2024-05-15T11:44:39-05:00 2023-06-30 990 2022-07-01 270898372 Wellmont Medical Associates Inc WELL 4233023467 311 Princeton Road Suite 1 Johnson City TN 376012080 Matt Lazari CFO-BHMA 4233023467 2024-05-15 Matt Lazari 999009999 1 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z Matthew Lazari 303 Med Tech Prkwy Johnson City TN 37604 135947538 0 X balladhealth.org X 2008 TN Honor those we serve by delivering the best possible care. 4 0 976 0 0 0 70448 58429 124931584 135621663 17515 -78076 4432161 248004 129451708 135850020 0 0 0 0 86679172 91480257 0 0 0 41648361 48939730 128327533 140419987 1124175 -4569967 18025626 25522846 19811991 21585369 -1786365 3937477 X 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. 0 0 133068667 0 135621663 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, WMA's 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 2023, WMA had 607,841 patient encounters.Recognizing some patients cannot afford essential medical services, WMA incurred a loss of $1,664,500 attributable to the provision of charity care in fiscal year 2023.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 $29,670,507.It is WMA's 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. 133068667 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 X 0 0 1 976 1 0 0 0 0 0 0 0 0 0 0 0 0 X 4 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X Shane Hilton 4233023467 303 Med Tech Parkway Suite 300 Johnson City TN 37604 Tim Belisle end July 2022 BH EVP & Gen Counsel 0.10 64.90 X X 0 827128 56231 Marvin Eichorn BH EVP/CAO 0.10 64.90 X X 0 3107146 45520 Alan Levine BH President & CEO/Chair 0.10 64.90 X X 0 3557360 247091 Andrew Wampler General Cnsel (start April 2023) 0.00 40.00 X X 0 207386 40760 Matthew Lazari start July 2022 BHMA CFO 40.00 0.00 X 142000 0 25409 Chase Wilson end April 2023 BHMA COO/CFO 40.50 4.50 X 0 296185 40312 Mark Patterson MD BH SVP BHMA Pres/CEO 54.50 0.50 X 661164 0 89742 Stephen Combs MD VP/CMO Medical Services 45.00 0.00 X 581817 0 36352 Daniel Krenk MD Physician 40.00 0.00 X 727868 0 37070 Girendra Hoskere MD Physician 40.00 0.00 X 957721 0 19602 Joseph Frye II MD Physician 40.00 0.00 X 899931 0 24151 Adel El Abbassi Physician 40.00 0.00 X 986159 0 17354 Paul Jett MD Physician 40.00 0.00 X 1008848 0 26032 Eric Deaton BH EVP/COO 0.10 64.90 X 0 1268808 106688 Lynn Krutak Former Officer BH EVP & CFO 0.10 64.90 X 0 1209478 109728 Howard Herrell MD Former Officer Sec/Treas 0.00 40.00 X 518018 0 43538 Leanne Cox end October 2020 Former Officer VP/BHMA CFO 0.00 40.00 X 0 106022 33250 Marta Wayt MD Former Officer/Chairman 39.90 0.10 X 0 439614 29017 David Thompson MD Former Officer/Vice Chair/ 40.00 0.00 X 287613 0 26267 Paul Kramer MD Physician 40.00 0.00 X 636880 0 40751 Karen Williams Former Key Employee 0.00 40.00 X 0 183892 32168 Landon Combs MD Former Officer 40.00 0.00 X 259505 0 34613 7667524 11203019 1161646 203 1 1 0 0 58429 58429 Net Patient Revenue 621990 80659990 80659990 Hospital Support 621990 42634556 42634556 Performance Bonuses/Cap 621990 11423603 11423603 Wellness Programs 621990 321770 321770 Medical Education Training 900099 259979 259979 321765 321765 135621663 19442 19442 97518 -97518 -97518 -97518 Medical Records 900099 142468 142468 Medical Director Fees 621990 86011 86011 BH EAP Revenue Alloc 621990 9035 9035 10490 10490 248004 135850020 135621663 0 169928 1932498 1932498 76125210 75786550 338660 2318927 2212769 106158 6752475 6714860 37615 4351147 4322594 28553 2612 2612 11650197 11491875 158322 39247 39247 854302 845719 8583 7319131 7225443 93688 653520 615583 37937 25224 25224 1571389 1420347 151042 407870 197520 210350 Support Services 15416959 11616193 3800766 Medical Supplies 8890846 8887443 3403 Maintenance 838720 838675 45 Dues & Subscriptions 583222 144286 438936 686491 684339 2152 140419987 133068667 7351320 0 62040 59113 2478571 2500138 66170 30000 713872 292532 5666790 5794324 27542642 21045364 6326714 6497278 -22568 1289456 1289456 1422013 9082573 18025626 25522846 13077249 14385094 1095229 0 5639513 7200275 19811991 21585369 X -1786365 3937477 -1786365 3937477 18025626 25522846 X -4569967 -2114 10295923 X 0 1 X 1 1 1 X 1173649 70448 58429 1302526 157985364 123132961 118596010 124901536 135524145 660140016 60558 160834 90791 4425697 248004 4985884 158045922 123293795 119860450 129397681 135830578 666428426 0 0 0 666428426 90328 61638 32778 54026 19442 258212 90328 61638 32778 54026 19442 258212 158136250 123355433 119893228 129451707 135850020 666686638 0.99960 0.99950 0.00040 0.00050 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2850683 1179657 1671026 10678763 6886591 3792172 13702622 12917862 784760 310574 61254 249320 6497278 Other Receivables 4508153 Due from Affiliates 4574420 9082573 Capital Lease Obligation ST 117204 Capital Lease Obligation LT 866525 Operating Lease Obligation ST 2368719 Operating Lease Obligation LT 3521165 Due to 3rd Party Payors 60185 Due to Payor Stimulus Funds 266477 7200275 X Part X, Line 2: 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, 2023 and 2022. Tax returns for 2020 through 2022 are subject to examination by the Internal Revenue Service." X 0 0 1 1 0 0 0 0 0 0 0 Alan Levine BH President & CEO/Chair 0 1351717 0 2162808 0 42835 0 218859 0 28232 0 3804451 0 0 Marvin Eichorn BH EVP/CAO 0 752788 0 598921 0 1755437 0 17400 0 28120 0 3152666 0 0 Eric Deaton BH EVP/COO 0 720293 0 530155 0 18360 0 84013 0 22675 0 1375496 0 0 Lynn Krutak Former Officer BH EVP & CFO 0 682629 0 520077 0 6772 0 82332 0 27396 0 1319206 0 0 Paul Jett MD Physician 287389 0 714218 0 7241 0 17047 0 8985 0 1034880 0 0 0 Adel El Abbassi Physician 699578 0 246311 0 40270 0 17129 0 225 0 1003513 0 0 0 Girendra Hoskere MD Physician 588897 0 335410 0 33414 0 19350 0 252 0 977323 0 0 0 Joseph Frye II MD Physician 382609 0 470932 0 46390 0 13751 0 10400 0 924082 0 0 0 Tim Belisle end July 2022 BH EVP & Gen Counsel 0 277977 0 310583 0 238568 0 29779 0 26452 0 883359 0 0 Daniel Krenk MD Physician 693707 0 33747 0 414 0 16020 0 21050 0 764938 0 0 0 Mark Patterson MD BH SVP BHMA Pres/CEO 500802 0 152838 0 7524 0 61791 0 27951 0 750906 0 0 0 Paul Kramer MD Physician 577283 0 57673 0 1924 0 18400 0 22351 0 677631 0 0 0 Stephen Combs MD VP/CMO Medical Services 460912 0 114216 0 6689 0 17728 0 18624 0 618169 0 0 0 Howard Herrell MD Former Officer Sec/Treas 349700 0 152623 0 15695 0 17400 0 26138 0 561556 0 0 0 Marta Wayt MD Former Officer/Chairman 0 280089 0 25659 0 133866 0 18396 0 10621 0 468631 0 0 Chase Wilson end April 2023 BHMA COO/CFO 0 229756 0 66225 0 204 0 14416 0 25896 0 336497 0 0 David Thompson MD Former Officer/Vice Chair/ 271993 0 3855 0 11765 0 0 0 26267 0 313880 0 0 0 Landon Combs MD Former Officer 250394 0 1250 0 7861 0 15663 0 18950 0 294118 0 0 0 Andrew Wampler General Cnsel (start April 2023) 0 202835 0 1250 0 3301 0 30762 0 9998 0 248146 0 0 Karen Williams Former Key Employee 0 176277 0 5071 0 2544 0 10854 0 21314 0 216060 0 0 Matthew Lazari start July 2022 BHMA CFO 140502 0 1250 0 248 0 5020 0 20389 0 167409 0 0 0 Leanne Cox end October 2020 Former Officer VP/BHMA CFO 0 103846 0 1250 0 926 0 6906 0 26344 0 139272 0 0 Part I, Line 1a Discretionary Spending WMA provided a monthly vehicle allowance to Stephen Combs, M.D., for travel expenses during the fiscal year ended June 30, 2023. The amount is included in taxable compensation. Part I, Line 1b 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. Part I, Lines 4a-b The following executives listed in Schedule J, Part II participated in a 457(f) retirement plan provided by Ballad Health (BH). The 457(f) plan is a nonqualified tax-deferred compensation plan available to a select group of key executives for the intent of supporting retention and to offer a competitive total retirement program. Account balances have a "substantial risk of forfeiture". In addition to creditor risk, substantial risk of forfeiture is created through default risk if the participant's employment with BH is terminated prior to age 65. However, the 457(f) plan contains a non-compete provision that provides the account balance to be paid in a lump sum after the executive satisfies the two-year non-compete period. This provision applies to employer contributions if the executive has provided eligible service for six or more years. The executive will receive the entire account balance if he/she becomes disabled, dies or if the executive terminates for "good reason or is involuntarily terminated without "good cause" within a 24-month period after a change-of-control occurs. Distributions from this plan are subject to federal, state, and local taxes on the entire account balance upon distribution. Alan Levine $201,459 Eric Deaton $66,613 Lynn Krutak $64,932 Tim Belisle $22,233 Andrew Wampler $18,111 Mark Patterson $43,898 The following executive received a change-of-control payment. The payment was reported as taxable income with appropriate tax withheld and remitted to the IRS. Tim Belisle $179,601 Landon Combs MD Family Member See Part V 0 Part IV Business Transactions Involving Interested Persons: Landon Combs, M.D., an employee and former officer of WMA, is a family member of Stephen Combs, M.D, key employee of WMA. Form 990, Part V, Line 1a For CY22 Ballad Health (BH), WMA's parent organization, filed Form 1096 on a consolidated basis for all subsidiaries that were required to file Forms 1099-MISC/NEC. WMA reimburses BH for all expenses related to vendor payments and the expenses are recorded on WMA's books. Form 990, Part VI, Section A, line 6 The business and affairs of Wellmont Medical Associates, Inc. (WMA) are governed by Wellmont Health System's Board of Directors. WMA's board of directors is designated by Wellmont Health System, the sole member of WMA. In addition to such rights of approval and consent as may be reserved to the sole member of WMA pursuant to applicable law, transactions of the following matters by WMA require the prior approval of Wellmont Health System: (A) Implementation of WMA's annual budget, (B) Incurring any loan or other indebtedness for borrowed money, (C) Acquisition of any equipment or personal property for a purchase price in excess of $50,000 or the acquisition of any real estate, regardless of purchase price, (D) The undertaking of certain contractual commitments, (E) Entering into any plan of merger or consolidation, (F) Acquisition of substantially all of the assets of any other legal entity, and (G) Institution of any litigation by or on behalf of WMA. Form 990, Part VI, Section A, line 7a Wellmont Health System (WHS) is WMA's sole member. The board of directors of Ballad Health, WHS's parent organization, serves as WHS's board of directors and is responsible for appointing the directors of WMA's board. Form 990, Part VI, Section A, line 7b 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, Section B, line 11b 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, Section B, line 12c Ballad Health policy requires Board of Directors and Board Committee members, the Executive Chair/President, and Executive Vice Presidents to complete a conflict of interest disclosure statement on an annual basis. Ballad Health policy also requires team members to complete an annual acknowledgement that they have read and understand the conflict of interest policy and they will complete a conflict of interest disclosure statement if they have a conflict of interest. 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. This applies to all Ballad Health organizations. Form 990, Part VI, Section B, line 15 Line 15a - Compensation Process for Top Official The executive compensation committee serves as the compensation oversight committee of Ballad Health's Board of Directors. The executive compensation committee is comprised of members who are determined to be independent and whom are not reliant upon any business relationship with Ballad Health for income or compensation. The compensation plan for Alan Levine, Ballad Health's Chairman, President and CEO, was reviewed and approved by the executive compensation committee and then by the Ballad Health Board of Directors in accordance with the Board's compensation policy and practice. The Board of Directors relies upon the advice of an independent and experienced compensation consultant with knowledge about pay practices for comparable positions within the industry, and who has access to broad data, studies and surveys in order to ensure the compensation falls within competitive and appropriate ranges for the position. Line 15b - Compensation Process for Officers On an annual basis, Ballad Health's Human Resources (H/R) Department evaluates compensation for all executives at a position level of Assistant Vice President and above. H/R's 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 Health's 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, Section C, line 19 Governing documents and conflict of interest policy are made available upon request to the appropriate parties requesting them. Financial statements are made available upon request to appropriate parties requesting them, and they are made available to those parties who own indebtedness of the company on a quarterly basis. Form 990, Part XI, line 9: Intercompany Transfers 10,295,923. Mountain States Health Alliance 303 Med Tech Parkway Suite 300 Johnson City TN 37604 620476282 Hospital System TN 501c3 Line_3_Hospital_Coop BALLAD HEALTH 0 MSHA Auxiliary 400 N State of Franklin Road Johnson City TN 37604 581418345 Supporting Organization TN 501c3 12a MSHA 0 Smyth County Community Hospital 245 Medical Park Drive Marion VA 24354 540794913 Hospital VA 501c3 Line_3_Hospital_Coop MSHA 0 Dickenson Community Hospital 312 Hospital Drive Clintwood VA 24228 770599553 Hospital VA 501c3 Line_3_Hospital_Coop WHS 0 Johnston Memorial Hospital 16000 Johnston Memorial Drive Abingdon VA 24211 540544705 Hospital VA 501c3 Line_3_Hospital_Coop MSHA 0 Abingdon Physician Partners 16000 Johnston Memorial Drive Abingdon VA 24211 205485346 Medical Services VA 501c3 12a JMH 0 Ballad Health 303 Med Tech Parkway Suite 300 Johnson City TN 37604 611771290 Supporting Organization TN 501c3 12b N/A 0 East TN Healthcare Holdings Inc 203 Gray Commons Circle Gray TN 37615 815475903 Opioid Treatment TN 501c3 Line_3_Hospital_Coop MSHA 0 Wellmont Health System 303 Med Tech Parkway Suite 300 Johnson City TN 37604 621636465 Hospital System TN 501c3 Line_3_Hospital_Coop BALLAD HEALTH 0 Wellmont Hawkins Co Memorial Hosp Inc 851 Locust Street Rogersville TN 37857 621816368 Hospital TN 501c3 Line_3_Hospital_Coop WHS 0 Takoma Regional Hospital Inc dba GCH 1420 Tusculum Boulevard Greeneville TN 37745 510603966 Hospital TN 501c3 Line_3_Hospital_Coop WHS 0 Wellmont Cardiology Services 303 Med Tech Parkway Ste 220B Johnson City TN 37604 263557623 Medical Services TN 501c3 Line_10_Organization WHS 0 Ballad Health Foundation 1019 West Oakland Ave Suite 2 Johnson City TN 37604 581594191 Fundraiser TN 501c3 Line_7_Organization_ BALLAD HEALTH 0 Wellmont Madison House 2000 Greenway Street Kingsport TN 37660 621308216 Assisted Living TN 501c3 Line_10_Organization WHS 0 Wellmont Wexford House 2421 North John B Dennis Highway Kingsport TN 37660 581859039 Nursing Home TN 501c3 Line_10_Organization WHS 0 Wellmont Imaging Services Inc 1905 American Way Kingsport TN 37660 861103148 Healthcare TN 501c3 12a WHS 0 Ballad Health Center for Early Learning 400 N State of Franklin Road Johnson City TN 37604 923891827 Child Day Care Services TN 501c3 Line_10_Organization BALLAD HEALTH 0 Emmaus Community Healthcare PLLC 6419 Bristol Hwy Piney Flats TN 37686 200577483 Medical Services TN N/A 0 0 Medical Specialists of JC LLC 2528 Wesley Street Suite 2 Johnson City TN 37601 272199037 Medical Services TN N/A 0 0 East Tennessee Ambulatory Surgery Center 701 Med Tech Parkway Suite 100 Johnson City TN 37604 621787537 Medical Services TN N/A 0 0 Quality Improvement Partners LLC 2528 Wesley Street Suite 2 Johnson City TN 37604 861932106 Healthcare TN N/A 0 0 Wellmont Inc 303 Med Tech Parkway Ste 220B Johnson City TN 37604 621320035 Medical Services TN N/A C 0 Wellmont Physician Services Inc 303 Med Tech Parkway Ste 220B Johnson City TN 37604 621567353 Medical Services TN N/A C 0 WPS Providers Inc 303 Med Tech Parkway Ste 220B Johnson City TN 37604 205564642 Medical Services TN N/A C 0 Wellmont Health Services Inc 303 Med Tech Parkway Ste 220B Johnson City TN 37604 621254373 Medical Services TN N/A C 0 Blue Ridge Medical Management Corp 303 Med Tech Parkway Ste 220B Johnson City TN 37604 621490616 Medical Services TN N/A C 0 Mediserve Medical Equipment 303 Med Tech Parkway Ste 220B Johnson City TN 37604 621212286 Durable Medical Equipment TN N/A C 0 Mountain States Properties 303 Med Tech Parkway Ste 220B Johnson City TN 37604 621845895 Property Management TN N/A C 0 Mountain States Physician Group 303 Med Tech Parkway Ste 220B Johnson City TN 37604 621700412 Medical Services TN N/A C 0 Community Home Care Inc 1490 Park Avenue NW Suite B Norton VA 24273 541453810 Durable Medical Equipment VA N/A C 0 Wilson Pharmacy Inc 303 Med Tech Parkway Ste 220B Johnson City TN 37604 620329587 Pharmacy TN N/A C 0 Nolichuckey Management Svcs Inc 1420 Tusculum Boulevard Greeneville TN 37745 621776681 Medical Services TN N/A C 0 Wellmont Insurance Co SPC LTD PO Box 30600 Grand Cayman CJ KY1-1203 981195624 Insurance CJ N/A C 0 Ballad Ventures LLC 400 N State of Franklin Road Johnson City TN 37604 844214681 Investments TN N/A C 0 Ballad Health Development Corporation 400 N State of Franklin Road Johnson City TN 37604 883118592 Investments TN N/A C 0 0 0 1 0 0 0 0 0 0 1 1 1 1 0 1 1 1 0 0