2011-05-16T14:13:05-05:00 2010-06-30 KPMG LLP 401 COMMERCE STREET SUITE 1000 NASHVILLE TN 37219 990 2009-07-01 621636465 WELLMONT HEALTH SYSTEM WELL 4232308200 1905 AMERICAN WAY KINGSPORT TN 37660 TODD J DOUGAN 4232308512 2011-05-16 true 6152441602 2009 2016-02-24 21:20:13Z TODD J DOUGAN 1905 AMERICAN WAY KINGSPORT TN 37660 681569486 false X WWW.WELLMONT.ORG X 1996 TN WE DELIVER SUPERIOR HEALTH CARE WITH COMPASSION. 15 12 6590 514 109936 3318056 2385595 610908730 601472119 4870083 7814832 7078908 10322525 626175777 621995071 1553071 1065798 0 0 274246851 249808413 0 0 0 348254463 337180801 624054385 588055012 2121392 33940059 877490702 906473724 626969469 609622506 250521233 296851218 WE DELIVER SUPERIOR HEALTH CARE WITH COMPASSION. false false 571593793 1065798 599173806 WELLMONT HEALTH SYSTEM PREPARES A CONSOLIDATED COMMUNITY BENEFIT REPORT WHICH INCLUDES THE ACTIVITIES OF ALL ITS OPERATIONS AND AFFILIATES. IN CONTRAST, AN IRS FORM 990 IS FILED FOR EACH TAX EXEMPT CORPORATION (6 SEPARATE FORM 990S) AND THERE IS NO SUCH IRS FORM FOR THE TAXABLE CORPORATIONS. IN ADDITION, THE IRS INSTRUCTIONS TO FORM 990 HAVE SPECIFIC DEFINITIONS, METHODS AND WORKSHEETS TO CALCULATE THE COMMUNITY BENEFITS TO BE INCLUDED ON THE FORM 990. AS A RESULT, THERE ARE SIGNIFICANT DIFFERENCES BETWEEN THE COMMUNITY BENEFITS REPORTED IN THE CONSOLIDATED COMMUNITY BENEFIT REPORT AND THE VARIOUS FORM 990S. FOR EXAMPLE, THERE ARE SIGNIFICANT LOSSES INCURRED IN THE TAXABLE CORPORATIONS THAT CANNOT BE REFLECTED IN THE VARIOUS FORM 990S, THE LARGEST OF WHICH ARE THE COSTS AND REVENUES ASSOCIATED WITH THE PHYSICIANS AND OTHER PROVIDERS WITHIN THESE CORPORATIONS WHO PROVIDE INDISPENSABLE SERVICES TO PATIENTS OF WELLMONT HEALTH SYSTEM. THERE ARE ALSO FUNDS AND SERVICES THAT ARE PROVIDED THAT DO NOT MEET THE SPECIFIC DEFINITIONS OF THE IRS INSTRUCTIONS, SUCH AS CONTRIBUTIONS TO COMMUNITY ORGANIZATIONS THAT DO NOT MEET THE DEFINITION OF "RESTRICTED TO ONE OR MORE OF THE ACTIVITIES DESCRIBED IN THE TABLE IN PART I, LINE 7" OF SCHEDULE H. WELLMONT HEALTH SYSTEM IS A PUBLIC TRUST. FROM KINGSPORT TO BRISTOL, FROM SNEEDVILLE TO NORTON, THE MEMBER HOSPITALS OF OUR ORGANIZATION WERE BORN OF THEIR COMMUNITIES' COMMITMENT TO SUPERIOR HEALTH CARE FOR THEIR CITIZENS. WE OFFER A VAST ARRAY OF MEDICAL SERVICES AND RESOURCES FOR THOUSANDS OF PATIENTS IN NORTHEAST TENNESSEE AND SOUTHWEST VIRGINIA. IN 2010, WE PROVIDED SERVICES TO 50,910 PATIENTS IN A BED, 212,383 EMERGENCY ROOM VISITS, 218,400 OUTPATIENT REGISTRATIONS (EXCLUDING ER), 2,238 NEWBORN DELIVERIES, 36,559 SURGERIES, AND 258,263 PHYSICIAN OFFICE VISITS. WELLMONT IS A TENNESSEE NOT-FOR-PROFIT CORPORATION. SIX TAX-EXEMPT COMMUNITY BASED HOSPITALS - BRISTOL REGIONAL MEDICAL CENTER (BRISTOL, TN.), HOLSTON VALLEY MEDICAL CENTER (KINGSPORT, TN.), LONESOME PINE HOSPITAL (BIG STONE GAP, VA.), HANCOCK COUNTY HOSPITAL (SNEEDVILLE, TN.), MOUNTAIN VIEW REGIONAL MEDICAL CENTER (NORTON, VA.) AND LEE REGIONAL MEDICAL CENTER (PENNINGTON GAP, VA.) - ARE INCLUDED IN THIS CORPORATION. BUT EVEN AS OUR SERVICE AREA SPANS MULTIPLE STATES AND OUR REVENUE IS REPORTED IN THE HUNDREDS OF MILLIONS OF DOLLARS, WE REMAIN A COMMUNITY-OWNED HEALTH SYSTEM. IT IS OUR MISSION TO DELIVER SUPERIOR HEALTH CARE WITH COMPASSION TO THE PEOPLE WE SERVE. IT IS OUR VISION TO DELIVER THE BEST HEALTH CARE ANYWHERE. CONSISTENT WITH THIS MISSION, WE HAVE WORKED TOWARD IMPROVING OUR COMMUNITY'S ACCESS TO QUALITY, AFFORDABLE HEALTH CARE, EDUCATING OUR REGION'S CAREGIVERS, IMPROVING THE HEALTH STATUS OF OUR COMMUNITIES AND CONTRIBUTING TO THE OVERALL QUALITY OF LIFE IN THE AREAS WE SERVE. OVERALL, WE RETURNED MORE THAN $31,252,081 IN BENEFITS TO OUR REGION, INCLUDING $18,924,174 OF COSTS FOR INDIGENT PATIENTS AND UNCOMPENSATED CARE FOR OTHER PATIENTS AND $12,327,907 FOR OTHER COMMUNITY ACTIVITIES OUTLINED BELOW. WELLMONT HEALTH SYSTEM IS IN COMPLIANCE WITH IRS GUIDELINES FOR FORM 990 SCHEDULE H REPORTING PURPOSES AND THE AMOUNTS REFLECTED ABOVE ARE NOT INCLUSIVE OF RESOURCES DESCRIBED IN WELLMONT HEALTH SYSTEM'S COMMUNITY BENEFIT REPORT AS THE ABOVE AMOUNTS ARE REPORTED ON SCHEDULE H. WE ARE MINDFUL OF OUR RESPONSIBILITIES AS ONE OF THE REGION'S LARGEST COMPANIES. SIX THOUSAND FIVE HUNDRED NINETY FAMILIES COUNT ON US FOR THEIR LIVELIHOODS. CITIES AND COUNTIES THROUGHOUT OUR SERVICE AREA RELY ON US AS A DRIVER OF ECONOMIC DEVELOPMENT. IT IS OUR DUTY AS A CORPORATE CITIZEN TO SUPPORT THOSE ENDEAVORS AND CAUSES THAT IMPROVE THE QUALITY OF LIFE IN OUR REGION. AND WE ALSO RECOGNIZE IT IS OUR RESPONSIBILITY TO CARE FOR THOSE IN NEED - REGARDLESS OF THEIR ABILITY TO PAY. IT IS OUR COMMITMENT - INDEED, IT IS OUR MISSION - TO SUPPORT THE CAUSES AND DEVELOP THE INITIATIVES THAT WILL PROPEL OUR COMMUNITIES TOWARD A BETTER, BRIGHTER, HEALTHIER AND MORE VIBRANT FUTURE. SERVING THE UNDERSERVED REGARDLESS OF RACE, RELIGION, ETHNICITY OR ABILITY TO PAY, WELLMONT HEALTH SYSTEM'S HOSPITALS TREAT ALL PATIENTS FOR MEDICALLY NECESSARY CONDITIONS. RECOGNIZING THAT SOME PATIENTS CANNOT AFFORD ESSENTIAL MEDICAL SERVICES, WELLMONT PROVIDED CARE FOR INDIGENT PATIENTS, WRITING OFF $ 32,343,421 OF CHARGES AND INCURRING COST OF $13,469,906. WELLMONT HEALTH SYSTEM IS IN COMPLIANCE WITH IRS GUIDELINES FOR FORM 990 SCHEDULE H REPORTING PURPOSES AND THE AMOUNTS REFLECTED ABOVE ARE NOT INCLUSIVE OF RESOURCES DESCRIBED IN WELLMONT HEALTH SYSTEM'S COMMUNITY BENEFIT REPORT AS THE ABOVE AMOUNTS ARE REPORTED ON SCHEDULE H. OTHER RECENT INITIATIVES INCLUDE: - OUR HEALTH SYSTEM, IN CONJUNCTION WITH A GRANT FROM SUSAN G. KOMEN FOR THE CURE TRI-CITIES, WAS ABLE TO FUND THE COST OF MAMMOGRAMS FOR SEVERAL HUNDRED WOMEN WHO WERE UNDERINSURED OR UNINSURED. PROJECT ACCESS TO BREAST CARE IS DESIGNED TO REACH WOMEN WHO LIVE IN HAWKINS, SULLIVAN, WASHINGTON, JOHNSON, UNICOI, HANCOCK, CARTER AND GREENE COUNTIES IN TENNESSEE AND WOMEN IN SCOTT COUNTY, VA. TO QUALIFY, WOMEN MUST BE BETWEEN THE AGES OF 35 AND 49 AND EITHER BE UNINSURED AND FINANCIALLY UNABLE TO PAY FOR A MAMMOGRAM OR INSURED AND HAVE A HIGH DEDUCTIBLE AND/OR CO-PAY THAT MAKES IT FINANCIALLY DIFFICULT TO OBTAIN A MAMMOGRAM. - HOLSTON VALLEY MEDICAL CENTER PROVIDED FINANCIAL SUPPORT OF $382,952 TO FRIENDS IN NEED WHICH INCLUDED CASH CONTRIBUTIONS TOTALING $150,000 AND DRUGS AND SUPPLIES AT A DIRECT COST OF $232,952. THE KINGSPORT-BASED CLINIC PROVIDES PRIMARY HEALTH CARE TO THE WORKING POOR AND THOSE WITHOUT INSURANCE COVERAGE. - BRISTOL REGIONAL MEDICAL CENTER RECRUITED DR. DAVE ARNOLD TO SERVE AS MEDICAL DIRECTOR OF HEALING HANDS HEALTH CENTER IN BRISTOL, TENN. DR. ARNOLD'S SALARY AND BENEFITS ARE PAID BY WELLMONT PHYSICIAN SERVICES, A TAXABLE SUBSIDIARY OF WELLMONT HEALTH SYSTEM. BRISTOL REGIONAL PROVIDES SUPPLIES, EQUIPMENT AND OTHER VARIOUS ITEMS VALUED AT $12,832 FOR THE HEALTH CENTER, WHICH PROVIDES QUALITY HEALTH CARE TO THE WORKING POOR. BRISTOL REGIONAL MEDICAL CENTER PROVIDED CASH DONATIONS TO HEALING HANDS TOTALING $7,500. - THE WELLMONT FOUNDATION FUNDED THE PURCHASE OF SEVERAL HUNDRED INFANT CAR SEATS FOR NEWBORNS WHOSE FAMILIES COULDN'T AFFORD THEM. TRAINING AND EDUCATING OUR HEALTHCARE PROFESSIONALS WELLMONT HEALTH SYSTEM WILL NOT SUCCEED IN OUR MISSION WITHOUT CONTINUALLY REINVESTING IN OUR MOST PRECIOUS RESOURCE - OUR PEOPLE. TO THAT END, WE SUPPORTED THE EDUCATION AND TRAINING OF HEALTH CARE PROFESSIONALS AT A DIRECT COST OF $6,991,127. RECENT INITIATIVES INCLUDE: - WELLMONT HEALTH SYSTEM PROVIDED AND PARTICIPATED IN SEVERAL FORMAL TRAINING PROGRAMS FOR HEALTH PROFESSIONALS, INCLUDING EAST TENNESSEE STATE UNIVERSITY'S INTERNSHIP AND RESIDENCY PROGRAMS. OUR CONTRIBUTIONS TOTALED $3,645,457 IN SUPPORT OF THE SCHOOL'S JAMES H. QUILLEN COLLEGE OF MEDICINE RESIDENCY PROGRAM. ADDITIONALLY, OUR HOSPITALS PROVIDE TRAINING FOR 50 PERCENT OF THE PHYSICIAN RESIDENTS IN THIS PROGRAM. - WELLMONT HEALTH SYSTEM CONTINUES TO WELCOME OSTEOPATHIC MEDICAL STUDENTS FROM LINCOLN MEMORIAL UNIVERSITY'S DEBUSK COLLEGE OF OSTEOPATHIC MEDICINE. THE STUDENTS PERFORM CLINICAL ROTATIONS IN WELLMONT HOSPITALS AS THEY MOVE TOWARD BECOMING THE NEXT GENERATION OF DOCTORS. THE STUDENTS, WHO RECEIVE FREE HOUSING ON THE CAMPUS OF MOUNTAIN VIEW REGIONAL MEDICAL CENTER, COMPLETE THEIR CORE CLINICAL ROTATIONS IN WELLMONT'S MOUNTAIN REGION HOSPITALS - MOUNTAIN VIEW REGIONAL MEDICAL CENTER, LONESOME PINE HOSPITAL AND LEE REGIONAL MEDICAL CENTER. THE STUDENTS PERFORM SUBSPECIALTY ROTATIONS AT HOLSTON VALLEY MEDICAL CENTER AND BRISTOL REGIONAL MEDICAL CENTER AND PRIMARY CORE ROTATIONS AT HAWKINS COUNTY MEMORIAL HOSPITAL. - CLINICIANS AT WELLMONT'S BRISTOL REGIONAL MEDICAL CENTER CAN NOW ENHANCE THEIR SKILLS IN A STATE-OF-THE-ART SIMULATION LABORATORY. ESTABLISHED IN PARTNERSHIP WITH EAST TENNESSEE STATE UNIVERSITY, THE LAB SIMULATES REAL-LIFE PATIENT CARE SITUATIONS USING A SPECIALLY DESIGNED MANNEQUIN THAT FEATURES A LIFELIKE HEARTBEAT, BREATHING SOUNDS AND A PULSE. - WELLMONT HEALTH SYSTEM HAS PUBLICLY SUPPORTED THE IDEA OF A MEDICAL SCHOOL AT KING COLLEGE TO PROVIDE ADDITIONAL PHYSICIANS TO OUR REGION. - THROUGH A PARTNERSHIP WITH KING COLLEGE, WELLMONT PROVIDES EMPLOYEES IN MANAGEMENT ROLES THE OPPORTUNITY TO EARN A MASTER'S DEGREE IN BUSINESS ADMINISTRATION AT NO COST TO THE EMPLOYEE. THIRTY-TWO (32) EMPLOYEES ARE CURRENTLY ENROLLED IN THE PROGRAM. - ALSO IN COLLABORATION WITH KING COLLEGE, THE SYSTEM SUPPORTED THE WELLMONT-KING COLLEGE SCHOOL OF NURSING AT A DIRECT COST OF $79,267. - WELLMONT HEALTH SYSTEM HAS MADE AVAILABLE CONTINUING EDUCATION AND TRAINING TO EMPLOYEES, MEDICAL STAFF, MEMBERS OF AFFILIATED HEALTH CARE ORGANIZATIONS AND SCHOOLS AND INTERESTED MEMBERS OF THE PUBLIC. SOME OF THOSE OPPORTUNITIES INCLUDED: - SOUTHWEST VIRGINIA EMS COUNCIL SYMPOSIUM; PROVIDED FREE OF CHARGE TO EMS PROVIDERS THROUGHOUT THE REGION - ANNUAL STROKE SYMPO 571593793 true true false true false false false false false true false true false false false false false false false false true true false true true false false false false false false false false false true false false false false true true true false false true 358 0 true 6590 true true true false false false false false false false false 15 12 false true false false false false false true true false false true true true true true true true true true false TN X TODD DOUGAN 4232308512 1905 AMERICAN WAY KINGSPORT TN 37660 PETER GALE MD 6.0 X 0 0 0 E WAYNE KIRK 6.0 X 0 0 0 THOMAS F PUGH MD 6.0 X 0 0 0 SPENCER QUESENBERRY 6.0 X 0 0 0 FIELDING ROLSTON 6.0 X 0 0 0 DAVID THOMPSON MD 40.0 X 369456 0 14934 DAVID CROCKETT 6.0 X 0 0 0 ROGER MOWEN 6.0 X 0 0 0 SKIP SKINNER 6.0 X 0 0 0 JOHN WILLIAMS 6.0 X 0 0 0 ROGER LEONARD 6.0 X 0 0 0 RAVAN KRICKBAUM 6.0 X 0 0 0 PIERRE ISTFAN MD 6.0 X 0 0 0 JULIE BENNETT 6.0 X 0 0 0 WAYNE KENNEDY 6.0 X 0 0 0 ROBERT F BURGIN 6.0 X X 0 0 0 HAMLIN WILSON 40.0 X 281491 0 18601 GARY D MILLER 40.0 X 260312 0 25437 PATRICK KANE 40.0 X 249610 0 26223 TODD J DOUGAN 40.0 X 227391 0 26053 MICHAEL SNOW 40.0 X 719633 0 25078 TRUMAN ESMOND 40.0 X 286614 0 0 MICHAEL BUNDY 40.0 X 267286 0 26843 ELIZABETH WARD 40.0 X 0 0 0 RON PREWITT 40.0 X 295040 0 26468 STEPHEN COMBS MD 40.0 X 328275 0 18232 BLAINE DOUGLAS 40.0 X 383059 0 31009 BARTHOLEMEW A HOVE 40.0 X 385043 0 30957 DAVID L BRASH 40.0 X 266517 0 27421 DALE SARGENT MD 40.0 X 171513 0 14386 FRED PELLE 2.0 X 24218 217955 23593 JORGE LODEIRO MD 40.0 X 857251 0 59553 ROBERT HARRIS MD 40.0 X 760815 0 52562 EDWIN A MCELROY MD 40.0 X 742893 0 50781 MALCOLM R MATTHEWS MD 40.0 X 652783 0 40570 ASHEESH SHIPSTONE MD 40.0 X 642232 0 42648 8171432 217955 581349 238 false true true ROBINS AND MORTON GROUP 5500 MARYLAND WAY SUITE 100 BRENTWOOD TN 37027 CONTRACTORS 39104392 HOLSTON ANESTHESIA ASSOCIATION 135 W RAVINE STREET SUITE 5B KINGSPORT TN 37662 MEDICAL SERVICES 6311261 HIGHLANDS PATHOLOGY CONSULTANTS PC 10368 WALLACE VALLEY 18 KINGSPORT TN 37663 MEDICAL SERVICES 2435154 CARDIOVASCULAR ASSOCIATES 2050 MEADOWVIEW PARKWAY KINGSPORT TN 37660 MEDICAL SERVICES 2791648 DELOITTE CONSULTING LLP PO BOX 7247-6447 PHILADELPHIA PA 19170 PERFORMANCE IMPROV 3397781 5 1699958 683103 2534 2385595 NET PATIENT REVENUE 621990 405677362 405677362 PHARMACY REVENUE 621990 183288259 183288259 BLOOD REVENUE 621990 11536826 11536826 ADMINISTRATIVE REVENUE 561000 969672 969672 601472119 8484433 -25792 8510225 0 0 6071305 1836466 4234839 4234839 4234840 50422215 6646133 49736994 8000955 685221 -1354822 -669601 -669601 0 0 0 CAFETERIA/VENDING 722210 2760674 2760674 GIFT SHOP REVENUE 453220 464552 464552 MISCELLANEOUS REVENUE 900099 2862460 135728 2726732 6087686 621995071 601472119 109936 18027422 1065798 1065798 0 0 0 5380259 5380259 0 170147018 169461947 685071 11381730 11142735 238995 48925883 48434219 491664 13973523 13696504 277019 0 1299891 856657 443234 797998 797998 96271 96271 0 45019 45019 71522612 69123756 2398856 1313101 1310485 2616 138220455 136821260 1399195 689209 689209 0 19529398 19484111 45287 1385385 1046926 338459 0 30040 30040 19307501 19307501 0 39929856 37933363 1996493 5115088 5115088 PROVISION FOR BAD DEBTS 32321089 32321089 PHYSICIAN RECRUITMENT 2749435 738831 2010604 DUES AND MEMBERSHIPS 737672 257654 480018 MISCELLANEOUS EXPENSE 1760453 1500308 260145 BOOKS AND PUBLICATIONS 330328 317024 13304 588055012 571593793 16461219 0 57660480 19280 0 29828198 92122111 86312132 13954244 14706814 4363804 5418512 857948314 432464532 419298668 425483782 247801678 303622399 32557713 20120565 4778521 4778521 4953483 16183521 877490702 906473724 64424711 59772029 454290000 430070000 108254758 119780477 626969469 609622506 X 250521233 296851218 250521233 296851218 877490702 906473724 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 96271 96271 96271 96271 587886289 620904477 587982560 621000748 1000000 1000000 250000 250000 false 1000000 1000000 1000000 1000000 4000000 6000000 193609 91230 68925 96271 450035 250000 250000 250000 250000 1000000 1500000 107181 32446099 32553280 514152398 203319062 310833336 2297835 348351 1949484 301421167 228797119 72624048 7523634 7523634 425483782 0 POST RETIREMENT BENEFITS 5860787 SWAP LIABILITY 12943505 OTHER LONG-TERM LIABILITIES 25585271 CAPITAL LEASE OBLIGATION 15279603 OTHER CURRENT LIABILITIES 33283589 DEFINED BENEFITS PENSION LIABI 10017722 TAXABLE BOND LIABILITIES 16810000 119780477 ASC TOPIC 740 (FIN 48) DISCLOSURE SCHEDULE D, PART X, LINE 2 ON JULY 1, 2007, WELLMONT ADOPTED NEW GUIDANCE ISSUED ON THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAX POSITIONS NOW CODIFIED INTO ASC TOPIC 740. IT ALSO PROVIDES GUIDANCE ON WHEN TAX POSITIONS ARE RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS AND HOW THE VALUES OF THESE POSITIONS ARE DETERMINED. THERE WAS NO IMPACT ON WELLMONT'S CONSOLIDATED FINANCIAL STATEMENTS AS A RESULT OF THE ADOPTION OF THE NEW GUIDANCE. true true X true X true X true true false true true 13469906 13469906 0.02130 62104513 56650245 5454268 0.00860 75574419 56650245 18924174 0.02990 6347400 1057382 5290018 0.00840 8097525 1399061 6698464 0.01060 5950 3600 2350 337075 337075 0.00050 14787950 2460043 12327907 0.01950 90362369 59110288 31252081 0.04940 false 9346603 161977054 155906211 6070843 X true true HWHN INC WHS HEALTH NETWORK 0.50000 0.50000 HOLSTON VALLEY IMAG RADIOLOGY SERVICES 0.75000 0.50000 RENAISSANCE SUR CTR SURGICAL SERVICES 0.33330 0.67670 HOLSTON VALLEY AMB SURGICAL SERVICES 0.52000 0.48000 SAPLING GROVE AMB SURGICAL SERVICES 0.65000 0.35000 BRISTOL REGIONAL MEDICAL CENTER

1 MEDICAL PARK BLVD BRISTOL TN 37620

X X X HOLSTON VALLEY MEDICAL CENTER

130 RAVINE ROAD KINGSPORT TN 37660

X X X LONESOME PINE HOSPITAL

1990 HOLTON AVENUE BIG STONE GAP VA 24219

X X HANCOCK COUNTY HOSPITAL

1519 MAIN STREET SNEEDVILLE TN 37869

X X X JENKINS COMMUNITY HOSPITAL

PO BOX 4729480 HIGHWAY 805MAIN ST JENKINS KY 41537

X X X SOLD APRIL 1, 2009 MOUNTAIN VIEW REGIONAL MEDICAL CENTER

310 3RD STREET NE NORTON VA 24273

X X LEE REGIONAL MEDICAL CENTER

PO BOX 589 127 HEALTH CARE DRIVE PENNINGTON GAP VA 24277

X HOLSTON VALLEY AMBULATORY SURGERY CENTER

103 WEST STONE DRIVE SUITE 100 KINGSPORT TN 37760

X JOINT VENTURE AMB. SURGERY CENTER SAPLING GROVE AMBULATORY SURGERY CENTER

220 MEDICAL PARK BOULEVARD SUITE 2 BRISTOL TN 37620

X JOINT VENTURE AMB. SURGERY CENTER RENAISSANCE SURGERY CENTER

320 BRISTOL WEST BOULEVARD SUITE 1 BRISTOL TN 37620

X JOINT VENTURE AMB. SURGERY CENTER WELLMONT HEALTH SYSTEM PREPARES A CONSOLIDATED COMMUNITY BENEFIT REPORT WHICH INCLUDES THE ACTIVITIES OF ALL ITS OPERATIONS AND AFFILIATES. IN CONTRAST, AN IRS FORM 990 IS FILED FOR EACH TAX EXEMPT CORPORATION (6 SEPARATE FORM 990S) AND THERE IS NO SUCH IRS FORM FOR THE TAXABLE CORPORATIONS. IN ADDITION, THE IRS INSTRUCTIONS TO FORM 990 HAVE SPECIFIC DEFINITIONS, METHODS AND WORKSHEETS TO CALCULATE THE COMMUNITY BENEFITS TO BE INCLUDED ON THE FORM 990. AS A RESULT, THERE ARE SIGNIFICANT DIFFERENCES BETWEEN THE COMMUNITY BENEFITS REPORTED IN THE CONSOLIDATED COMMUNITY BENEFIT REPORT AND THE VARIOUS FORM 990S. FOR EXAMPLE, THERE ARE SIGNIFICANT LOSSES INCURRED IN THE TAXABLE CORPORATIONS THAT CANNOT BE REFLECTED IN THE VARIOUS FORM 990S, THE LARGEST OF WHICH ARE THE COSTS AND REVENUES ASSOCIATED WITH THE PHYSICIANS AND OTHER PROVIDERS WITHIN THESE CORPORATIONS WHO PROVIDE INDISPENSABLE SERVICES TO PATIENTS OF WELLMONT HEALTH SYSTEM. THERE ARE ALSO FUNDS AND SERVICES THAT ARE PROVIDED THAT DO NOT MEET THE SPECIFIC DEFINITIONS OF THE IRS INSTRUCTIONS, SUCH AS CONTRIBUTIONS TO COMMUNITY ORGANIZATIONS THAT DO NOT MEET THE DEFINITION OF "RESTRICTED TO ONE OR MORE OF THE ACTIVITIES DESCRIBED IN THE TABLE IN PART I, LINE 7..." RATIO OF PATIENT CARE COST-TO-CHARGES, WAS USED TO DETERMINE THE COSTS FOR AMOUNTS IN LINE 7A AND 7B COLUMN (C) BY FACILITY. THE COSTS INCLUDED IN THE COST-TO-CHARGE RATIO INCLUDED THE COSTS FROM ALL PATIENT SEGMENTS. ACTUAL COSTS FROM THE GENERAL LEDGER WERE USED FOR AMOUNTS IN LINE 7F AND 7I COLUMN (C). THE BAD DEBT EXPENSE OF $32,321,089 WAS INCLUDED ON FORM 990 PART IX, LINE 25 COLUMN (A) BUT WAS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN. IN ADDITION, $22,331 WAS SUBTRACTED FOR WELLMONT HEALTH SYSTEM'S SHARE OF JOINT VENTURE BAD DEBT EXPENSE. THE COST REPORTED ON LINE 2 IS CALCULATED AS THE BAD DEBT EXPENSE FROM THE GENERAL LEDGER TIMES THE RATIO OF COST TO CHARGES AS CALCULATED ON WORKSHEET 2 BY FACILITY (INCLUDING JOINT VENTURES). THERE ARE NO AMOUNTS REPORTED ON LINE 3. DISCOUNTS ON PATIENT ACCOUNTS ARE NOT INCLUDED IN BAD DEBT EXPENSE. PAYMENTS ON PATIENT ACCOUNTS THAT HAVE PREVIOUSLY BEEN WRITTEN OFF AS BAD DEBT ARE USED TO REDUCE BAD DEBT EXPENSE. A THIRD PARTY VENDOR IS USED TO HELP DETERMINE THE AMOUNT THAT REASONABLY COULD BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE CHARITY CARE POLICY. TEXT OF NOTE TO FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE: NET PATIENT SERVICE REVENUE IS REPORTED ON THE ACCRUAL BASIS IN THE PERIOD IN WHICH SERVICES ARE PROVIDED AT THE ESTIMATED NET REALIZABLE AMOUNTS EXPECTED TO BE COLLECTED. NET PATIENT SERVICE REVENUE INCLUDES AMOUNTS ESTIMATED BY MANAGEMENT TO BE REIMBURSABLE BY PATIENTS AND VARIOUS THIRD-PARTY PAYORS UNDER PROVISIONS OF REIMBURSEMENT FORMULAS IN EFFECT, INCLUDING RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS. ESTIMATED RETROACTIVE ADJUSTMENTS ARE ACCRUED IN THE PERIOD RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS AS FINAL AND OTHER SETTLEMENTS ARE DETERMINED. WELLMONT PROVIDES CARE TO PATIENTS WHO MEET CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE WELLMONT DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT INCLUDED IN NET PATIENT SERVICE REVENUE. PATIENT ACCOUNTS RECEIVABLE ARE REPORTED NET OF BOTH AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS. THE CONTRACTUAL ALLOWANCE REPRESENTS THE DIFFERENCE BETWEEN ESTABLISHED BILLING RATES AND ESTIMATED REIMBURSEMENT FROM MEDICARE, TENNCARE, MEDICAID, AND OTHER THIRD-PARTY PAYMENT PROGRAMS. WELLMONT'S POLICY DOES NOT REQUIRE COLLATERAL OR OTHER SECURITY FOR PATIENT ACCOUNTS RECEIVABLE. WELLMONT ROUTINELY OBTAINS ASSIGNMENT OF, OR IS OTHERWISE ENTITLED TO RECEIVE, PATIENT BENEFITS PAYABLE UNDER HEALTH INSURANCE PROGRAMS, PLANS, OR POLICIES. THE MEDICARE COST REPORT COST FINDING METHODOLOGY AND COST TO CHARGE RATIOS WERE USED TO DETERMINE THE AMOUNT REPORTED ON LINE 6. LINE 7 IS A SURPLUS SO IT IS NOT INCLUDED AS COMMUNITY BENEFIT. THE IRS INSTRUCTIONS FOR SCHEDULE H, PART III, SECTION B, LINES 5-7 SPECIFICALLY INDICATE TO INCLUDE ONLY THOSE ALLOWABLE COSTS AND MEDICARE REIMBURSEMENTS THAT ARE REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT FOR THE YEAR. THIS REPORTING DOES NOT TAKE INTO ACCOUNT THOSE COSTS AND REVENUES ASSOCIATED WITH PHYSICIANS WHO ARE TREATING MEDICARE PATIENTS AT HOSPITAL-OWNED CLINIC AND PHYSICIAN PRACTICE SITES. ACCORDINGLY, THE NET RESULT OF TREATING MEDICARE PATIENTS FROM A FINANCIAL PERSPECTIVE MAY DIFFER AS REPORTED FOR FINANCIAL REPORTING PURPOSES AND COMMUNITY BENEFIT REPORTING PURPOSES FROM THE SURPLUS OR SHORTFALL SHOWN ON LINE 7 OF SECTION B OF PART III OF SCHEDULE H. A THIRD PARTY VENDOR WAS USED BEGINNING IN FISCAL YEAR 2010 (TAX YEAR 2009) TO IDENTIFY PATIENTS WHO HAD BEEN SENT TO A COLLECTION AGENCY BUT WHO LIKELY WOULD QUALIFY FOR CHARITY CARE. THESE PATIENTS' ACCOUNTS ARE THEN WRITTEN OFF AS CHARITY CARE. SUCH PATIENTS ARE NOTIFIED OF THE REDUCTION OR ELIMINATION OF THE OUTSTANDING CHARGES AND COLLECTIONS ARE NOT PURSUED. WELLMONT HEALTH SYSTEM EXAMINES THE HEALTHCARE NEEDS OF THE COMMUNITIES IT SERVES BY CONDUCTING PHYSICIAN NEEDS ASSESSMENTS FOR ITS HOSPITALS. AS PART OF THIS EFFORT, WELLMONT REVIEWS ITS SERVICE AREA AND DEMOGRAPHICS, EXAMINES PHYSICIAN DEMOGRAPHICS AND CONDUCTS FOCUS GROUPS. IT MAKES A DETERMINATION OF PHYSICIAN NEED WHILE CALCULATING ITS PHYSICIAN SURPLUSES AND DEFICITS AND HIGHLIGHTING ITS RECRUITMENT PRIORITIES AND PLANS. WELLMONT ANNUALLY DETERMINES ITS PRIMARY, SECONDARY AND TERTIARY MARKETS THROUGH THE USE OF COUNTY-BY-COUNTY ANALYSIS TO IDENTIFY THE FOLLOWING CUSTOMER GROUPS: PATIENTS AND POTENTIAL PATIENTS, COMMUNITY/EMPLOYER GROUPS AND LOCAL PHYSICIANS. THE HEALTH SYSTEM ALSO RELIES ON THE EXPERTISE OF CONSULTANTS TO PERIODICALLY REVIEW ALL FACETS OF OPERATIONS AND MAKE RECOMMENDATIONS FOR CHANGES. WELLMONT HEALTH SYSTEM PROACTIVELY INFORMS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY BY POSTING THE POLICY ON ITS WEB SITE AS WELL AS POSTING THE POLICY AT POINTS OF REGISTRATION IN THE HOSPITALS. WELLMONT HEALTH SYSTEM USES PROGRAM ELIGIBILITY SPECIALISTS WHO CONTACT THE UNINSURED PATIENT POPULATION. THESE SPECIALISTS DISCUSS THE VARIOUS GOVERNMENTAL ASSISTANCE PROGRAMS THAT ARE AVAILABLE TO PATIENTS IN ORDER TO DETERMINE IF THE PATIENT WOULD QUALIFY FOR ANY OF THESE PROGRAMS. THE SPECIALISTS WILL WORK WITH THE PATIENTS TO COMPLETE ANY NECESSARY APPLICATIONS AND WILL HELP THEM THROUGH THE QUALIFICATION PROCESS. WELLMONT HEALTH SYSTEM'S SERVICE AREA IS DEFINED BY MANAGEMENT AT THE COUNTY LEVEL BASED ON PATIENT ACTIVITY AND LOCATIONS OF OUR CAMPUSES. THE PRIMARY SERVICE AREA ("PSA") INCLUDES THE TENNESSEE COUNTIES OF SULLIVAN, HAWKINS AND HANCOCK AND THE VIRGINIA COUNTIES OF WASHINGTON, WISE, LEE AND SCOTT. THE SECONDARY SERVICE AREA ("SSA") IS DEFINED AS WASHINGTON, GREENE, CARTER, JOHNSON AND UNICOI COUNTIES OF TENNESSEE AND RUSSELL, BUCHANAN, SMYTH, TAZEWELL, DICKENSON AND WYTHE COUNTIES OF VIRGINIA. THE DEMOGRAPHICS OF THESE AREAS ARE AS FOLLOWS: PSA - POPULATION 384,685; MEDIAN HOUSEHOLD INCOME $37,711. SSA - POPULATION 456,180; MEDIAN HOUSEHOLD INCOME $33,982. APPROXIMATELY 13.5% OF OUR PATIENTS ARE MEDICAID RECIPIENTS AND 6.5% ARE UNINSURED AND TWO OF THE PSA COUNTIES ARE DESIGNATED AS MEDICALLY UNDERSERVED AREAS (HAWKINS COUNTY, TENNESSEE AND LEE COUNTY, VIRGINIA). WELLMONT HEALTH SYSTEM'S HOSPITALS AND OTHER HEALTHCARE FACILITIES FURTHER THEIR EXEMPT PURPOSE BY PROVIDING MILLIONS IN UNCOMPENSATED CARE AND OTHER CHARITABLE DONATIONS. IN FISCAL YEAR 2009-10, WELLMONT PROVIDED $71,028,000 IN UNCOMPENSATED CARE. THE HEALTH SYSTEM ALSO DONATED $918,448 TO COMMUNITY ORGANIZATIONS SUCH AS THE AMERICAN HEART ASSOCIATION, UNITED WAY, SUSAN G. KOMEN FOR THE CURE AND THE AMERICAN CANCER SOCIETY. WELLMONT PROVIDED NEARLY $5,375,454 FOR COMMUNITY HEALTH AND OUTREACH AND $6,991,127 FOR TRAINING AND EDUCATION OF HEALTHCARE PROFESSIONALS. EMPLOYEES, PHYSICIANS, AND VOLUNTEERS DONATED 102,619 HOURS OF COMMUNITY SERVICE. WELLMONT HEALTH SYSTEM ("WELLMONT") IS A TENNESSEE NON-PROFIT CORPORATION BASED IN KINGSPORT, TENNESSEE AND A PREMIER PROVIDER OF HEALTHCARE SERVICES IN NORTHEAST TENNESSEE AND SOUTHWEST VIRGINIA. WELLMONT WAS FORMED IN JULY 1996 WITH THE MERGER OF BRISTOL MEMORIAL HOSPITAL IN BRISTOL, TENNESSEE AND HOLSTON VALLEY MEDICAL CENTER IN KINGSPORT, TENNESSEE. OVER THE PAST DECADE, WELLMONT HAS GROWN TO INCLUDE SIX ADDITIONAL HOSPITALS, AN INTEGRATED PHYSICIAN NETWORK AND SEVERAL AMBULATORY SITES. WELLMONT HOSPITALS OFFER A BROAD SCOPE OF SERVICES RANGING FROM COMMUNITY-BASED ACUTE CARE TO HIGHLY SPECIALIZED TERTIARY SERVICES INCLUDING TWO TRAUMA CENTERS, COMPREHENSIVE HEART CARE AND CANCER CARE. WELLMONT OWNS AND OPERATES AN INTEGRATED HEALTH CARE DELIVERY SYSTEM PROVIDING INPATIENT, OUTPATIENT AND OTHER HEALTH CARE SERVICES AT MULTIPLE LOCATIONS IN NORTHEAST TENNESSEE AND SOUTHWEST VIRGINIA. CURRENTLY, WELLMONT OWNS AND OPERATES SIX ACUTE CARE HOSPITAL FACILITIES AND ONE CRITICAL ACCESS HOSPITAL WITH A TOTAL OF 1,253 LICENSED BEDS AND, THROUGH A JOINT VENTURE, PARTNERS TO OPERATE AN ADDITIONAL ACUTE CARE HOSPITAL FACILITY WITH 100 LICENSED BEDS. THE ACUTE CARE FACILITIES OWNED BY WELLMONT INCLUDE HOLSTON VALLEY MEDICAL CENTER, BRISTOL REGIONAL MEDICAL CENTER, MOUNTAIN VIEW REGIONAL MEDICAL CENTER IN NORTON, VIRGINIA, LEE REGIONAL MEDICAL CENTER IN PENNINGTON GAP, VIRGINIA, LONESOME PINE HOSPITAL IN BIG STONE GAP, VIRGINIA, HAWKINS COUNTY MEMORIAL HOSPITAL IN ROGERSVILLE, TENNESSEE AND THE CRITICAL ACCESS HOSPITAL, HANCOCK COUNTY HOSPITAL IN SNEEDVILLE, TENNESSEE. WELLMONT IS THE MAJORITY PARTNER WITH ADVENTIST HEALTH SYSTEM AT TAKOMA REGIONAL HOSPITAL, AN ACUTE CARE HOSPITAL IN GREENEVILLE, TENNESSEE. WELLMONT ALSO, DIRECTLY OR INDIRECTLY, CONTROLS, OWNS OR IS AFFILIATED WITH VARIOUS NONPROFIT AND FOR-PROFIT CORPORATIONS AND OTHER ORGANIZATIONS THAT CURRENTLY PROVIDE HEALTH CARE AND HEALTH CARE-RELATED SERVICES THROUGHOUT THE SERVICE AREA. IN ADDITION TO THE HOSPITAL CAMPUSES AND AMBULATORY CARE CENTERS DESCRIBED ABOVE, WELLMONT ALSO OPERATES MEDICAL CLINICS, AMBULATORY SURGERY CENTERS, COMPREHENSIVE CANCER CARE CENTERS, AND IMAGING FACILITIES. TN VA true AMERICAN CANCER SOCIETY 508 PRINCETON ROAD SUITE 102 JOHNSON CITY TN 37601 640329009 501(C)(3) 15351 RELAY FOR LIFE SPONSORSHIP BARTER FOUNDATION INC STATE THEATRE OF VA PO BOX 867 ABINGDON VA 24212 546000120 501(C)(3) 20000 SEASONAL SPONSORSHIP KINGSPORT AREA CHAMBER OF COMMERCE 151 E MAIN STREET KINGSPORT TN 37660 620446834 501(C)(6) 31113 KPT CHAMBER SPONSORS SCIENCE HILL HIGH SCHOOL 1509 JOHN EXUM PARKWAY JOHNSON CITY TN 37604 626000320 GOVERNMENT 5300 ATHLETIC SPONSORSHIP TENNESSEE CHAMBER OF COMMERCE AND INDUSTRY 611 COMMERCE STREET SUITE 3030 NASHVILLE TN 37203 621236022 501(C)(6) 5500 ANNUAL SPONSORSHIP YWCA 106 STATE STREET BRISTOL TN 37620 620488044 501(C)(3) 10000 TRIBUTE TO WOMEN SPONSORSHIP KOSBE 151 EAST MAIN ST KINSGPORT TN 37660 581453565 501(C)(3) 7757 SPONSORSHIP AMERICAN HEART & STROKE ASSOCIATION 1101 NORTHCHAST PKWY SUITE 1 MARIETTA GA 30067 135613797 501(C)(3) 36200 GO RED FOR WOMEN SPONSORSHIP SYMPHONY OF THE MOUNTAINS 1200 E CENTER STREET BOX 13 KINGSPORT TN 37660 620534228 501(C)(3) 17800 2009 HOLIDAY CONCERT SPONSORSHIP TENNESSEE HIGH VIKING BOOSTER CLUB PO BOX 3224 BRISTOL TN 37625 621757051 501(C)(3) 5500 FUNDRAISING CAMPAIGN GREATER KINGSPORT FAMILY YMCA 1100 FRANKLIN SQUARE KINGSPORT TN 37664 581564232 501(C)(3) 22500 ANNUAL CONTRIBUTION APPALACHIAN MOUNTAIN PROJECT ACCESS PO BOX 973 JOHNSON CITY TN 37605 262102040 501(C)(3) 34000 HEALTH ACCESS PROJECT CONTRIBUTION BUCCANEER ATHLETIC SCHOLARSHIP ASSOCIATION BOX 70707 JOHNSON CITY TN 37614 237092731 501(C)(3) 23000 ATHLETIC SPONSORSHIP FRIENDS IN NEED HEALTH CENTER 1105 WEST STONE DRIVE KINGSPORT TN 37660 621541637 501(C)(3) 150000 232952 COST DRUGS AND SUPPLIES HEALTHCARE ASSISTANCE FOR UNINS. HEALING HANDS HEALTH CENTER 210 MEMORIAL DRIVE BRISTOL TN 37620 621677000 501(C)(3) 7500 12832 COST MEDICAL SUPPLIES HEALTHCARE ASSISTANCE FOR UNINS. AMERICAN CANCER SOCIETY PO BOX 246 ABINGDON VA 24212 580659875 501(C)(3) 8250 RELAY FOR LIFE SPONSORSHIP BRISTOL CHAMBER OF COMMERCE 20 VOLUNTEER PARKWAY BRISTOL TN 37620 540150315 501(C)(6) 5615 SPONSORSHIP CARDINAL HEALTH PO BOX 95600 ALBUQUERQUE NM 87100 344095179 N/A 27174 FMV MEDICAL SUPPLIES HAITI RELIEF FUND CONTACT CONCERN OF KINGSPORT PO BOX 3336 KINGSPORT TN 37664 620962876 501(C)(3) 9500 CONTRIBUTION DOWNTOWN KINGSPORT ASSOCIATION 140 W MAIN STREET KINGSPORT TN 37660 626097264 501(C)(3) 10000 SPONSORSHIP JULY 4TH FIREWORKS FISCHER ROSS GROUP INC 2 SOUND VIEW DRIVE SUITE 100 GREENWICH CT 06830 205111271 N/A 15066 TALENT FEE FOR GO RED LUNCHEON FUN FEST 2010 151 EAST MAIN ST KINGSPORT TN 37660 620446834 501(C)(6) 6140 HOT AIR BALLOON RALLY SPONSORSHIP GAP PARTNERSHIP 619 GILLEY AVENUE BIG STONE GAP VT 24219 541269523 501(C)(3) 6000 SPONSORSHIP KINGSPORT LEADERSHIP PO BOX 1403 KINGSPORT TN 37662 581453565 501(C)(3) 20000 SPONSORSHIP KINGSPORT TIMES-NEWS PO BOX 479 KINGSPORT TN 37662 620673926 N/A 5881 SPONSORSHIP WOMEN'S EXPO KINGSPORT TOMORROW 214 COMMERCE STREET SUITE 103 KINGSPORT TN 37660 581941002 501(C)(3) 11950 GOLF TOURNAMENT SPONSORSHIP MISSIONARY FLIGHTS INTERNATIONAL 3170 AIRMANS DRIVE FORT PIERCE FL 34946 237199063 501(C)(3) 10000 FMV MEDICAL SUPPLIES HAITI RELIEF FUND WATAUGA ORTHOPAEDICS PO BOX 2267 JOHNSON CITY TN 37605 621586264 N/A 20000 ATHLETE OF THE WEEK SPONSORSHIP WCYB APPALACHIAN BROADCASTING CORP PO BOX 601063 CHARLOTTE NC 28260 540467002 N/A 19936 MEDIA PLACEMENT GO RED CARE SPARK PO BOX 657 KINGSPORT TN 37664 202694144 501(C)(3) 50000 GENERAL SUPPORT 22 9 MONITORING THE USE OF GRANT FUNDS PART I, LINE 2 ALL REQUESTS FOR CHARITABLE ASSISTANCE ARE REVIEWED BY THE SENIOR VICE PRESIDENT OF MARKETING COMMUNICATIONS. THE REQUEST FOR GRANT FUNDS IS EVALUATED ON THE BASIS OF THE FOLLOWING ITEMS: THE DEGREE TO WHICH THE REQUEST SUPPORTS WELLMONT HEALTH SYSTEM'S MISSION, REPRESENTATION OF WELLMONT HEALTH SYSTEM AS A GOOD CORPORATE CITIZEN, AND THE ANNUAL BUDGET. THE SENIOR VICE PRESIDENT THEN MAKES A DETERMINATION OF APPROVAL FOR ALL REQUESTS AND THE PAYMENT IS SENT DIRECTLY TO ACCOUNTS PAYABLE FOR PAYMENT. X X true true X X false false false false false false false false false HAMLIN WILSON 209539 0 43560 0 28392 0 12144 0 6457 0 300092 0 0 0 GARY D MILLER 204386 0 41305 0 14621 0 11255 0 14182 0 285749 0 0 0 RON PREWITT 234881 0 44603 0 15556 0 12819 0 13649 0 321508 0 0 0 DAVID THOMPSON MD 282514 0 83046 0 3896 0 0 0 14934 0 384390 0 0 0 PATRICK KANE 184609 0 38677 0 26324 0 10402 0 15821 0 275833 0 0 0 STEPHEN COMBS MD 249808 0 40913 0 37554 0 13299 0 4933 0 346507 0 0 0 TODD J DOUGAN 174616 0 35050 0 17725 0 10002 0 16051 0 253444 0 0 0 BLAINE DOUGLAS 303237 0 60023 0 19799 0 16408 0 14601 0 414068 0 0 0 BARTHOLEMEW A HOVE 290108 0 60986 0 33949 0 16409 0 14548 0 416000 0 0 0 DAVID L BRASH 216560 0 42884 0 7073 0 11767 0 15654 0 293938 0 0 0 MICHAEL SNOW 472501 0 177424 0 69708 0 18207 0 6871 0 744711 0 0 0 TRUMAN ESMOND 136614 0 150000 0 0 0 0 0 0 0 286614 0 0 0 MICHAEL BUNDY 213997 0 42544 0 10745 0 11481 0 15362 0 294129 0 0 0 DALE SARGENT MD 163078 0 0 0 8435 0 7125 0 7261 0 185899 0 0 0 JORGE LODEIRO MD 706468 0 149423 0 1360 0 43766 0 15787 0 916804 0 0 0 ROBERT HARRIS MD 760345 0 200 0 270 0 18578 0 13984 0 793377 0 0 0 EDWIN A MCELROY MD 628417 0 114358 0 118 0 37744 0 13037 0 793674 0 0 0 MALCOLM R MATTHEWS MD 450490 0 201105 0 1188 0 27325 0 13245 0 693353 0 0 0 ASHEESH SHIPSTONE MD 450344 0 191384 0 504 0 29257 0 13391 0 684880 0 0 0 FRED PELLE 19491 175418 3832 34485 895 8052 1056 9500 1304 11733 26578 239188 0 0 HOUSING ALLOWANCE SCHEDULE J, PART I, LINE 1 WELLMONT HEALTH SYSTEM OFFERED MIKE SNOW A HOUSING ALLOWANCE DURING THE FISCAL YEAR ENDED JUNE 30,2010. THE HOUSING ALLOWANCE PAID TO MIKE SNOW WAS INCLUDED IN HIS TAXABLE COMPENSATION. HEALTH OR SOCIAL CLUB DUES SCHEDULE J, PART I, LINE 1 DURING THE FISCAL YEAR ENDED JUNE 30,2010, WELLMONT HEALTH SYSTEM PROVIDED COUNTRY CLUB MEMBERSHIPS FOR BARTHOLEMEW HOVE, PATRICK KANE, RON PREWITT, AND MIKE SNOW. IN ADDITION, WELLMONT HEALTH SYSTEM PROVIDES HEALTH CLUB MEMBERSHIPS FOR BLAINE DOUGLAS, GARY D. MILLER, JORGE LODEIRO MD, AND FRED PELLE. THESE AMOUNTS ARE INCLUDED IN TAXABLE COMPENSATION. MANAGEMENT COMPANY SCHEDULE J, PART II FOR THE CALENDAR YEAR 2009, WELLMONT HEALTH SYSTEM PAID TATUM, LLC (EIN: 58-2361736) IN THE AMOUNT OF $561,441 FOR SERVICES THAT TRUMAN ESMOND PROVIDED TO WELLMONT HEALTH SYSTEM. IN ADDITION, WELLMONT HEALTH SYSTEM ISSUED A FORM 1099 DIRECTLY TO MR. ESMOND IN THE AMOUNT OF $286,614 FOR SERVICES RENDERED TO WELLMONT HEALTH SYSTEM. SULLIVAN COUNTY TENNESSEE HEALTH EDL AND FACS 621256662 865293AC8 2006-11-02 200000000 RENOVATION/CONS. OF HOLSTON VALLEY false false VIRGINIA SMALL BUSINESS FINANCING AUTHORITY 541300845 928101AC8 2007-07-31 55000000 PURCHASE OF HOSPITALS false false SULLIVAN COUNTY TENNESSEE HEALTH EDL AND FACS 621256662 865292DY9 2003-06-01 59100000 REFUND OF PREVIOUSLY ISSUED BOND false false SULLIVAN COUNTY TENNESSEE HEALTH EDL AND FACS 621256662 865292DZ6 2005-12-13 70620000 REFUND OF PREVIOUSLY ISSUED BOND false false SULLIVAN COUNTY TENNESSEE HEALTH EDL AND FACS 621256662 865293AB0 2006-06-29 76595000 REFUND OF PREVIOUSLY ISSUED BOND false false 207055314 18977995 0 12534857 2164568 0 187573513 2011 false false false true 55658570 5464590 0 0 1026366 0 49167614 2007 false false true true 67546371 5300282 60061731 0 2184358 0 0 2003 false true true true 71923735 0 71529827 0 266958 126950 0 2005 false true true true 76595000 0 75610171 0 984829 0 0 2006 false true true true false false false false true 0.00000 0.00000 0.00000 true false false false false true 0.00000 0.00000 0.00000 true false false false false true 0.00000 0.00000 0.00000 true false false false false true 0.00000 0.00000 0.00000 true false false false false true 0.00000 0.00000 0.00000 true false false false true MERRIL LYNCH 4. true false false false false false false false false false false false false true true LEHMAN BROTHERS 10.8 false false false true false false false HIGHLANDS PATHOLOGY CONSULTANTS PC PETER GALE, >5% 1881186 PATHOLOGY SERVICES false VOLUNTEER HOURS FORM 990, PART I, LINE 6 WELLMONT HEALTH SYSTEM'S 514 VOLUNTEERS PROVIDED SERVICES WHICH INCLUDED ANSWERING TELEPHONES, GREETING AND ESCORTING PATIENTS/VISITORS, AND VARIOUS OTHER SERVICES. THESE VOLUNTEERS ALSO INCLUDE CHAPLAIN SERVICES FOR THE HOSPITAL AND ARE AVAILABLE TWENTY-FOUR HOURS, SEVEN DAYS A WEEK TO PATIENTS, PATIENTS' FAMILIES AND EMPLOYEES. DELEGATION OF MANAGEMENT DUTIES TO A MANAGEMENT COMPANY OR OTHER PERSON FORM 990 PART VI, SECTION A, LINE 3 WELLMONT HEALTH SYSTEM CONTRACTED WITH TATUM, LLC TO PERFORM AN EXECUTIVE SEARCH IN ORDER TO PLACE AN INTERIM CFO DURING THE PREVIOUS TAX YEAR. TRUMAN ESMOND WAS PLACED BY TATUM, LLC TO ACT AS INTERIM CFO. MR. ESMOND DISCONTINUED HIS POSITION WITH WELLMONT HEALTH SYSTEM ON DECEMBER 31, 2010. REVIEW OF 990 FORM 990 PART VI, SECTION A, LINE 11A WELLMONT HEALTH SYSTEM'S FORM 990 IS REVIEWED BY THE WELLMONT HEALTH SYSTEM BOARD, EXECUTIVE VICE PRESIDENT/CFO, SENIOR VICE PRESIDENT OF FINANCE, AND THE MANAGER OF ACCOUNTING FOR WELLMONT HEALTH SYSTEM PRIOR TO FILING. ANY QUESTIONS/COMMENTS ARISING FROM THE INITIAL REVIEW ARE ADDRESSED TO ENSURE THE RETURN IS COMPLETE AND ACCURATE. ANY CHANGES/CORRECTIONS ARE MADE AND THE RETURN IS THEN PROVIDED TO THE ABOVE INDIVIDUALS PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. CONFLICT OF INTEREST POLICY FORM 990 PART VI, SECTION B, LINE 12C WELLMONT HEALTH SYSTEM HAS A CONFLICT OF INTEREST POLICY. ANNUALLY, BOARD MEMBERS ARE PROVIDED THE POLICY AND GIVEN A DISCLOSURE FORM THAT IS SENT TO GENERAL COUNSEL FOR REVIEW AND ACTION. WELLMONT ALSO HAS A POLICY ON BUSINESS PRACTICES THAT ALL EMPLOYEES MUST REVIEW AND SIGN THAT DISCUSSES CONFLICT OF INTEREST AND INFORMS THE WORKFORCE TO DISCLOSE ANY ISSUES TO THE CORPORATE COMPLIANCE OFFICER FOR RESOLUTION. WELLMONT ALSO USES A HOTLINE THAT ALLOWS ANONYMOUS REPORTING OF POSSIBLE CONFLICT OF INTEREST SITUATIONS FOR INVESTIGATION BY THE CORPORATE COMPLIANCE OFFICER. COMPENSATION REVIEW FORM 990 PART VI, SECTION B, LINE 15A & B THE WELLMONT HEALTH SYSTEM CEO AND HIS DIRECT REPORTS' COMPENSATION (LISTED BELOW)IS REVIEWED, APPROVED,AND DOCUMENTED BY THE WELLMONT HEALTH SYSTEM PERSONNEL COMMITTEE AND BOARD OF DIRECTORS. THESE BODIES USE COMPARABILITY DATA TO DETERMINE APPROPRIATE COMPENSATION. ALL COMPENSATION DELIBERATIONS AND REVIEWS ARE CONTEMPORANEOUSLY DOCUMENTED. THIS PROCESS IS COMPLETED ON AN ANNUAL BASIS WITH THE LAST PROCESS BEING COMPLETED IN JULY 2009. OTHER OFFICERS/KEY EMPLOYEES OF THE ORGANIZATION HAVE WRITTEN EMPLOYMENT CONTRACTS AND COMPENSATION IS BASED ON SURVEYS/STUDIES AND THEN APPROVED BY THE WELLMONT HEALTH SYSTEM CEO. WELLMONT HEALTH SYSTEM EVP AND CFO WELLMONT HEALTH SYSTEM SR. VP OF OPERATIONS WELLMONT HEALTH SYSTEM SR. VP OF HUMAN RESOURCES WELLMONT HEALTH SYSTEM SR. VP OF LEGAL AFFAIRS WELLMONT HEALTH SYSTEM CHIEF MEDICAL OFFICER WELLMONT HEALTH SYSTEM SR. VP OF MARKETING AND COMMUNICATION BRISTOL REGIONAL MEDICAL CENTER CEO HOLSTON VALLEY MEDICAL CENTER CEO LONESOME PINE HOSPITAL CEO HANCOCK COUNTY HOSPITAL CEO MOUNTAIN VIEW REGIONAL MEDICAL CENTER CEO LEE REGIONAL MEDICAL CENTER CEO PARTICIPATION WITH JOINT VENTURES OR SIMILAR ARRANGEMENTS FORM 990 PART VI, SECTION B, LINE 16 WELLMONT HEALTH SYSTEM HAS TAKEN STEPS TO SAFEGUARD THE ORGANIZATION'S EXEMPT STATUS. THE WELLMONT HEALTH SYSTEM LEGAL DEPARTMENT REVIEWS ALL JOINT VENTURE RELATIONS AND DETERMINES IF THE RELATIONSHIP MEETS WELLMONT HEALTH SYSTEM'S EXEMPT PURPOSE. IF THE RELATIONSHIP MEETS WELLMONT HEALTH SYSTEM'S EXEMPT PURPOSE, THE BOARD OF DIRECTORS WILL APPROVE THE RELATIONSHIP. ANY ONGOING RELATIONSHIP IS THEN MONITORED AND REVIEWED DURING THE ANNUAL AUDIT OF THE CONSOLIDATED WELLMONT HEALTH SYSTEM CONSOLIDATED GROUP. AVERAGE HOURS PER WEEK FORM 990 PART VII, SECTION A, COLUMN B THE FOLLOWING OFFICERS AND VOTING BOARD MEMBERS DEVOTED TIME PROVIDING SERVICES TO A RELATED ENTITY. FRED PELLE (38 HOURS) GARY MILLER (1 HOUR) MICHAEL SNOW (1 HOUR) ELIZABETH WARD (1 HOUR) TRUMAN ESMOND (1 HOUR) MICHAEL BUNDY (1 HOUR) BLAINE DOUGLAS (1 HOUR) BART HOVE (1 HOUR) TODD DOUGAN (1 HOUR) PUBLIC DISCLOSURE FORM 990 PART VI, SECTION C, LINE 19 THE WELLMONT HEALTH SYSTEM'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC. FEDERAL LAW DOES NOT REQUIRE SUCH DOCUMENTS BE MADE PUBLICLY AVAILABLE UNLESS THEY WERE INCLUDED ON FORMS THAT ARE PUBLICLY AVAILABLE SUCH AS FORM 1023 OR FORM 1024. WELLMONT HEALTH SYSTEM'S AUDITED FINANCIAL STATEMENTS AND QUARTERLY UNAUDITED FINANCIAL STATEMENTS ARE AVAILABLE THROUGH THE ELECTRONIC MUNICIPAL MARKET ACCESS WEBSITE AS WELL AS THE CORPORATE OFFICE OF WELLMONT HEALTH SYSTEM. FORM 990 IS ALSO AVAILABLE FOR PUBLIC INSPECTION AT THE CORPORATE OFFICE OF WELLMONT HEALTH SYSTEM. AUDIT OF FINANCIAL STATEMENTS FORM 990, PART XI, LINE 2C WELLMONT HEALTH SYSTEM'S FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2010 WERE AUDITED AS PART OF WELLMONT HEALTH SYSTEM'S CONSOLIDATED FINANCIAL STATEMENTS. WELLMONT HEALTH SYSTEM HAS AN AUDIT COMMITTEE WHICH ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR. WELLMONT HEALTH MANAGEMENT SERVICES LLC 1905 AMERICAN WAY KINGSPORT TN 37660 621825259 HEALTHCARE TN 0 0 WHS WELLMONT HAWKINS CO MEMORIAL HOSPITAL 1905 AMERICAN WAY KINGSPORT TN 37660 621816368 HEALTHCARE TN 501(C)(3) 3 NA WELLMONT MADISON HOUSE 1905 AMERICAN WAY KINGSPORT TN 37660 621308216 HEALTHCARE TN 501(C)(3) 9 WHS WELLMONT IMAGING SERVICES INC 1905 AMERICAN WAY KINGSPORT TN 37660 861103148 HEALTHCARE TN 501(C)(3) 3 WHS WELLMONT FOUNDATION 1905 AMERICAN WAY KINGSPORT TN 37660 581594191 HEALTHCARE TN 501(C)(3) 7 WHS TAKOMA REGIONAL HOSPITAL INC 401 TAKOMA AVENUE GREENEVILLE TN 37743 510603966 HEALTHCARE TN 501(C)(3) 3 WHS WELLMONT CARDIOLOGY SERVICES 1905 AMERICAN WAY KINGSPORT TN 37660 263557623 HEALTHCARE TN 501(C)(3) 3 WHS HOLSTON VALLEY IMAGING CENTER 103 W STONE DRIVE KINGSPORT TN 37660 202043285 HEALTHCARE TN WELLMONT IMAGIN RELATED 0 0 false 0 false SAPLING GROVE AMBULATORY SURGERY CENTER 220 MEDICAL PARK BLVD BRISTOL TN 37620 204450153 SURGERY TN WHS RELATED 364690 4442797 false 0 false HOLSTON VALLEY AMBULATORY SURGERY 103 WEST STONE DRIVE KINGSPORT TN 37660 621816864 SURGERY TN WHS RELATED 724458 1641229 false 0 false WELLMONT INC 1905 AMERICAN WAY KINGSPORT TN 37660 621320035 PHYSICIAN SVCS TN WHS C CORP -12890251 -46151031 1.00000 MCOT INC 1905 AMERICAN WAY KINGSPORT TN 37660 621325938 MEDICAL SVCS TN WELLMONT INC C CORP 0 0 0.00000 MEDICAL LAUNDRY OF TRI-CITIES INC 1905 AMERICAN WAY KINGSPORT TN 37660 621482226 MEDICAL SVCS TN WELLMONT INC C CORP 0 0 0.00000 MEDICAL MALL PHARMACY INC 1905 AMERICAN WAY KINGSPORT TN 37660 621565006 MEDICAL SVCS TN WELLMONT INC C CORP 0 0 0.00000 WELLMONT PHYSICIAN SERVICES INC 1905 AMERICAN WAY KINGSPORT TN 37660 621567353 PHYSICIAN SVCS TN WELLMONT INC C CORP 0 0 0.00000 WELLMONT HEALTH SERVICES INC 1905 AMERICAN WAY KINGSPORT TN 37660 621254373 HEALTHCARE TN WELLMONT INC C CORP 0 0 0.00000 WPS PROVIDERS INC 1905 AMERICAN WAY KINGSPORT TN 37660 205564642 PHYSICIAN SVCS TN WELLMONT INC C CORP 0 0 0.00000 false true true false false false false false true false true true true true false true false true WELLMONT MADISON HOUSE B 610224 WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL B 5122476 WELLMONT FOUNDATION INC C 1666687 HOLSTON VALLEY IMAGING CENTER INC I 935215 WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL I 183766 MEDICAL LAUNDRY OF TRI-CITIES INC I 92750 HOLSTON VALLEY AMBULATORY SURGERY CENTER I 826104 WELLMONT PHYSICIAN SERVICES INC I 1065024 WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL K 2035949 MCOT INC L 2290699 MEDICAL MALL PHARMACY INC L 239220 MEDICAL LAUNDRY OF TRI-CITIES INC L 1996746 WELLMONT PHYSICIAN SERVICES INC L 132140 WELLMONT CARDIOLOGY SERVICES INC L 511776 HOLSTON VALLEY IMAGING CENTER INC P 592313 SAPLING GROVE AMBULATORY SURGERY CENTER R 495000 FOR SCHEDULE C PURPOSES, WELLMONT HEALTH SYSTEM WOULD BE CONSIDERED AN AFFILIATED GROUP WITH THE FOLLOWING ENTITIES: WELLMONT HEALTH SYSTEM (62-1636465) WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL (62-1816368) WELLMONT MADISON HOUSE (62-1308216) WELLMONT IMAGING SERVICES, INC. (86-1103148) WELLMONT CARDIOLOGY SERVICES, INC. (26-3557623) THE FILING ORGANIZATION, WELLMONT HEALTH SYSTEM, IS THE ONLY ENTITY ABOVE THAT INCURRED LOBBYING EXPENSES. THE FILING ORGANIZATION IS THE ONLY ENTITY LISTED ABOVE THAT HAS MADE AN ELECTION UNDER IRC SECTION 501(H).