2016-05-11T07:17:09-05:00 2015-06-30 990 2014-07-01 270898372 WELLMONT MEDICAL ASSOCIATES INC WELL 4232308200 1905 AMERICAN WAY KINGSPORT TN 37660 TODD J DOUGAN SR. VP OF FINANCE 4232308200 2016-05-11 2014 2016-08-17 19:52:53Z TODD J DOUGAN 1905 AMERICAN WAY KINGSPORT TN 37660 74105569 false X WWW.WELLMONT.ORG X 2008 TN WE DELIVER SUPERIOR HEALTH CARE WITH COMPASSION. 19 0 880 80143 38508 7086 65388372 72229456 -23057 1176302 1691695 66603182 73905180 0 0 65572700 74914469 0 0 27973727 27656826 93546427 102571295 -26943245 -28666115 -20436727 7358030 6506517 7678595 -26943244 -320565 X WE DELIVER SUPERIOR HEALTH CARE WITH COMPASSION. false false 97913725 73817951 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, INC.'S COMMITMENT TO PHYSICIAN LEADERSHIP IS CLEAR. WELLMONT MEDICAL ASSOCIATES, INC., 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, INC. OFFERS THE LATEST IN TECHNOLOGICAL ADVANCES TO ENSURE PATIENTS RECEIVE SUPERIOR CARE. (CON'T ON SCHEDULE O) WE ARE DEDICATED TO IMPROVING OUR COMMUNITY'S ACCESS TO QUALITY, AFFORDABLE HEALTH CARE, EDUCATING OUR REGION'S CAREGIVERS, IMPROVING THE HEALTH STATUS OF OUR COMMUNITIES AND CONTRIBUTING TO THE OVERALL QUALITY OF LIFE IN THE AREAS WE SERVE. IN FISCAL YEAR 2015, WE HAD 399,465 OFFICE VISITS AND 138,570 HOSPITAL/NURSING HOME VISITS AND PATIENT ENCOUNTERS OF 538,035. REGARDLESS OF RACE, RELIGION, ETHNICITY OR ABILITY TO PAY, WELLMONT MEDICAL ASSOCIATES, INC. TREATS ALL PATIENTS FOR MEDICALLY NECESSARY CONDITIONS. RECOGNIZING THAT SOME PATIENTS CANNOT AFFORD ESSENTIAL MEDICAL SERVICES, WE PROVIDED CARE FOR INDIGENT PATIENTS INCURRING COSTS OF 1,227,430. ADDITIONALLY, WE PROVIDED CARE TO PERSONS COVERED BY MEDICARE, MEDICAID, TENNCARE AND CHAMPUS AT LESS THAN COST. DUE TO MANDATED REDUCTIONS IN MEDICARE FUNDING FROM THE BALANCED BUDGET ACT AND DECLINING REIMBURSEMENT FROM TENNCARE, THE SHORTFALL BETWEEN RECEIPTS AND THE COST OF PROVIDING CARE TO THESE PATIENTS TOTALED 35,089,640. OVERALL, WE RETURNED MORE THAN 33,862,210 IN BENEFITS TO OUR REGION. 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 - WORKING WITH FRIENDS IN NEED, WHICH PROVIDES ON-SITE PRIMARY CARE - PROVIDING FREE MEDICAL CARE THROUGH REMOTE AREA MEDICAL CLINIC - WORKING WITH APPALACHIAN MOUNTAIN PROJECT ACCESS - TEACHING AT LINCOLN MEMORIAL UNIVERSITY-DEBUSK COLLEGE OF OSTEOPATHIC MEDICINE - TEACHING AT UNIVERSITY OF VIRGINIA'S COLLEGE AT WISE - PROVIDING A FREE CLINIC IN CHURCH HILL, TENNESSEE - THE HEALTH WAGON IN WISE, VIRGINIA 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 TRI-CITIES AFFILIATE OF SUSAN G. KOMEN FOR THE CURE. THEY ALSO DONATED AS PART OF WELLMONT'S EMPLOYEE GIVING CAMPAIGN TO FUNDS SUCH AS THE WELLMONT CANCER INSTITUTE PATIENT ASSISTANCE FUND, EMPLOYEE EMERGENCY FUND AND MANY OTHERS. 97913725 true true false false false false false false false false true false false false false false false true false false false false false false false false false false false true false false false false false false false true false false false false false true false false false true 74 0 true 880 true true true false false false false false false false false false false false X 19 0 false false false false true true true true true true false true true true true true true true true false TN X TODD J DOUGAN 4232308200 1905 AMERICAN WAY KINGSPORT TN 37660 X MARGARET DENARVAEZ TERMED 91614 WHS PRESIDEN 1.00 40.00 X X 0 2554461 65341 PAUL JETT MD PHYSICIAN/DI 40.00 X 645410 0 9142 IBRAHIM NAKHOUL MD PHYSICIAN/DI 40.00 X 576863 0 27302 ANILKUMAR TUMKUR MD TRM 121814 DIRECTOR 40.00 X 563797 0 26855 JAMES BECKNER MD DIRECTOR 40.00 X 548836 0 29084 JASON BRAZEE MD TERMED 2715 CHIEF ADM ME 40.00 X X 454688 0 26317 MAURICE NIDA DO DIRECTOR 40.00 X 439765 0 25570 KELLY OGGERO MD PHYSICIAN/DI 40.00 X 435704 0 12150 DAVID THOMPSON MD EX-OFFICIO B 40.00 X X 433561 0 8407 SUE PRILL MD DIRECTOR 40.00 X 429608 0 25492 STEPHEN COMBS MD EX-OFFICIO B 40.00 X X 423602 0 26658 BARTON A HOVE EX-OFFICIO B 1.00 39.00 X 0 394913 16374 MIHIR PATEL MD DIRECTOR 40.00 X 382627 0 22252 LENITA THIBAULT MD DIRECTOR 40.00 X 373622 0 18208 MARTA WAYT MD DIRECTOR 40.00 X 371129 0 16518 MARK KADOWAKI MD TRM 41315 DIRECTOR 40.00 X 369621 0 16615 DAVID L BRASH EX-OFFICIO B 1.00 39.00 X X 0 319658 21654 KIM ONESKO EX-OFFICIO B 40.00 X X 310043 0 14492 LANDON COMBS MD SECRETARY\TR 40.00 X X 284379 0 20919 AMANDA DOVE MD DIRECTOR,WES 40.00 0.00 X 238318 0 4107 DAVID ASTIN MD DIRECTOR 40.00 X 232283 0 17116 JOSEPH SMIDDY MD RES 91814 VICE CHAIR 40.00 X X 227593 0 12427 MONIKA KARAKATTU MD PHYSICIAN/DI 40.00 X 217952 0 18213 PARMINDERJIT SINGH MD PHYSICIAN/DI 40.00 X 215635 0 4965 KIMBERLY ROLLER MD DIRECTOR 40.00 X 5504 0 722 MARISSA VITO CRUZ MD DIRECTOR X 0 0 0 ROGER MOWEN EX-OFFICIO B 1.00 X 0 0 0 KAREN J WILLIAMS EXEC DIRECTO 40.00 X 173325 0 10266 WILLIAM C WILSON TERMED 6515 VP FINANCE A 40.00 X 137150 0 14980 DANIEL KRENK MD PHYSICIAN 40.00 X 812366 0 32845 PAUL KRAMER MD PHYSICIAN 40.00 X 731383 0 30630 GIRENDRA HOSKERE MD PHYSICIAN 40.00 X 721186 0 27734 HARSHA VARDHANA MD PHYSICIAN 40.00 X 606949 0 27491 PERRIE RYAN MD PHYSICIAN 40.00 X 568932 0 26358 11931831 3269032 657204 167 false true false EMERGENCY CARE PHYSICIANS INC 3633 HONEYWOOD DRIVE JOHNSON CITY TN 37604 MEDICAL CARE 1021766 BARTON ASSOCIATES INC PO BOX 417844 BOSTON MA 02241 MEDICAL SVS 651945 COMPHEALTH INC PO BOX 972651 DALLAS TX 75397 PHSICIAN SVS 418388 BLUE RIDGE RADIOLOGY PC 3053 WEST STATE STREET BRISTOL TN 37620 PROFESSIONAL SV 324779 WATAUGA ORTHOPAEDICS PLC 2410 SUSANNAH STREET JOHNSON CITY TN 376011748 MEDICAL CARE 313387 10 7086 7086 PATIENT SERVICE REVENUE-NET 621990 70785314 70785314 CAPITATION & HUMANA REVENUE 621990 835844 835844 BILLING REVENUE 621990 499155 499155 UNRELATED BUSINESS TAX INCOME 541700 80143 80143 DIAGNOSTIC INTERPRETATIONS 621990 29000 29000 72229456 156801 156801 20531 43588 -23057 -23057 -23057 MEANINGFUL USE REVENUE 621990 707333 707333 MEDICAL DIRECTORSHIP 621990 542000 542000 MISCELLANEOUS REVENUE 611710 442362 442362 1691695 73905180 73817951 80143 7428350 6757492 670858 59009051 57300539 1708512 1236042 1188322 47720 3964349 3688350 275999 3276677 3156031 120646 1562048 1421678 140370 2935106 2861959 73147 30438 3884 26554 928939 869189 59750 6569801 6211556 358245 179517 144981 34536 166709 165400 1309 1930846 1809006 121840 733501 590760 142741 MSO ALLOCATIONS 7045877 7045877 DRUGS & MEDICAL SUPPLIES 2589894 2589894 PHYSICIAN GUARANTEE & INT 1285141 1275141 10000 DUES AND MEMBERSHIPS 708937 220554 488383 990072 613112 376960 102571295 97913725 4657570 0 1242 204511 -35211956 -8160283 1342086 966321 382224 131521 25636555 12710795 11746210 12925760 1303467 1290200 -20436727 7358030 6446986 7678595 59531 6506517 7678595 X -26943244 -320565 -26943244 -320565 -20436727 7358030 -28666115 55288794 X false true X true false X 55725 38508 7086 101319 2657332 13594208 667540667 66564675 73921151 824278033 2657332 13594208 667596392 66603183 73928237 824379352 824379352 3759 45201 153831 156801 359592 3759 45201 153831 156801 359592 2661091 13639409 667596392 66757014 74085038 824738944 0.99960 0.00000 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 28688 28688 6425548 2288281 4137267 7701080 1901191 5799889 9489709 6591945 2897764 1991530 1929378 62152 12925760 X X X true true true true false false false false true false false MARGARET DENARVAEZ TERMED 91614 WHS PRESIDENT & CEO 544420 265980 1744061 58432 6909 2619802 PAUL JETT MD PHYSICIAN/DIRECTOR 529571 25000 90839 9142 654552 IBRAHIM NAKHOUL MD PHYSICIAN/DIRECTOR 515246 60437 1180 18440 8862 604165 ANILKUMAR TUMKUR MD TRM 121814 DIRECTOR 517139 46658 17993 8862 590652 JAMES BECKNER MD DIRECTOR 487040 61796 19464 9620 577920 JASON BRAZEE MD TERMED 2715 CHIEF ADM MED OFFICR 423500 2400 28788 17910 8407 481005 MAURICE NIDA DO DIRECTOR 253076 29279 157410 14000 11570 465335 KELLY OGGERO MD PHYSICIAN/DIRECTOR 400498 35206 3743 8407 447854 DAVID THOMPSON MD EX-OFFICIO BRD MBR 288751 66310 78500 8407 441968 SUE PRILL MD DIRECTOR 352487 42835 34286 16795 8697 455100 STEPHEN COMBS MD EX-OFFICIO BRD MBR 329466 38066 56070 15088 11570 450260 BARTON A HOVE EX-OFFICIO BRD MBR 315138 50000 29775 6754 9620 411287 MIHIR PATEL MD DIRECTOR 224889 55600 102138 10970 11282 404879 LENITA THIBAULT MD DIRECTOR 347483 24951 1188 15082 3126 391830 MARTA WAYT MD DIRECTOR 233279 33428 104422 13334 3184 387647 MARK KADOWAKI MD TRM 41315 DIRECTOR 359999 9622 7558 9057 386236 DAVID L BRASH EX-OFFICIO BRD MEMBR 277473 41832 353 12034 9620 341312 KIM ONESKO EX-OFFICIO BRD MBR 260866 40003 9174 10385 4107 324535 LANDON COMBS MD SECRETARY\TREASURER 206325 78054 11299 9620 305298 AMANDA DOVE MD DIRECTOR,WEST REGION 183997 15276 39045 4107 242425 DAVID ASTIN MD DIRECTOR 182708 27520 22055 8133 8983 249399 JOSEPH SMIDDY MD RES 91814 VICE CHAIR 227593 6155 6272 240020 MONIKA KARAKATTU MD PHYSICIAN/DIRECTOR 195504 12069 10379 8593 9620 236165 PARMINDERJIT SINGH MD PHYSICIAN/DIRECTOR 154749 6250 54636 4965 220600 KAREN J WILLIAMS EXEC DIRECTOR WMA OP 155946 17128 251 6722 3544 183591 WILLIAM C WILSON TERMED 6515 VP FINANCE AND OPERA 118521 18565 64 5360 9620 152130 DANIEL KRENK MD PHYSICIAN 812186 180 22885 9960 845211 PAUL KRAMER MD PHYSICIAN 520180 160846 50357 22223 8407 762013 GIRENDRA HOSKERE MD PHYSICIAN 455243 219898 46045 20702 7032 748920 HARSHA VARDHANA MD PHYSICIAN 425000 181777 172 18326 9165 634440 PERRIE RYAN MD PHYSICIAN 407500 161162 270 17951 8407 595290 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 AND MARGARET D. DENARVAEZ. 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 SCHEDULE J, PAGE 1, PART I, LINE 6B INCENTIVE COMPENSATION IS BASED ON MEETING BUDGETED OPERATING MARGIN GOALS. SCHEDULE J, PART III PART I, LINE 4A - SEVERANCE PAYMENT MARGARET DENARVAEZ, FORMER CEO OF WELLMONT HEALTH SYSTEM, ENTERED INTO A CONFIDENTIAL SEPARATION AGREEMENT AND GENERAL RELEASE (THE "AGREEMENT") AS OF SEPTEMBER 16, 2014. 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". PART 1, LINE 4B - NONQUALIFIED RETIREMENT PLAN WELLMONT HEALTH SYSTEM HAS AN EXECUTIVE RETIREMENT PROGRAM THAT INCLUDED MARGARET DENARVAEZ 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. THE HEART CENTER PARTNERSHIP BOARD OVERLAP 163233 LEASE AGREEMENT false TRI-STATE PROFESSIONAL SUITES OWNER BOARD OVERLAP 72297 LEASE AGREEMENT false SCHEDULE L, PART V SCHEDULE L, PART IV, LINE 1, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: WELLMONT HEALTH SYSTEM (LESSEE), WHICH IS THE SOLE MEMBER OF THE CORPORATION, WELLMONT MEDICAL ASSOCIATES, ENTERED INTO A LEASE AGREEMENT WITH THE HEART CENTER PARTNERSHIP (LESSOR) ON APRIL 30, 2010 TO LEASE 49,481 RENTABLE SQUARE FEET IN THE BUILDING KNOWN AS THE HEART CENTER,LOCATED AT 2050 MEADOWVIEW PARKWAY, KINGSPORT, TENNESSEE 37660 FOR A TEN YEAR TERM WITH RENEWABLE TERMS IN SIX MONTH INCREMENTS, OF WHICH, WELLMONT MEDICAL ASSOCIATES LEASES 4,205 RENTABLE SQUARE FEET ON THE SECOND FLOOR. THE AGREEMENT PROVIDES FOR THE LESSEE'S PURCHASE RIGHT OF FIRST REFUSAL AND A MULTI-LESSEE RIGHT OF FIRST OFFER. THERE ARE CURRENTLY 37 PHYSICIANS EMPLOYED BY WELLMONT CARDIOLOGY SERVICES OF WHICH, 25 ARE SENIOR PHYSICIANS THAT ARE THE CURRENT PARTNERS OF THE HEART CENTER PARTNERSHIP,AS IS TIM ATTEBERY, PRESIDENT OF HOLSTON VALLEY MEDICAL CENTER, WHICH IS WELLMONT HEALTH SYSTEM'S LARGEST HOSPITAL. THE HEART CENTER PARTNERSHIP IS NOT OWNED BY WELLMONT HEALTH SYSTEM, WELLMONT CARDIOLOGY SERVICES, OR ANY AFFILIATED ENTITIES. THE 25 PHYSICIAN PARTNERS MENTIONED IN THE LEASE AGREEMENT ARE AS FOLLOWS: DAVID C. BECKNER, M.D. JOHN F. BERRY, M.D. JOHN R. BERTUSO, M.D. GERALD G. BLACKWELL, M.D. MARK A. BORSCH, M.D. THOMAS M. BULLE, M.D. JONATHAN W. BURRESS, M.D. LARRY H. COX, M.D. STANLEY A. GALL, JR., M.D. DAVID TYLER GREENFIELD, M.D. PIERRE ISTFAN, M.D. GREGORY K. JONES, M.D. CHRISTOPHER J. KENNEDY, M.D. ROBERT KEITH KRAMER, M.D. HERBERT D. LADLEY, M.D. MARC W. MAYHEW, M.D. JAMES J. MERRILL, M.D. WILLIAM M. MESSERSCHMIDT, M.D. DAVID CHRISTOPHER METZGER, M.D. ARUN RAO, M.D. PABITRA K. SAHA, M.D. DANIEL E. SIMPSON, M.D. HARRISON D. TURNER, M.D. FREDDIE M. WILLIAMS, M.D. MARCUS WILLIAMS, M.D. SCHEDULE L, PART IV, LINE 2, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: WELLMONT HEALTH SYSTEM (LESSEE), WHICH IS THE SOLE MEMBER OF THE CORPORATION, WELLMONT MEDICAL ASSOCIATES, ENTERED INTO A LEASE AGREEMENT WITH TRI-STATE PROFESSIONAL SUITES OWNERS ASSOCIATION, INC. (LESSOR), ON OCTOBER 11, 2011 TO LEASE 23,503 RENTABLE SQUARE FEET IN THE BUILDING KNOWN AS TRI-STATE PROFESSIONAL SUITES, LOCATED AT 2428 KNOB CREEK ROAD, UNIT 1, JOHNSON CITY, TN, 37601 FOR A TWELVE YEAR TERM WITH RENEWABLE TERMS IN SIX MONTH INCREMENTS, OF WHICH, WELLMONT MEDICAL ASSOCIATES SUBLEASES FROM WELLMONT CARDIOLOGY SERVICES 2,633 SQUARE FEET OF RENTABLE SPACE. THE AGREEMENT PROVIDES FOR THE LESSEE'S PURCHASE RIGHT OF FIRST REFUSAL. TRI- STATE PROFESSIONAL SUITES OWNERS ASSOCIATION, INC. SOLD THE BUILDING ON JANUARY 23, 2015. THE 4 PARTNERS ARE AS FOLLOWS: HAROLD ALISON, M.D. JOSEPH BAILEY, M.D. MARK CHANG, M.D. COLLIER JORDAN, M.D. FORM 990, PAGE 2, PART III, LINE 4A WE ARE DEDICATED TO IMPROVING OUR COMMUNITY'S ACCESS TO QUALITY, AFFORDABLE HEALTH CARE, EDUCATING OUR REGION'S CAREGIVERS, IMPROVING THE HEALTH STATUS OF OUR COMMUNITIES AND CONTRIBUTING TO THE OVERALL QUALITY OF LIFE IN THE AREAS WE SERVE. IN FISCAL YEAR 2015, WE HAD 399,465 OFFICE VISITS AND 138,570 HOSPITAL/NURSING HOME VISITS AND PATIENT ENCOUNTERS OF 538,035. REGARDLESS OF RACE, RELIGION, ETHNICITY OR ABILITY TO PAY, WELLMONT MEDICAL ASSOCIATES, INC. TREATS ALL PATIENTS FOR MEDICALLY NECESSARY CONDITIONS. RECOGNIZING THAT SOME PATIENTS CANNOT AFFORD ESSENTIAL MEDICAL SERVICES, WE PROVIDED CARE FOR INDIGENT PATIENTS INCURRING COSTS OF 1,227,430. ADDITIONALLY, WE PROVIDED CARE TO PERSONS COVERED BY MEDICARE, MEDICAID, TENNCARE AND CHAMPUS AT LESS THAN COST. DUE TO MANDATED REDUCTIONS IN MEDICARE FUNDING FROM THE BALANCED BUDGET ACT AND DECLINING REIMBURSEMENT FROM TENNCARE, THE SHORTFALL BETWEEN RECEIPTS AND THE COST OF PROVIDING CARE TO THESE PATIENTS TOTALED 35,089,640. OVERALL, WE RETURNED MORE THAN 33,862,210 IN BENEFITS TO OUR REGION. 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 - WORKING WITH FRIENDS IN NEED, WHICH PROVIDES ON-SITE PRIMARY CARE - PROVIDING FREE MEDICAL CARE THROUGH REMOTE AREA MEDICAL CLINIC - WORKING WITH APPALACHIAN MOUNTAIN PROJECT ACCESS - TEACHING AT LINCOLN MEMORIAL UNIVERSITY-DEBUSK COLLEGE OF OSTEOPATHIC MEDICINE - TEACHING AT UNIVERSITY OF VIRGINIA'S COLLEGE AT WISE - PROVIDING A FREE CLINIC IN CHURCH HILL, TENNESSEE - THE HEALTH WAGON IN WISE, VIRGINIA 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 TRI-CITIES AFFILIATE OF SUSAN G. KOMEN FOR THE CURE. THEY ALSO DONATED AS PART OF WELLMONT'S EMPLOYEE GIVING CAMPAIGN TO FUNDS SUCH AS THE WELLMONT CANCER INSTITUTE PATIENT ASSISTANCE FUND, EMPLOYEE EMERGENCY FUND AND MANY OTHERS. FORM 990, PAGE 6, PART VI, LINE 6 THE BUSINESS AND AFFAIRS OF WELLMONT MEDICAL ASSOCIATES, INC. (THE CORPORATION) SHALL BE GOVERNED EXCLUSIVELY BY THE BOARD OF DIRECTORS. THE CORPORATION'S BOARD OF DIRECTORS IS DESIGNATED BY WELLMONT HEALTH SYSTEM, THE SOLE MEMBER OF THE CORPORATION. IN ADDITION TO SUCH RIGHTS OF APPROVAL AND CONSENT AS MAY BE RESERVED TO THE SOLE MEMBER OF THE CORPORATION PURSUANT TO APPLICABLE LAW, TRANSACTIONS OF THE FOLLOWING MATTERS BY THE CORPORATION SHALL REQUIRE THE PRIOR APPROVAL OF WELLMONT HEALTH SYSTEM, THE SOLE MEMBER OF THE CORPORATION: (A) IMPLEMENTATION OF CORPORATION'S ANNUAL BUDGET, (B) INCURRING ANY LOAN OR OTHER INDEBTEDNESS FOR BORROWED MONEY, (C) ACQUISITION OF ANY EQUIPMENT OR PERSONAL PROPERTY FOR A PURCHASE PRICE IN EXCESS OF 50,000 OR THE ACQUISITION OF ANY REAL ESTATE, REGARDLESS OF PURCHASE PRICE, (D) THE UNDERTAKING OF CERTAIN CONTRACTUAL COMMITMENTS, (E) ENTERING INTO ANY PLAN OF MERGER OR CONSOLIDATION, (F) ACQUISITION OF SUBSTANTIALLY ALL OF THE ASSETS OF ANY OTHER LEGAL ENTITY, AND (G) INSTITUTION OF ANY LITIGATION BY OR ON BEHALF OF CORPORATION. FORM 990, PAGE 6, PART VI, LINE 7A SEE FORM 990, PART VI, SECTION A, LINE 6 EXPLANATION. 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 MARGARET DENARVAEZ (TERMED 9/16/14) 1905 AMERICAN WAY KINGSPORT, TN 37660 WILLIAM C. WILSON (TERMED 6/5/15) 1905 AMERICAN WAY KINGSPORT, TN 37660 FORM 990, PAGE 6, PART VI, LINE 11B WELLMONT MEDICAL ASSOCIATES, INC.'S FORM 990 IS REVIEWED BY THE SENIOR VICE PRESIDENT OF FINANCE, THE CORPORATE CONTROLLER, AND THE MANAGER OF ACCOUNTING OF WELLMONT HEALTH SYSTEM, AND THE BOARD OF DIRECTORS OF WELLMONT MEDICAL ASSOCIATES, INC. PRIOR TO FILING. ANY QUESTIONS OR COMMENTS ARISING FROM THE INITIAL REVIEW ARE ADDRESSED TO ENSURE THE RETURN IS COMPLETE AND ACCURATE. ANY CHANGES OR CORRECTIONS ARE IDENTIFIED, REVISED IN THE RETURN, AND REVIEWED BY THE INDIVIDUALS LISTED ABOVE PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PAGE 6, PART VI, LINE 12C OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO SIGN A CONFLICT OF INTEREST POLICY ACKNOWLEDGEMENT. ANY POTENTIAL CONFLICTS ARE DISCUSSED WITH THE COMPLIANCE AND AUDIT SERVICES DEPARTMENT, AS THEY ARISE. WELLMONT MEDICAL ASSOCIATES, INC.'S OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE GOVERNED BY WELLMONT HEALTH SYSTEM'S CONFLICT OF INTEREST POLICY. WELLMONT HEALTH SYSTEM ALSO HAS A POLICY ON BUSINESS PRACTICES THAT DISCUSSES CONFLICT OF INTEREST AND INFORMS THE WORKFORCE TO DISCLOSE ANY ISSUES TO THE COMPLIANCE AND AUDIT SERVICES DEPARTMENT, FOR RESOLUTION. WELLMONT HEALTH SYSTEM ALSO USES A HOTLINE THAT ALLOWS ANONYMOUS REPORTING OF POSSIBLE CONFLICT OF INTEREST SITUATIONS FOR INVESTIGATION BY THE COMPLIANCE AND AUDIT SERVICES DEPARTMENT. FORM 990, PAGE 6, PART VI, LINE 15A DAVID THOMPSON, M.D. RECEIVES NO COMPENSATION FOR SERVING AS CHAIR OF THE BOARD OF DIRECTORS OF WELLMONT MEDICAL ASSOCIATES. THE COMPENSATION THAT DAVID THOMPSON, M.D. RECEIVES AS A PHYSICIAN OF WELLMONT MEDICAL ASSOCIATES IS REVIEWED, APPROVED AND DOCUMENTED BY THE WELLMONT HEALTH SYSTEM BOARD OF DIRECTORS. WELLMONT HEALTH SYSTEM USES ONE OR MORE OF THE METHODS DESCRIBED TO ESTABLISH THE COMPENSATION OF DAVID THOMPSON, M.D. THE COMPENSATION OF BARTON A. HOVE, THE PRESIDENT AND CEO OF WELLMONT HEALTH SYSTEM, IS REVIEWED, APPROVED AND DOCUMENTED BY THE WELLMONT HEALTH SYSTEM HUMAN RESOURCES COMMITTEE AND BOARD OF DIRECTORS. BARTON A. HOVE IS ALSO A BOARD MEMBER OF WELLMONT CARDIOLOGY SERVICES. IN ADDITION, THESE BODIES USE COMPARABILITY DATA TO DETERMINE THE APPROPRIATE COMPENSATION. ALL COMPENSATION DELIBERATIONS AND REVIEWS ARE CONTEMPORANEOUSLY DOCUMENTED. THE LAST COMPENSATION DELIBERATION AND REVIEW PROCESS FOR BARTON A. HOVE WAS COMPLETED AND APPROVED BY THE BOARD OF DIRECTORS OF WELLMONT HEALTH SYSTEM ON MARCH 20, 2015. 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 CARDIOLOGY SERVICES. 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. FORM 990, PAGE 6, PART VI, LINE 15B WELLMONT MEDICAL ASSOCIATES USES ONE OR MORE OF THE METHODS DESCRIBED TO ESTABLISH THE COMPENSATION OF STEPHEN COMBS, M.D., CHIEF EXECUTIVE MEDICAL OFFICER, KIM ONESKO, CHIEF ADMINISTRATIVE OFFICER, JASON BRAZEE, M.D.,CHIEF ADMINISTRATIVE MEDICAL OFFICER, KAREN J. WILLIAMS, EXECUTIVE DIRECTOR WMA OPERATIONS, AND WILLIAM C. WILSON, VICE PRESIDENT OF FINANCE AND OPERATIONS. 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 19 WELLMONT MEDICAL ASSOCIATES, INC.'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC. WELLMONT HEALTH SYSTEM'S AUDITED FINANCIAL STATEMENTS AND QUARTERLY UNAUDITED FINANCIAL STATEMENTS ARE AVAILABLE THROUGH THE ELECTRONIC MUNICIPAL MARKET ACCESS WEBSITE. FORM 990, PAGE 7, PART VII AVERAGE HOURS PER WEEK THE SECRETARY AND VARIOUS BOARD MEMBERS SERVE IN A DIFFERENT CAPACITY FOR SEVERAL RELATED ORGANIZATIONS. THE MAJORITY OF THEIR TIME IS DEVOTED TO A RELATED ORGANIZATION (GREATER THAN 38 HOURS PER WEEK). HOWEVER, BOARD MEMBERS WHO ARE PHYSICIANS HAVE DEDICATED AN AVERAGE OF 40 HOURS PER WEEK TO WELLMONT MEDICAL ASSOCIATES, INC. FORM 990, PART XI, LINE 9 INTERCOMPANY RESOLUTION 26,943,241 INTERCOMPANY-HOSPITAL ALLOCATIONS 28,345,548 ROUNDING 5 WELLMONT HEALTH SYSTEM 1905 AMERICAN WAY KINGSPORT TN 37660 621636465 HEALTHCARE TN 501C3 3 NA false WELLMONT HAWKINS CTY MEM HOSPITAL 1905 AMERICAN WAY KINGSPORT TN 37660 621816368 HEALTHCARE TN 501C3 3 WHS false WELLMONT CARDIOLOGY SERVICES 1905 AMERICAN WAY KINGSPORT TN 37660 263557623 HEALTHCARE TN 501C3 9 WHS false WELLMONT FOUNDATION INC 1905 AMERICAN WAY KINGSPORT TN 37660 581594191 HEALTHCARE TN 501C3 7 WHS false WELLMONT MADISON HOUSE 1905 AMERICAN WAY KINGSPORT TN 37660 621308216 HEALTHCARE TN 501C3 9 WHS false WELLMONT WEXFORD HOUSE 1905 AMERICAN WAY KINGSPORT TN 37660 581859039 HEALTHCARE TN 501C3 9 WHS false WELLMONT SLEEP SERVICES 1905 AMERICAN WAY KINGSPORT TN 37660 273777167 HEALTHCARE TN 501C3 3 WHS false WELLMONT IMAGING SERVICES INC 1905 AMERICAN WAY KINGSPORT TN 37660 861103148 HEALTHCARE TN 501C3 11A WHS false SAPLING GROVE AMBULATORY SURGERY 220 MEDICAL PARK BOULEVARD BRISTOL TN 37620 204450153 HEALTHCARE TN N/A false false HOLSTON VALLEY AMBULATORY SURGERY 103 WEST STONE DRIVE KINGSPORT TN 37660 621816864 HEALTHCARE TN N/A false false HOLSTON VALLEY IMAGING CENTER 103 WEST STONE DRIVE KINGSPORT TN 37660 202043285 HEALTHCARE TN N/A false false WELLMONT INC 1905 AMERICAN WAY KINGSPORT TN 37660 621320035 PHYS SVCS TN N/A false MCOT INC 1905 AMERICAN WAY KINGSPORT TN 37660 621325938 MED SVCS TN N/A false MEDICAL LAUNDRY OF TRI-CITIES INC 1905 AMERICAN WAY KINGSPORT TN 37660 621482226 MED SVCS TN N/A false WELLMONT MALL PHARMACY INC 1905 AMERICAN WAY KINGSPORT TN 37660 621565006 MED SVCS TN N/A false WELLMONT PHYSICIANS SERVICES INC 1905 AMERICAN WAY KINGSPORT TN 37660 621567353 PHYS SVCS TN N/A false WELLMONT HEALTH SERVICES INC 1905 AMERICAN WAY KINGSPORT TN 37660 621254373 HEALTHCARE TN N/A false WPS PROVIDERS INC 1905 AMERICAN WAY KINGSPORT TN 37660 625564642 PHYS SVCS TN N/A false WELLMONT INTEGRATED NETWORK LLC 1905 AMERICAN WAY KINGSPORT TN 37660 455443060 MED SVS TN N/A false false false true false false false false false true true true true true false false false false false false WELLMONT HEALTH SYSTEM C 26943241 CAPITAL CONTRIBUTION WELLMONT HEALTH SYSTEM I 167734 ASSET TRANSFERS WELLMONT HEALTH SYSTEM J 55313 LEASE AGREEMENT WELLMONT HEALTH SYSTEM K 1466772 LEASE AGREEMENT WELLMONT HEALTH SYSTEM L 545532 SERVICE AGREEMENT WELLMONT HEALTH SYSTEM M 111231 SERVICE AGREEMENTS WELLMONT CARDIOLOGY SERVICES K 79864 LEASE AGREEMENT SCHEDULE R PART V, LINE 2 RELATED ORGANIZATION TRANSACTIONS WITH WELLMONT FOUNDATION, WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL, INC. AND WELLMONT WEXFORD HOUSE, TOTALED 45,178 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 FOUNDATION C 28,785 NEED WELLMONT HAWKINS COUNTY M 7,870 SERVICE AGREEMENTS MEMORIAL HOSPITAL, INC. WELLMONT WEXFORD HOUSE L 8,523 INVOICES