WELLMONT WEXFORD HOUSE: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- WELLMONT WEXFORD HOUSE (EIN 58-1859039)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2016-05-05
- IRS object ID
- 201641269349300049
- Schema version
- 2014v6.0
- 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 | 2016-05-05T09:21:43-05:00 | ReturnTs |
| Tax Period End | 2015-06-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 581859039 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WELLMONT WEXFORD HOUSE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WELL | BusinessNameControlTxt |
| Phone | 4232308200 | PhoneNum |
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 |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TODD J DOUGAN | PersonNm |
| Person Title | SR. VP OF FINANCE | PersonTitleTxt |
| Phone | 4232308200 | PhoneNum |
| Signature | 2016-05-05 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TODD J DOUGAN | 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 | $15,098,830 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.WELLMONT.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1989 | FormationYr |
| Legal Domicile State | TN | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE FACILITIES AND HEALTHCARE FOR THE ELDERLY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 3 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 296 | TotalEmployeeCnt |
| Total Volunteers | 16 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $15,124,952 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $15,032,184 | CYProgramServiceRevenueAmt |
| PY Investment Income | $13 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $82,912 | PYOtherRevenueAmt |
| CY Other Revenue | $66,646 | CYOtherRevenueAmt |
| PY Total Revenue | $15,207,877 | PYTotalRevenueAmt |
| CY Total Revenue | $15,098,830 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $7,997,665 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $7,709,709 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,100,927 | PYOtherExpensesAmt |
| CY Other Expenses | $5,961,504 | CYOtherExpensesAmt |
| PY Total Expenses | $14,098,592 | PYTotalExpensesAmt |
| CY Total Expenses | $13,671,213 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,109,285 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,427,617 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,164,274 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,534,675 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,367,040 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,107,058 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $797,234 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,427,617 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | PROVIDE FACILITIES AND HEALTHCARE FOR THE ELDERLY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $12,411,385 | ExpenseAmt |
| Revenue | $15,032,184 | RevenueAmt |
| Desc | A SKILLED NURSING FACILITY LOCATED IN KINGSPORT, TENNESSEE, WELLMONT WEXFORD HOUSE JOINED WELLMONT HEALTH SYSTEM IN DECEMBER 2013. SERVING THE RESIDENTS OF SULLIVAN COUNTY AND SURROUNDING COMMUNITIES, OUR LICENSED AND CERTIFIED NURSING FACILITY IS RECOGNIZED AS A HEALTH CARE LEADER, PROVIDING SHORT-TERM AND LONG-TERM MEDICAL CARE AND REHABILITATION. WELLMONT WEXFORD HOUSE IS A 174-BED SKILLED AND LONG-TERM CARE FACILITY WITH 210 EMPLOYEES. OUR TEAM OF PROFESSIONAL CAREGIVERS HAS A GOAL TO PROVIDE EACH RESIDENT WITH HIGH-QUALITY HEALTH CARE IN A COMFORTABLE HOME- LIKE ENVIRONMENT. THEIR EXPERTISE ENSURES EFFECTIVE MEDICAL SERVICES FOR SKILLED AND REHABILITATIVE NURSING CARE, INCLUDING (CON'T ON SCHEDULE O) INPATIENT AND OUTPATIENT PHYSICAL THERAPY, SPEECH THERAPY AND OCCUPATIONAL THERAPY, RESIDENTIAL CUSTODIAL CARE, RESPITE AND HOSPICE CARE. THE ALIGNING OF THE TWO ORGANIZATIONS ENHANCES THE CONTINUUM OF CARE THE REGION'S PATIENTS RECEIVE. IT RESULTS IN A SEAMLESS TRANSITION FROM ONE HEALTHCARE SETTING TO ANOTHER, WHILE RETAINING THE SAME QUALITY THROUGHOUT THE CARE PROCESS. SPECIAL ATTENTION IS GIVEN TO THE PERSONAL NEEDS OF EACH RESIDENT. SOCIAL, RELIGIOUS, RECREATIONAL AND EDUCATIONAL PROGRAMS, ALONG WITH OTHER AMENITIES, ARE PROVIDED SO EACH RESIDENT CAN LEAD A FULFILLING LIFE AND EXPERIENCE AS MUCH PERSONAL FREEDOM AS POSSIBLE. SERVICES AT WELLMONT WEXFORD HOUSE INCLUDE NURSING AND HEALTH CARE PROGRAMS THAT OFFER A WIDE RANGE OF INDIVIDUALIZED CARE. IN ADDITION TO THE SERVICES NOTED ABOVE, OTHER EXAMPLES INCLUDE RESPIRATORY CARE, THERAPEUTIC MANAGEMENT, RESTORATIVE THERAPIES, NUTRITIONAL COUNSELING AND RECREATIONAL ACTIVITIES, AS WELL AS CONVALESCENT NURSING CARE TO THE ACUTELY ILL. RESIDENTS ALSO HAVE ONSITE ACCESS TO DIAGNOSTIC SERVICES SUCH AS ULTRASOUND, X-RAY AND EKG. MOTIVATIONAL PROGRAMS EMPHASIZE THE REHABILITATION OF EACH RESIDENT TO THEIR MAXIMUM LEVEL OF FUNCTIONING. OTHER MEDICAL SERVICES OFFERED INCLUDE ENTERAL NUTRITIONAL AND TUBE FEEDING, FOLEY CATHETER CARE, COLOSTOMY, UROSTOMY, NEPHROSTOMY CARE, TRACHEOSTOMY CARE AND NASO/PHARYNGEAL SUCTIONING, IV ACCESS CARE AND THERAPY/ANTIBIOTICS, PAIN MANAGEMENT, DIABETES CARE, WOUND CARE, LAB SERVICES, ORTHOPEDIC REHABILITATION, INCONTINENCE CARE, AND DENTAL AND VISION CARE. WELLMONT WEXFORD HOUSE EARNED THE JOINT COMMISSION'S GOLD SEAL OF APPROVAL FOR ACCREDITATION AND CERTIFICATION. IT ACHIEVED THAT DESIGNATION BY COMPLYING WITH NATIONAL STANDARDS FOR ADVANCED REHABILITATION SERVICES, HEALTHCARE QUALITY AND PATIENT AND RESIDENT SAFETY IN NURSING HOME CARE. FOR THE ELEVENTH YEAR IN A ROW, WEXFORD HOUSE WAS SELECTED BY KINGSPORT TIMES-NEWS READERS AS THE BEST NURSING HOME. DURING FISCAL YEAR 2015, WEXFORD HOUSE SERVED 419 RESIDENTS AND PROVIDED 60,674 DAYS OF CARE. | Desc |
| Total Program Service Expenses | $12,411,385 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | 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 | Yes (true) | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| 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 | false | 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 | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| 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 | 11 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 296 | 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 |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 3 | 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 | Yes (true) | 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 | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | 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 | TODD J DOUGAN | PersonNm |
| Phone | 4232308200 | PhoneNum |
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 |
Form990 Part VII Section A Form990PartVIISectionAGrp (8 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 |
|---|---|---|---|---|---|---|---|
| TRACEY P MOFFATT TERMED 10314 | |||||||
| BD MEM/WHS S | 1.00 | 39.00 | Yes (X) | $0 | $575,375 | $21,418 | |
| ALICE POPE | |||||||
| SEC/TRES/WHS | 1.00 | 39.00 | Yes (X) | $0 | $479,861 | $27,467 | Yes (X) |
| TIM ATTEBERY | |||||||
| BD MEM/PRESI | 1.00 | 39.00 | Yes (X) | $0 | $446,896 | $25,151 | |
| BARTON A HOVE | |||||||
| PRES/WHS PRE | 1.00 | 39.00 | Yes (X) | $0 | $394,913 | $16,374 | Yes (X) |
| GARY D MILLER | |||||||
| BD MEM/SR VP | 1.00 | 39.00 | Yes (X) | $0 | $346,188 | $16,104 | |
| LOUIS COLLIER TERMED 92614 | |||||||
| VP POST ACUT | 32.00 | 8.00 | $170,434 | $38,735 | $9,358 | Yes (X) | |
| KATHY GREEN TERMED 11414 | |||||||
| EXECUTIVE DI | 40.00 | $132,916 | $0 | $6,205 | Yes (X) | ||
| MARVIN LEE ELLIOTT | |||||||
| EXECUTIVE DI | 40.00 | $23,031 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $326,381 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,281,968 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $122,077 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt | Address Line2ContractorAddress/USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|
| REHAB SOLUTIONS | ||||||
| 536 OLD HOWELL ROAD | GREENEVILLE | SC | 29615 | REHAB SERVICES | $1,113,428 | |
| PHARMACY NETWORK SERVICES | ||||||
| 527 N STATE OF FRANKLIN ROAD | JOHNSON CITY | TN | 37604 | MEDICAL SUPPLIE | $543,596 | |
| GORDON FOOD SERVICES | ||||||
| P O BOX 88029 | CHICAGO | IL | 60680 | FOOD SERVICE | $429,451 | |
| NETWORK SERVICES COMPANY | ||||||
| LOCKBOX 231805 | CHICAGO | IL | 60689 | CLEANING SUPPLI | $119,960 | 1805 MOMENTUM PLACE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NURSING FACILITIES REVENUE | 623000 | $15,031,984 | $15,031,984 |
| MEDICAL RECORD FEES | 624100 | $200 | $200 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $15,032,184 | TotalProgramServiceRevenueAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| MISCELLANEOUS REVENUE | 900099 | $40,601 | $40,601 |
| CAFETERIA/VENDING | 900099 | $26,045 | $26,045 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $66,646 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,098,830 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $15,032,184 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $66,646 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $217,172 | TotalAmt |
| Management And General | $217,172 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,010,924 | TotalAmt |
| Program Services | $5,470,802 | ProgramServicesAmt |
| Management And General | $540,122 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,138 | TotalAmt |
| Program Services | $106,443 | ProgramServicesAmt |
| Management And General | $12,695 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,002,607 | TotalAmt |
| Program Services | $909,442 | ProgramServicesAmt |
| Management And General | $93,165 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $359,868 | TotalAmt |
| Program Services | $316,794 | ProgramServicesAmt |
| Management And General | $43,074 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35 | TotalAmt |
| Management And General | $35 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,688,427 | TotalAmt |
| Program Services | $1,500,095 | ProgramServicesAmt |
| Management And General | $188,332 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,097 | TotalAmt |
| Program Services | $2,704 | ProgramServicesAmt |
| Management And General | $2,393 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,056,106 | TotalAmt |
| Program Services | $943,295 | ProgramServicesAmt |
| Management And General | $112,811 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $243,715 | TotalAmt |
| Program Services | $242,468 | ProgramServicesAmt |
| Management And General | $1,247 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,853 | TotalAmt |
| Program Services | $3,400 | ProgramServicesAmt |
| Management And General | $1,453 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $889 | TotalAmt |
| Program Services | $790 | ProgramServicesAmt |
| Management And General | $99 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $138,730 | TotalAmt |
| Program Services | $138,730 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $401,069 | TotalAmt |
| Program Services | $381,016 | ProgramServicesAmt |
| Management And General | $20,053 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $190,104 | TotalAmt |
| Program Services | $190,104 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $843,106 | $842,852 | $254 |
| PROVISION FOR BAD DEBTS | $744,083 | $744,083 | |
| OTHER EXPENSE | $645,290 | $618,367 | $26,923 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,671,213 | TotalAmt |
| Program Services | $12,411,385 | ProgramServicesAmt |
| Management And General | $1,259,828 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,051,294 | BOYAmt |
| EOY | $304,762 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,374,731 | BOYAmt |
| EOY | $1,674,030 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,870 | BOYAmt |
| EOY | $16,737 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $5,943,466 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $626,553 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,505,808 | BOYAmt |
| EOY | $5,316,913 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,689,031 | BOYAmt |
| EOY | $7,622,979 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$14,477,460 | BOYAmt |
| EOY | -$12,400,746 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,164,274 | BOYAmt |
| EOY | $2,534,675 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,259,532 | BOYAmt |
| EOY | $1,041,601 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,690 | BOYAmt |
| EOY | $36,506 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $81,818 | BOYAmt |
| EOY | $28,951 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,367,040 | BOYAmt |
| EOY | $1,107,058 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $797,234 | BOYAmt |
| EOY | $1,427,617 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $797,234 | BOYAmt |
| EOY | $1,427,617 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,164,274 | BOYAmt |
| EOY | $2,534,675 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,427,617 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$797,234 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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 | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $12,565,715 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,054,291 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $14,854,991 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,207,877 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $15,032,184 | CurrentTaxYearAmt |
| Total | $71,715,058 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $66,646 | CurrentTaxYearAmt |
| Total | $66,646 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $12,565,715 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,054,291 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $14,854,991 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,207,877 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $15,098,830 | CurrentTaxYearAmt |
| Total | $71,781,704 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $386,642 | CurrentTaxYearAmt |
| Total | $386,642 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $386,642 | CurrentTaxYearAmt |
| Total | $386,642 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $71,395,062 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,367 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $145 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $109 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $13 | CurrentTaxYearMinus1YearAmt |
| Total | $1,634 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,367 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $145 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $109 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $13 | CurrentTaxYearMinus1YearAmt |
| Total | $1,634 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,654 | CurrentTaxYearMinus4YearsAmt |
| Total | $4,654 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $12,571,736 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,054,436 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $14,855,100 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,207,890 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $15,098,830 | CurrentTaxYearAmt |
| Total | $71,787,992 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99450 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99950 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART III, LINE 12 | FormAndLineReferenceDesc |
| Explanation | 4,654 | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | false | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (true) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $505,992 | OtherCostOrOtherBasisAmt |
| Book Value | $505,992 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,525,037 | OtherCostOrOtherBasisAmt |
| Depreciation | $475,602 | DepreciationAmt |
| Book Value | $4,049,435 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $563,868 | OtherCostOrOtherBasisAmt |
| Depreciation | $87,629 | DepreciationAmt |
| Book Value | $476,239 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $348,569 | OtherCostOrOtherBasisAmt |
| Depreciation | $63,322 | DepreciationAmt |
| Book Value | $285,247 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,316,913 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| OBLIGATIONS CAPITAL LEASES-CURRENT | $28,951 |
| WORKERS COMPENSATION INSURANCE | |
| OBLIGATIONS CAPITAL LEASES-LONG TERM |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $28,951 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 2, PART IV, LINE 2B | FormAndLineReferenceDesc |
| Explanation | PATIENT TRUST LIABILITY ACCOUNT IS MONIES OWNED BY THE RESIDENTS OF WELLMONT WEXFORD HOUSE TO BE USED FOR PERSONAL EXPENSES. THE RESIDENT'S SOCIAL SECURITY CHECK AND OTHER PERSONAL FUNDS ARE DEPOSITED TO WELLMONT WEXFORD HOUSE REGIONS BANK ACCOUNT, SOLELY USED FOR THE RESIDENTS, AND CHECKS ARE WRITTEN FROM THIS ACCOUNT BY WELLMONT WEXFORD HOUSE BUSINESS OFFICER MANAGER FOR RESIDENT'S PERSONAL EXPENSES. THE PATIENT TRUST LIABILITY ACCOUNT IS MONITORED CLOSELY BY THE STATE OF TENNESSEE TO ENSURE DISBURSEMENTS ARE IN COMPLIANCE WITH STATE LAW. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Severance Payment | Yes (true) | 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 | Yes (true) | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|---|---|---|---|---|---|
| TRACEY P MOFFATT TERMED 10314 | ||||||||||
| BD MEM/WHS SR VP&COO | $334,601 | $230,000 | $10,774 | $18,100 | $3,318 | $596,793 | ||||
| ALICE POPE | ||||||||||
| SEC/TRES/WHS EVP&CFO | $383,559 | $87,632 | $8,670 | $15,897 | $11,570 | $507,328 | ||||
| TIM ATTEBERY | ||||||||||
| BD MEM/PRESIDENT-HV | $379,628 | $66,854 | $414 | $16,454 | $8,697 | $472,047 | ||||
| BARTON A HOVE | ||||||||||
| PRES/WHS PRES/CEO | $315,138 | $50,000 | $29,775 | $6,754 | $9,620 | $411,287 | ||||
| GARY D MILLER | ||||||||||
| BD MEM/SR VP&GENCOUN | $287,236 | $57,296 | $1,656 | $12,920 | $3,184 | $362,292 | ||||
| LOUIS COLLIER TERMED 92614 | ||||||||||
| VP POST ACUTE SERVIC | $38,691 | $44 | $1,733 | $40,468 | $170,242 | $192 | $7,625 | $178,059 | ||
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PAGE 1, PART I, LINE 1A | HEALTH OR SOCIAL CLUB DUES DURING THE FISCAL YEAR ENDED JUNE 30, 2015, WELLMONT HEALTH SYSTEM PROVIDED A COUNTRY CLUB MEMBERSHIP TO TRACEY P. MOFFATT AND BARTON A. HOVE. THIS AMOUNT WAS INCLUDED IN THEIR TAXABLE COMPENSATION. |
| SCHEDULE J, PAGE 1, PART I, LINE 3 | WELLMONT HEALTH SYSTEM USES ONE OR MORE OF THE METHODS DESCRIBED TO ESTABLISH THE COMPENSATION OF ALL PERSONS LISTED ON FORM 990, PART VII, SECTION A AS MORE FULLY DESCRIBED IN SCHEDULE O. |
| SCHEDULE J, PAGE 1, PART I, LINE 4 | TRACEY P. MOFFATT (TERMED 10/3/14) 275,000 0 0 |
| SCHEDULE J, PAGE 1, PART I, LINE 6B | INCENTIVE COMPENSATION IS BASED ON MEETING BUDGETED OPERATING MARGIN GOALS. |
| SCHEDULE J, PART III | PART I, LINE 4A - SEVERANCE PAYMENT TRACEY P. MOFFATT, FORMER COO OF WELLMONT HEALTH SYSTEM, ENTERED INTO A CONFIDENTIAL SEPARATION AGREEMENT AND MUTUAL RELEASE (THE "AGREEMENT") AS OF OCTOBER 3, 2014. THE TERMS OF THIS AGREEMENT INCLUDED THE PAYMENT OF 275,000 FOR ITEMS WHICH ARE CONSIDERED "SEVERANCE", INCLUDING PAYMENT FOR RELEASE OF CLAIMS. PART I, LINE 4B - PARTICIPATION IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN WELLMONT HEALTH SYSTEM HAS AN EXECUTIVE RETIREMENT PROGRAM THAT INCLUDED ALICE POPE FOR THE FISCAL YEAR ENDING JUNE 30, 2015. THIS PROGRAM HAS A TARGET BENEFIT OF 60% OF THE HIGHEST THREE YEAR AVERAGE SALARY (LESS EMPLOYER PROVIDER BENEFITS) AND THE EXECUTIVE MUST HAVE TWENTY YEARS OF SERVICE TO RECEIVE THE FULL BENEFIT. THE EXECUTIVE MAY RETIRE EARLY AT AGE 60 AND RECEIVE REDUCED BENEFITS. THERE WERE NO PAYMENTS MADE UNDER THIS PROGRAM FOR THE FISCAL YEAR ENDING JUNE 30, 2015. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 2, PART III, LINE 4A | INPATIENT AND OUTPATIENT PHYSICAL THERAPY, SPEECH THERAPY AND OCCUPATIONAL THERAPY, RESIDENTIAL CUSTODIAL CARE, RESPITE AND HOSPICE CARE. THE ALIGNING OF THE TWO ORGANIZATIONS ENHANCES THE CONTINUUM OF CARE THE REGION'S PATIENTS RECEIVE. IT RESULTS IN A SEAMLESS TRANSITION FROM ONE HEALTHCARE SETTING TO ANOTHER, WHILE RETAINING THE SAME QUALITY THROUGHOUT THE CARE PROCESS. SPECIAL ATTENTION IS GIVEN TO THE PERSONAL NEEDS OF EACH RESIDENT. SOCIAL, RELIGIOUS, RECREATIONAL AND EDUCATIONAL PROGRAMS, ALONG WITH OTHER AMENITIES, ARE PROVIDED SO EACH RESIDENT CAN LEAD A FULFILLING LIFE AND EXPERIENCE AS MUCH PERSONAL FREEDOM AS POSSIBLE. SERVICES AT WELLMONT WEXFORD HOUSE INCLUDE NURSING AND HEALTH CARE PROGRAMS THAT OFFER A WIDE RANGE OF INDIVIDUALIZED CARE. IN ADDITION TO THE SERVICES NOTED ABOVE, OTHER EXAMPLES INCLUDE RESPIRATORY CARE, THERAPEUTIC MANAGEMENT, RESTORATIVE THERAPIES, NUTRITIONAL COUNSELING AND RECREATIONAL ACTIVITIES, AS WELL AS CONVALESCENT NURSING CARE TO THE ACUTELY ILL. RESIDENTS ALSO HAVE ONSITE ACCESS TO DIAGNOSTIC SERVICES SUCH AS ULTRASOUND, X-RAY AND EKG. MOTIVATIONAL PROGRAMS EMPHASIZE THE REHABILITATION OF EACH RESIDENT TO THEIR MAXIMUM LEVEL OF FUNCTIONING. OTHER MEDICAL SERVICES OFFERED INCLUDE ENTERAL NUTRITIONAL AND TUBE FEEDING, FOLEY CATHETER CARE, COLOSTOMY, UROSTOMY, NEPHROSTOMY CARE, TRACHEOSTOMY CARE AND NASO/PHARYNGEAL SUCTIONING, IV ACCESS CARE AND THERAPY/ANTIBIOTICS, PAIN MANAGEMENT, DIABETES CARE, WOUND CARE, LAB SERVICES, ORTHOPEDIC REHABILITATION, INCONTINENCE CARE, AND DENTAL AND VISION CARE. WELLMONT WEXFORD HOUSE EARNED THE JOINT COMMISSION'S GOLD SEAL OF APPROVAL FOR ACCREDITATION AND CERTIFICATION. IT ACHIEVED THAT DESIGNATION BY COMPLYING WITH NATIONAL STANDARDS FOR ADVANCED REHABILITATION SERVICES, HEALTHCARE QUALITY AND PATIENT AND RESIDENT SAFETY IN NURSING HOME CARE. FOR THE ELEVENTH YEAR IN A ROW, WEXFORD HOUSE WAS SELECTED BY KINGSPORT TIMES-NEWS READERS AS THE BEST NURSING HOME. DURING FISCAL YEAR 2015, WEXFORD HOUSE SERVED 419 RESIDENTS AND PROVIDED 60,674 DAYS OF CARE. |
| FORM 990, PAGE 6, PART VI, LINE 6 | THE BUSINESS AND AFFAIRS OF WELLMONT WEXFORD HOUSE (THE CORPORATION) SHALL BE GOVERNED EXCLUSIVELY BY THE BOARD OF DIRECTORS. THE CORPORATION'S BOARD OF DIRECTORS IS DESIGNATED BY WELLMONT HEALTH SYSTEM, THE SOLE MEMBER OF THE CORPORATION. IN ADDITION TO SUCH RIGHTS OF APPROVAL AND CONSENT AS MAY BE RESERVED TO THE SOLE MEMBER OF THE CORPORATION PURSUANT TO APPLICABLE LAW, TRANSACTIONS OF THE FOLLOWING MATTERS BY THE CORPORATION SHALL REQUIRE THE PRIOR APPROVAL OF WELLMONT HEALTH SYSTEM, THE SOLE MEMBER OF THE CORPORATION: A) IMPLEMENTATION OF THE CORPORATION'S ANNUAL BUDGET, B) INCURRING ANY LOAN OR OTHER INDEBTEDNESS FOR BORROWED MONEY, C) ACQUISITION OF ANY EQUIPMENT OR PERSONAL PROPERTY FOR A PURCHASE PRICE IN EXCESS OF 50,000 OR THE ACQUISITION OF ANY REAL ESTATE, REGARDLESS OF PURCHASE PRICE, D) THE UNDERTAKING OF CERTAIN CONTRACTUAL COMMITMENTS, E) ENTERING INTO ANY PLAN OF MERGER OR CONSOLIDATION, F) ACQUISITION OF SUBSTANTIALLY ALL OF THE ASSETS OF ANY OTHER LEGAL ENTITY, AND G) INSTITUTION OF ANY LITIGATION BY OR ON BEHALF OF THE CORPORATION. |
| FORM 990, PAGE 6, PART VI, LINE 7A | SEE FORM 990, PART VI, SECTION A, LINE 6 EXPLANATION. |
| FORM 990, PAGE 6, PART VI, LINE 7B | SEE FORM 990, PART VI, SECTION A, LINE 6 EXPLANATION. |
| FORM 990, PAGE 6, PART VI, LINE 9 | LOUIS COLLIER (TERMED 9/26/14) 1905 AMERICAN WAY KINGSPORT, TN 37660 TRACEY P. MOFFATT (TERMED 10/3/14) 1905 AMERICAN WAY KINGSPORT, TN 37660 KATHY GREEN (TERMED 11/4/14) 1905 AMERICAN WAY KINGSPORT, TN 37660 |
| FORM 990, PAGE 6, PART VI, LINE 11B | WELLMONT WEXFORD HOUSE FORM 990 IS REVIEWED BY THE EXECUTIVE DIRECTOR OF WELLMONT WEXFORD HOUSE, THE SENIOR VICE PRESIDENT OF FINANCE, THE CORPORATE CONTROLLER, AND THE MANAGER OF ACCOUNTING FOR WELLMONT HEALTH SYSTEM, AND THE BOARD OF DIRECTORS OF WELLMONT WEXFORD HOUSE PRIOR TO FILING. ANY QUESTIONS OR COMMENTS ARISING FROM THE INITIAL REVIEW ARE ADDRESSED TO ENSURE THE RETURN IS COMPLETE AND ACCURATE. ANY CHANGES OR CORRECTIONS ARE MADE, AND THE RETURN IS THEN PROVIDED TO THE ABOVE INDIVIDUALS PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PAGE 6, PART VI, LINE 12C | OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO SIGN A CONFLICT OF INTEREST POLICY ACKNOWLEDGEMENT. ANY POTENTIAL CONFLICTS ARE DISCUSSED WITH THE COMPLIANCE AND AUDIT SERVICES DEPARTMENT, AS THEY ARISE. WELLMONT WEXFORD HOUSE OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE GOVERNED BY WELLMONT HEALTH SYSTEM'S CONFLICT OF INTEREST POLICY. WELLMONT HEALTH SYSTEM ALSO HAS A POLICY ON BUSINESS PRACTICES THAT DISCUSSES CONFLICT OF INTEREST AND INFORMS THE WORKFORCE TO DISCLOSE ANY ISSUES TO THE COMPLIANCE AND AUDIT SERVICES DEPARTMENT, FOR RESOLUTION. WELLMONT HEALTH SYSTEM ALSO USES A HOTLINE THAT ALLOWS ANONYMOUS REPORTING OF POSSIBLE CONFLICT OF INTEREST SITUATIONS FOR INVESTIGATION BY THE COMPLIANCE AND AUDIT SERVICES DEPARTMENT. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE COMPENSATION OF BARTON A. HOVE, THE PRESIDENT AND CEO OF WELLMONT HEALTH SYSTEM, IS REVIEWED, APPROVED AND DOCUMENTED BY THE WELLMONT HEALTH SYSTEM HUMAN RESOURCES COMMITTEE AND BOARD OF DIRECTORS. BARTON A. HOVE IS ALSO A BOARD MEMBER OF WELLMONT WEXFORD HOUSE. IN ADDITION, THESE BODIES USE COMPARABILITY DATA TO DETERMINE THE APPROPRIATE COMPENSATION. ALL COMPENSATION DELIBERATIONS AND REVIEWS ARE CONTEMPORANEOUSLY DOCUMENTED. THE LAST COMPENSATION DELIBERATION AND REVIEW PROCESS FOR BARTON A. HOVE WAS COMPLETED AND APPROVED BY THE BOARD OF DIRECTORS OF WELLMONT HEALTH SYSTEM ON MARCH 20, 2015. |
| FORM 990, PAGE 6, PART VI, LINE 15B | THE COMPENSATION OF THE OTHER OFFICERS AND KEY EMPLOYEES OF WELLMONT WEXFORD HOUSE ARE REVIEWED, APPROVED AND DOCUMENTED BY THE WELLMONT HEALTH SYSTEM HUMAN RESOURCES COMMITTEE OF THE BOARD OF DIRECTORS. OTHER OFFICERS AND 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. IN ADDITION, THESE BODIES USE COMPARABILITY DATA TO DETERMINE THE APPROPRIATE COMPENSATION. ALL COMPENSATION DELIBERATIONS AND REVIEWS ARE CONTEMPORANEOUSLY DOCUMENTED. THIS PROCESS IS COMPLETED ON AN ANNUAL BASIS. THE HUMAN RESOURCES COMMITTEE OF THE BOARD OF DIRECTORS REVIEW THE SALARY AND MARKET COMPENSATION DATA FOR THE FOLLOWING OTHER OFFICERS AND KEY EMPLOYEES ON DECEMBER 10, 2013. - WELLMONT HEALTH SYSTEM CHIEF OPERATIONS OFFICER - TRACEY P. MOFFATT - WELLMONT HEALTH SYSTEM EXECUTIVE VP AND CHIEF FINANCIAL OFFICER - ALICE POPE WELLMONT HEALTH SYSTEM USES ONE OR MORE OF THE METHODS DESCRIBED TO ESTABLISH THE COMPENSATION OF THE FOLLOWING OTHER OFFICERS AND KEY EMPLOYEES. - WELLMONT HEALTH SYSTEM SR. VP AND GENERAL COUNSEL - GARY D. MILLER - HOLSTON VALLEY MEDICAL CENTER PRESIDENT - TIM ATTEBERY - WELLMONT HEALTH SYSTEM VP POST ACUTE SERVICES AND HOSPITALIST CARE - LOUIS COLLIER - WELLMONT WEXFORD HOUSE EXECUTIVE DIRECTOR - LEE ELLIOTT - WELLMONT WEXFORD HOUSE EXECUTIVE DIRECTOR - KATHY GREEN |
| FORM 990, PAGE 6, PART VI, LINE 19 | WELLMONT WEXFORD HOUSE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC. WELLMONT HEALTH SYSTEM'S AUDITED FINANCIAL STATEMENTS AND QUARTERLY UNAUDITED FINANCIAL STATEMENTS ARE AVAILABLE THROUGH THE ELECTRONIC MUNICIPAL MARKET ACCESS WEBSITE. |
| FORM 990, PART IX, LINE 11G | PURCHASE SERVICES 1,500,095 188,332 0 |
| FORM 990, PART XI, LINE 9 | INTERCOMPANY DISTRIBUTION 797,234 |
| FORM 990, PAGE 12, PART XII, LINE 2C | WELLMONT WEXFORD HOUSE FINANCIAL STATEMENTS ARE INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF WELLMONT HEALTH SYSTEM. WELLMONT WEXFORD HOUSE FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2015 WERE AUDITED AS PART OF WELLMONT HEALTH SYSTEM'S CONSOLIDATED FINANCIAL STATEMENTS. WELLMONT HEALTH SYSTEM HAS AN AUDIT COMMITTEE WHICH ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR. THIS REVIEW PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| WELLMONT HEALTH SYSTEM | ||||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 621636465 | HEALTHCARE | TN | 501C3 | 3 | WHS | false |
| WELLMONT HAWKINS COUNTY MEM HOSPITA | ||||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 621816368 | HEALTHCARE | TN | 501C3 | 3 | WHS | false |
| WELLMONT CARDIOLOGY SERVICES | ||||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 263557623 | HEALTHCARE | TN | 501C3 | 3 | WHS | false |
| WELLMONT MEDICAL ASSOCIATES | ||||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 270898372 | HEALTHCARE | TN | 501C3 | 7 | WHS | false |
| WELLMONT INTEGRATED NETWORK LLC | ||||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 621308216 | HEALTHCARE | TN | 501C3 | 9 | WHS | false |
| WELLMONT SLEEP SERVICES | ||||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 273777167 | HEALTHCARE | TN | 501C3 | 3 | WHS | false |
| WELLMONT FOUNDATION INC | ||||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 581594191 | HEALTHCARE | TN | 501C3 | 7 | WHS | false |
| WELLMONT MADISON HOUSE | ||||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 621308216 | HEALTHCARE | TN | 501C3 | 9 | WHS | false |
| WELLMONT IMAGING SERVICES INC | ||||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 861103148 | HEALTHCARE | TN | 501C3 | 11A | WHS | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| HOLSTON VALLEY IMAGING CENTER | |||||||||
| 103 WEST STONE DRIVE | KINGSPORT | TN | 37660 | 202043285 | HEALTHCARE | TN | N/A | false | false |
| SAPLING GROVE AMBULATORY SURGERY | |||||||||
| 220 MEDICAL PARK BOULEVARD | BRISTOL | TN | 37620 | 204450153 | HEALTHCARE | TN | N/A | false | false |
| HOLSTON VALLEY AMBULATORY SURGERY C | |||||||||
| 103 WEST STONE DRIVE | KINGSPORT | TN | 37660 | 621816864 | HEALTHCARE | TN | N/A | false | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|
| WELLMONT INC | ||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 621320035 | PHYS SVCS | TN | N/A | false |
| MCOT INC | ||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 621325938 | MED SVCS | TN | N/A | false |
| MEDICAL LAUNDRY OF TRI-CITIES INC | ||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 621482226 | MED SVCS | TN | N/A | false |
| MEDICAL MALL PHARMACY | ||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 621565006 | MED SVCS | TN | N/A | false |
| WELLMONT PHYSICIAN SERVICES INC | ||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 621567353 | PHYS SVCS | TN | N/A | false |
| WPS PROVIDERS INC | ||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 205564642 | PHYS SVCS | TN | N/A | false |
| WELLMONT HEALTH SERVICES INC | ||||||||
| 1905 AMERICAN WAY | KINGSPORT | TN | 37660 | 621254373 | HEALTHCARE | TN | N/A | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | 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 | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WELLMONT HEALTH SYSTEM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | B | TransactionTypeTxt |
| Involved | $797,234 | InvolvedAmt |
| Method Of Amount Determination | CAPITAL CONTRIBUTION | MethodOfAmountDeterminationTxt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R | FormAndLineReferenceDesc |
| Explanation | PART V, LINE 2 RELATED ORGANIZATION TRANSACTIONS WITH WELLMONT HEALTH SYSTEM, WELLMONT MEDICAL ASSOCIATES, AND MCOT, INC, TOTALED 16,137 DURING THE FISCAL YEAR ENDED JUNE 30, 2015, AND DID NOT MEET THE 50,000 THRESHOLD AMOUNT FOR SEPARATE DISCLOSURE. ORGANIZATION TRANS TYPE AMOUNT METHOD DETERMINATION WELLMONT HEALTH SYSTEM M 8,523 INVOICES WELLMONT MEDICAL ASSOCIATES M 4,477 INVOICES MCOT, INC. M 3,137 INVOICES | ExplanationTxt |