WELLMONT MEDICAL ASSOCIATES INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- WELLMONT MEDICAL ASSOCIATES INC (EIN 27-0898372)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-05-09
- IRS object ID
- 202211299349301881
- Schema version
- 2020v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-05-09T09:15:53-07:00 | ReturnTs |
| Tax Period End | 2021-06-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 270898372 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Wellmont Medical Associates Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WELL | BusinessNameControlTxt |
| Phone | 4233023374 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 311 Princeton Road Suite 1 | AddressLine1Txt |
| City | Johnson City | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37601 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Chase Wilson | PersonNm |
| Person Title | VP/COO-BHMA | PersonTitleTxt |
| Signature | 2022-05-09 | SignatureDt |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Chase | PersonFirstNm |
| Person Last | Wilson | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Federated Assurance Level | FAL1 | FederatedAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
| Principal Officer | Chase Wilson | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1905 American Way | AddressLine1Txt |
| City | Kingsport | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37660 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $119,893,228 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | balladhealth.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2008 | FormationYr |
| Legal Domicile State | TN | LegalDomicileStateCd |
| Activity Or Mission | 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. | ActivityOrMissionDesc |
| Voting Members Governing Body | 22 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 1012 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| CY Contributions Grants | $1,173,649 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $122,459,725 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $118,507,895 | CYProgramServiceRevenueAmt |
| PY Investment Income | $35,348 | PYInvestmentIncomeAmt |
| CY Investment Income | $14,433 | CYInvestmentIncomeAmt |
| PY Other Revenue | $860,360 | PYOtherRevenueAmt |
| CY Other Revenue | $166,783 | CYOtherRevenueAmt |
| PY Total Revenue | $123,355,433 | PYTotalRevenueAmt |
| CY Total Revenue | $119,862,760 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $88,600,873 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $86,661,498 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $34,955,250 | PYOtherExpensesAmt |
| CY Other Expenses | $35,801,499 | CYOtherExpensesAmt |
| PY Total Expenses | $123,556,123 | PYTotalExpensesAmt |
| CY Total Expenses | $122,462,997 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$200,690 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,600,237 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $20,115,154 | TotalAssetsBOYAmt |
| Total Assets EOY | $20,328,734 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $22,269,644 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $23,109,479 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$2,154,490 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$2,780,745 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Honor those we serve by delivering the best possible care.Ballad Health is dedicated to improving the health of the 29-county Appalachian Highlands region. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $110,595,302 | ExpenseAmt |
| Revenue | $118,596,009 | RevenueAmt |
| Desc | Wellmont Medical Associates, Inc. (WMA) is physician-led and professionally managed. From the WMA board of directors and leadership team members to the providers who care for patients every day, WMAs commitment to physician leadership is clear.WMA, 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, WMA offers the latest in technological advances to ensure patients receive superior care. Medical services provided by Wellmont Medical Associates include:- Primary care- OB/GYN- Surgery- Oncology- Outpatient and urgent care centers- Neurology- Pulmonology- Spine and rehabilitation- Behavioral health- Sleep center- Occupational medicine- Physical therapy- Pain management- Palliative medicine- HospitalistsWMA is dedicated to improving the community's access to quality, affordable healthcare, educating the region's caregivers, improving the health status of the communities and contributing to the overall quality of life in the areas served.In fiscal year 2021, WMA had 646,542 patient encounters.Recognizing some patients cannot afford essential medical services, WMA incurred a loss of $1,055,310 attributable to the provision of charity care in fiscal year 2021.Additionally, WMA 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 $35,913,669.It is WMAs obligation to support the causes that improve the quality of life in the region. WMA 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 uninsured and underinsured as well as full-time college studentsWMA 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. | Desc |
| Total Program Service Expenses | $110,595,302 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (true) | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 86 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 1012 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Form8282 Filed | 0 | Form8282FiledCnt |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 22 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Lynn Krutak | PersonNm |
| Phone | 4233023374 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 303 Med Tech Parkway Suite 300 | AddressLine1Txt |
| City | Johnson City | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37604 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (33 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|
| Scott Dulebohn MD | |||||||
| Director | 40.00 | 0.00 | Yes (X) | $0 | $1,152,038 | $35,245 | |
| Eric Deaton | |||||||
| BH EVP/COO | 0.10 | 64.90 | Yes (X) | $0 | $1,039,919 | $94,315 | |
| Paul Jett MD | |||||||
| Physician | 40.00 | 0.00 | $902,062 | $0 | $39,411 | ||
| Adel El Abbassi MD | |||||||
| Physician | 40.00 | 0.00 | $872,230 | $0 | $17,062 | ||
| Israel Garcia MD | |||||||
| Director | 40.00 | 0.00 | Yes (X) | $0 | $854,164 | $19,181 | |
| Clay Runnels MD | |||||||
| BH EVP/Chief Ph | 0.10 | 64.90 | Yes (X) | $0 | $778,006 | $94,084 | |
| Girendra Hoskere MD | |||||||
| Director | 40.00 | 0.00 | Yes (X) | $832,616 | $0 | $8,192 | |
| Daniel Krenk MD | |||||||
| Physician | 40.00 | 0.00 | $758,982 | $0 | $41,187 | ||
| Mark Patterson MD BH SVP | |||||||
| BHMA Pres/CEO | 54.50 | 0.50 | Yes (X) | $669,080 | $0 | $73,897 | Yes (X) |
| Mark Chang MD | |||||||
| Director | 0.10 | 39.90 | Yes (X) | $0 | $680,367 | $43,703 | |
| Anthony Palazzo MD | |||||||
| Director | 40.00 | 0.00 | Yes (X) | $0 | $679,250 | $42,246 | |
| Samuel Deel MD | |||||||
| Physician | 40.00 | 0.00 | $658,216 | $0 | $42,649 | ||
| Paul Kramer MD | |||||||
| Physician | 40.00 | 0.00 | $658,083 | $0 | $39,094 | ||
| Greg Miller MD | |||||||
| Director | 40.00 | 0.00 | Yes (X) | $0 | $623,333 | $28,107 | |
| Wes Pectol MD | |||||||
| Director | 40.00 | 0.00 | Yes (X) | $0 | $578,932 | $41,577 | |
| Elizabeth Jackson MD | |||||||
| Director | 0.10 | 39.90 | Yes (X) | $0 | $539,864 | $34,630 | |
| Stephen Combs MD | |||||||
| VP/CMO Medical Services | 45.00 | 0.00 | $526,463 | $0 | $25,126 | ||
| Howard Herrell MD | |||||||
| Secretary/Treas | 40.00 | 0.00 | Yes (X) | $0 | $511,310 | $39,035 | Yes (X) |
| Maurice Nida DO | |||||||
| Director | 40.00 | 0.00 | Yes (X) | $462,280 | $0 | $30,067 | |
| Tamara Musgrave MD | |||||||
| Director | 40.00 | 0.00 | Yes (X) | $469,123 | $0 | $21,176 | |
| Marta Wayt MD | |||||||
| Chairman | 39.90 | 0.10 | Yes (X) | $423,408 | $0 | $25,109 | Yes (X) |
| Rohini Nathan MD | |||||||
| Director | 40.00 | 0.00 | Yes (X) | $381,810 | $0 | $42,067 | |
| David Thompson MD | |||||||
| Vice Chair/CAMO | 40.00 | 0.00 | Yes (X) | $341,547 | $0 | $30,398 | Yes (X) |
| Landon Combs MD | |||||||
| Former Officer | 40.00 | 0.00 | $284,781 | $0 | $34,326 | ||
| Leanne Cox end 102020 | |||||||
| VP/BHMA CFO | 20.25 | 24.75 | $0 | $238,020 | $37,109 | Yes (X) | |
| Stephanie Dominy end 0820 | |||||||
| Interim BHMACEO | 45.00 | 0.00 | $0 | $223,436 | $26,407 | Yes (X) | |
| Marilyn Bishop MD | |||||||
| Director | 40.00 | 0.00 | Yes (X) | $0 | $235,361 | $13,268 | |
| Karen Williams | |||||||
| Former Key Employee | 40.00 | 0.00 | $0 | $185,820 | $32,244 | ||
| Chase Wilson | |||||||
| COO/CFO | 40.50 | 4.50 | $0 | $167,843 | $31,136 | Yes (X) | |
| Joshua Stone PA-C | |||||||
| Director | 40.00 | 0.00 | Yes (X) | $0 | $149,516 | $31,527 | |
| Karen Stallard NP | |||||||
| Director | 40.00 | 0.00 | Yes (X) | $141,610 | $0 | $27,991 | |
| Megan Johnson MD | |||||||
| Director | 40.00 | 0.00 | Yes (X) | $0 | $145,768 | $8,911 | |
| Tim Schwob MD | |||||||
| Director | 40.00 | 0.00 | Yes (X) | $0 | $63,871 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $8,382,291 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $8,846,818 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,150,477 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 206 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Powell River Emergency Group | |||||
| PO Box 677979 | Dallas | TX | 75267 | Medical Staffing | $751,123 |
| Pain Medicine Associates PC | |||||
| 101 MedTech Parkway Suite 200 | Johnson City | TN | 37604 | Medical Staffing | $718,622 |
| Weatherby Locums Inc | |||||
| PO Box 972633 | Dallas | TX | 75397 | Medical Staffing | $613,341 |
| Blue Ridge Radiology PC | |||||
| 3053 West State Street | Bristol | TN | 37620 | Radiology Services | $306,213 |
| LocumTenenscom LLC | |||||
| PO Box 405547 | Atlanta | GA | 30384 | Medical Staffing | $273,778 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 8 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,173,649 | GovernmentGrantsAmt |
| Total Contributions | $1,173,649 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| CARES Act Revenue | 900099 | $4,162,266 | $4,162,266 |
| CMS Oncology Care Model | 900099 | $227,325 | $227,325 |
| Hospital Support | 621990 | $27,509,732 | $27,509,732 |
| Net Patient Revenue | 621990 | $74,177,545 | $74,177,545 |
| Performance Bonuses/Cap | 621990 | $12,430,595 | $12,430,595 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $432 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $432 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $118,507,895 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,433 | TotalRevenueColumnAmt |
| Exclusion | $14,433 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $18,346 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $30,468 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$12,122 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$12,122 | TotalRevenueColumnAmt |
| Exclusion | -$12,122 | ExclusionAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| Medical Director Fees | 900099 | $88,114 | $88,114 | |
| Medical Records | 900099 | $79,885 | $79,885 | |
| Recovery of Unclaimed Property | 900099 | $7,614 | $7,614 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,292 | TotalRevenueColumnAmt |
| Exclusion | $3,292 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $178,905 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $119,862,760 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $118,596,009 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $93,102 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,291,371 | TotalAmt |
| Program Services | $3,267,248 | ProgramServicesAmt |
| Management And General | $1,024,123 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,586,736 | TotalAmt |
| Program Services | $70,504,226 | ProgramServicesAmt |
| Management And General | $82,510 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,358,560 | TotalAmt |
| Program Services | $2,297,174 | ProgramServicesAmt |
| Management And General | $61,386 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,475,537 | TotalAmt |
| Program Services | $5,466,982 | ProgramServicesAmt |
| Management And General | $8,555 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,949,294 | TotalAmt |
| Program Services | $3,915,839 | ProgramServicesAmt |
| Management And General | $33,455 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,420 | TotalAmt |
| Program Services | $8,420 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,245,789 | TotalAmt |
| Program Services | $9,475,182 | ProgramServicesAmt |
| Management And General | $770,607 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,000 | TotalAmt |
| Program Services | $25,965 | ProgramServicesAmt |
| Management And General | $35 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $867,455 | TotalAmt |
| Program Services | $834,585 | ProgramServicesAmt |
| Management And General | $32,870 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $794 | TotalAmt |
| Program Services | $794 | ProgramServicesAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,974,704 | TotalAmt |
| Program Services | $5,764,627 | ProgramServicesAmt |
| Management And General | $210,077 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $640,547 | TotalAmt |
| Program Services | $624,510 | ProgramServicesAmt |
| Management And General | $16,037 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,747 | TotalAmt |
| Program Services | $62,747 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,616,234 | TotalAmt |
| Program Services | $1,441,349 | ProgramServicesAmt |
| Management And General | $174,885 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $130,049 | TotalAmt |
| Program Services | $125,312 | ProgramServicesAmt |
| Management And General | $4,737 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| Support Services | $9,132,071 | $9,132,071 | |
| Medical Supplies | $5,508,813 | $5,508,813 | |
| Maintenance | $560,408 | $41,530 | $518,878 |
| Dues & Subscriptions | $516,280 | $263,357 | $252,923 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $511,188 | TotalAmt |
| Program Services | $499,728 | ProgramServicesAmt |
| Management And General | $11,460 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $122,462,997 | TotalAmt |
| Program Services | $110,595,302 | ProgramServicesAmt |
| Management And General | $11,867,695 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $65,192 | BOYAmt |
| EOY | $63,661 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,644,679 | BOYAmt |
| EOY | $5,849,545 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,166 | BOYAmt |
| EOY | $12,500 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $201,173 | BOYAmt |
| EOY | $106,146 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $97,016 | BOYAmt |
| EOY | $1,440,316 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,636,362 | BOYAmt |
| EOY | $4,376,625 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $27,652,773 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $20,924,048 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,238,058 | BOYAmt |
| EOY | $6,728,725 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,289,456 | BOYAmt |
| EOY | $1,289,456 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,914,052 | BOYAmt |
| EOY | $461,760 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,115,154 | BOYAmt |
| EOY | $20,328,734 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,606,967 | BOYAmt |
| EOY | $13,704,156 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,201,302 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,662,677 | BOYAmt |
| EOY | $8,204,021 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,269,644 | BOYAmt |
| EOY | $23,109,479 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$2,154,490 | BOYAmt |
| EOY | -$2,780,745 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$2,154,490 | BOYAmt |
| EOY | -$2,780,745 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,115,154 | BOYAmt |
| EOY | $20,328,734 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$2,600,237 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $1,973,982 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $797 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,888 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year | $1,173,649 | CurrentTaxYearAmt |
| Total | $1,176,334 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $108,656,694 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $149,020,081 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $157,985,364 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $123,132,961 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $118,596,010 | CurrentTaxYearAmt |
| Total | $657,391,110 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $137,073 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $60,558 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $160,834 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $90,791 | CurrentTaxYearAmt |
| Total | $449,256 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $108,657,491 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $149,159,042 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $158,045,922 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $123,293,795 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $119,860,450 | CurrentTaxYearAmt |
| Total | $659,016,700 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $659,016,700 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $114,832 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $101,010 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $90,328 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $61,638 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $32,778 | CurrentTaxYearAmt |
| Total | $400,586 | TotalAmt |
Post1975 UBTI Post1975UBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $114,832 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $101,010 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $90,328 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $61,638 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $32,778 | CurrentTaxYearAmt |
| Total | $400,586 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $108,772,323 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $149,260,052 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $158,136,250 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $123,355,433 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $119,893,228 | CurrentTaxYearAmt |
| Total | $659,417,286 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99940 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99930 | PublicSupportPY509Pct |
| Investment Income CY | 0.00060 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00070 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,432,779 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,003,919 | DepreciationAmt |
| Book Value | $428,860 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,516,733 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,148,654 | DepreciationAmt |
| Book Value | $5,368,079 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,630,045 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,719,399 | DepreciationAmt |
| Book Value | $910,646 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $73,216 | OtherCostOrOtherBasisAmt |
| Depreciation | $52,076 | DepreciationAmt |
| Book Value | $21,140 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $6,728,725 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| COVID-19 FICA Loan | $910,580 |
| Due to 3rd Parties-Medicare Adv Pmts S/T | $2,082,096 |
| Due to 3rd Party Payors | $60,185 |
| Due to Affiliates | $951,258 |
| Operating Lease Obligation L/T | $2,581,247 |
| Operating Lease Obligation S/T | $1,618,655 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $8,204,021 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X : FIN48 Footnote | FormAndLineReferenceDesc |
| Explanation | 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 is included in the accompanying consolidated financial statements. Taxable subsidiaries are discussed in Note K. No significant uncertain tax positions exist at June 30, 2021 and 2020. Tax returns for 2018 through 2020 are subject to examination by the Internal Revenue Service." | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Discretionary Spending Acct | Yes (X) | DiscretionarySpendingAcctInd |
| Written Policy Ref T And E Expnss | false | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | false | SubstantiationRequiredInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (32 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Adel El Abbassi MD | ||||||||||||
| Physician | $456,167 | $415,285 | $778 | $16,670 | $392 | $889,292 | ||||||
| Anthony Palazzo MD | ||||||||||||
| Director | $607,346 | $45,500 | $26,404 | $17,314 | $24,932 | $721,496 | ||||||
| Chase Wilson | ||||||||||||
| COO/CFO | $135,247 | $32,356 | $240 | $8,999 | $22,137 | $198,979 | ||||||
| Clay Runnels MD | ||||||||||||
| BH EVP/Chief Ph | $474,281 | $289,754 | $13,971 | $68,948 | $25,136 | $872,090 | ||||||
| Daniel Krenk MD | ||||||||||||
| Physician | $694,736 | $50,500 | $13,746 | $17,225 | $23,962 | $800,169 | ||||||
| David Thompson MD | ||||||||||||
| Vice Chair/CAMO | $339,844 | $500 | $1,203 | $5,113 | $25,285 | $371,945 | ||||||
| Elizabeth Jackson MD | ||||||||||||
| Director | $492,575 | $45,268 | $2,021 | $17,034 | $17,596 | $574,494 | ||||||
| Eric Deaton | ||||||||||||
| BH EVP/COO | $577,023 | $447,591 | $15,305 | $73,799 | $20,516 | $1,134,234 | ||||||
| Girendra Hoskere MD | ||||||||||||
| Director | $486,851 | $342,428 | $3,337 | $7,800 | $392 | $840,808 | ||||||
| Greg Miller MD | ||||||||||||
| Director | $527,542 | $85,002 | $10,789 | $4,300 | $23,807 | $651,440 | ||||||
| Howard Herrell MD | ||||||||||||
| Secretary/Treas | $386,799 | $124,316 | $195 | $16,800 | $22,235 | $550,345 | ||||||
| Israel Garcia MD | ||||||||||||
| Director | $820,850 | $500 | $32,814 | $16,800 | $2,381 | $873,345 | ||||||
| Joshua Stone PA-C | ||||||||||||
| Director | $93,249 | $54,844 | $1,423 | $9,387 | $22,140 | $181,043 | ||||||
| Karen Stallard NP | ||||||||||||
| Director | $62,036 | $79,461 | $113 | $8,740 | $19,251 | $169,601 | ||||||
| Karen Williams | ||||||||||||
| Former Key Employee | $183,581 | $500 | $1,739 | $11,492 | $20,752 | $218,064 | ||||||
| Landon Combs MD | ||||||||||||
| Former Officer | $241,375 | $500 | $42,906 | $16,599 | $17,727 | $319,107 | ||||||
| Leanne Cox end 102020 | ||||||||||||
| VP/BHMA CFO | $183,988 | $40,575 | $13,457 | $12,137 | $24,972 | $275,129 | ||||||
| Marilyn Bishop MD | ||||||||||||
| Director | $208,933 | $24,127 | $2,301 | $13,268 | $248,629 | |||||||
| Mark Chang MD | ||||||||||||
| Director | $494,545 | $184,033 | $1,789 | $18,322 | $25,381 | $724,070 | ||||||
| Mark Patterson MD BH SVP | ||||||||||||
| BHMA Pres/CEO | $437,603 | $215,209 | $16,268 | $48,050 | $25,847 | $742,977 | ||||||
| Marta Wayt MD | ||||||||||||
| Chairman | $346,021 | $53,244 | $24,143 | $16,322 | $8,787 | $448,517 | ||||||
| Maurice Nida DO | ||||||||||||
| Director | $408,458 | $35,869 | $17,953 | $13,195 | $16,872 | $492,347 | ||||||
| Megan Johnson MD | ||||||||||||
| Director | $130,846 | $14,815 | $107 | $8,710 | $201 | $154,679 | ||||||
| Paul Jett MD | ||||||||||||
| Physician | $276,635 | $616,750 | $8,677 | $14,446 | $24,965 | $941,473 | ||||||
| Paul Kramer MD | ||||||||||||
| Physician | $561,332 | $95,962 | $789 | $17,907 | $21,187 | $697,177 | ||||||
| Rohini Nathan MD | ||||||||||||
| Director | $357,178 | $21,516 | $3,116 | $17,780 | $24,287 | $423,877 | ||||||
| Samuel Deel MD | ||||||||||||
| Physician | $494,415 | $119,684 | $44,117 | $17,687 | $24,962 | $700,865 | ||||||
| Scott Dulebohn MD | ||||||||||||
| Director | $1,051,116 | $85,296 | $15,626 | $17,299 | $17,946 | $1,187,283 | ||||||
| Stephanie Dominy end 0820 | ||||||||||||
| Interim BHMACEO | $204,173 | $19,263 | $13,169 | $13,238 | $249,843 | |||||||
| Stephen Combs MD | ||||||||||||
| VP/CMO Medical Services | $430,892 | $74,383 | $21,188 | $17,196 | $7,930 | $551,589 | ||||||
| Tamara Musgrave MD | ||||||||||||
| Director | $466,320 | $700 | $2,103 | $21,176 | $490,299 | |||||||
| Wes Pectol MD | ||||||||||||
| Director | $566,018 | $500 | $12,414 | $16,800 | $24,777 | $620,509 | ||||||
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 1a: Relevant information in regards to selections on 1a. | Discretionary SpendingWMA provided a monthly vehicle allowance to Stephen Combs, M.D., for travel expenses during the fiscal year ended June 30, 2021. The amount is included in taxable compensation. |
| Part I, Line 1b: Reason for not following policy regarding payment provisions for expenses | As part of Dr. Stephen Combs' employment agreement for assuming the WMA CMO position, he receives $400 a month to provide for his personal auto usage. As CMO, 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. |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Marta Wayt MD | PersonNm |
| Relationship With Org | Phy/Brd Mbm | RelationshipWithOrgTxt |
| Loan Purpose | Education | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $50,000 | OriginalPrincipalAmt |
| Balance Due | $12,500 | BalanceDueAmt |
| Default | false | DefaultInd |
| Board Or Committee Approval | false | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (true) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $12,500 | TotalBalanceDueAmt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Landon Combs MD | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | Family Member | RelationshipDescriptionTxt |
| Transaction | $268,787 | TransactionAmt |
| Transaction | See Part V | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule L, Part V Supplemental Information | FormAndLineReferenceDesc |
| Explanation | (1) Landon Combs, M.D., an employee and former officer of WMA, is a family member of Stephen Combs, M.D., key employee of WMA. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder | 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, Part VI, Line 7a: How Members or Shareholders Elect Governing Body | 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, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders | Certain decisions of the board are, pursuant to charter, subject to approval of the members. No ordinary, day-to-day decisions are subject to member approval. |
| Form 990, Part VI, Line 11b: Form 990 Review Process | The Ballad Health Tax Department prepares and reviews the Form 990. During preparation other functional areas within the organization provide information and support to complete an accurate return. The return is reviewed by the organization's VP/COO and is provided in electronic form to all members of the Board of Directors prior to being filed with the IRS. |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | 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 committee is responsible for disclosing conflicts of interest, it is also the responsibility of any board member aware of a conflict which has not been disclosed to ensure the board is made aware. The presiding officer of a board or board committee meeting may ask a conflicted member to excuse themselves from the meeting during the discussion related to the issue with which the conflict of interest applies. Under no circumstances shall a member vote on a matter that gives rise to a potential conflict. |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | Governing documents and conflict of interest policy are made available uponrequest to the appropriate parties requesting them. Financial statementsare made available upon request to appropriate parties requesting them, and they are made available to those parties who own indebtedness of the company on a quarterly basis. |
| Other Changes In Net Assets Or Fund Balances - Other Increases | Intercompany Transfers = $1973982 |
| Form 990, Part VI, Line 15a - Compensation Process for Top Official | WMAs Board Chair, Dr. Wayt, receives no compensation for her board service to WMA. Her compensation is derived from medical services provided to WMA. Her compensation, consistent with all WMA physicians, is evaluated periodically by utilizing an independent third-party firm which blends compensation data from three independent databases: MGMA, AMG, and Sullivan-Cotter. This data is then evaluated by executive leadership at Wellmont Medical Associates. Wellmont Medical Associates President will then have final review and approval of compensation. On an annual basis, Ballad Healths Human Resources (H/R) Department evaluates compensation for all executives at a position level of Assistant Vice President and above. The review includes WMAs Interim CEO and WMAs President/CEO. H/Rs evaluation is based on market data obtained from independent third-party consultants for positions with similar responsibilities at similarly situated organizations. Based on this comparable data, Ballad Healths CEO evaluates the data and, if appropriate, makes necessary adjustments. Any adjustments to Senior Vice Presidents or above are reviewed by the Board of Directors Executive Compensation Committee. In addition, Ballad Health offers an incentive plan to executives based on targeted achievement metrics categorized by; Quality, Service and Safety; Access to Care; Financial Stewardship, and any other metrics approved from time to time by the Board of Directors. |
| Form 990, Part VI, Line 15b - Compensation for Officers | Physician directors/officers do not receive compensation for services provided to WMA as a board member. Their compensation relates to medical services they provide to WMA. Their compensation, consistent with all WMA physicians, is evaluated periodically by utilizing an independent third-party firm which blends compensation data from three independent databases: MGMA, AMG, and Sullivan-Cotter. This data is then evaluated by executive leadership at WMA. WMA's president will then have final review and approval of compensation. Non-physician officer and key employee compensation is determined according to Ballad Healths salary policy: Ballad Healths Human Resources (H/R) Department evaluates compensation for all executives at a position level of Assistant Vice President and above. H/Rs evaluation is based on market data obtained from independent third-party consultants for positions with similar responsibilities at similarly situated organizations. Based on this comparable data, Ballad Healths CEO evaluates the data and, if appropriate, makes necessary adjustments. Any adjustments to Senior Vice Presidents or above are reviewed by the Board of Directors Executive Compensation Committee. In addition, Ballad Health offers an incentive plan to executives based on targeted achievement metrics categorized by; Quality, Service and Safety; Access to Care; Financial Stewardship, and any other metrics approved from time to time by the Board of Directors. Positions below Assistant Vice President are evaluated periodically by HR using data from various external sources for similar positions in similarly situated organizations. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (18 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Mountain States Health Alliance | ||||||||||
| 303 Med Tech Parkway Suite 220 | Johnson City | TN | 37604 | 620476282 | Hospital System | TN | 501c3 | 3 | BALLAD HEALTH | false |
| MSHA Auxiliary | ||||||||||
| 400 N State of Franklin Road | Johnson City | TN | 37604 | 581418345 | Supporting Organization | 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 | WHS | false |
| Dickenson Community Hospital | ||||||||||
| 312 Hospital Drive | Clintwood | VA | 24228 | 770599553 | Hospital | VA | 501c3 | 3 | WHS | 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 | Medical Services | VA | 501c3 | 12a | JMH | false |
| Ballad Health | ||||||||||
| 303 Med Tech Parkway Suite 220 | Johnson City | TN | 37604 | 611771290 | Supporting Organization | TN | 501c3 | 12b | NA | false |
| East TN Healthcare Holdings Inc | ||||||||||
| 203 Gray Commons Circle | Gray | TN | 37615 | 815475903 | Opioid Treatment | TN | 501c3 | 3 | MSHA | false |
| Wellmont Health System | ||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621636465 | Hospital System | TN | 501c3 | 3 | BALLAD HEALTH | false |
| Wellmont Hawkins Co Memorial Hosp | ||||||||||
| 851 Locust Street | Rogersville | TN | 37857 | 621816368 | Hospital | TN | 501c3 | 3 | WHS | false |
| Takoma Regional Hospital Inc dba GCH | ||||||||||
| 1420 Tusculum Boulevard | Greeneville | TN | 37745 | 510603966 | Hospital | TN | 501c3 | 3 | WHS | false |
| Wellmont Cardiology Services | ||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 263557623 | Medical Services | TN | 501c3 | 10 | WHS | false |
| Ballad Health Foundation | ||||||||||
| 1019 West Oakland Ave Suite 2 | Johnson City | TN | 37604 | 581594191 | Fundraiser | TN | 501c3 | 7 | BALLAD HEALTH | false |
| Wellmont Madison House | ||||||||||
| 2000 Greenway Street | Kingsport | TN | 37660 | 621308216 | Assisted Living | TN | 501c3 | 10 | WHS | false |
| Wellmont Wexford House | ||||||||||
| 2421 North John B Dennis Highway | Kingsport | TN | 37660 | 581859039 | Nursing Home | TN | 501c3 | 10 | WHS | false |
| Wellmont Imaging Services Inc | ||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 861103148 | Healthcare | TN | 501c3 | 12a | WHS | false |
| Wellmont Sleep Services | ||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 273777167 | Medical Services | TN | 501c3 | 3 | WHS | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| Greeneville Physician Services LLC | |||||||||
| 1905 American Way | Kingsport | TN | 37660 | 455070419 | Medical Services | TN | NA | false | false |
| Rehabilitation Hospital of Bristol LLC | |||||||||
| 103 North Street | Bristol | VA | 24201 | 205612001 | Medical Services | VA | NA | false | false |
| Emmaus Community Healthcare PLLC | |||||||||
| 6419 Bristol Hwy | Piney Flats | TN | 37686 | 200577483 | Medical Services | TN | NA | false | false |
| Medical Specialists of Johnson City LLC | |||||||||
| 2528 Wesley Street Suite 2 | Johnson City | TN | 37601 | 272199037 | Medical Services | TN | NA | false | false |
| East Tennessee Ambulatory Surgery Center | |||||||||
| 701 Med Tech Parkway Suite 100 | Johnson City | TN | 37604 | 621787537 | Medical Services | TN | NA | false | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (16 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Wellmont Inc | ||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621320035 | Medical Services | TN | WHS | C | false | |||||
| Wellmont Collections Inc | ||||||||||||||
| 2004 American Way Suite 211 | Kingsport | TN | 37660 | 621325938 | Business Services | TN | NA | C | false | |||||
| Medical Mall Pharmacy Inc | ||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621565006 | Medical Services | TN | NA | C | false | |||||
| Wellmont Physician Services | ||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621567353 | Medical Services | TN | NA | C | false | |||||
| WPS Providers Inc | ||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 205564642 | Medical Services | TN | NA | C | false | |||||
| Wellmont Health Services Inc | ||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621254373 | Medical Services | TN | NA | C | false | |||||
| Blue Ridge Medical Management Corp | ||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621490616 | Medical Services | TN | MSHA | C | false | |||||
| Mediserve Medical Equipment | ||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621212286 | Durable Medical Equipment | TN | BRMMC | C | false | |||||
| Mountain States Properties | ||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621845895 | Property Management | TN | BRMMC | C | false | |||||
| Mountain States Physician Grp | ||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621700412 | Medical Services | TN | BRMMC | C | false | |||||
| Community Home Care Inc | ||||||||||||||
| 1490 Park Avenue NW Suite B | Norton | VA | 24273 | 541453810 | Durable Medical Equipment | VA | NCH | C | false | |||||
| Wilson Pharmacy Inc | ||||||||||||||
| PO Box 5289 | Johnson City | TN | 37604 | 620329587 | Pharmacy | TN | BRMMC | C | false | |||||
| Crestpoint Health Insurance Company | ||||||||||||||
| 509 Med Tech Parkway Suite 100 | Johnson City | TN | 37604 | 620381170 | Insurance | TN | ISHN | C | false | |||||
| Nolichuckey Management Svcs Inc | ||||||||||||||
| 1420 Tusculum Boulevard | Greeneville | TN | 37745 | 621776681 | Medical Services | TN | LMH | C | false | |||||
| Ballad Ventures LLC | ||||||||||||||
| 400 N State of Franklin Road | Johnson City | TN | 37604 | 844214681 | Investments | TN | NA | C | false | |||||
| Wellmont Insurance Co SPC LTD | ||||||||||||||
| 981195624 | Insurance | NA | C | false | PO Box 30600 | Grand Cayman | CJ | KY1-1203 | CJ | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |