STORES - KAVANAUGH CALL CENTER GROUP - VIRGINIA STATE DELEGATE TERRY KILGORE - KINGSPORT AREA CHAMBER OF COMMERCE - KINGSPORT OFFICE OF SMALL BUSINESS DEVELOPMENT & ENTREPRENEURSHIP - LANDMARK REALTY, INC. - LEE COUNTY, VA. - MEADOWVIEW CONFERENCE RESORT & CONVENTION CENTER - VIRGINIA STATE DELEGATE JAMES "WILL" MOREFIELD - MOUNTAIN EMPIRE OLDER CITIZENS, INC. - NASH AND POWERS INSURANCE SERVICES - NORTON INDUSTRIAL DEVELOPMENT AUTHORITY - OAK HILL CEMETERY - VIRGINIA STATE DELEGATE ISRAEL O'QUINN - PHARMACEUTICAL PRODUCT DEVELOPMENT - VIRGINIA STATE SENATOR PHILLIP PUCKETT - TENNESSEE LT. GOVERNOR RON RAMSEY - THE REGIONAL EYE CENTER - THE ROBINETTE COMPANY - RURAL HEALTH SERVICES CONSORTIUM - SOUTHWEST VIRGINIA COMMUNITY HEALTH SYSTEMS, INC. - STRONGWELL CORPORATION - SULLIVAN COUNTY, TN - SULLIVAN COUNTY REGIONAL HEALTH DEPARTMENT - SULLIVAN COUNTY SCHOOL SYSTEM - TELE-OPTICS, INC. - TOWN OF ABINGDON, VA - TOWN OF BIG STONE GAP, VA - TOWN OF PENNINGTON GAP, VA - TOWN OF JONESVILLE, VA - TRISUMMIT BANK - UNIVERSAL FIBERS - UNIVERSITY OF VIRGINIA'S COLLEGE AT WISE - VIRGINIA CITY HYBRID ENERGY CENTER - VIRGINIA DEPARTMENT OF HEALTH - CUMBERLAND PLATEAU HEALTH DISTRICT - VIRGINIA DEPARTMENT OF HEALTH - LENOWISCO DISTRICT - WCYB-TV - WELLMONT MEDICAL ASSOCIATES - WISE COUNTY CHAMBER OF COMMERCE - WISE COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY - WISE COUNTY, VA - YWCA BRISTOL
GROUP A, FACILITY 2, BRISTOL REGIONAL MEDICAL CENTER - PART V, LINE 6A - HOLSTON VALLEY MEDICAL CENTER - LONESOME PINE HOSPITAL - HAWKINS COUNTY MEMORIAL HOSPITAL - HANCOCK COUNTY HOSPITAL - MOUNTAIN VIEW REGIONAL MEDICAL CENTER
GROUP A, FACILITY 2, BRISTOL REGIONAL MEDICAL CENTER - PART V, LINE 11 KEY FINDINGS NOTED DURING THE CHNA WERE LACK OF SUFFICIENT PSYCHIATRIC HEALTH AND DENTAL CARE. THESE FINDINGS FALL OUTSIDE THE CORE BUSINESS AND MISSON OF WELLMONT HEALTH SYSTEM. TO HELP MEET THESE NEEDS, WELLMONT HEALTH SYSTEM WILL CONTINUE TO STRENGTHEN OUR PARTNERSHIPS AND CONTINUUM OF CARE OPPORTUNITIES WITH AREA HEALTH DEPARTMENTS, FEDERALLY QUALIFIED HEALTH CENTERS AND FRONTIER HEALTH, THE REGION'S LEADING PROVIDER OF BEHAVIORAL HEALTH SERVICES.
GROUP A, FACILITY 2, BRISTOL REGIONAL MEDICAL CENTER - PART V, LINE 22D BRISTOL REGIONAL MEDICAL CENTER FOLLOWS TENNESSEE STATUTE WHICH IS 175% OF AVERAGE COST FOR ITS HOSPITALS.
GROUP A, FACILITY 3, LONESOME PINE HOSPITAL - PART V, LINE 5 INFORMATION FOR THE CHNA ASSESSMENT WAS GATHERED FROM A VARIETY OF SOURCES, INCLUDING: - INTERVIEWS WITH PATIENTS - INTERVIEWS WITH KEY COMMUNITY LEADERS AND STAKEHOLDERS, INCLUDING REPRESENTATIVE OF UNDERSERVED POPULATIONS AND AREAS WITH HEALTHCARE DISPARITIES - INTERVIEWS WITH LEADERS AND STAFF IN OTHER HEALTHCARE ORGANIZATIONS OR CIVIC ORGANIZATIONS WITH A SHARED MISSION TO POSITIVELY IMPACT THE HEALTH STATUS OF THE COMMUNITY - PHYSICIAN NEEDS ASSESSMENT - COMMUNITY HEALTH FACILITY ASSESSMENT - MENTAL HEALTH NEEDS ASSESSMENT - DIALYSIS AND DENTAL NEEDS ASSESSMENT - PUBLICLY AVAILABLE POPULATION AND DEMOGRAPHIC INFORMATION - PUBLICLY AVAILABLE POPULATION HEALTH INFORMATION THE INFORMATION WAS THEN COLLATED AND ASSESSED TO DETERMINE THE GREATEST UNMET HEALTH NEEDS FACING OUR REGION. STRATEGIES TO ADDRESS THESE NEEDS WERE THEN DEVELOPED, UTILIZING INTERNAL RESOURCES AND PARTNERSHIPS WITH OTHER HEALTHCARE ORGANIZATIONS AND PHYSICIANS. SEVERAL COMMUNITY LEADERS PARTICIPATED IN THE CHNA THROUGH PERSONAL INTERVIEWS, SURVEYS AND OTHER MEANS. THEIR FEEDBACK WAS INVALUABLE IN ASSESSING THE HEALTH NEEDS OF THE COMMUNITIES WE SERVE AND DEVELOPING ACTIONS PLANS TO ENSURE THOSE NEEDS WERE MET. THE TIME, TALENT AND INSIGHT OF ELECTED REPRESENTATIVES AND LEADERS OF BUSINESSES, MUNICIPALITIES AND ORGANIZATIONS LISTED BELOW WERE GREATLY APPRECIATED. - ADVANCED HOME CARE - BELIEVE IN BRISTOL - BILL GATTON AUTOMOTIVE GROUP - BRISTOL COMPRESSORS INTERNATIONAL - BRISTOL TENNESEE CITY SCHOOLS - VIRGINIA STATE SENATOR BILL CARRICO - CHILTERN INTERNATIONAL - CITY OF BRISTOL, TN - CITY OF BRISTOL, VA - CITY OF KINGSPORT, TN - CITY OF NORTON, VA - CITY OF NORTON SCHOOL SYSTEM - CITY OF ROGERSVILLE, TN - CITY OF SNEEDVILLE, TN - DICKENSON COUNTY CHAMBER OF COMMERCE - DOMTAR - DR. GLENN E. VANCE, JR., DDS - ELECTRO-MECHANICAL CORPORATION - FIRST TENNESSEE BANK - FRIENDS IN NEED HEALTHCARE, INC. - FRONTIER HEALTH - US REPRESENTATIVE MORGAN GRIFFITH - HANCOCK MANOR NURSING HOME - HAWKINS COUNTY GAS UTILITY - HAWKINS AND HANCOCK COUNTY HEALTH DEPARTMENTS - HEALING HANDS HEALTH CENTER - THE HEALTH WAGON - HUNTER, SMITH & DAVIS, ATTORNEYS AT LAW - INDUSTRIAL DEVELOPMENT AUTHORITY OF DICKENSON COUNTY - KVAT FOOD STORES - KAVANAUGH CALL CENTER GROUP - VIRGINIA STATE DELEGATE TERRY KILGORE - KINGSPORT AREA CHAMBER OF COMMERCE - KINGSPORT OFFICE OF SMALL BUSINESS DEVELOPMENT & ENTREPRENEURSHIP - LANDMARK REALTY, INC. - LEE COUNTY, VA. - MEADOWVIEW CONFERENCE RESORT & CONVENTION CENTER - VIRGINIA STATE DELEGATE JAMES "WILL" MOREFIELD - MOUNTAIN EMPIRE OLDER CITIZENS, INC. - NASH AND POWERS INSURANCE SERVICES - NORTON INDUSTRIAL DEVELOPMENT AUTHORITY - OAK HILL CEMETERY - VIRGINIA STATE DELEGATE ISRAEL O'QUINN - PHARMACEUTICAL PRODUCT DEVELOPMENT - VIRGINIA STATE SENATOR PHILLIP PUCKETT - TENNESSEE LT. GOVERNOR RON RAMSEY - THE REGIONAL EYE CENTER - THE ROBINETTE COMPANY - RURAL HEALTH SERVICES CONSORTIUM - SOUTHWEST VIRGINIA COMMUNITY HEALTH SYSTEMS, INC. - STRONGWELL CORPORATION - SULLIVAN COUNTY, TN - SULLIVAN COUNTY REGIONAL HEALTH DEPARTMENT - SULLIVAN COUNTY SCHOOL SYSTEM - TELE-OPTICS, INC. - TOWN OF ABINGDON, VA - TOWN OF BIG STONE GAP, VA - TOWN OF PENNINGTON GAP, VA - TOWN OF JONESVILLE, VA - TRISUMMIT BANK - UNIVERSAL FIBERS - UNIVERSITY OF VIRGINIA'S COLLEGE AT WISE - VIRGINIA CITY HYBRID ENERGY CENTER - VIRGINIA DEPARTMENT OF HEALTH - CUMBERLAND PLATEAU HEALTH DISTRICT - VIRGINIA DEPARTMENT OF HEALTH - LENOWISCO DISTRICT - WCYB-TV - WELLMONT MEDICAL ASSOCIATES - WISE COUNTY CHAMBER OF COMMERCE - WISE COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY - WISE COUNTY, VA - YWCA BRISTOL
GROUP A, FACILITY 3, LONESOME PINE HOSPITAL - PART V, LINE 6A - BRISTOL REGIONAL MEDICAL CENTER - HOLSTON VALLEY MEDICAL CENTER - HAWKINS COUNTY MEMORIAL HOSPITAL - HANCOCK COUNTY HOSPITAL - MOUNTAIN VIEW REGIONAL MEDICAL CENTER
GROUP A, FACILITY 3, LONESOME PINE HOSPITAL - PART V, LINE 11 KEY FINDINGS NOTED DURING THE CHNA WERE LACK OF SUFFICIENT PSYCHIATRIC HEALTH AND DENTAL CARE. THESE FINDINGS FALL OUTSIDE THE CORE BUSINESS AND MISSON OF WELLMONT HEALTH SYSTEM. TO HELP MEET THESE NEEDS, WELLMONT HEALTH SYSTEM WILL CONTINUE TO STRENGTHEN OUR PARTNERSHIPS AND CONTINUUM OF CARE OPPORTUNITIES WITH AREA HEALTH DEPARTMENTS, FEDERALLY QUALIFIED HEALTH CENTERS AND FRONTIER HEALTH, THE REGION'S LEADING PROVIDER OF BEHAVIORAL HEALTH SERVICES.
GROUP A, FACILITY 3, LONESOME PINE HOSPITAL - PART V, LINE 22D LONESOME PINE HOSPITAL FOLLOWS TENNESSEE STATUTE WHICH IS 175% OF AVERAGE COST FOR ITS HOSPITALS (IN THE ABSENCE OF VIRGINIA STATUTE).
GROUP A, FACILITY 4, MOUNTAIN VIEW REGIONAL MEDICAL CTR - PART V, LINE 5 INFORMATION FOR THE CHNA ASSESSMENT WAS GATHERED FROM A VARIETY OF SOURCES, INCLUDING: - INTERVIEWS WITH PATIENTS - INTERVIEWS WITH KEY COMMUNITY LEADERS AND STAKEHOLDERS, INCLUDING REPRESENTATIVE OF UNDERSERVED POPULATIONS AND AREAS WITH HEALTHCARE DISPARITIES - INTERVIEWS WITH LEADERS AND STAFF IN OTHER HEALTHCARE ORGANIZATIONS OR CIVIC ORGANIZATIONS WITH A SHARED MISSION TO POSITIVELY IMPACT THE HEALTH STATUS OF THE COMMUNITY - PHYSICIAN NEEDS ASSESSMENT - COMMUNITY HEALTH FACILITY ASSESSMENT - MENTAL HEALTH NEEDS ASSESSMENT - DIALYSIS AND DENTAL NEEDS ASSESSMENT - PUBLICLY AVAILABLE POPULATION AND DEMOGRAPHIC INFORMATION - PUBLICLY AVAILABLE POPULATION HEALTH INFORMATION THE INFORMATION WAS THEN COLLATED AND ASSESSED TO DETERMINE THE GREATEST UNMET HEALTH NEEDS FACING OUR REGION. STRATEGIES TO ADDRESS THESE NEEDS WERE THEN DEVELOPED, UTILIZING INTERNAL RESOURCES AND PARTNERSHIPS WITH OTHER HEALTHCARE ORGANIZATIONS AND PHYSICIANS. SEVERAL COMMUNITY LEADERS PARTICIPATED IN THE CHNA THROUGH PERSONAL INTERVIEWS, SURVEYS AND OTHER MEANS. THEIR FEEDBACK WAS INVALUABLE IN ASSESSING THE HEALTH NEEDS OF THE COMMUNITIES WE SERVE AND DEVELOPING ACTIONS PLANS TO ENSURE THOSE NEEDS WERE MET. THE TIME, TALENT AND INSIGHT OF ELECTED REPRESENTATIVES AND LEADERS OF BUSINESSES, MUNICIPALITIES AND ORGANIZATIONS LISTED BELOW WERE GREATLY APPRECIATED. - ADVANCED HOME CARE - BELIEVE IN BRISTOL - BILL GATTON AUTOMOTIVE GROUP - BRISTOL COMPRESSORS INTERNATIONAL - BRISTOL TENNESEE CITY SCHOOLS - VIRGINIA STATE SENATOR BILL CARRICO - CHILTERN INTERNATIONAL - CITY OF BRISTOL, TN - CITY OF BRISTOL, VA - CITY OF KINGSPORT, TN - CITY OF NORTON, VA - CITY OF NORTON SCHOOL SYSTEM - CITY OF ROGERSVILLE, TN - CITY OF SNEEDVILLE, TN - DICKENSON COUNTY CHAMBER OF COMMERCE - DOMTAR - DR. GLENN E. VANCE, JR., DDS - ELECTRO-MECHANICAL CORPORATION - FIRST TENNESSEE BANK - FRIENDS IN NEED HEALTHCARE, INC. - FRONTIER HEALTH - US REPRESENTATIVE MORGAN GRIFFITH - HANCOCK MANOR NURSING HOME - HAWKINS COUNTY GAS UTILITY - HAWKINS AND HANCOCK COUNTY HEALTH DEPARTMENTS - HEALING HANDS HEALTH CENTER - THE HEALTH WAGON - HUNTER, SMITH & DAVIS, ATTORNEYS AT LAW - INDUSTRIAL DEVELOPMENT AUTHORITY OF DICKENSON COUNTY - KVAT FOOD STORES - KAVANAUGH CALL CENTER GROUP - VIRGINIA STATE DELEGATE TERRY KILGORE - KINGSPORT AREA CHAMBER OF COMMERCE - KINGSPORT OFFICE OF SMALL BUSINESS DEVELOPMENT & ENTREPRENEURSHIP - LANDMARK REALTY, INC. - LEE COUNTY, VA. - MEADOWVIEW CONFERENCE RESORT & CONVENTION CENTER - VIRGINIA STATE DELEGATE JAMES "WILL" MOREFIELD - MOUNTAIN EMPIRE OLDER CITIZENS, INC. - NASH AND POWERS INSURANCE SERVICES - NORTON INDUSTRIAL DEVELOPMENT AUTHORITY - OAK HILL CEMETERY - VIRGINIA STATE DELEGATE ISRAEL O'QUINN - PHARMACEUTICAL PRODUCT DEVELOPMENT - VIRGINIA STATE SENATOR PHILLIP PUCKETT - TENNESSEE LT. GOVERNOR RON RAMSEY - THE REGIONAL EYE CENTER - THE ROBINETTE COMPANY - RURAL HEALTH SERVICES CONSORTIUM - SOUTHWEST VIRGINIA COMMUNITY HEALTH SYSTEMS, INC. - STRONGWELL CORPORATION - SULLIVAN COUNTY, TN - SULLIVAN COUNTY REGIONAL HEALTH DEPARTMENT - SULLIVAN COUNTY SCHOOL SYSTEM - TELE-OPTICS, INC. - TOWN OF ABINGDON, VA - TOWN OF BIG STONE GAP, VA - TOWN OF PENNINGTON GAP, VA - TOWN OF JONESVILLE, VA - TRISUMMIT BANK - UNIVERSAL FIBERS - UNIVERSITY OF VIRGINIA'S COLLEGE AT WISE - VIRGINIA CITY HYBRID ENERGY CENTER - VIRGINIA DEPARTMENT OF HEALTH - CUMBERLAND PLATEAU HEALTH DISTRICT - VIRGINIA DEPARTMENT OF HEALTH - LENOWISCO DISTRICT - WCYB-TV - WELLMONT MEDICAL ASSOCIATES - WISE COUNTY CHAMBER OF COMMERCE - WISE COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY - WISE COUNTY, VA - YWCA BRISTOL
GROUP A, FACILITY 4, MOUNTAIN VIEW REGIONAL MEDICAL CTR - PART V, LINE 6A - BRISTOL REGIONAL MEDICAL CENTER - HOLSTON VALLEY MEDICAL CENTER - LONESOME PINE HOSPITAL - HAWKINS COUNTY MEMORIAL HOSPITAL - HANCOCK COUNTY HOSPITAL
GROUP A, FACILITY 4, MOUNTAIN VIEW REGIONAL MEDICAL CTR - PART V, LINE 11 KEY FINDINGS NOTED DURING THE CHNA WERE LACK OF SUFFICIENT PSYCHIATRIC HEALTH AND DENTAL CARE. THESE FINDINGS FALL OUTSIDE THE CORE BUSINESS AND MISSON OF WELLMONT HEALTH SYSTEM. TO HELP MEET THESE NEEDS, WELLMONT HEALTH SYSTEM WILL CONTINUE TO STRENGTHEN OUR PARTNERSHIPS AND CONTINUUM OF CARE OPPORTUNITIES WITH AREA HEALTH DEPARTMENTS, FEDERALLY QUALIFIED HEALTH CENTERS AND FRONTIER HEALTH, THE REGION'S LEADING PROVIDER OF BEHAVIORAL HEALTH SERVICES.
GROUP A, FACILITY 4, MOUNTAIN VIEW REGIONAL MEDICAL CTR - PART V, LINE 22D MOUNTAIN VIEW REGIONAL MEDICAL CENTER FOLLOWS TENNESSEE STATUTE WHICH IS 175% OF AVERAGE COST FOR ITS HOSPITALS (IN THE ABSENCE OF VIRGINIA STATUTE).
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?  
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATION PART I, LINE 6A: WELLMONT HEALTH SYSTEM PREPARES A CONSOLIDATED COMMUNITY BENEFIT REPORT WHICH INCLUDES THE ACTIVITIES OF ALL ITS OPERATIONS AND AFFILIATES. IN CONTRAST, AN IRS FORM 990 IS FILED FOR EACH TAX EXEMPT CORPORATION (7 SEPARATE FORM 990S) AND THERE IS NO SUCH IRS FORM FOR THE TAXABLE CORPORATIONS. IN ADDITION, THE IRS INSTRUCTIONS TO FORM 990 HAVE SPECIFIC DEFINITIONS, METHODS AND WORKSHEETS TO CALCULATE THE COMMUNITY BENEFITS TO BE INCLUDED ON THE FORM 990. AS A RESULT, THERE ARE SIGNIFICANT DIFFERENCES BETWEEN THE COMMUNITY BENEFITS REPORTED IN THE CONSOLIDATED COMMUNITY BENEFIT REPORT AND THE VARIOUS FORM 990S. THERE ARE ALSO FUNDS AND SERVICES THAT ARE PROVIDED THAT DO NOT MEET THE SPECIFIC DEFINITIONS OF THE IRS INSTRUCTIONS, SUCH AS CONTRIBUTIONS TO COMMUNITY ORGANIZATIONS THAT DO NOT MEET THE DEFINITION OF "RESTRICTED TO ONE OR MORE OF THE ACTIVITIES DESCRIBED IN THE TABLE IN PART I, LINE 7...".
PART I, LINE 7, COLUMN (F) - EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE THE BAD DEBT EXPENSE OF 41,617,056 WAS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT WAS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN.
PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION RATIO OF PATIENT CARE COST-TO-CHARGES, WAS USED TO DETERMINE THE COSTS FOR AMOUNTS IN LINE 7A AND 7B, COL (C) BY FACILITY. THE COSTS INCLUDED IN THE COST-TO-CHARGE RATIO INCLUDED THE COSTS FROM ALL PATIENT SEGMENTS. ACTUAL COSTS FROM THE GENERAL LEDGER WERE USED FOR AMOUNTS IN LINE 7F AND 7I, COL.(C).
PART II - COMMUNITY BUILDING ACTIVITIES WELLMONT HEALTH SYSTEM PROMOTED THE HEALTH OF THE COMMUNITIES IT SERVES IN A VARIETY OF WAYS. COMMUNITY SUPPORT A MEMBER OF THE BRISTOL REGIONAL MEDICAL CENTER PHYSICAL THERAPY DEPARTMENT PROVIDED VOLUNTEER HOURS WITH HEALING HANDS HEALTH CENTER AND SAMARITAN'S PURSE. SAMARITAN'S PURSE HOLDS AN ANNUAL OPERATION CHRISTMAS CHILD EVENT TO SHIP GIFTS IN SHOEBOXES THAT REACHES 8.5 MILLION CHILDREN AROUND THE WORLD. THE HOLSTON VALLEY MEDICAL CENTER TRAUMA AND EMERGENCY DEPARTMENTS HOSTED AN APPRECIATION PICNIC FOR LOCAL EMS MEMBERS. COMMUNITY HEALTH IMPROVEMENT ADVOCACY TO PROMOTE COMMUNITY HEALTH IMPROVEMENTS AND SAFETY, HOLSTON VALLEY MEDICAL CENTER (HVMC) PROVIDED RESOURCES TO CONDUCT VARIOUS PRESENTATIONS TO THE COMMUNITY SUCH AS TRAUMA NURSES TALK TOUGH, EBOLA EDUCATION, DISTRACTED DRIVER SIMULATOR PROGRAM, AND BATTLE OF THE BELT/SEAT BELT CHECK PROGRAM.
PART VI, LINE 2 - NEEDS ASSESSMENT WELLMONT HEALTH SYSTEM EXAMINES THE HEALTHCARE NEEDS OF THE COMMUNITIES IT SERVES BY CONDUCTING PHYSICIAN NEEDS ASSESSMENTS FOR ITS HOSPITALS. AS PART OF THIS EFFORT, WELLMONT REVIEWS ITS SERVICE AREA AND DEMOGRAPHICS, EXAMINES PHYSICIAN DEMOGRAPHICS AND CONDUCTS FOCUS GROUPS. IT MAKES A DETERMINATION OF PHYSICIAN NEED WHILE CALCULATING ITS PHYSICIAN SURPLUSES AND DEFICITS AND HIGHLIGHTING ITS RECRUITMENT PRIORITIES AND PLANS. WELLMONT ANNUALLY DETERMINES ITS PRIMARY, SECONDARY AND TERTIARY MARKETS THROUGH THE USE OF COUNTY-BY-COUNTY ANALYSIS TO IDENTIFY THE FOLLOWING CUSTOMER GROUPS: PATIENTS AND POTENTIAL PATIENTS, COMMUNITY/EMPLOYER GROUPS AND LOCAL PHYSICIANS. THE HEALTH SYSTEM ALSO RELIES ON THE EXPERTISE OF CONSULTANTS TO PERIODICALLY REVIEW ALL FACETS OF OPERATIONS AND MAKE RECOMMENDATIONS FOR CHANGES.
PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE WELLMONT HEALTH SYSTEM PROACTIVELY INFORMS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY BY POSTING THE POLICY ON ITS WEB SITE AS WELL AS POSTING THE POLICY AT POINTS OF REGISTRATION IN THE HOSPITALS. WELLMONT HEALTH SYSTEM USES PROGRAM ELIGIBILITY SPECIALISTS WHO CONTACT THE UNINSURED PATIENT POPULATION. THESE SPECIALISTS DISCUSS THE VARIOUS GOVERNMENTAL ASSISTANCE PROGRAMS THAT ARE AVAILABLE TO PATIENTS IN ORDER TO DETERMINE IF THE PATIENT WOULD QUALIFY FOR ANY OF THESE PROGRAMS. THE SPECIALISTS WILL WORK WITH THE PATIENTS TO COMPLETE ANY NECESSARY APPLICATIONS AND WILL HELP THEM THROUGH THE QUALIFICATION PROCESS.
PART VI, LINE 4 - COMMUNITY INFORMATION WELLMONT HEALTH SYSTEM'S SERVICE AREA IS DEFINED BY MANAGEMENT AT THE COUNTY LEVEL BASED ON PATIENT ACTIVITY AND LOCATIONS OF OUR CAMPUSES. THE PRIMARY SERVICE AREA ("PSA") INCLUDES THE TENNESSEE COUNTIES OF SULLIVAN, HAWKINS, AND HANCOCK, AND THE VIRGINIA COUNTIES OF WASHINGTON, WISE, LEE, AND SCOTT. THE SECONDARY SERVICE AREA ("SSA") IS DEFINED AS WASHINGTON, GREENE, CARTER, JOHNSON, AND UNICOI COUNTIES OF TENNESSEE, AND RUSSELL, BUCHANAN, SMYTH, TAZEWELL, DICKENSON, AND WYTHE COUNTIES OF VIRGINIA. THE DEMOGRAPHICS OF THESE AREAS ARE AS FOLLOWS: PSA- POPULATION 362,438; MEDIAN HOUSEHOLD INCOME 38,234 SSA- POPULATION 457,850; MEDIAN HOUSEHOLD INCOME 36,557 APPROXIMATELY 17.24% OF OUR PATIENTS ARE MEDICAID RECIPIENTS, AND 10.17% ARE UNINSURED AND TWO OF THE PSA COUNTIES ARE DESIGNATED AS MEDICALLY UNDERSERVED AREAS (HAWKINS COUNTY, TENNESSEE, AND LEE COUNTY, VIRGINIA).
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH WELLMONT HEALTH SYSTEM'S HOSPITALS AND OTHER HEALTHCARE FACILITIES FURTHER THEIR EXEMPT PURPOSE BY PROVIDING MILLIONS IN UNCOMPENSATED CARE AND OTHER CHARITABLE DONATIONS. IN FISCAL YEAR 2015, WELLMONT PROVIDED 72,940,011 IN UNCOMPENSATED CARE. THE HEALTH SYSTEM ALSO DONATED 288,632 TO COMMUNITY ORGANIZATIONS SUCH AS CHILDREN'S MIRACLE NETWORK, UNITED WAY, SUSAN G. KOMEN FOR THE CURE, AND THE AMERICAN CANCER SOCIETY. WELLMONT PROVIDED 5,761,249 FOR COMMUNITY HEALTH AND OUTREACH, 1,531 FOR COMMUNITY BENEFIT OPERATIONS, 30,007 FOR COMMUNITY BUILDING ACTIVITIES, 5,748,416 FOR TRAINING AND EDUCATION OF HEALTHCARE PROFESSIONALS AND 140,715 FOR CLINICAL TRIALS AND RESEARCH. EMPLOYEES, PHYSICIANS, AND VOLUNTEERS DONATED IN EXCESS OF 74,936 HOURS OF COMMUNITY SERVICE.
PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM WELLMONT HEALTH SYSTEM("WELLMONT") IS A TENNESSEE NON-PROFIT CORPORATION, BASED IN KINGSPORT, TENNESSEE,AND A PREMIER PROVIDER OF HEALTHCARE SERVICES IN NORTHEAST TENNESSEE AND SOUTHWEST VIRGINIA. WELLMONT WAS FORMED IN JULY, 1996, WITH THE MERGER OF BRISTOL MEMORIAL HOSPITAL IN BRISTOL, TENNESSEE, AND HOLSTON VALLEY MEDICAL CENTER IN KINGSPORT, TENNESSEE. OVER THE PAST 18 YEARS, WELLMONT HAS GROWN TO INCLUDE FIVE ADDITIONAL HOSPITALS, AN INTEGRATED PHYSICIAN NETWORK, AND SEVERAL AMBULATORY SITES. WELLMONT HOSPITALS OFFER A BROAD SCOPE OF SERVICES RANGING FROM COMMUNITY BASED ACUTE CARE TO HIGHLY SPECIALIZED TERTIARY SERVICES INCLUDING TWO TRAUMA CENTERS, COMPREHENSIVE HEART CARE, AND CANCER CARE. WELLMONT OWNS AND OPERATES AN INTEGRATED HEALTH CARE DELIVERY SYSTEM PROVIDING INPATIENT, OUTPATIENT, AND OTHER HEALTH CARE SERVICES AT MULTIPLE LOCATIONS IN NORTHEAST TENNESSEE AND SOUTHWEST VIRGINIA. CURRENTLY, WELLMONT OWNS AND OPERATES FIVE ACUTE CARE HOSPITAL FACILITIES AND ONE CRITICAL ACCESS HOSPITAL WITH A TOTAL OF 1,091 LICENSED BEDS. THE ACUTE CARE FACILITIES OWNED BY WELLMONT INCLUDE HOLSTON VALLEY MEDICAL CENTER, BRISTOL REGIONAL MEDICAL CENTER, MOUNTAIN VIEW REGIONAL MEDICAL CENTER IN NORTON, VIRGINIA, LONESOME PINE HOSPITAL IN BIG STONE GAP, VIRGINIA, HAWKINS COUNTY MEMORIAL HOSPITAL IN ROGERSVILLE, TENNESSEE, AND THE CRITICAL ACCESS HOSPITAL, HANCOCK COUNTY HOSPITAL IN SNEEDVILLE, TENNESSEE. WELLMONT ALSO, DIRECTLY OR INDIRECTLY, CONTROLS, OWNS, OR IS AFFILIATED WITH VARIOUS NON-PROFIT AND FOR-PROFIT CORPORATIONS AND OTHER ORGANIZATIONS THAT CURRENTLY PROVIDE HEALTH CARE AND HEALTH CARE-RELATED SERVICES THROUGHOUT THE SERVICE AREA. IN ADDITION TO THE HOSPITAL CAMPUSES AND AMBULATORY CARE CENTERS DESCRIBED ABOVE, WELLMONT ALSO OPERATES MEDICAL CLINICS, AMBULATORY SURGERY CENTERS, COMPREHENSIVE CANCER CARE CENTERS, AND IMAGING FACILITIES.
PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT TENNESSEE
ADDITIONAL INFORMATION PART III, LINE 4: THE COST REPORTED ON LINE 2 IS CALCULATED AS THE BAD DEBT EXPENSE FROM THE GENERAL LEDGER TIMES THE RATIO OF COST TO CHARGES AS CALCULATED ON WORKSHEET 2 BY FACILITY. THERE ARE NO AMOUNTS REPORTED ON LINE 3. DISCOUNTS ON PATIENT ACCOUNTS ARE NOT INCLUDED IN BAD DEBT EXPENSE. PAYMENTS ON PATIENT ACCOUNTS THAT HAVE BEEN PREVIOUSLY WRITTEN OFF AS BAD DEBT ARE USED TO REDUCE BAD DEBT EXPENSE. A THIRD PARTY VENDOR IS USED TO HELP DETERMINE THE AMOUNT THAT COULD REASONABLY BE ATTRIBUTABLE TO PATIENTS WHO LIKELY COULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE CHARITY CARE POLICY. TEXT OF NOTE TO FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE: NET PATIENT SERVICE REVENUE IS REPORTED ON THE ACCRUAL BASIS IN THE PERIOD IN WHICH SERVICES ARE PROVIDED AT THE NET REALIZABLE AMOUNTS EXPECTED TO BE COLLECTED. NET PATIENT SERVICE REVENUE INCLUDES AMOUNTS ESTIMATED BY MANAGEMENT TO BE REIMBURSABLE BY PATIENTS AND VARIOUS THIRD-PARTY PAYORS UNDER PROVISIONS OF REIMBURSEMENT FORMULAS IN EFFECT, INCLUDING RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS. ESTIMATED RETROACTIVE ADJUSTMENTS ARE ACCRUED IN THE PERIOD RELATED SERVICES ARE RENDERED AND ADJUSTED IN PERIODS AS FINAL AND OTHER SETTLEMENTS ARE DETERMINED. WELLMONT PROVIDES CARE TO PATIENTS WHO MEET CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE WELLMONT DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT INCLUDED IN NET PATIENT SERVICE REVENUE. PATIENT ACCOUNTS RECEIVABLE ARE REPORTED NET OF BOTH AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS. THE CONTRACTUAL ALLOWANCE REPRESENTS THE DIFFERENCE BETWEEN ESTABLISHED BILLING RATES AND ESTIMATED REIMBURSEMENT FROM MEDICARE, TENNCARE, MEDICAID, AND OTHER THIRD-PARTY PAYMENT PROGRAMS. WELLMONT'S POLICY DOES NOT REQUIRE COLLATERAL OR OTHER SECURITY FOR PATIENT ACCOUNTS RECEIVABLE. WELLMONT ROUTINELY OBTAINS ASSIGNMENT OF, OR IS OTHERWISE ENTITLED TO RECEIVE, PATIENT BENEFITS PAYABLE UNDER HEALTH INSURANCE PROGRAMS, PLANS, OR POLICIES. THE MEDICARE COST REPORT COST FINDING METHODOLOGY AND COST TO CHARGE RATIOS WERE USED TO DETERMINE THE AMOUNT REPORTED ON LINE 6. LINE 7 IS A SURPLUS, SO IT IS NOT INCLUDED AS COMMUNITY BENEFIT. THE IRS INSTRUCTIONS FOR SCHEDULE H, PART III, SECTION B, LINES 5-7, SPECIFICALLY INDICATE TO INCLUDE ONLY THOSE APPLICABLE COSTS AND MEDICARE REIMBURSEMENTS THAT ARE REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT FOR THE YEAR. THIS REPORTING DOES NOT TAKE INTO ACCOUNT THOSE COSTS AND REVENUES ASSOCIATED WITH PHYSICIANS WHO ARE TREATING MEDICARE PATIENTS AT HOSPITAL-OWNED CLINIC AND PHYSICIAN PRACTICE SITES. ACCORDINGLY, THE RESULT OF TREATING MEDICARE PATIENTS FROM A FINANCIAL PERSPECTIVE MAY DIFFER AS REPORTED FOR FINANCIAL REPORTING PURPOSES AND COMMUNITY BENEFIT REPORTING PURPOSES FROM THE SURPLUS OR SHORTFALL SHOWN ON LINE 7 OF SECTION B OF PART III OF SCHEDULE H. PART III, LINE 9B: A THIRD PARTY VENDOR IS USED TO HELP DETERMINE THE AMOUNT THAT COULD REASONABLY BE ATTRIBUTABLE TO PATIENTS WHO LIKELY COULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE CHARITY CARE POLICY.
Schedule H (Form 990) 2014
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
WELLMONT HEALTH SYSTEM
 
Employer identification number
62-1636465
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC section
if applicable
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
non-cash assistance
(h) Purpose of grant
or assistance
(1) BARTER THEATRE
PO BOX 867
ABINDGON,VA24212
54-6000120 501(C) 10,000       SPONSORSHIP
(2) EAST TENNESSEE STATE UNIVERSITY
PO BOX 70732
JOHNSON CITY,TN37614
23-7092731 501(C) 5,100       ATHLETIC SPONSORSHIP
(3) GREATER KINGSPORT FAMILY YMCA
1840 MEADOWVIEW PARKWAY
KINGSPORT,TN37660
58-1564232 501(C) 10,000       SPONSORSHIP
(4) KINGSPORT CHAMBER OF COMMERCE
151 EAST MAIN ST
KINGSPORT,TN37662
62-0446834 501(C) 25,835       ANNUAL SPONSORSHIP
(5) NORTHEAST STATE COMMUNITY COLLEGE
PO BOX 246
2425 HWY 75
BLOUNTVILLE,TN37617
62-1033870 501(C) 5,500       SPONSORSHIP
(6) SUSAN G KOMEN FOR THE CURE
PO BOX 5835
KINGSPORT,TN37663
84-1689067 501(C) 25,150       SPONSORSHIP
(7) FRIENDS IN NEED HEALTH CENTER INC
1105 W STONE DRIVE
KINGSPORT,TN37660
62-1541637 501(C) 15,000       NEED
(8) UNITED WAY OF BRISTOL
PO BOX 696
BRISTOL,TN376210698
62-0476656 501(C) 10,000       SPONSORSHIP








2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
 
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2014

Schedule I (Form 990) 2014
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients
(c)Amount of
cash grant
(d)Amount of
non-cash assistance
(e)Method of valuation (book,
FMV, appraisal, other)
(f)Description of non-cash assistance












Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
SCHEDULE I, PAGE 1, PART I, LINE 2 ALL REQUESTS FOR CHARITABLE ASSISTANCE ARE REVIEWED BY THE SENIOR VICE PRESIDENT OF SYSTEM ADVANCEMENT. THE REQUEST FOR GRANT FUNDS IS EVALUATED ON THE BASIS OF THE FOLLOWING ITEMS: THE DEGREE TO WHICH THE REQUEST SUPPORTS WELLMONT HEALTH SYSTEM'S MISSION, REPRESENTATION OF WELLMONT HEALTH SYSTEM AS A GOOD CORPORATE CITIZEN, AND THE ANNUAL BUDGET. THE SENIOR VICE PRESIDENT THEN MAKES A DETERMINATION OF APPROVAL FOR ALL REQUESTS AND THE REQUEST IS SENT DIRECTLY TO ACCOUNTS PAYABLE FOR PAYMENT. WELLMONT HEALTH SYSTEM MAKES MINIMAL GRANTS (LESS THAN 5,000 PER ENTITY) THROUGHOUT THE YEAR. THE USE OF THESE GRANT FUNDS IS NOT MONITORED BY WELLMONT HEALTH SYSTEM AS THESE GRANTS ARE MADE IN GENERAL SUPPORT OF THE GRANT RECIPIENT.
Schedule I (Form 990) 2014


Additional Data


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Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, 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
2014
Open to Public Inspection
Name of the organization
WELLMONT HEALTH SYSTEM
 
Employer identification number

62-1636465
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
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....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
Yes
 
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation in column(B) reported as deferred in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1STANLEY GALL MDBOARD MEMBER (i)
(ii)
 
...............................
549,641
 
...............................
14,266
 
...............................
414
 
...............................
19,924
 
...............................
19,240
 
...............................
593,865
 
...............................
 
2DAVID THOMPSON MDBOARD MEMBER (i)
(ii)
 
...............................
288,751
 
...............................
66,310
 
...............................
78,500
 
...............................
 
 
...............................
16,814
 
...............................
441,968
 
...............................
 
3MARGARET DENARVAEZ TERMED 91614PRESIDENT/CEO (i)
(ii)
544,420
...............................
 
265,980
...............................
 
1,744,061
...............................
 
58,432
...............................
 
6,909
...............................
 
2,619,802
...............................
 
 
...............................
 
4TRACEY P MOFFATT TERMED 10314SR VP & WHS COO (i)
(ii)
334,601
...............................
 
230,000
...............................
 
10,774
...............................
 
18,100
...............................
 
6,636
...............................
 
596,793
...............................
 
 
...............................
 
5ALICE POPEEVP & CFO (i)
(ii)
383,559
...............................
 
87,632
...............................
 
8,670
...............................
 
15,897
...............................
 
23,140
...............................
 
507,328
...............................
 
 
...............................
 
6BARTON A HOVEWHS PRESIDENT & CEO (i)
(ii)
315,138
...............................
 
50,000
...............................
 
29,775
...............................
 
6,754
...............................
 
19,240
...............................
 
411,287
...............................
 
 
...............................
 
7WILLIAM SHOWALTER TERMED 41715SR VP - INFO TECH (i)
(ii)
325,000
...............................
 
67,714
...............................
 
622
...............................
 
 
...............................
 
17,394
...............................
 
402,033
...............................
 
 
...............................
 
8HAMLIN J WILSONSR VP-HUMAN RESOURC (i)
(ii)
293,968
...............................
 
52,810
...............................
 
774
...............................
 
12,365
...............................
 
7,998
...............................
 
363,916
...............................
 
 
...............................
 
9GARY D MILLERSR VP & GEN COUNSEL (i)
(ii)
287,236
...............................
 
57,296
...............................
 
1,656
...............................
 
12,920
...............................
 
6,368
...............................
 
362,292
...............................
 
 
...............................
 
10TODD J DOUGANSR VP-FINANCE (i)
(ii)
248,894
...............................
 
43,571
...............................
 
 
...............................
 
10,202
...............................
 
19,240
...............................
 
312,287
...............................
 
 
...............................
 
11LOWELL TODD NORRISSR VP INST & SYS ADV (i)
(ii)
46,377
...............................
185,506
9,222
...............................
36,888
54
...............................
216
2,123
...............................
8,490
3,622
...............................
14,492
59,587
...............................
238,346
 
...............................
 
12TIMOTHY ATTEBERYPRESIDENT/CEO-HVMC (i)
(ii)
379,628
...............................
 
66,854
...............................
 
414
...............................
 
16,454
...............................
 
17,394
...............................
 
472,047
...............................
 
 
...............................
 
13GREG NEALPRESIDENT/CEO-BRMC (i)
(ii)
338,462
...............................
 
62,505
...............................
 
8,670
...............................
 
14,502
...............................
 
19,240
...............................
 
433,759
...............................
 
 
...............................
 
14FRED PELLEPRESIDENT & CEO COMM (i)
(ii)
67,899
...............................
220,691
 
...............................
35,813
274
...............................
9,139
2,576
...............................
9,294
4,440
...............................
14,800
72,969
...............................
282,337
 
...............................
 
15DAVID L BRASHSR VP OF BUS DEV (i)
(ii)
277,473
...............................
 
41,832
...............................
 
353
...............................
 
12,034
...............................
 
19,250
...............................
 
341,312
...............................
 
 
...............................
 
16MARTHA CHILLSYSTEM VP/EMR DIR (i)
(ii)
266,160
...............................
 
42,189
...............................
 
1,821
...............................
 
10,150
...............................
 
23,140
...............................
 
331,890
...............................
 
 
...............................
 
17VIRGINIA FRANK TERMED 8814PRESIDENT-HVMC (i)
(ii)
231,000
...............................
 
 
...............................
 
607
...............................
 
 
...............................
 
12,880
...............................
 
238,047
...............................
 
 
...............................
 
18DANIEL CARLSON TERMED 5815CHIEF MEDICAL OFFICE (i)
(ii)
358,717
...............................
 
54,607
...............................
 
2,172
...............................
 
16,028
...............................
 
19,240
...............................
 
441,144
...............................
 
 
...............................
 
19SUSAN LINDENBUSCHVP WHS ONCOLOGY SVS (i)
(ii)
266,147
...............................
 
50,505
...............................
 
9,174
...............................
 
11,967
...............................
 
7,304
...............................
 
341,445
...............................
 
 
...............................
 
20WILLIAM TROY CLARK TERMED 121214VP/HV CHIEF OPER OFF (i)
(ii)
274,297
...............................
 
41,730
...............................
 
180
...............................
 
11,681
...............................
 
19,240
...............................
 
337,508
...............................
 
 
...............................
 
21DAVID ARROWOODCRNA (i)
(ii)
271,484
...............................
 
11,278
...............................
 
3,033
...............................
 
9,219
...............................
 
19,168
...............................
 
304,598
...............................
 
 
...............................
 
22BRAD PRICESR VP-RESOURCE MGT (i)
(ii)
247,069
...............................
 
38,348
...............................
 
180
...............................
 
11,032
...............................
 
11,032
...............................
 
296,629
...............................
 
 
...............................
 
23PIERRE ISTFAN MDBOARD MEMBER-FORMER (i)
(ii)
 
...............................
552,696
 
...............................
14,266
 
...............................
774
 
...............................
20,369
 
...............................
19,024
 
...............................
597,617
 
...............................
 
24KENT PETTY TERMED 4114CHIEF INFORM OFF (i)
(ii)
4,577
...............................
 
300,000
...............................
 
 
...............................
 
6,000
...............................
 
 
...............................
 
310,577
...............................
 
 
...............................
 
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
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 CHARTER TRAVEL AND TRAVEL FOR COMPANIONS WELLMONT HEALTH SYSTEM PROVIDED AIRPLANE TRAVEL FOR ITS EXECUTIVES THROUGH A PARTIAL OWNERSHIP OF AN AIRPLANE. IN SEPTEMBER 2014, WELLMONT HEALTH SYSTEM SOLD ITS OWNERSHIP INTEREST IN THE AIRPLANE. ON OCCASION, TRAVEL WAS PROVIDED FOR EXECUTIVES AND THEIR COMPANIONS FOR PERSONAL USE. WELLMONT HEALTH SYSTEM FOLLOWED IRS GUIDELINES AND INCLUDED THE APPROPRIATE AMOUNTS IN THEIR TAXABLE COMPENSATION. HEALTH OR SOCIAL CLUB DUES DURING THE FISCAL YEAR ENDED JUNE 30, 2015, WELLMONT HEALTH SYSTEM PROVIDED COUNTRY CLUB MEMBERSHIPS TO BARTON A. HOVE, MARGARET D. DENARVAEZ AND TRACEY P. MOFFATT. THESE AMOUNTS ARE INCLUDED IN TAXABLE COMPENSATION.
SCHEDULE J, PAGE 1, PART I, LINE 4 MARGARET DENARVAEZ (TERMED 9/16/14) 1,745,528 0 0 TRACEY P. MOFFATT (TERMED 10/3/14) 275,000 0 0
SCHEDULE J, PAGE 1, PART I, LINE 6A INCENTIVE COMPENSATION IS PARTIALLY 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. THE TERMS OF THIS AGREEMENT INCLUDED THE PAYMENT OF 1,745,538 FOR ITEMS WHICH ARE CONSIDERED "SEVERANCE", INCLUDING PAYMENT IN LIEU OF A NOTICE PERIOD, EARLY TERMINATION CLAUSE, RELEASE OF CLAIMS, AND REIMBURSEMENT OF HEALTH INSURANCE PREMIUMS FOLLOWING TERMINATION. THERE WERE OTHER PAYMENTS FOR EARNED INCENTIVE COMPENSATION, ACCRUED VACATION, AND REIMBURSEMENT OF RELOCATION COSTS THAT ARE NOT CONSIDERED "SEVERANCE". TRACEY P. MOFFATT, FORMER COO OF WELLMONT HEALTH SYSTEM, ENTERED INTO A CONFIDENTIAL SEPARATION AGREEMENT AND MUTUAL RELEASE (THE "AGREEMENT") AS OF OCTOBER 3, 2014. THE TERMS OF THIS AGREEMENT INCLUDED THE PAYMENT OF 275,000 FOR ITEMS WHICH ARE CONSIDERED "SEVERANCE", INCLUDING PAYMENT FOR RELEASE OF CLAIMS. PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN WELLMONT HEALTH SYSTEM HAS AN EXECUTIVE RETIREMENT PROGRAM THAT INCLUDED MARGARET DENARVAEZ AND ALICE POPE FOR THE FISCAL YEAR ENDING JUNE 30, 2015. THIS PROGRAM HAS A TARGET BENEFIT OF 60% OF THE HIGHEST THREE YEAR AVERAGE SALARY (LESS EMPLOYER PROVIDER BENEFITS) AND THE EXECUTIVE MUST HAVE TWENTY YEARS OF SERVICE TO RECEIVE THE FULL BENEFIT. THE EXECUTIVE MAY RETIRE EARLY AT AGE 60 AND RECEIVE REDUCED BENEFITS. THERE WERE NO PAYMENTS MADE UNDER THIS PROGRAM FOR THE FISCAL YEAR ENDING JUNE 30, 2015.
Schedule J (Form 990) 2014

Additional Data


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Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990.

SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
WELLMONT HEALTH SYSTEM
 
Employer identification number
62-1636465
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A SULLIVAN CNTY TENN HEALTH EDL & HSG
 
62-1256662 865293AC8 11-02-2006 200,000,000 CONSTRUCTION AT HVMC   X   X   X
B VIRGINIA SMALL BUSINESS FING AUTH H
 
54-1300845 928101AC8 07-31-2007 55,000,000 PURCHASE OF HOSPITALS   X   X   X
C SULLIVAN CNTY TENN HEALTH EDL & HSG
 
62-1256662 865293AG9 05-05-2011 76,165,000 REFUND 2006A BOND   X   X   X
D SULLIVAN CNTY TENN HEALTH EDL& HSG
2012 TAX-EXEMPT MASTER LEASE/SUBLEA
62-1256662   12-01-2012 42,500,000 PURCHASE EPIC EMR   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . .        
2 Amount of bonds legally defeased . . . . . . . . . . .        
3 Total proceeds of issue . . . . . . . . . . . . . . 207,055,314 55,658,570 76,165,000 42,500,000
4 Gross proceeds in reserve funds . . . . . . . . . . . . 18,977,995 5,464,590    
5 Capitalized interest from proceeds . . . . . . . . . . .        
6 Proceeds in refunding escrows . . . . . . . . . . . . 74,942,165   74,942,165  
7 Issuance costs from proceeds . . . . . . . . . . . . 2,164,568 1,026,366 1,298,533 31,809
8 Credit enhancement from proceeds . . . . . . . . . . .        
9 Working capital expenditures from proceeds . . . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . . 182,892,751 49,167,614   42,468,191
11 Other spent proceeds . . . . . . . . . . . . . .        
12 Other unspent proceeds . . . . . . . . . . . . . .        
13 Year of substantial completion . . . . . . . . . . . . 2011 2007 2011 2014
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . .   X   X   X   X
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X   X X     X
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X   X   X   X
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?                
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .   X   X   X   X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet        
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet        
6 Total of lines 4 and 5 . . . . . . . . . . . . .        
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . .
X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .   X   X   X   X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X   X   X   X
b Exception to rebate? . . . . . . . .   X   X X   X  
c No rebate due? . . . . . . . . X   X     X   X
If "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . .   X   X   X   X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X X     X
b Name of provider . . . . . . . . . BANK OF AMERICA
 
 
 
BANK OF AMERICA
 
 
 
c Term of hedge . . . . . . . . . . 2.000000000000   2.000000000000  
d Was the hedge superintegrated? . . . .   X       X    
e Was the hedge terminated? . . . . . .   X       X    
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . . X     X   X   X
b Name of provider . . . . . . . . . MASS MUTUAL LIF
 
 
 
 
 
 
 
c Term of GIC . . . . . . . . . . 4.000000000000      
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . X              
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .   X   X   X   X
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?   X   X   X   X
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
SCHEDULE K - DATE REBATE COMPUTATION PERFORMED SULLIVAN CNTY TENN HEALTH EDL & HSG 10/31/11 VIRGINIA SMALL BUSINESS FING AUTH HO 07/31/12
Schedule K (Form 990) 2014

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet 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.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
WELLMONT HEALTH SYSTEM
 
Employer identification number

62-1636465
Part I
Excess Benefit Transactions (section 501(c)(3), 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 (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





2
Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
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?
To From Yes No Yes No Yes No
Total ......Small Bullet $  
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) 2014
Schedule L (Form 990 or 990-EZ) 2014
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?
Yes No
(1) NELSON GWALTNEY MD VENDOR/BRD MEMB 142,000 MEDICAL DIRECTORSHIP   No
(2) RAVAN KRICKBAUM BOARD MEMBER 74,334 COMPENSATION   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
SCHEDULE L, PART V NELSON GWALTNEY, MD IS PART OWNER OF BRISTOL SURGICAL ASSOCIATES, MEMBER AND BOARD MEMBER OF QUALUABLE, MEMBER AND BOARD MEMBER OF HIGHLANDS PHYSICIANS, INC., BOARD MEMBER OF HIGHLANDS WELLMONT HEALTH NETWORK, INC., AND MEDICAL DIRECTOR OF BRISTOL REGIONAL MEDICAL CENTER VASCULAR LAB AND WOUND CARE CLINIC. DR. GWALTNEY'S OWNERSHIP IS LESS THAN 35% IN ALL OF THE ABOVE ENTITIES. TWO OF RAVEN KRICKBAUM'S DAUGHTERS ARE EMPLOYEES OF WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL, INC., WHICH IS AN AFFILIATE OF WELLMONT HEALTH SYSTEM.
Schedule L (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version:  




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
2014
Open to Public
Inspection
Name of the organization
WELLMONT HEALTH SYSTEM
 
Employer identification number

62-1636465
Return Reference Explanation
FORM 990, PAGE 1, ITEM B THE WELLMONT HEALTH SYSTEM FY2016 FORM 990 IS BEING AMENDED TO CORRECT THE FOLLOWING ERRORS: -SCHEDULE C, PART II-A, LINE D TOTAL WAS ENTERED IN TAX SOFTWARE IN ERROR CAUSING LINE E TO NOT RECONCILE TO FORM 990, PART IX STATEMENT OF FUNCTIONAL EXPENSES, TOTAL EXPENSES, LINE 25, COLUMN A. -SCHEDULE H, PART L, LINE 7A-COLUMN C AND LINE 7B-COLUMN D CONTAINED KEYPUNCH ERRORS.
FORM 990 FORM 990, PART X, BALANCE SHEET CERTAIN BALANCE SHEET ACCOUNTS HAVE BEEN RECLASSIFIED FOR BETTER COMPARISON TO THE CURRENT YEAR FINANCIAL STATEMENTS.
FORM 990, PAGE 2, PART III, LINE 4A ORGANIZATIONS THAT DO NOT MEET THE DEFINITION OF "RESTRICTED TO ONE OR MORE OF THE ACTIVITIES DESCRIBED IN THE TABLE IN PART I, LINE 7" OF SCHEDULE H. WELLMONT IS A PUBLIC TRUST. FROM KINGSPORT TO BRISTOL, FROM SNEEDVILLE TO NORTON, THE MEMBER HOSPITALS OF OUR ORGANIZATION WERE BORN OF THEIR COMMUNITIES' COMMITMENT TO SUPERIOR HEALTH CARE FOR THEIR CITIZENS. WE OFFER A VAST ARRAY OF MEDICAL SERVICES AND RESOURCES FOR THOUSANDS OF PATIENTS IN NORTHEAST TENNESSEE AND SOUTHWEST VIRGINIA. IN 2015, WE PROVIDED SERVICES TO 47,949 PATIENTS IN A BED, 161,995 EMERGENCY ROOM VISITS, 2,246 NEWBORN DELIVERIES, AND 22,175 SURGERIES. WELLMONT IS A TENNESSEE NOT-FOR-PROFIT CORPORATION. FIVE TAX-EXEMPT COMMUNITY BASED HOSPITALS - BRISTOL REGIONAL MEDICAL CENTER (BRISTOL, TENN.), HOLSTON VALLEY MEDICAL CENTER (KINGSPORT, TENN.), LONESOME PINE HOSPITAL (BIG STONE GAP, VA.), HANCOCK COUNTY HOSPITAL (SNEEDVILLE, TENN.), AND MOUNTAIN VIEW REGIONAL MEDICAL CENTER (NORTON, VA.)- ARE INCLUDED IN THIS CORPORATION. BUT EVEN AS OUR SERVICE AREA SPANS MULTIPLE STATES AND OUR REVENUE IS REPORTED IN THE HUNDREDS OF MILLIONS OF DOLLARS, WE REMAIN A COMMUNITY- OWNED HEALTH SYSTEM. IT IS OUR MISSION TO DELIVER SUPERIOR HEALTH CARE WITH COMPASSION TO THE PEOPLE WE SERVE. IT IS OUR VISION TO DELIVER THE BEST HEALTH CARE ANYWHERE. CONSISTENT WITH THIS MISSION, WE HAVE WORKED TOWARD IMPROVING OUR COMMUNITY'S ACCESS TO QUALITY, AFFORDABLE HEALTH CARE, EDUCATING OUR REGION'S CAREGIVERS, IMPROVING THE HEALTH STATUS OF OUR COMMUNITIES AND CONTRIBUTING TO THE OVERALL QUALITY OF LIFE IN THE AREAS WE SERVE. OVERALL, WE RETURNED MORE THAN 44,497,460 IN BENEFITS TO OUR REGION, INCLUDING 34,447,475 OF COSTS FOR INDIGENT PATIENTS AND UNCOMPENSATED CARE FOR OTHER PATIENTS AND 10,049,985 FOR OTHER COMMUNITY ACTIVITIES OUTLINED BELOW. WELLMONT IS IN COMPLIANCE WITH IRS GUIDELINES FOR FORM 990 SCHEDULE H REPORTING PURPOSES AND THE AMOUNTS REFLECTED ABOVE ARE NOT INCLUSIVE OF RESOURCES DESCRIBED IN WELLMONT'S COMMUNITY BENEFIT REPORT AS THE ABOVE AMOUNTS ARE REPORTED ON SCHEDULE H. WE ARE MINDFUL OF OUR RESPONSIBILITIES AS ONE OF THE REGION'S LARGEST EMPLOYERS. 6,429 FAMILIES COUNT ON US FOR THEIR LIVELIHOODS. CITIES AND COUNTIES THROUGHOUT OUR SERVICE AREA RELY ON US AS A DRIVER OF ECONOMIC DEVELOPMENT. IT IS OUR DUTY AS A CORPORATE CITIZEN TO SUPPORT THOSE ENDEAVORS AND CAUSES THAT IMPROVE THE QUALITY OF LIFE IN OUR REGION. AND WE ALSO RECOGNIZE IT IS OUR RESPONSIBILITY TO CARE FOR THOSE IN NEED - REGARDLESS OF THEIR ABILITY TO PAY. IT IS OUR COMMITMENT - INDEED, IT IS OUR MISSION - TO SUPPORT THE CAUSES AND DEVELOP THE INITIATIVES THAT WILL PROPEL OUR COMMUNITIES TOWARD A BETTER, BRIGHTER, HEALTHIER AND MORE VIBRANT FUTURE. SERVING THE UNDERSERVED REGARDLESS OF RACE, RELIGION, ETHNICITY OR ABILITY TO PAY, WELLMONT'S HOSPITALS TREAT ALL PATIENTS FOR MEDICALLY NECESSARY CONDITIONS. RECOGNIZING THAT SOME PATIENTS CANNOT AFFORD ESSENTIAL MEDICAL SERVICES, WELLMONT PROVIDED CARE FOR INDIGENT PATIENTS, WRITING OFF 58,016,379 OF CHARGES AND INCURRING COST OF 13,427,105. WELLMONT IS IN COMPLIANCE WITH IRS GUIDELINES FOR FORM 990 SCHEDULE H REPORTING PURPOSES AND THE AMOUNTS REFLECTED ABOVE ARE NOT INCLUSIVE OF RESOURCES DESCRIBED IN WELLMONT'S COMMUNITY BENEFIT REPORT AS THE ABOVE AMOUNTS ARE REPORTED ON SCHEDULE H. OTHER RECENT INITIATIVES INCLUDE: THE WELLMONT HEALTH COACH IS PART OF WELLMONT'S ONGOING EFFORTS TO IMPROVE THE HEALTH OF OUR COMMUNITIES AND ENCOURAGE WELLNESS IN THE MOUNTAINS OF NORTHEAST TENNESSEE AND SOUTHWEST VIRGINIA. FUNDED BY COMMUNITY SUPPORT THROUGH THE WELLMONT FOUNDATION, THE COACH OFFERS A HOST OF COMPREHENSIVE SCREENINGS THAT HELP IDENTIFY POTENTIAL HEALTH PROBLEMS. OUR HEALTH SYSTEM, IN CONJUNCTION WITH A GRANT FROM SUSAN G. KOMEN FOR THE CURE TRI-CITIES, WAS ABLE TO FUND THE COST OF MAMMOGRAMS FOR SEVERAL HUNDRED WOMEN WHO WERE UNDERINSURED OR UNINSURED. PROJECT ACCESS TO BREAST CARE IS DESIGNED TO REACH WOMEN WHO LIVE IN HAWKINS, SULLIVAN, WASHINGTON, JOHNSON, UNICOI, HANCOCK, CARTER AND GREENE COUNTIES IN TENNESSEE AND WOMEN IN SCOTT COUNTY, VA. TO QUALIFY, WOMEN MUST BE BETWEEN THE AGES OF 35 AND 49 AND EITHER BE UNINSURED AND FINANCIALLY UNABLE TO PAY FOR A MAMMOGRAM OR INSURED AND HAVE A HIGH DEDUCTIBLE AND/OR CO-PAY THAT MAKES IT FINANCIALLY DIFFICULT TO OBTAIN A MAMMOGRAM. BRISTOL REGIONAL MEDICAL CENTER PROVIDES SUPPLIES AND OTHER VARIOUS ITEMS VALUED AT 20,406 TO HEALING HANDS HEALTH CENTER IN BRISTOL, TENN., WHICH PROVIDES QUALITY HEALTH CARE TO THE WORKING POOR. DR. DAVE ARNOLD SERVES AS THE MEDICAL DIRECTOR OF HEALING HANDS HEALTH CENTER IN BRISTOL, TENN. AND HIS SALARY AND BENEFITS ARE PAID BY HEALING HANDS HEALTH CENTER. TRAINING AND EDUCATING OUR HEALTHCARE PROFESSIONALS WELLMONT WILL NOT SUCCEED IN OUR MISSION WITHOUT CONTINUALLY REINVESTING IN OUR MOST PRECIOUS RESOURCE - OUR PEOPLE. TO THAT END, WE SUPPORTED THE EDUCATION AND TRAINING OF HEALTH CARE PROFESSIONALS AT A DIRECT COST OF 5,748,416. RECENT INITIATIVES INCLUDE: WELLMONT PROVIDED AND PARTICIPATED IN SEVERAL FORMAL TRAINING PROGRAMS FOR HEALTH PROFESSIONALS, INCLUDING EAST TENNESSEE STATE UNIVERSITY'S INTERNSHIP AND RESIDENCY PROGRAMS. OUR CONTRIBUTIONS TOTALED 991,864 IN SUPPORT OF THE SCHOOL'S JAMES H. QUILLEN COLLEGE OF MEDICINE RESIDENCY PROGRAM. WELLMONT CONTINUES TO WELCOME OSTEOPATHIC MEDICAL STUDENTS FROM LINCOLN MEMORIAL UNIVERSITY'S DEBUSK COLLEGE OF OSTEOPATHIC MEDICINE. THE STUDENTS PERFORM CLINICAL ROTATIONS IN WELLMONT HOSPITALS AS THEY MOVE TOWARD BECOMING THE NEXT GENERATION OF DOCTORS. THE STUDENTS, WHO RECEIVE FREE HOUSING ON THE CAMPUS OF MOUNTAIN VIEW REGIONAL MEDICAL CENTER, COMPLETE THEIR CORE CLINICAL ROTATIONS AT MOUNTAIN VIEW REGIONAL. THE STUDENTS PERFORM SUB-SPECIALTY ROTATIONS AT HOLSTON VALLEY MEDICAL CENTER AND BRISTOL REGIONAL MEDICAL CENTER AND PRIMARY CORE ROTATIONS AT HAWKINS COUNTY MEMORIAL HOSPITAL. FREE HOUSING IS AVAILABLE ON THE MOUNTAIN VIEW REGIONAL MEDICAL CENTER AND HOLSTON VALLEY MEDICAL CENTER CAMPUSES FOR OUR MOUNTAIN REGION CORE SITE MEDICAL STUDENTS. OUR CONTRIBUTIONS TOTALED 730,534 IN SUPPORT OF THE DEBUSK COLLEGE OF OSTEOPATHIC MEDICINE. WELLMONT AND LINCOLN MEMORIAL UNIVERSITY'S DEBUSK COLLEGE OF OSTEOPATHIC MEDICINE ALSO PARTNER TO PROVIDE THE WELLMONT ORTHOPEDIC RESIDENCY PROGRAM AT HOLSTON VALLEY MEDICAL CENTER, ONE OF JUST 41 SUCH PROGRAMS IN THE COUNTRY TO HELP TRAIN THE NEXT GENERATION OF SPECIALTY PHYSICIANS. OUR CONTRIBUTIONS TOTALED 20,738 IN SUPPORT OF THE LINCOLN MEMORIAL UNIVERSITY'S DEBUSK COLLEGE OF OSTEOPATHIC MEDICINE ORTHOPEDIC RESIDENCY PROGRAM. WELLMONT CONTINUES TO EXERT TREMENDOUS EFFORT TO ACHIEVE MEANINGFUL USE OF AN ELECTRONIC HEALTH RECORD. THIS NATIONAL MANDATE CREATES TREMENDOUS EFFICIENCIES FOR CAREGIVERS, ENHANCES PATIENT CARE AND ULTIMATELY IMPROVES PATIENT SAFETY BY REDUCING THE POTENTIAL FOR ERRORS ASSOCIATED WITH PAPER DOCUMENTATION AS WELL AS INCREASING THE SECURITY AND SHARING OF DATA AMONG PROVIDERS. WELLMONT COMPLETED THE IMPLEMENTATION OF MYWELLMONT, WHICH IS AN ONLINE PORTAL THAT ALLOWS WELLMONT PATIENTS TO SECURELY ACCESS THEIR HEALTH INFORMATION FROM VIRTUALLY ANYWHERE. PATIENTS CAN ELECTRONICALLY REQUEST APPOINTMENTS, VIEW TEST RESULTS, RENEW PRESCRIPTIONS, PAY BILLS AND PERFORM MANY OTHER ROUTINE ACTIVITIES. MOST IMPORTANTLY, PATIENTS AND PROVIDERS CAN CONNECT IN MORE WAYS THAN EVER BEFORE, ENHANCING RELATIONSHIPS AND BUILDING A TEAM-BASED APPROACH TO CARE. WELLMONT HAS MADE AVAILABLE CONTINUING EDUCATION AND TRAINING TO EMPLOYEES, MEDICAL STAFF, MEMBERS OF AFFILIATED HEALTH CAREORGANIZATIONS AND SCHOOLS AND INTERESTED MEMBERS OF THE PUBLIC. SOME OF THOSE OPPORTUNITIES INCLUDED: -ANNUAL STROKE SYMPOSIUM; OPEN TO WELLMONT PHYSICIANS AND STAFF AND THE COMMUNITY; -ANNUAL CRITICAL CARE AND TRAUMA CONFERENCE; OPEN TO WELLMONT PHYSICIANS AND STAFF AND THE COMMUNITY; -ANNUAL CARDIOVASCULAR SUMMIT; OPEN TO WELLMONT PHYSICIANS AND STAFFAND THE COMMUNITY; -ANNUAL WOMEN AND CHILDREN'S EXPOSITION, OPEN TO WELLMONT PHYSICIANS AND STAFF AND THE COMMUNITY; -ANNUAL DIABETES EXPOSITION, OPEN TO WELLMONT PHYSICIANS AND STAFF AND THE COMMUNITY; -A PRESCRIPTION DRUG ABUSE CONFERENCE -REGULAR EDUCATION FOR CLINICAL STAFF ON TOPICS INCLUDING CPR PROGRAMS, ADVANCED CARDIOVASCULAR LIFE SUPPORT, PEDIATRIC ADVANCED LIFE SUPPORT, ADVANCED TRAUMA LIFE SUPPORT AND ADVANCED TRAUMA COURSE FOR NURSING. WELLMONT SUPPORTS A NURSE EXTERN PROGRAM THAT UTILIZES NURSING STAFF THAT HAVE COMPLETED A DEGREE BUT NOT YET PASSED BOARD CERTIFICATION. THIS PROVIDES INVALUABLE EXPERIENCE FOR NEW NURSES, WHO ARE SUPERVISED BY BOARD CERTIFIED NURSES DURING THIS TIME. THE EXTERNS ARE NOT REQUIRED TO WORK FOR WELLMONT AFTER EARNING THEIR CERTIFICATION. AT A DIRECT COST OF 180,771, OUR ORGANIZATION STAFFED AND MAINTAINED A MEDICAL LIBRARY PROGRAM FOR EMPLOYEES, MEDICAL STAFF AND MEMBERS OF AFFILIATED HEALTHCARE ORGANIZATIONS TO HELP ENHANCE KNOWLEDGE WITH THE LATEST RESEARCH FINDING AND THINKING. WELLMONT AND NORTHEAST STATE TECHNICAL COM
FORM 990, PAGE 6, PART VI, LINE 9 MARGARET DENARVAEZ (TERMED 9/16/14) 1905 AMERICAN WAY KINGSPORT, TN 37660 TRACEY P. MOFFATT (TERMED 10/3/14) 1905 AMERICAN WAY KINGSPORT, TN 37660 KENT PETTY (TERMED 4/1/14) 1905 AMERICAN WAY KINGSPORT, TN 37660 VIRGINIA FRANK (TERMED 8/8/14) 1905 AMERICAN WAY KINGSPORT, TN 37660 WILLIAM TROY CLARK (TERMED 12/12/14) 1905 AMERICAN WAY KINGSPORT, TN 37660 WILLIAM SHOWALTER (TERMED 4/17/15)
FORM 990, PAGE 6, PART VI, LINE 11B WELLMONT HEALTH SYSTEM'S FORM 990 IS REVIEWED BY THREE INDIVIDUALS OF WELLMONT HEALTH SYSTEM (THE SENIOR VICE PRESIDENT OF FINANCE, THE CORPORATE CONTROLLER, AND THE MANAGER OF ACCOUNTING) AND THE BOARD OF DIRECTORS OF WELLMONT HEALTH SYSTEM. ANY QUESTIONS OR COMMENTS ARISING FROM THE INITIAL REVIEW ARE ADDRESSED TO ENSURE THE RETURN IS COMPLETE AND ACCURATE. ANY CHANGES OR CORRECTIONS ARE IDENTIFIED, REVISED IN THE RETURN, AND REVIEWED BY THE INDIVIDUALS LISTED ABOVE PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PAGE 6, PART VI, LINE 12C OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO SIGN A CONFLICT OF INTEREST POLICY ACKNOWLEDGEMENT. ANY POTENTIAL CONFLICTS ARE DISCUSSED WITH THE COMPLIANCE AND AUDIT SERVICES DEPARTMENT AS THEY ARISE. WELLMONT HEALTH SYSTEM ALSO HAS A POLICY ON BUSINESS PRACTICES THAT DISCUSSES CONFLICT OF INTEREST AND INFORMS THE WORKFORCE TO DISCLOSE ANY ISSUES TO THE COMPLIANCE AND AUDIT SERVICES DEPARTMENT, FOR RESOLUTION. WELLMONT HEALTH SYSTEM ALSO USES A HOTLINE THAT ALLOWS ANONYMOUS REPORTING OF POSSIBLE CONFLICT OF INTEREST SITUATIONS FOR INVESTIGATION BY THE COMPLIANCE AND AUDIT SERVICES DEPARTMENT.
FORM 990, PAGE 6, PART VI, LINE 15A 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 THE BOARD OF DIRECTORS. BARTON A. HOVE IS ALSO ON THE BOARD OF DIRECTORS OF WELLMONT FOUNDATION, INC. 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. THE COMPENSATION OF MARGARET D. DENARVAEZ, THE FORMER PRESIDENT AND CEO OF WELLMONT HEALTH SYSTEM THROUGH SEPTEMBER 16, 2014, IS REVIEWED, APPROVED AND DOCUMENTED BY THE WELLMONT HEALTH SYSTEM HUMAN RESOURCES COMMITTEE AND THE BOARD OF DIRECTORS. MARGARET D. DENARVAEZ IS ALSO ON THE BOARD OF DIRECTORS OF WELLMONT FOUNDATION, INC. THE LAST COMPENSATION DELIBERATION AND REVIEW PROCESS FOR MARGARET D. DENARVAEZ WAS COMPLETED NOVEMBER 29, 2012, AND APPROVED BY THE BOARD OF DIRECTORS OF WELLMONT HEALTH SYSTEM ON DECEMBER 4, 2012. IN ADDITION, THESE BODIES USE COMPARABILITY DATA TO DETERMINE THE APPROPRIATE COMPENSATION. ALL COMPENSATION DELIBERATIONS AND REVIEWS ARE CONTEMPORANEOUSLY DOCUMENTED.
FORM 990, PAGE 6, PART VI, LINE 15B THE COMPENSATION OF THE OTHER OFFICERS AND KEY EMPLOYEES OF WELLMONT HEALTH SYSTEM ARE REVIEWED, APPROVED AND DOCUMENTED BY THE WELLMONT HEALTH SYSTEM HUMAN RESOURCES COMMITTEE OF THE BOARD OF DIRECTORS. OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION HAVE WRITTEN EMPLOYMENT CONTRACTS, AND COMPENSATION IS BASED ON SURVEYS/STUDIES AND THEN APPROVED BY THE WELLMONT HEALTH SYSTEM CEO. IN ADDITION, THESE BODIES USE COMPARABILITY DATA TO DETERMINE THE APPROPRIATE COMPENSATION. ALL COMPENSATION DELIBERATIONS AND REVIEWS ARE CONTEMPORANEOUSLY DOCUMENTED. THIS PROCESS IN COMPLETED ON AN ANNUAL BASIS. THE HUMAN RESOURCES COMMITTEE OF THE BOARD OF DIRECTORS REVIEWED THE SALARY AND MARKET COMPENSATION DATA FOR THE FOLLOWING OTHER OFFICERS AND KEY EMPLOYEES ON DECEMBER 10, 2013. -WELLMONT HEALTH SYSTEM CHIEF OPERATIONS OFFICER - TRACEY P. MOFFAT -WELLMONT HEALTH SYSTEM EXECUTIVE VP AND CHIEF FINANCIAL OFFICER - ALICE POPE -WELLMONT HEALTH SYSTEM SR. VP OF HUMAN RESOURCES - HAMLIN J. WILSON -WELLMONT HEALTH SYSTEM VP OF MARKETING AND COMMUNICATIONS - LOWELL TODD NORRIS -BRISTOL REGIONAL MEDICAL CENTER PRESIDENT - GREG NEAL -COMMUNITY HOSPITAL PRESIDENT AND CEO - FRED PELLE -HOLSTON VALLEY MEDICAL CENTER PRESIDENT - TIM ATTEBERY WELLMONT HEALTH SYSTEM USES ONE OR MORE OF THE METHODS DESCRIBED TO ESTABLISH THE COMPENSATION OF THE FOLLOWING OTHER OFFICERS AND KEY EMPLOYEES. -WELLMONT HEALTH SYSTEM SR. VP OF FINANCE - TODD J. DOUGAN -WELLMONT HEALTH SYSTEM CHIEF INFORMATION OFFICER - KENT PETTY -WELLMONT HEALTH SYSTEM SR. VP OF BUSINESS DEVELOPMENT & RURAL STRATEGY - DAVID L. BRASH -WELLMONT HEALTH SYSTEM SR. VP GENERAL COUNSEL - GARY MILLER -WELLMONT HEALTH SYSTEM SR. VP INFORMATION TECHNOLOGY - WILLIAM SHOWALTER
FORM 990, PAGE 6, PART VI, LINE 19 WELLMONT HEALTH SYSTEM'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE NOT AVAILABLE TO THE PUBLIC. WELLMONT HEALTH SYSTEM'S AUDITED FINANCIAL STATEMENTS AND QUARTERLY UNAUDITED FINANCIAL STATEMENTS ARE AVAILABLE THROUGH THE ELECTRONIC MUNICIPAL MARKET ACCESS WEBSITE.
FORM 990, PART XI, LINE 9 UNREALIZED SWAP LOSS -563,153 INTERCOMPANY RESOLUTION -37,543,799 UNREALIZED LOSS ON INVESTMENTS -16,777,139 CHANGE IN PENSION LIABILITY -2,495,449 LOSS ON BOND DISSOLUTION -1,388,700 DISTRIBUTIONS TO WHS -1,186,676 INTERCOMPANY - RELATED ORGANIZATIONS -7,478,313
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet
Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
WELLMONT HEALTH SYSTEM
 
Employer identification number

62-1636465
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (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

(1) WELLMONT HEALTH MANAGEMENT
WELLMONT HEALTH MANAGEMENT
1905 AMERICAN WAY
KINGSPORT,TN37660
62-1825259
HEALTHCARE TN     WHS
 
(2) WELLMONT INTEGRATED NETWORK LLC
WELLMONT INTEGRATED NETWORK LLC
1905 AMERICAN WAY
KINGSPORT,TN37660
45-5443060
HEALTHCARE TN -8,518 -8,518 WHS
 








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


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1) WELLMONT HAWKINS CO MEMORIAL HOSPI
1905 AMERICAN WAY

KINGSPORT,TN37660
62-1816368
HEALTHCARE TN 501C3 3 WHS
 
Yes
 
(2) WELLMONT CARDIOLOGY SERVICES
1905 AMERICAN WAY

KINGSPORT,TN37660
26-3557623
HEALTHCARE TN 501C3 9 WHS
 
Yes
 
(3) WELLMONT MEDICAL ASSOCIATES
1905 AMERICAN WAY

KINGSPORT,TN37660
27-0898372
HEALTHCARE TN 501C3 7 WHS
 
Yes
 
(4) WELLMONT FOUNDATION
1905 AMERICAN WAY

KINGSPORT,TN37660
58-1594191
HEALTHCARE TN 501C3 7 WHS
 
Yes
 
(5) WELLMONT MADISON HOUSE
1905 AMERICAN WAY

KINGSPORT,TN37660
62-1308216
HEALTHCARE TN 501C3 9 WHS
 
Yes
 
(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
 
Yes
 
(8) WELLMONT SLEEP SERVICES
1905 AMERICAN WAY

KINGSPORT,TN37660
HEALTHCARE TN 501C3 3 WHS
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?



(k)
Percentage
ownership


Yes No Yes No
(1) SAPLING GROVE AMBULATORY
SURGERY
220 MEDICAL PARK BOULEVARD
BRISTOL,TN37620
  TN WHS
 
RELATED 618,640 3,595,432   No     No 65.000 %
(2) HOLSTON VALLEY AMBULATORY
SURGERY
103 WEST STONE DRIVE
KINGSPORT,TN37660
  TN WHS
 
RELATED 1,353,805 1,100,560   No     No 52.000 %
(3) HOLSTON VALLEY IMAGING CENTER

103 WEST STONE DRIVE
KINGSPORT,TN37660
  TN WHS
IMAGING
RELATED       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
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) WELLMONT INC

1905 AMERICAN WAY
KINGSPORT,TN37660
62-1320035
PHYS. SVCS TN WHS
 
C CORP 823,312 -89,243,614     No
(2) MCOT INC

1905 AMERICAN WAY
KINGSPORT,TN37660
62-1325938
MED. SVCS. TN N/A
          No
(3) MEDICAL LAUNDRY OF TRI-CITIES
MEDICAL LAUNDRY OF TRI-CITIES
1905 AMERICAN WAY
KINGSPORT,TN37660
62-1482226
MED. SVCS. TN N/A
          No
(4) MEDICAL MALL PHARMACY INC

1905 AMERICAN WAY
KINGSPORT,TN37660
62-1565006
MED. SVCS. TN N/A
          No
(5) WELLMONT PHYSICIAN SERVICES
WELLMONT PHYSICIAN SERVICES
1905 AMERICAN WAY
KINGSPORT,TN37660
62-1567353
PHYS. SVCS TN N/A
          No
(6) WPS PROVIDERS INC

1905 AMERICAN WAY
KINGSPORT,TN37660
20-5564642
PHYS. SVCS TN N/A
          No
(7) WELLMONT HEALTH SERVICES INC

1905 AMERICAN WAY
KINGSPORT,TN37660
62-1254373
HEALTHCARE TN N/A
          No
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
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
No
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 . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
Yes
 
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
No
2
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 CARDIOLOGY SERVICES

B 12,439,471 CAPITAL CONTRIBUTIONS
(2) WELLMONT MEDICAL ASSOCIATES

B 26,943,241 CAPITAL CONTRIBUTIONS
(3) WELLMONT HAWKINS COUNTY MEMORIAL HO

C 3,585,497 CAPITAL CONTRIBUTIONS
(4) WELLMONT FOUNDATION

C 3,971,218 NEED
(5) WELLMONT WEXFORD HOUSE

C 797,234 CAPITAL CONTRIBUTIONS
(6) MCOT INC

C 1,316,832 CAPITAL CONTRIBUTIONS
(7) WELLMONT MEDICAL ASSOCIATES

I 167,734 ASSET TRANSFER
(8) HOLSTON VALLEY IMAGING CENTER INC

I 5,477,046 ASSET TRANSFER
(9) WELLMONT HAWKINS COUNTY MEMORIAL HO

J 257,705 LEASE AGREEMENT
(10) WELLMONT CARDIOLOGY SERVICES

J 384,323 LEASE AGREEMENT
(11) WELLMONT MEDICAL ASSOCIATES

J 1,466,772 LEASE AGREEMENT
(12) HOLSTON VALLEY AMBULATORY SURGERY C

J 878,578 LEASE AGREEMENT
(13) HOLSTON VALLEY IMAGING CENTER INC

J 234,758 LEASE AGREEMENT
(14) WELLMONT MEDICAL ASSOCIATES

K 55,313 LEASE AGREEMENT
(15) WELLMONT HAWKINS COUNTY MEMORIAL HO

L 9,198,996 SUPPORT SERVICES
(16) WELLMONT HAWKINS COUNTY MEMORIAL HO

L 90,464 INVOICES
(17) WELLMONT HAWKINS COUNTY MEMORIAL HO

L 85,544 SUPPORT SERVICES
(18) WELLMONT CARDIOLOGY SERVICES

L 114,415 INVOICES
(19) WELLMONT MEDICAL ASSOCIATES

L 111,231 SUPPORT SERVICES
(20) WELLMONT CARDIOLOGY SERVICES

M 2,051,924 COST - INVOICES
(21) WELLMONT MEDICAL ASSOCIATES

M 545,532 SERVICE AGREEMENT
(22) WELLMONT FOUNDATION

M 568,576 INVOICES
(23) MCOT INC

M 2,250,877 COLLECTION AGREEMENT
(24) WELLMONT HAWKINS COUNTY MEMORIAL HO

O 348,498 NEED
(25) SAPLING GROVE AMBULATORY SURGE

R 380,676 DISTRIBUTION
(26) HOLSTON VALLEY AMBULATORY SURGERY C

R 806,000 DISTRIBUTION
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(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?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
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 WELLMONT FOUNDATION PERFORMS FUNDRAISING SERVICES FOR WELLMONT HEALTH SYSTEM AND ITS RELATED 501(C)(3) ENTITIES. THE COST OF THESE SERVICES IS 568,576 AND CANNOT BE DETERMINED BY ENTITY. OTHER RELATED ORGANIZATION TRANSACTIONS WITH WELLMONT CARDIOLOGY SERVICES, WELLMONT MADISON HOUSE AND WELLMONT WEXFORD HOUSE TOTALED 76,934 DURING THE FISCAL YEAR ENDED JUNE 30, 2015, AND DID NOT MEET THE 50,000 THRESHOLD AMOUNT FOR SEPARATE DISCLOSURE. ORGANIZATION TRANS TYPE AMOUNT METHOD DETERMINATION WELLMONT CARDIOLOGY SERVICES K 25,225 LEASE AGREEMENT WELLMONT MADISON HOUSE B 13,042 CAPITAL CONTRIBUTIONS WELLMONT MADISON HOUSE L 34,190 SERVICE AGREEMENTS WELLMONT WEXFORD HOUSE L 4,477 INVOICES
Schedule R (Form 990) 2014
Additional Data


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