2019-05-13T09:30:52-05:00 2018-06-30 990 2017-07-01 270898372 WELLMONT MEDICAL ASSOCIATES INC WELL 4233023374 1905 AMERICAN WAY KINGSPORT TN 37660 LEANNE COX VP CFO 4233023374 2019-05-13 151.102.241.104 2019-05-13 09:30:52 CD P B63603CA6CC0E7A9B40672C01A3D6D8A952705BD 39095CF110B0C8EE9B5E629A9826572B753F4624 2017 2019-02-21 02:37:17Z LEANNE COX 1905 AMERICAN WAY KINGSPORT TN 37660 149282472 false X BALLADHEALTH.ORG X 2008 TN MISSION: HONOR THOSE WE SERVE BY DELIVERING THE BEST POSSIBLE CARE. VISION: TO BUILD A LEGACY OF SUPERIOR HEALTH BY LISTENING TO AND CARING FOR THOSE WE SERVE. 18 0 1055 22420 21420 797 1888 108299781 148824625 -54796 340001 404330 108640579 149176047 0 0 88922126 91125923 0 0 46723067 58889685 135645193 150015608 -27004614 -839561 24682966 24202148 9228549 24202148 15454417 0 X HONOR THOSE WE SERVE BY DELIVERING THE BEST POSSIBLE CARE. false false 136514055 148946175 WELLMONT MEDICAL ASSOCIATES, INC. IS PHYSICIAN-LED AND PROFESSIONALLY MANAGED. FROM ITS BOARD OF DIRECTORS AND LEADERSHIP TEAM MEMBERS TO THE PROVIDERS WHO CARE FOR PATIENTS EVERY DAY, WELLMONT MEDICAL ASSOCIATES' COMMITMENT TO PHYSICIAN LEADERSHIP IS CLEAR. WELLMONT MEDICAL ASSOCIATES, A NON-PROFIT HEALTHCARE PROVIDER, DELIVERS EXCEPTIONAL CARE TO PATIENTS IN THE TRI-CITIES REGION OF NORTHEAST TENNESSEE AND SOUTHWEST VIRGINIA. BASED IN KINGSPORT, TENNESSEE, AS WELL AS LOCATIONS EXPANDING FROM SNEEDVILLE, TENNESSEE, TO MARION, VIRGINIA, WELLMONT MEDICAL ASSOCIATES OFFERS THE LATEST IN TECHNOLOGICAL ADVANCES TO ENSURE PATIENTS RECEIVE SUPERIOR CARE. (CON'T ON SCHEDULE O) MEDICAL SERVICES PROVIDED BY WELLMONT MEDICAL ASSOCIATES INCLUDE: -PRIMARY CARE -OB/GYN -SURGERY -ONCOLOGY -OUTPATIENT AND URGENT CARE CENTERS -NEUROLOGY -PULMONOLOGY -SPINE AND REHABILITATION -BEHAVORIAL HEALTH -SLEEP CENTER -OCCUPATIONAL MEDICINE -PHYSICAL THERAPY -PAIN MANAGEMENT -PALLIATIVE MEDICINE -HOSPITALISTS WE ARE DEDICATED TO IMPROVING OUR COMMUNITY'S ACCESS TO QUALITY, AFFORDABLE HEALTHCARE, 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. IN FISCAL YEAR 2018, WE HAD 532,608 OFFICE VISITS AND 168,505 HOSPITAL/NURSING HOME VISITS FOR A TOTAL OF 701,113 PATIENT ENCOUNTERS. RECOGNIZING SOME PATIENTS CANNOT AFFORD ESSENTIAL MEDICAL SERVICES, WE PROVIDED CARE FOR INDIGENT PATIENTS INCURRING UNREIMBURSED COSTS OF 2,773,193. ADDITIONALLY, WE PROVIDED CARE TO PEOPLE COVERED BY MEDICARE, MEDICAID, TENNCARE AND CHAMPUS AT A LOSS. DUE TO MANDATED REDUCTIONS IN MEDICARE FUNDING AND DECLINING REIMBURSEMENT FROM TENNCARE, THE SHORTFALL BETWEEN REIMBURSEMENT AND THE COST OF PROVIDING CARE TO THESE PATIENTS TOTALED 63,730,721. IT IS OUR OBLIGATION TO SUPPORT THE CAUSES THAT IMPROVE THE QUALITY OF LIFE IN OUR REGION. WE SPONSORED EDUCATIONAL, COMMUNITY-BASED PROGRAMS ON HEALTHY LIFESTYLES, RISK FACTOR IDENTIFICATION AND OPTIONS FOR DIAGNOSIS AND TREATMENT. PROGRAMS INCLUDED: -LECTURES ABOUT ASTHMA TO AREA ELEMENTARY SCHOOLS -PROVIDING A FREE CLINIC IN CHURCH HILL, TENNESSEE -PROVIDING FREE MEDICAL CARE THROUGH THE REMOTE AREA MEDICAL CLINIC -SUPPORTING THE HEALTH WAGON IN WISE, VIRGINIA -TEACHING AT LINCOLN MEMORIAL UNIVERSITY-DEBUSK COLLEGE OF OSTEOPATHIC MEDICINE -TEACHING AT THE UNIVERSITY OF VIRGINIA'S COLLEGE AT WISE -WORKING WITH APPALACHIAN MOUNTAIN PROJECT ACCESS -WORKING WITH FRIENDS IN NEED, A LOCAL NONPROFIT THAT PROVIDES PRIMARY CARE AND DENTAL CARE TO THE WORKING UNINSURED AND UNDERINSURED AS WELL AS FULL TIME COLLEGE STUDENTS WE ALSO PARTICIPATED IN A NUMBER OF HEALTH FAIRS AND COMMUNITY SCREENINGS. EMPLOYEES GAVE THEIR TIME TO AREA NONPROFIT ORGANIZATIONS, WHICH INCLUDED THE UNITED WAY AND THE EAST TENNESSEE AFFILIATE OF SUSAN G. KOMEN FOR THE CURE. 136514055 true false false false false false false false false false true false false false true true false true false false false false false false false false false false false true false false false true false false false false false false false false false true false false false true 72 0 true 1055 true true true false false false false false false false false false X 18 0 true false false false true true true true true true false true true true true true true false false false X LYNN KRUTAK 4233023374 303 MED TECH PARKWAY SUITE 300 JOHNSON CITY TN 37604 BARTON HOVE RETIRED 1312018 WHS PRESIDEN 0.10 31.90 X 0 1219926 49559 PAUL JETT MD DIRECTOR/VIC 40.00 0.00 X X 1086770 0 49346 GIRENDRA HOSKERE MD DIRECTOR 40.00 0.00 X 946580 0 27856 IBRAHIM NAKHOUL MD DIRECTOR 40.00 0.00 X 589969 0 39744 PUSHKAS GOPALAN MD DIRECTOR 40.00 X 510161 0 34460 MAURICE NIDA DO DIRECTOR/CHA 40.00 0.00 X X 468396 0 30220 LINDA PEARSON MD DIRECTOR 40.00 X 462783 0 23907 MARTA WAYT MD DIRECTOR 40.00 0.00 X 460820 0 24279 STEPHEN COMBS MD DIRECTOR/CEM 40.00 0.00 X X 457846 0 36588 DAVID THOMPSON MD DIRECTOR/CAM 40.00 X X 451658 0 28977 DAVID BRASH DIR/WMA PRES 40.00 0.00 X X 451251 0 35268 BRYAN WATSON MD DIRECTOR 40.00 X 338163 0 23816 PARMINDERJIT SINGH MD DIRECTOR 40.00 0.00 X 330468 0 32453 STEVE BAUMRUCKER MD DIRECTOR 40.00 X 319434 0 18745 LENITA THIBAULT MD DIRECTOR 40.00 0.00 X 267496 0 15847 LANDON COMBS MD DIRECTOR/SEC 40.00 0.00 X X 248349 0 24207 DAVID ASTIN MD DIRECTOR 40.00 0.00 X 233943 0 24482 VYVYAN DEROUEN DIRECTOR/CAO 40.00 0.00 X X 179276 0 20528 WENDY VOGEL NP DIRECTOR 40.00 X 94252 0 20937 KAREN WILLIAMS VP COO 40.00 0.00 X 215623 0 20221 DANIEL KRENK MD PHYSICIAN 40.00 X 851333 0 43285 PAUL KRAMER MD PHYSICIAN 40.00 X 789979 0 40251 ADEL EL ABBASSI MD PHYSICIAN 40.00 X 702019 0 21553 SAMUEL DEEL MD PHYSICIAN 40.00 X 595050 0 35717 ROGER MCSHARRY MD PHYSICIAN 40.00 X 547424 0 39248 11599043 1219926 761494 225 false true false BLUE RIDGE RADIOLOGY PC 3053 WEST STATE STREET BRISTOL TN 37620 RADIOLOGY SVCS 504188 WEATHERBY LOCUMS INC 15300 WESTON PARKWAY CARY NC 27513 PHYSICIAN SVCS 435313 HAYES LOCUMS 6700 N ANDREWS AVE SUITE 600 FORT LAUDERDALE FL 33309 PHYSICIAN SVCS 351173 BARTON ASSOCIATES INC PO BOX 417844 BOSTON MA 02241 PHYSICIAN SVCS 288826 WATAUGA ORTHOPAEDICS PLC 2410 SUSANNAH STREET JOHNSON CITY TN 37601 MEDICAL CARE 260949 13 1888 1888 PATIENT SERVICE REVENUE-NET 621990 114011321 114011321 HOSPITAL SUPPORT 621990 32906680 32906680 QUALITY & PERFORMANCE REVENUE 621990 1463059 1463059 WELLNESS REVENUE 621990 373534 373534 VASCULAR READS REVENUE 621990 47449 47449 22582 22582 148824625 101010 32519 68491 68491 68491 19110 73906 -54796 -54796 -54796 MEDICAL RECORDS 621990 98098 98098 REIMBURSEMENT FROM TENANT 900099 67100 67100 TELECOMMUNICATIONS REBATES 900099 63691 63691 106950 78248 22420 6282 335839 149176047 148946175 22420 205564 8834623 7862510 972113 69853597 67736777 2116820 1952775 1901461 51314 6239628 5886928 352700 4245300 4044402 200898 3218 3218 10353635 9738438 615197 9498 9498 773847 730842 43005 6672449 6231263 441186 285244 225438 59806 400001 378754 21247 2223314 2223314 261910 261910 DRUGS & MEDICAL SUPPLIES 28495818 28495818 BILLING & IT FEES 7803678 7803678 REPAIRS & MAINTENANCE 655139 447109 208030 DUES AND MEMBERSHIPS 546085 263065 283020 405849 347936 57913 150015608 136514055 13501553 0 17333 18633 7324960 7807529 26334 953668 914419 656120 529625 121978 79407 32860943 19324198 14319451 13536745 1289456 1289456 24682966 24202148 9228549 10527526 13674622 9228549 24202148 X 15454417 15454417 0 24682966 24202148 X -839561 -14614856 X X false true X true false X 38508 7086 5358 797 1888 53637 66564675 73921151 74067183 108656694 149020081 472229784 137073 137073 66603183 73928237 74072541 108657491 149159042 472420494 472420494 153831 156801 89681 114832 101010 616155 153831 156801 89681 114832 101010 616155 66757014 74085038 74162222 108772323 149260052 473036649 0.99870 0.99950 0.00000 0.00000 X 28688 28688 2840252 2866927 -26675 15133747 5515738 9618009 12624886 8846928 3777958 2233370 2094605 138765 13536745 DUE TO AFFILIATES 13674622 13674622 X SCHEDULE D, PAGE 3, PART X WELLMONT MEDICAL ASSOCIATES 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 HAS BEEN MADE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS FOR BALLAD AND ITS TAX- EXEMPT SUBSIDIARIES. BALLAD'S TAXABLE SUBSIDIARIES ARE DISCUSSED IN NOTE L. BALLAD HAS NO SIGNIFICANT UNCERTAIN TAX POSITIONS AT JUNE 30, 2018. AT JUNE 30, 2018, TAX RETURNS FOR MSHA AND WHS FOR 2015 THROUGH 2017 ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE." X false false false false false false false false false false false BARTON HOVE RETIRED 1312018 WHS PRESIDENT/CEO 817290 391085 11551 27695 21864 1269485 PAUL JETT MD DIRECTOR/VICE-CHAIR 805626 280871 273 29116 20230 1136116 GIRENDRA HOSKERE MD DIRECTOR 528236 418054 290 25800 2056 974436 IBRAHIM NAKHOUL MD DIRECTOR 523121 66300 548 19187 20557 629713 PUSHKAS GOPALAN MD DIRECTOR 487527 22344 290 13773 20687 544621 MAURICE NIDA DO DIRECTOR/CHAIR 467602 794 15658 14562 498616 LINDA PEARSON MD DIRECTOR 369674 92945 164 9345 14562 486690 MARTA WAYT MD DIRECTOR 398775 61845 200 15420 8859 485099 STEPHEN COMBS MD DIRECTOR/CEMO 405497 46790 5559 16334 20254 494434 DAVID THOMPSON MD DIRECTOR/CAMO 391467 58947 1244 9189 19788 480635 DAVID BRASH DIR/WMA PRESIDENT 314430 136312 509 14837 20431 486519 BRYAN WATSON MD DIRECTOR 234175 71185 32803 7398 16418 361979 PARMINDERJIT SINGH MD DIRECTOR 307942 22344 182 12123 20330 362921 STEVE BAUMRUCKER MD DIRECTOR 294621 23571 1242 11533 7212 338179 LENITA THIBAULT MD DIRECTOR 261131 4059 2306 10080 5767 283343 LANDON COMBS MD DIRECTOR/SEC/TREAS 201554 44278 2517 9034 15173 272556 DAVID ASTIN MD DIRECTOR 189643 43594 706 8845 15637 258425 VYVYAN DEROUEN DIRECTOR/CAO 161479 17568 229 6559 13969 199804 KAREN WILLIAMS VP COO 181247 33511 865 7621 12600 235844 DANIEL KRENK MD PHYSICIAN 826043 25000 290 24173 19112 894618 PAUL KRAMER MD PHYSICIAN 615812 173733 434 25194 15057 830230 ADEL EL ABBASSI MD PHYSICIAN 511570 190257 192 20942 611 723572 SAMUEL DEEL MD PHYSICIAN 466607 102219 26224 16898 18819 630767 ROGER MCSHARRY MD PHYSICIAN 371892 174515 1017 18437 20811 586672 SCHEDULE J, PAGE 1, PART I, LINE 1A DISCRETIONARY SPENDING WELLMONT MEDICAL ASSOCIATES PROVIDED A MONTHLY VEHICLE ALLOWANCE TO STEPHEN COMBS, M.D. FOR TRAVEL EXPENSES DURING THE FISCAL YEAR ENDED JUNE 30, 2018. THE AMOUNT IS INCLUDED IN TAXABLE COMPENSATION. SCHEDULE J, PAGE 1, PART I, LINE 1B AS PART OF DR. COMBS' EMPLOYMENT AGREEMENT FOR ASSUMING THE WMA CEMO POSITION, HE RECEIVES 400 A MONTH TO PROVIDE FOR HIS PERSONAL AUTO USAGE. AS CEMO, DR. COMBS IS REQUIRED TO ATTEND NUMEROUS MEDICAL STAFF MEETINGS, EXECUTIVE BUSINESS MEETINGS, SERVE ON VARIOUS COMMITTEES AND IS RESPONSIBLE FOR VARIOUS OTHER CLINICAL DUTIES. HE TRAVELS TO MULTIPLE LOCATIONS IN EAST TENNESSEE AND SOUTHWEST VIRGINIA IN PERFORMANCE OF THESE RESPONSIBILITIES. THE AGREEMENT WAS APPROVED BY THE WELLMONT HEALTH SYSTEM CEO. SAMUEL DEEL MD HIGHEST COMPENSATED MEDICAL SCHOOL LOAN ASSISTANCE X 80000 25188 false false true BRYAN WATSON MD BOARD MEMBER MEDICAL SCHOOL LOAN ASSISTANCE X 30000 1146 false false true 26334 SCHEDULE L, PART V SCHEDULE L, PART II, LINE 1, LOANS TO AND/OR FROM INTERESTED PERSONS: SAMUEL DEEL'S EMPLOYMENT AGREEMENT ALLOWS FOR THREE (3) INSTALLMENT PAYMENTS UP TO 80,000 FOR THE PURPOSE OF REPAYING LOANS INCURRED BY HIM WHILE IN MEDICAL SCHOOL. THE PROMISSORY NOTE WAS APPROVED BY THE PRESIDENT OF WELLMONT HEALTH SYSTEM. BRYAN WATSON'S EMPLOYMENT AGREEMENT ALLOWS FOR A PAYMENT OF 30,000 FOR THE PURPOSE OF REPAYING LOANS INCURRED BY HIM WHILE IN MEDICAL SCHOOL. THE PROMISSORY NOTE WAS APPROVED BY THE PRESIDENT OF WELLMONT MEDICAL ASSOCIATES, INC. FORM 990, PAGE 2, PART III, LINE 4A MEDICAL SERVICES PROVIDED BY WELLMONT MEDICAL ASSOCIATES INCLUDE: -PRIMARY CARE -OB/GYN -SURGERY -ONCOLOGY -OUTPATIENT AND URGENT CARE CENTERS -NEUROLOGY -PULMONOLOGY -SPINE AND REHABILITATION -BEHAVORIAL HEALTH -SLEEP CENTER -OCCUPATIONAL MEDICINE -PHYSICAL THERAPY -PAIN MANAGEMENT -PALLIATIVE MEDICINE -HOSPITALISTS WE ARE DEDICATED TO IMPROVING OUR COMMUNITY'S ACCESS TO QUALITY, AFFORDABLE HEALTHCARE, 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. IN FISCAL YEAR 2018, WE HAD 532,608 OFFICE VISITS AND 168,505 HOSPITAL/NURSING HOME VISITS FOR A TOTAL OF 701,113 PATIENT ENCOUNTERS. RECOGNIZING SOME PATIENTS CANNOT AFFORD ESSENTIAL MEDICAL SERVICES, WE PROVIDED CARE FOR INDIGENT PATIENTS INCURRING UNREIMBURSED COSTS OF 2,773,193. ADDITIONALLY, WE PROVIDED CARE TO PEOPLE COVERED BY MEDICARE, MEDICAID, TENNCARE AND CHAMPUS AT A LOSS. DUE TO MANDATED REDUCTIONS IN MEDICARE FUNDING AND DECLINING REIMBURSEMENT FROM TENNCARE, THE SHORTFALL BETWEEN REIMBURSEMENT AND THE COST OF PROVIDING CARE TO THESE PATIENTS TOTALED 63,730,721. IT IS OUR OBLIGATION TO SUPPORT THE CAUSES THAT IMPROVE THE QUALITY OF LIFE IN OUR REGION. WE SPONSORED EDUCATIONAL, COMMUNITY-BASED PROGRAMS ON HEALTHY LIFESTYLES, RISK FACTOR IDENTIFICATION AND OPTIONS FOR DIAGNOSIS AND TREATMENT. PROGRAMS INCLUDED: -LECTURES ABOUT ASTHMA TO AREA ELEMENTARY SCHOOLS -PROVIDING A FREE CLINIC IN CHURCH HILL, TENNESSEE -PROVIDING FREE MEDICAL CARE THROUGH THE REMOTE AREA MEDICAL CLINIC -SUPPORTING THE HEALTH WAGON IN WISE, VIRGINIA -TEACHING AT LINCOLN MEMORIAL UNIVERSITY-DEBUSK COLLEGE OF OSTEOPATHIC MEDICINE -TEACHING AT THE UNIVERSITY OF VIRGINIA'S COLLEGE AT WISE -WORKING WITH APPALACHIAN MOUNTAIN PROJECT ACCESS -WORKING WITH FRIENDS IN NEED, A LOCAL NONPROFIT THAT PROVIDES PRIMARY CARE AND DENTAL CARE TO THE WORKING UNINSURED AND UNDERINSURED AS WELL AS FULL TIME COLLEGE STUDENTS WE ALSO PARTICIPATED IN A NUMBER OF HEALTH FAIRS AND COMMUNITY SCREENINGS. EMPLOYEES GAVE THEIR TIME TO AREA NONPROFIT ORGANIZATIONS, WHICH INCLUDED THE UNITED WAY AND THE EAST TENNESSEE AFFILIATE OF SUSAN G. KOMEN FOR THE CURE. FORM 990, PAGE 6, PART VI, LINE 2 STEPHEN COMBS, M.D. LANDON COMBS, M.D. DIRECTOR DIR./OFFICER FAMILY RELATIONSHIP FORM 990, PAGE 6, PART VI, LINE 6 THE BUSINESS AND AFFAIRS OF WELLMONT MEDICAL ASSOCIATES, INC. (WMA) ARE GOVERNED BY WELLMONT HEALTH SYSTEM'S BOARD OF DIRECTORS. WMA'S BOARD OF DIRECTORS IS DESIGNATED BY WELLMONT HEALTH SYSTEM, THE SOLE MEMBER OF WMA. IN ADDITION TO SUCH RIGHTS OF APPROVAL AND CONSENT AS MAY BE RESERVED TO THE SOLE MEMBER OF WMA PURSUANT TO APPLICABLE LAW, TRANSACTIONS OF THE FOLLOWING MATTERS BY WMA REQUIRE THE PRIOR APPROVAL OF WELLMONT HEALTH SYSTEM: (A) IMPLEMENTATION OF WMA'S ANNUAL BUDGET, (B) INCURRING ANY LOAN OR OTHER INDEBTEDNESS FOR BORROWED MONEY, (C) ACQUISITION OF ANY EQUIPMENT OR PERSONAL PROPERTY FOR A PURCHASE PRICE IN EXCESS OF 50,000 OR THE ACQUISITION OF ANY REAL ESTATE, REGARDLESS OF PURCHASE PRICE, (D) THE UNDERTAKING OF CERTAIN CONTRACTUAL COMMITMENTS, (E) ENTERING INTO ANY PLAN OF MERGER OR CONSOLIDATION, (F) ACQUISITION OF SUBSTANTIALLY ALL OF THE ASSETS OF ANY OTHER LEGAL ENTITY, AND (G) INSTITUTION OF ANY LITIGATION BY OR ON BEHALF OF WMA. FORM 990, PAGE 6, PART VI, LINE 7A WELLMONT HEALTH SYSTEM (WHS) IS WMA'S SOLE MEMBER. THE BOARD OF DIRECTORS OF BALLAD HEALTH, WHS'S PARENT ORGANIZATION, SERVES AS WHS'S BOARD OF DIRECTORS AND IS RESPONSIBLE FOR APPOINTING THE DIRECTORS OF WMA'S BOARD. FORM 990, PAGE 6, PART VI, LINE 7B SEE FORM 990, PART VI, SECTION A, LINE 6 EXPLANATION. FORM 990, PAGE 6, PART VI, LINE 9 BARTON HOVE (RETIRED 1/31/2018) FORM 990, PAGE 6, PART VI, LINE 11B THE VP/CFO OF WMA REVIEWED THE FORM 990 WITH WMA'S BOARD OF DIRECTORS PRIOR TO FILING THE RETURN. BOARD MEMBERS WERE PROVIDED THE RETURN IN AN ELECTRONIC FORMAT PRIOR TO THE REVIEW. FORM 990, PAGE 6, PART VI, LINE 12C WMA IS PART OF THE NEWLY FORMED BALLAD HEALTH HEALTHCARE SYSTEM FORMED WHEN WELLMONT HEALTH SYSTEM AND MOUNTAIN STATES HEALTH ALLIANCE MERGED IN FEBRUARY 2018. 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. 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 COMMITTEES ARE 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, PAGE 6, PART VI, LINE 15A WMA'S BOARD CHAIR, DR. NIDA, RECEIVES NO COMPENSATION FOR HIS BOARD SERVICE TO WMA. HIS COMPENSATION IS DERIVED FROM MEDICAL SERVICES PROVIDED TO WMA. HIS COMPENSATION, CONSISTENT WITH ALL WMA PHYSICIANS, IS EVALUATED PERIODICALLY BY WELLMONT HEALTH SYSTEM'S HUMAN RESOURCES DEPARTMENT UTILIZING MGMA DATA. COMPENSATION FOR DAVID BRASH, WMA'S PRESIDENT, WAS REVIEWED AND APPROVED DURING THE TAX YEAR BY THE HUMAN RESOURCES COMMITTEE OF WMA'S SOLE MEMBER, WELLMONT HEALTH SYSTEM, AND SUBSEQUENTLY APPROVED BY THE BOARD OF WELLMONT'S PARENT ORGANIZATION, BALLAD HEALTH. WELLMONT MERGED WITH MOUNTAIN STATES HEALTH ALLIANCE DURING FY18 TO FORM BALLAD HEALTH. AT MERGER, BALLAD'S BOARD OF DIRECTORS ASSUMED BOARD RESPONSIBILITIES FOR BOTH WELLMONT AND MOUNTAIN STATES. DATA OF COMPARABLE POSITIONS IN SIMILARLY SITUATED ORGANIZATIONS FROM AN INDEPENDENT COMPENSATION CONSULTANT WAS USED WHEN DETERMINING COMPENSATION. FORM 990, PAGE 6, PART VI, LINE 15B PHYSICIAN DIRECTORS/OFFICERS DO NOT RECEIVE COMPENSATION FOR SERVICES PROVIDED TO WMA AS A BOARD MEMBER. PHYSICIAN SALARIES ARE EVALUATED BY WELLMONT HEALTH SYSTEM'S CORPORATE HUMAN RESOURCES (HR) DEPARTMENT UTILIZING MGMA DATA. NON-PHYSICIAN OFFICER AND KEY EMPLOYEE COMPENSATION IS DETERMINED ACCORDING TO BALLAD HEALTH'S SALARY POLICY: POSITIONS AT THE ASSISTANT VICE PRESIDENT LEVEL AND ABOVE ARE REVIEWED AND APPROVED ON AN ANNUAL BASIS BY BALLAD HEALTH'S BOARD OF DIRECTORS. POSITIONS BELOW ASSISTANT VICE PRESIDENT ARE EVALUATED PERIODICALLY BY HR USING DATA FROM VARIOUS EXTERNAL SOURCES FOR SIMILAR POSITIONS IN SIMILARLY SITUATED ORGANIZATIONS. FORM 990, PAGE 6, PART VI, 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 APPROPRIATE PARTIES REQUESTING THEM. FORM 990, PART XI, LINE 9 INTERCOMPANY SETTLEMENTS -14,592,436 EMPLOYER PROVIDED PARKING - NOT ON BOOKS -22,420 TOTAL -14,614,856 FORM 990, PAGE 12, PART XII, LINE 2C BALLAD HEALTH (BALLAD) IS A TAX-EXEMPT ENTITY AND THE PARENT CORPORATION OF BOTH WELLMONT HEALTH SYSTEM (WHS), WELLMONT MEDICAL ASSOCIATES' SOLE MEMBER, AND MOUNTAIN STATES HEALTH ALLIANCE (MSHA). THE TWO HEALTHCARE SYSTEMS CAME TOGETHER ON FEBRUARY 1, 2018 AS A RESULT OF A MERGER APPROVED BY BOTH TENNESSEE AND VIRGINIA DEPARTMENTS OF HEALTH. THE INDIVIDUALS SERVING AS THE BOARD OF DIRECTORS OF BALLAD ALSO SERVE AS THE BOARD OF DIRECTORS OF WHS AND MSHA. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS OF BALLAD INCLUDE WHS, MSHA AND THEIR SUBSIDIARIES AND AFFILIATES WHICH WERE PREVIOUSLY INCLUDED IN EITHER WHS OR MSHA AUDITED CONSOLIDATED FINANCIAL STATEMENTS. BALLAD HAS AN AUDIT COMMITTEE WHICH ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR. FORM 990 - ADDITIONAL INFORMATION FY18 FORM 990 HAS NUMEROUS CHANGES FROM PRIOR YEAR RETURNS. WE BELIEVE THESE CHANGES ARE NECESSARY TO BETTER REFLECT THE ORGANIZATION'S ACTIVITY. WELLMONT HEALTH SYSTEM 1905 AMERICAN WAY KINGSPORT TN 37660 621636465 HOSP. SYS. TN 501C3 3 BALLAD false WELLMONT HAWKINS CO MEMORIAL HOSP 851 LOCUST STREET ROGERSVILLE TN 37857 621816368 HOSPITAL TN 501C3 3 WHS false TAKOMA REGIONAL HOSPITAL INC 401 TAKOMA AVENUE GREENEVILLE TN 37743 510603966 HOSPITAL TN 501C3 3 WHS false TAKOMA REGIONAL HOSPITAL FDN INC 1905 AMERICAN WAY KINGSPORT TN 37660 471334302 FUNDRAISER TN 501C3 7 WHS false WELLMONT CARDIOLOGY SERVICES 1905 AMERICAN WAY KINGSPORT TN 37660 263557623 MED. SERV. TN 501C3 10 WHS false WELLMONT FOUNDATION INC 1905 AMERICAN WAY KINGSPORT TN 37660 581594191 FUNDRAISER TN 501C3 7 WHS false WELLMONT MADISON HOUSE 1905 AMERICAN WAY KINGSPORT TN 37660 621308216 ASST. LIV. TN 501C3 10 WHS false WELLMONT WEXFORD HOUSE 1905 AMERICAN WAY KINGSPORT TN 37660 581859039 NSG. HOME TN 501C3 10 WHS false WELLMONT SLEEP SERVICES 1905 AMERICAN WAY KINGSPORT TN 37660 273777167 MED. SERV. TN 501C3 3 WHS false WELLMONT IMAGING SERVICES INC 1905 AMERICAN WAY KINGSPORT TN 37660 861103148 HEALTHCARE TN 501C3 12A WHS false MOUNTAIN STATES HEALTH ALLIANCE 303 MED TECH PARKWAY SUITE 220 JOHNSON CITY TN 37604 620476282 HOSP. SYS. TN 501C3 3 BALLAD false MOUNTAIN STATES FOUNDATION 2335 KNOB CREEK ROAD SUITE 101 JOHNSON CITY TN 37604 581418862 FUNDRAISER TN 501C3 12A MSHA false MSHA AUXILIARY 400 N STATE OF FRANKLIN ROAD JOHNSON CITY TN 37604 581418345 SUPP. ORG. TN 501C3 12A MSHA false SMYTH COUNTY COMMUNITY HOSPITAL 245 MEDICAL PARK DRIVE MARION VA 24354 540794913 HOSPITAL VA 501C3 3 MSHA false NORTON COMMUNITY HOSPITAL 100 15TH STREET NW NORTON VA 24273 540566029 HOSPITAL VA 501C3 3 NA false DICKENSON COMMUNITY HOSPITAL 312 HOSPITAL DRIVE CLINTWOOD VA 24228 770599553 HOSPITAL VA 501C3 3 NCH false JOHNSTON MEMORIAL HOSPITAL 16000 JOHNSTON MEMORIAL DRIVE ABINGDON VA 24211 540544705 HOSPITAL VA 501C3 3 NA false ABINGDON PHYSICIAN PARTNERS 16000 JOHNSTON MEMORIAL DRIVE ABINGDON VA 24211 205485346 MED. SERV. VA 501C3 12A JMH false BALLAD HEALTH 303 MED TECH PARKWAY SUITE 220 JOHNSON CITY TN 37604 611771290 SUPP. ORG. TN 501C3 12B NA false EAST TN HEALTHCARE HOLDINGS INC 203 GRAY COMMONS CIRCLE GRAY TN 37615 815475903 OPIOID TRT TN 501C3 3 MSHA false LAUGHLIN MEMORIAL HOSPITAL INC 1420 TUSCULUM BOULEVARD GREENEVILLE TN 37745 620701119 HOSPITAL TN 501C3 3 MSHA false LAUGHLIN HEALTHCARE FOUNDATION 1420 TUSCULUM BOULEVARD GREENEVILLE TN 37745 582105493 FUNDRAISER TN 501C3 12A MSHA false SAPLING GROVE AMB SURGERY CENTER 220 MEDICAL PARK BOULEVARD BRISTOL TN 37620 204450153 MED. SERV. TN N/A false false HOLSTON VALLEY AMB SURGERY CENTER 103 WEST STONE DRIVE KINGSPORT TN 37660 621816864 MED. SERV. TN N/A false false WELLMONT INC 1905 AMERICAN WAY KINGSPORT TN 37660 621320035 MED. SERV. TN N/A false MCOT INC 1905 AMERICAN WAY KINGSPORT TN 37660 621325938 BUS. SERV. TN N/A false WELLMONT MALL PHARMACY INC 1905 AMERICAN WAY KINGSPORT TN 37660 621565006 MED. SERV. TN N/A false WELLMONT PHYSICIANS SERVICES INC 1905 AMERICAN WAY KINGSPORT TN 37660 621567353 MED. SERV. 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