ABINGDON PHYSICIAN PARTNERS: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- ABINGDON PHYSICIAN PARTNERS (EIN 20-5485346)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-12
- IRS object ID
- 202311329349304256
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-05-12T11:15:46-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 205485346 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Abingdon Physician Partners | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ABIN | BusinessNameControlTxt |
| Phone | 2762582800 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 311 Princeton Road Suite 1 | AddressLine1Txt |
| City | Johnson City | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 376012080 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | John Jeter | PersonNm |
| Person Title | VP, CEO | PersonTitleTxt |
| Phone | 2762582861 | PhoneNum |
| Signature | 2023-05-12 | SignatureDt |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | John | PersonFirstNm |
| Person Last | Jeter | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
| Principal Officer | John Jeter | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 16000 Johnston Memorial Drive | AddressLine1Txt |
| City | Abingdon | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 24211 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $13,338,326 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.balladhealth.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2006 | FormationYr |
| Legal Domicile State | VA | LegalDomicileStateCd |
| Activity Or Mission | Our mission: Honor those we serve by delivering the best possible care | ActivityOrMissionDesc |
| Voting Members Governing Body | 4 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 120 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $70,755 | PYContributionsGrantsAmt |
| CY Contributions Grants | $33,036 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $13,882,984 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $13,280,444 | CYProgramServiceRevenueAmt |
| PY Investment Income | $244 | PYInvestmentIncomeAmt |
| CY Investment Income | $15,592 | CYInvestmentIncomeAmt |
| PY Other Revenue | $4,211 | PYOtherRevenueAmt |
| CY Other Revenue | $6,796 | CYOtherRevenueAmt |
| PY Total Revenue | $13,958,194 | PYTotalRevenueAmt |
| CY Total Revenue | $13,335,868 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $9,529,775 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,928,361 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,678,810 | PYOtherExpensesAmt |
| CY Other Expenses | $4,541,567 | CYOtherExpensesAmt |
| PY Total Expenses | $13,208,585 | PYTotalExpensesAmt |
| CY Total Expenses | $13,469,928 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $749,609 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$134,060 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,256,381 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,959,735 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,036,373 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,426,743 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$779,992 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $532,992 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Honor those we serve by delivering the best possible care.Ballad Health is dedicated to improving the health of the 29-county Appalachian Highlands region. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $13,460,893 | ExpenseAmt |
| Revenue | $13,302,727 | RevenueAmt |
| Desc | Abingdon Physician Partners (APP) was created to augment Johnston Memorial Hospital's exempt purpose of responding to the healthcare needs of individuals and communities in its service area. To promote the general health and welfare of the communities served, the corporation has more than 10 primary care, general surgery, orthopedic, gynecology, and oncology clinics.Multiple APP clinics also serve as outpatient teaching locations for family medicine and internal medicine residency programs. | Desc |
| Total Program Service Expenses | $13,460,893 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 10 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 120 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 4 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | VA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lynn Krutak | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4233023374 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 303 Med Tech Prkwy Ste 300 | AddressLine1Txt |
| City | Johnson City | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37604 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| John Jeter | |||||||||
| VP/CEO JMH/BRMC/APP | 0.50 | 44.50 | Yes (X) | Yes (X) | $0 | $432,983 | $38,431 | ||
| Mark Patterson MD BHMA SVP | |||||||||
| Director, Through Nov. 2021 | 0.50 | 54.50 | Yes (X) | $0 | $716,186 | $86,766 | |||
| David H Smith MD | |||||||||
| Director, Through Nov. 2021 | 40.00 | 0.00 | Yes (X) | $193,199 | $0 | $36,494 | |||
| Karl Kindig | |||||||||
| Chairman, Through Nov. 2021 | 0.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| James Gardner MD | |||||||||
| Director, Through Nov. 2021 | 40.00 | 0.00 | Yes (X) | $4,405 | $0 | $0 | |||
| Alan Levine BH PresCEO | |||||||||
| Director, Beg. Nov. 2021 | 1.00 | 64.00 | Yes (X) | Yes (X) | $0 | $4,083,029 | $240,343 | ||
| Marvin Eichorn BH EVPCAO | |||||||||
| Director, Beg. Nov. 2021 | 1.00 | 64.00 | Yes (X) | Yes (X) | $0 | $1,154,466 | $43,904 | ||
| Eric Deaton BH EVPCOO | |||||||||
| Director, Beg. Nov. 2021 | 1.00 | 64.00 | Yes (X) | Yes (X) | $0 | $1,021,443 | $104,184 | ||
| Tim Belisle BH EVPGen Cnsl | |||||||||
| Director, Beg. Nov. 2021 | 1.00 | 64.00 | Yes (X) | Yes (X) | $0 | $670,583 | $87,406 | ||
| Edward Pryor | |||||||||
| AVP/CFO JMH/APP | 0.50 | 44.50 | Yes (X) | $0 | $102,116 | $8,035 | |||
| Lynn Krutak | |||||||||
| BH EVP/CFO | 1.00 | 64.00 | Yes (X) | $0 | $956,968 | $104,263 | |||
| William Cummins MD | |||||||||
| Physician | 40.00 | 0.00 | $401,599 | $0 | $34,239 | Yes (X) | |||
| Matthew Dorn MD | |||||||||
| Physician | 40.00 | 0.00 | $383,142 | $0 | $41,417 | Yes (X) | |||
| Timothy Davis MD | |||||||||
| Physician | 40.00 | 0.00 | $417,313 | $0 | $40,426 | Yes (X) | |||
| Amy Hitchcock MD | |||||||||
| Physician | 40.00 | 0.00 | $327,697 | $0 | $16,013 | Yes (X) | |||
| Adrienne Griffin MD | |||||||||
| Physician | 40.00 | 0.00 | $313,119 | $0 | $17,964 | Yes (X) | |||
| Edward Hickson VPPres SWMkt | |||||||||
| Former Officer | 0.00 | 45.00 | $0 | $660,570 | $37,119 | Yes (X) | |||
| Carl Kilgore BH SVP Retail | |||||||||
| Former Officer | 0.00 | 55.00 | $0 | $667,536 | $92,580 | Yes (X) | |||
| Justin Ivory | |||||||||
| Former CFO - JMH/APP | 0.00 | 40.00 | $0 | $104,629 | $16,577 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,040,474 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $10,570,509 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,046,161 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 24 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Weatherby Locums Inc | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 972633 | AddressLine1Txt |
| City | Dallas | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75397 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | Med Staffing Svcs | ServicesDesc |
| Compensation | $402,741 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $33,036 | GovernmentGrantsAmt |
| Total Contributions | $33,036 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net Patient Revenue | 621110 | $6,684,983 | $6,684,983 |
| Hospital Support | 621110 | $5,926,458 | $5,926,458 |
| CARES Act Revenue | 900099 | $405,533 | $405,533 |
| Medical Educ. Training | 621110 | $225,064 | $225,064 |
| Performance Bonuses | 621110 | $38,406 | $38,406 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $13,280,444 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $60 | TotalRevenueColumnAmt |
| Exclusion | $60 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $17,990 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $2,458 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $15,532 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,532 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $15,532 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| Misc | 900099 | $4,751 | $4,751 | |
| Tax Refund | 900099 | $2,000 | $2,000 | |
| Medical Records | 900099 | $45 | $45 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $6,796 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,335,868 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,302,727 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $105 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $156,523 | TotalAmt |
| Program Services | $156,523 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,410,634 | TotalAmt |
| Program Services | $7,410,634 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $231,400 | TotalAmt |
| Program Services | $231,400 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $687,124 | TotalAmt |
| Program Services | $687,124 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $442,680 | TotalAmt |
| Program Services | $442,680 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,503 | TotalAmt |
| Program Services | $3,503 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,621,748 | TotalAmt |
| Program Services | $2,621,748 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,022 | TotalAmt |
| Program Services | $55,793 | ProgramServicesAmt |
| Management And General | $7,229 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $846,645 | TotalAmt |
| Program Services | $845,222 | ProgramServicesAmt |
| Management And General | $1,423 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $371,833 | TotalAmt |
| Program Services | $371,450 | ProgramServicesAmt |
| Management And General | $383 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $656 | TotalAmt |
| Program Services | $656 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| Medical Supplies | $485,168 | $485,168 |
| Maintenance | $131,378 | $131,378 |
| Licenses & Permits | $13,881 | $13,881 |
| Miscellaneous | $3,733 | $3,733 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,469,928 | TotalAmt |
| Program Services | $13,460,893 | ProgramServicesAmt |
| Management And General | $9,035 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $464,106 | BOYAmt |
| EOY | $174,275 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,017,516 | BOYAmt |
| EOY | $1,491,393 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $82,588 | BOYAmt |
| EOY | $35,354 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $89,261 | BOYAmt |
| EOY | $39,187 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $3,848,587 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,663,689 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,545,658 | BOYAmt |
| EOY | $1,184,898 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,628 | BOYAmt |
| EOY | $34,628 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,624 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,256,381 | BOYAmt |
| EOY | $2,959,735 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,760,742 | BOYAmt |
| EOY | $1,645,519 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,275,631 | BOYAmt |
| EOY | $781,224 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,036,373 | BOYAmt |
| EOY | $2,426,743 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$779,992 | BOYAmt |
| EOY | $532,992 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$779,992 | BOYAmt |
| EOY | $532,992 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,256,381 | BOYAmt |
| EOY | $2,959,735 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$134,060 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $1,447,044 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type1 | Yes (X) | SupportingOrgType1Ind |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Johnston Memorial Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 540544705 | EIN |
| Organization Type | 3 | OrganizationTypeCd |
| Governing Document Listed | Yes (1) | GoverningDocumentListedInd |
| Support | $0 | SupportAmt |
| Other Support | $0 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (1) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Power Appoint Majority Dir Trst | Yes (1) | PowerAppointMajorityDirTrstInd |
| Operate Benefit Non Suprt Org | 0 | OperateBenefitNonSuprtOrgInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $290,915 | OtherCostOrOtherBasisAmt |
| Depreciation | $157,656 | DepreciationAmt |
| Book Value | $133,259 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $243,021 | OtherCostOrOtherBasisAmt |
| Depreciation | $241,299 | DepreciationAmt |
| Book Value | $1,722 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,314,651 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,264,734 | DepreciationAmt |
| Book Value | $1,049,917 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,184,898 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Due to Affiliates | $742,037 |
| Operating Lease Obligation ST | $12,044 |
| Operating Lease Obligation LT | $27,143 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $781,224 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | Abingdon Physician Partners is included in the audited consolidated financial statements of Ballad Health. The footnote explanation relative to income taxes reads: "Ballad is classified as an organization exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code. As such, no provision for federal income taxes is included in the accompanying consolidated financial statements. Taxable subsidiaries are discussed in Note K. No significant uncertain tax positions exist at June 30, 2022 and 2021. Tax returns for 2019 through 2021 are subject to examination by the Internal Revenue Service." | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (16 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Alan Levine BH PresCEO | ||||||||||||||
| Director, Beg. Nov. 2021 | $0 | $1,328,603 | $0 | $1,687,893 | $0 | $1,066,533 | $0 | $216,552 | $0 | $23,791 | $0 | $4,323,372 | $0 | $1,002,170 |
| Marvin Eichorn BH EVPCAO | ||||||||||||||
| Director, Beg. Nov. 2021 | $0 | $738,294 | $0 | $347,261 | $0 | $68,911 | $0 | $17,100 | $0 | $26,804 | $0 | $1,198,370 | $0 | $0 |
| Eric Deaton BH EVPCOO | ||||||||||||||
| Director, Beg. Nov. 2021 | $0 | $656,895 | $0 | $334,180 | $0 | $30,368 | $0 | $83,012 | $0 | $21,172 | $0 | $1,125,627 | $0 | $0 |
| Lynn Krutak | ||||||||||||||
| BH EVP/CFO | $0 | $638,754 | $0 | $299,081 | $0 | $19,133 | $0 | $80,962 | $0 | $23,301 | $0 | $1,061,231 | $0 | $0 |
| Mark Patterson MD BHMA SVP | ||||||||||||||
| Director, Through Nov. 2021 | $0 | $494,284 | $0 | $205,450 | $0 | $16,452 | $0 | $60,534 | $0 | $26,232 | $0 | $802,952 | $0 | $0 |
| Carl Kilgore BH SVP Retail | ||||||||||||||
| Former Officer | $0 | $464,334 | $0 | $183,773 | $0 | $19,429 | $0 | $64,464 | $0 | $28,116 | $0 | $760,116 | $0 | $0 |
| Tim Belisle BH EVPGen Cnsl | ||||||||||||||
| Director, Beg. Nov. 2021 | $0 | $444,154 | $0 | $202,357 | $0 | $24,072 | $0 | $61,801 | $0 | $25,605 | $0 | $757,989 | $0 | $0 |
| Edward Hickson VPPres SWMkt | ||||||||||||||
| Former Officer | $0 | $256,355 | $0 | $165,100 | $0 | $239,115 | $0 | $14,934 | $0 | $22,185 | $0 | $697,689 | $0 | $0 |
| John Jeter | ||||||||||||||
| VP/CEO JMH/BRMC/APP | $0 | $314,926 | $0 | $110,719 | $0 | $7,338 | $0 | $17,251 | $0 | $21,180 | $0 | $471,414 | $0 | $0 |
| Timothy Davis MD | ||||||||||||||
| Physician | $391,600 | $0 | $20,500 | $0 | $5,213 | $0 | $17,028 | $0 | $23,398 | $0 | $457,739 | $0 | $0 | $0 |
| William Cummins MD | ||||||||||||||
| Physician | $320,140 | $0 | $69,572 | $0 | $11,887 | $0 | $15,984 | $0 | $18,255 | $0 | $435,838 | $0 | $0 | $0 |
| Matthew Dorn MD | ||||||||||||||
| Physician | $370,629 | $0 | $500 | $0 | $12,013 | $0 | $17,080 | $0 | $24,337 | $0 | $424,559 | $0 | $0 | $0 |
| Amy Hitchcock MD | ||||||||||||||
| Physician | $308,733 | $0 | $500 | $0 | $18,464 | $0 | $0 | $0 | $16,013 | $0 | $343,710 | $0 | $0 | $0 |
| Adrienne Griffin MD | ||||||||||||||
| Physician | $292,450 | $0 | $500 | $0 | $20,169 | $0 | $5,065 | $0 | $12,899 | $0 | $331,083 | $0 | $0 | $0 |
| David H Smith MD | ||||||||||||||
| Director, Through Nov. 2021 | $190,495 | $0 | $500 | $0 | $2,204 | $0 | $12,000 | $0 | $24,494 | $0 | $229,693 | $0 | $0 | $0 |
| Justin Ivory | ||||||||||||||
| Former CFO - JMH/APP | $0 | $101,777 | $0 | $2,750 | $0 | $102 | $0 | $0 | $0 | $16,577 | $0 | $121,206 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Lines 4a-b | FormAndLineReferenceDesc |
| Explanation | The following executives listed in Schedule J, Part II participated in a 457(f) retirement plan provided by Ballad Health (BH). The 457(f) plan is a nonqualified tax-deferred compensation plan available to a select group of key executives for the intent of supporting retention and to offer a competitive total retirement program. Account balances have a "substantial risk of forfeiture". In addition to creditor risk, substantial risk of forfeiture is created through default risk if the participant's employment with Ballad Health is terminated prior to age 65. However, the 457(f) plan contains a non-compete provision that provides the account balance to be paid in a lump sum after the executive satisfies the two-year non-compete period. This provision applies to employer contributions if the executive has provided eligible service for six or more years. The executive will receive the entire account balance if he/she becomes disabled, dies or if the executive terminates for "good reason or is involuntarily terminated without "good cause" within a 24-month period after a change-of-control occurs. Distributions from this plan are subject to federal, state, and local taxes on the entire account balance upon distribution. Additionally, during the year a one-time acceleration of the supplemental executive retirement plan occurred for the CEO in the amount of $1,002,170. This amount was taxable in the year accelerated and is included in total compensation for purposes of reporting. Alan Levine $199,452 Eric Deaton $ 65,950 Tim Belisle $ 44,703 Mark Patterson $ 43,434 Lynn Krutak $ 63,862 Carl Kilgore $ 47,364 The following executive received a change-of-control payment. The payment was reported as taxable income with appropriate tax withheld and remitted to the IRS. Edward Hickson $237,700 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 3 | Line 3 explanation - The corporation contracted with Blue Ridge Medical Management Corporation, a for-profit corporation, to perform management duties such as accounting, payroll, budgeting, financial operations, and management responsibilities. |
| Form 990, Part VI, Section A, line 6 | Line 6 explanation - The corporation is organized as a Virginia non-stock, nonprofit organization with Johnston Memorial Hospital, a Section 501(c)(3) organization, as the sole member. |
| Form 990, Part VI, Section A, line 7a | Line 7a explanation - There is a single class of member, Johnston Memorial Hospital. |
| Form 990, Part VI, Section A, line 7b | Line 7b explanation - Certain decisions of the board are, pursuant to charter and Virginia statute, subject to approval of the members. These decisions include: dissolution of the corporation; merger of the corporation; non-ordinary course of business sale of assets, etc. No ordinary, day-to-day decisions are subject to member approval. |
| Form 990, Part VI, Section B, line 11b | Line 11b Explanation - The Ballad Health Tax Department prepares and reviews the Form 990. During preparation other functional areas within the orgainzation provide information and support to complete an accurate return. The return is reviewed by the organization's CEO and is provided in electronic form to all members of the Board of Directors prior to filing with the IRS. |
| Form 990, Part VI, Section B, line 12c | Ballad Health has a conflict of interest policy for all members of the Board of Directors, the Executive Chair/President, Executive Vice Presidents, Senior Vice Presidents, and Vice Presidents, and applies to all Ballad Health organizations, including Abingdon Physician Partners. All persons covered by this policy are required to complete a conflict of interest disclosure form on an annual basis. Should a conflict arise, it is the responsibility of the conflicted individual to update his or her disclosure immediately. All meetings of the board or board committees have a standing agenda item first on the agenda titled "Conflicts of Interest". If a member of the board or board committee has a conflict of interest involving any issue on the board agenda, he or she must declare the conflict of interest during the period allotted for disclosure. If any issue arises during a meeting in which the board member has a conflict of interest, he or she must immediately declare the conflict. While each member of the board or board committee is responsible for disclosing conflicts of interest, it is also the responsibility of any board member aware of a conflict which has not been disclosed to ensure the board is made aware. The presiding officer of a board or board committee meeting may ask a conflicted member to excuse themselves from the meeting during the discussion related to the issue with which the conflict of interest applies. Under no circumstances shall a member vote on a matter that gives rise to a potential conflict. |
| Form 990, Part VI, Section B, line 15 | Line 15a - Compensation Process for Top Official The executive compensation committee serves as the compensation oversight committee of Ballad Health's Board of Directors. The executive compensation committee is comprised of members who are determined to be independent and whom are not reliant upon any business relationship with Ballad Health for income or compensation. The compensation plan for Alan Levine, Ballad Health's Chairman, President and CEO, was reviewed and approved by the executive compensation committee and then by the Ballad Health Board of Directors in accordance with the Board's compensation policy and practice. The Board of Directors relies upon the advice of an independent and experienced compensation consultant with knowledge about pay practices for comparable positions within the industry, and who has access to broad data, studies and surveys in order to ensure the compensation falls within competitive and appropriate ranges for the position. Line 15b - Compensation Process for Officers On an annual basis, Ballad Health's Human Resources (H/R) Department evaluates compensation for all executives at a position level of Assistant Vice President and above. H/R's evaluation is based on market data obtained from independent third-party consultants for positions with similar responsibilities at similarly situated organizations. Based on this comparable data, Ballad Health's CEO evaluates the data and, if appropriate, makes necessary adjustments. Any adjustments to Senior Vice Presidents or above are reviewed by the Board of Directors Executive Compensation Committee. In addition, Ballad Health offers an incentive plan to executives based on targeted achievement metrics categorized by; Quality, Service and Safety; Access to Care; Financial Stewardship, and any other metrics approved from time to time by the Board of Directors. |
| Form 990, Part VI, Section C, line 19 | Governing documents and conflict of interest policy are made available upon request to the appropriate parties requesting them. Financial statements are made available upon request to the appropriate parties requesting them, and they are made available to those parties who own indebtedness of the company on a quarterly basis. |
| Form 990, Part IX, line 11g | Environmental Services: Program service expenses 17,322. Management and general expenses 0. Fundraising expenses 0. Total expenses 17,322. Laundry Services: Program service expenses 3,066. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,066. Collection Services: Program service expenses 274,474. Management and general expenses 0. Fundraising expenses 0. Total expenses 274,474. Credentialing Fees: Program service expenses 47,298. Management and general expenses 0. Fundraising expenses 0. Total expenses 47,298. Contract Labor: Program service expenses 2,182,510. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,182,510. Other: Program service expenses 97,078. Management and general expenses 0. Fundraising expenses 0. Total expenses 97,078. |
| Form 990, Part XI, line 9: | Intercompany Debt Forgiveness 1,447,044. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (16 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Mountain States Health Alliance | |||||||||||
| 303 Med Tech Parkway Suite 220 | Johnson City | TN | 37604 | 620476282 | Hospital System | TN | 501C3 | Line_3_Hospital_Coop | BALLAD | 0 | |
| MSHA Auxiliary | |||||||||||
| 400 N State of Franklin Road | Johnson City | TN | 37604 | 581418345 | Supporting Organization | TN | 501C3 | 12a | MSHA | 0 | |
| Smyth County Community Hospital | |||||||||||
| 245 Medical Park Drive | Marion | VA | 24354 | 540794913 | Hospital | VA | 501C3 | Line_3_Hospital_Coop | MSHA | 0 | |
| Dickenson Community Hospital | |||||||||||
| 312 Hospital Drive | Clintwood | VA | 24228 | 770599553 | Hospital | VA | 501C3 | Line_3_Hospital_Coop | WHS | 0 | |
| Johnston Memorial Hospital | |||||||||||
| 16000 Johnston Memorial Drive | Abingdon | VA | 24211 | 540544705 | Hospital | VA | 501C3 | Line_3_Hospital_Coop | MSHA | 0 | |
| Johnston Memorial Healthcare Fdn | |||||||||||
| 851 French Moore Jr Blvd Ste 110 | Abingdon | VA | 24210 | 262870970 | Fundraiser | VA | 501C3 | 12b | 0 | N/A | |
| Ballad Health | |||||||||||
| 303 Med Tech Parkway Suite 220 | Johnson City | TN | 37604 | 611771290 | Supporting Organization | TN | 501C3 | 12b | 0 | N/A | |
| Ballad Health Foundation | |||||||||||
| 1019 West Oakland Ave Suite 2 | Johnson City | TN | 37604 | 581594191 | Fundraiser | TN | 501C3 | Line_7_Organization_ | BALLAD | 0 | |
| Wellmont Health System | |||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621636465 | Hospital System | TN | 501C3 | Line_3_Hospital_Coop | BALLAD | 0 | |
| Wellmont Hawkins Co Memorial Hosp | |||||||||||
| 851 Locust Street | Rogersville | TN | 37857 | 621816368 | Hospital | TN | 501C3 | Line_3_Hospital_Coop | WHS | 0 | |
| Takoma Regional Hospital Inc DBA GCH | |||||||||||
| 1420 Tusculum Boulevard | Greeneville | TN | 37745 | 510603966 | Hospital | TN | 501C3 | Line_3_Hospital_Coop | WHS | 0 | |
| Wellmont Cardiology Services | |||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 263557623 | Medical Services | TN | 501C3 | Line_10_Organization | WHS | 0 | |
| Wellmont Medical Associates | |||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 270898372 | Medical Services | TN | 501C3 | Line_7_Organization_ | WHS | 0 | |
| Wellmont Madison House | |||||||||||
| 2000 Greenway Street | Kingsport | TN | 37660 | 621308216 | Assisted Living | TN | 501C3 | Line_10_Organization | WHS | 0 | |
| Wellmont Wexford House | |||||||||||
| 2421 N John B Dennis Hwy | Kingsport | TN | 37660 | 581859039 | Nursing Home | TN | 501C3 | Line_10_Organization | WHS | 0 | |
| Wellmont Imaging Services Inc | |||||||||||
| 400 N State of Franklin Road | Johnson City | TN | 37604 | 861103148 | Healthcare | TN | 501C3 | 12a | WHS | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Emmaus Community Healthcare PLLC | ||||||||||
| 6419 Bristol Hwy | Piney Flats | TN | 37686 | 200577483 | Medical Services | TN | N/A | N/A | 0 | 0 |
| Medical Specialists of JC LLC | ||||||||||
| 2528 Wesley Street Suite 2 | Johnson City | TN | 37601 | 272199037 | Medical Services | TN | N/A | N/A | 0 | 0 |
| East TN Ambulatory Surgery Center | ||||||||||
| 701 Med Tech Parkway Suite 100 | Johnson City | TN | 37604 | 621787537 | Medical Services | TN | N/A | N/A | 0 | 0 |
| Rehabilitation Hospital of Bristol LLC | ||||||||||
| 103 North Street | Britol | VA | 24201 | 205612001 | Medical Services | VA | N/A | N/A | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (13 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Blue Ridge Medical Management Corp | ||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621490616 | Medical Services | TN | N/A | C | 0 | |||||
| Mediserve Medical Equipment | ||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621212286 | Durable Medical Equipment | TN | N/A | C | 0 | |||||
| Mountain States Properties | ||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621845895 | Property Management | TN | N/A | C | 0 | |||||
| Mountain States Physician Grp | ||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621700412 | Medical Services | TN | N/A | C | 0 | |||||
| Community Home Care Inc | ||||||||||||||
| 1490 Park Avenue NW Suite B | Norton | VA | 24273 | 541453810 | Durable Medical Equipment | VA | N/A | C | 0 | |||||
| Wilson Pharmacy Inc | ||||||||||||||
| PO Box 5289 | Johnson City | TN | 37604 | 620329587 | Pharmacy | TN | N/A | C | 0 | |||||
| Wellmont Inc | ||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621320035 | Medical Services | TN | N/A | C | 0 | |||||
| Wellmont Physician Services | ||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621567353 | Medical Services | TN | N/A | C | 0 | |||||
| WPS Providers Inc | ||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 205564642 | Medical Services | TN | N/A | C | 0 | |||||
| Wellmont Health Services Inc | ||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621254373 | Medical Services | TN | N/A | C | 0 | |||||
| Nolichuckey Mgmt Svcs Inc | ||||||||||||||
| 1420 Tusculum Boulevard | Greeneville | TN | 37745 | 621776681 | Medical Services | TN | N/A | C | 0 | |||||
| Wellmont Insurance Co SPC LTD | ||||||||||||||
| 981195624 | Insurance | N/A | C | 0 | PO Box 30600 | Grand Cayman | CJ | KY1-1203 | CJ | |||||
| Ballad Ventures LLC | ||||||||||||||
| 400 N State of Franklin Road | Johnson City | TN | 37604 | 844214681 | Investments | TN | N/A | C | 0 | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
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