2026-05-13T08:28:36-05:00 2025-06-30 990 2024-07-01 621636465 Wellmont Health System WELL 4233023467 311 Princeton Road Suite 1 Johnson City TN 376012080 Shane Hilton BH EVP & CFO 4233023467 2026-05-13 1 2024 2025-03-06 01:10:19Z Alan Levine BH PresCEO 303 Med Tech Prkwy Johnson City TN 37604 935886089 0 X balladhealth.org X 1996 TN Honor those we serve by delivering the best possible care. 4 0 3971 292 106130 0 2585954 1292489 847869552 915454723 1366593 10804512 5090630 5660719 856912729 933212443 1441838 985054 0 0 302903430 334232061 0 0 0 522995593 585588897 827340861 920806012 29571868 12406431 469564946 539183268 162866469 204159511 306698477 335023757 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 784496123 985054 915785940 See Schedule O 784496123 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 0 0 1 3971 1 1 1 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 1 1 TN VA X Shane Hilton 4233023467 303 Med Tech Pkwy JC TN 37604 X Alan Levine BH PresCEO Director/Chair 1.00 64.00 X X 0 3848876 286146 Marvin Eichorn BH EVPCAO Director 1.00 64.00 X X 0 1445711 53543 Eric Deaton BH EVPCOO Director 1.00 64.00 X X 0 1747698 137400 Julie Bennett CLOGovnc Offcr Director/Secretary 1.00 64.00 X X 0 976689 102286 Shane Hilton BH EVP/CFO 1.00 64.00 X 0 988163 113059 Phillip Childree CFO Wise, Lee & Dickenson 6.00 39.00 X 0 176651 17826 Chris Miller COO BRMC 45.00 0.00 X 327857 0 47959 Robert Kennedy COO HVMC 45.00 0.00 X 326413 0 49248 Chad Couch MD Regional President 45.00 0.00 X 881505 0 104627 Shannon Showalter CEO Wise County 24.00 21.00 X 0 429816 51544 Rebecca Beck CEO HVMC 45.00 0.00 X 512717 0 46450 Robert Bender CFO BRMC 36.00 9.00 X 364079 0 44061 Bobbie Murphy Regional CNO 45.00 0.00 X 346139 0 32605 Sean Mills CFO Acute Svcs Reg Operations 1.00 44.00 X 498867 0 44489 John Jeter CEO BRMC/JMH 22.00 23.00 X 0 526257 50737 James Price MD Physician 40.00 0.00 X 467906 0 46069 Elie Nader MD Physician 40.00 0.00 X 433338 0 45225 John Morehead MD Physician 40.00 0.00 X 619606 0 23542 Donovan Mabe MD Physician 40.00 0.00 X 458775 0 43606 Jamie Bartley DO CMO BRMC 40.00 0.00 X 371599 0 47053 Andrew Wampler BH SVPGen Cnsl Former Officer 1.00 54.00 X 0 464057 77887 Tim Belisle Former Officer 0.00 0.00 X 0 448129 0 Lynn Krutak Former Officer 1.00 64.00 X 0 1101262 76184 Dale Clark CEO SCCH Former CEO Wise County 0.00 45.00 X 0 416813 29259 Lisa Smithgall Former Key Employee/CNE 0.00 55.00 X 0 628794 92266 5608801 13198916 1663071 341 1 1 0 0 292693 890211 109585 1292489 Patient Revenue 622110 913913968 913913968 Rent to Exempt Affiliates 621511 1224044 1224044 Wellness Program Revenue 900099 316711 316711 915454723 102796 102796 158 158 3997859 2156605 1841254 1841254 1841254 104234 11114365 0 517041 104234 10597324 10701558 -320501 104234 10917825 Cafeteria/Vending 722514 2988546 2988546 Support Services 900099 280013 280013 Trauma Center Funding 900099 264542 264542 286364 107163 1896 177305 3819465 933212443 915785940 106130 16027884 X 985054 985054 3684688 3684688 266162411 213976254 52186157 7495219 5921622 1573597 40751053 23757034 16994019 16138690 15459577 679113 209975 10880 199095 -2384 -2384 236127975 195833843 40294132 180061 14105 165956 6049753 5767495 282258 11655967 9954606 1701361 11682620 11454564 228056 750817 688541 62276 10558618 10393268 165350 22136327 21956376 179951 3148618 3022749 125869 Medical Supplies 191709520 191709520 Hosp Provider Assessmnt 40162661 40162661 Maintenance 21001072 20764086 236986 Support Services 18397347 2944320 15453027 11819950 9721952 2097998 920806012 784496123 136309889 0 56425 8289 71202 57282 161523 61549 99059219 165262919 12008888 3085308 18863511 17779510 6606607 11507995 966229149 722060153 242923855 244168996 37626739 37626739 52186977 59624681 469564946 539183268 75545515 118599607 460675 768255 67428820 63196839 5315304 4749358 14116155 16845452 162866469 204159511 X 306576673 334872707 121804 151050 306698477 335023757 469564946 539183268 X 12406431 -8442 15927291 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 22194 0 0 0 22194 0 Part II-B, Line 1: Wellmont Health System had lobbying expenses of $22,194 which represents the portion of dues paid to various organizations attributable to direct lobbying, including Tennessee Hospital Association and Virginia Hospital and Healthcare Association. 107181 15913965 16021146 551991885 397861075 154130810 8851877 5790534 3061343 358596260 301396348 57199912 30767981 17012196 13755785 244168996 2011 Interest Fund-AWUIL 79 Due from Affiliates 59624602 59624681 Due to 3rd Party Payors 2550548 Due to Payor Stimulus Reserve 474865 Defined Pension Payable LT 5008301 Operating Lease Obligation ST 1607258 Operating Lease Obligation LT 6894566 Other Reserves 309914 16845452 X Part X, Line 2: Wellmont Health System 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, 2025 and 2024. Tax returns for 2022 through 2024 are subject to examination by the Internal Revenue Service." 1 1 X 1 X 225.000000000000 1 X 450.000000000000 1 1 1 0 1 1 19986549 0 19986549 0.02170 152779298 146348228 6431070 0.00700 0 0 172765847 146348228 26417619 0.02870 4746809 122030 4624779 0.00500 21345685 9319142 12026543 0.01310 57131964 21345822 35786142 0.03890 2132620 89771 2042849 0.00220 916778 0 916778 0.00100 86273856 30876765 55397091 0.06020 259039703 177224993 81814710 0.08890 6600 6600 0.00000 6600 6600 0.00000 1 50642557 2532128 141928871 134330193 7598678 X 1 1 5 1 Holston Valley Medical Center 130 W Ravine Road Kingsport TN 37660 balladhealth.org 0000000133 X X X X A 2 Bristol Regional Medical Center 1 Medical Park Boulevard Bristol TN 37620 balladhealth.org 0000000131 X X X X Mental Health A 3 Lonesome Pine Hospital 1990 Holston Avenue Big Stone Gap VA 24219 balladhealth.org H 1915 X X X X A 4 Norton Community Hospital 100 15th Street NW Norton VA 24273 balladhealth.org H 1879 X X X X A 5 Hancock County Hospital 1519 Main Street Sneedville TN 37869 balladhealth.org 0000000165 X X X A Facility Reporting Group - A 0 0 1 X X X X X X X X X X 24 1 1 0 1 X balladhealth.org/locations X 1 25 0 1 0 1 X 225.000000000000 450.000000000000 X X X X X 1 1 X X X X 1 X balladhealth.org X balladhealth.org X balladhealth.org X X X X X X 1 X 0 X X X X 1 X 0 0 Part V, Section B Facility Reporting Group A Facility Reporting Group A consists of: - Facility 1: Holston Valley Medical Center, - Facility 2: Bristol Regional Medical Center, - Facility 3: Lonesome Pine Hospital, - Facility 4: Norton Community Hospital, - Facility 5: Hancock County Hospital Facility Reporting Group - A Part V, Section B, line 3j: The Community Health Needs Assessment report also included information related to other findings from the data collection process. Special topics such as Adverse Childhood Experiences, Access, Child Health, and others were also detailed. The report also included extensive data appendices further describing the community and health and social related outcomes. Facility Reporting Group - A Part V, Section B, line 5: To assess the health of those living in our service area, Ballad Health utilized the Mobilizing for Action through Planning and Partnerships (MAPP 2.0) framework. This comprehensive assessment was conducted from summer 2023 through spring 2024 and included all Ballad Health hospitals. We gathered primary data through surveys with community partners and members, as well as stakeholder meetings. There was broad representation from multi-sector community partners such as, but not exclusively, health departments, academic institutions, community-based organizations, faith-based organizations, justice systems, behavioral health organizations, clinical providers, governmental agencies, emergency personnel, and social services. There was also special focus on including vulnerable and marginalized populations input. Additionally, we compiled secondary data from national, state, regional and county sources. This thorough approach helps us understand and address the unique health needs of our communities. Throughout the community health needs assessment process, we focused on identifying health priorities and disparities within each community. Community members ranked the top three health issues in their area, providing valuable local insights. Combining these perspectives with county, state and national data gives us a comprehensive view of the region's health. This foundation helps us develop effective solutions to improve health outcomes for all. Facility Reporting Group - A Part V, Section B, line 6a: The comprehensive assessment was conducted from summer 2023 through spring 2024 and included all Ballad Health hospitals (Bristol Regional Medical Center, Dickenson Community Hospital, Franklin Woods Community Hospital, Greeneville Community Hospital, Hancock County Hospital, Hawkins County Memorial Hospital, Holston Valley Medical Center, Indian Path Community Hospital, Johnson City Medical Center, Johnson County Community Hospital, Johnston Memorial Hospital, Lee County Community Hospital, Lonesome Pine Hospital, Niswonger Children's Hospital, Norton Community Hospital, Russell County Hospital, Smyth County Community Hospital, Sycamore Shoals Hospital, Unicoi County Hospital, and Woodridge Hospital). Facility Reporting Group - A Part V, Section B, line 11: Phase 3 of the MAPP 2.0 framework focuses on the continuous improvement of the community. As part of this phase, presentations on Ballad Health's Community Health Needs Assessment (CHNA) process were provided to each of the hospital boards to promote engagement and secure buy-in ahead of the development of Community Health Improvement Plans (CHIPs). These presentations aimed to ensure that hospital leadership fully understood the CHNA process and were committed to the subsequent steps. The CHIPs were developed by each facility based on the CHNA findings and involve collaboration between hospital leadership and community partners in their design and implementation. Each CHIP outlines specific, actionable strategies tailored to address the priority health issues identified in the CHNA. These strategies include measurable objectives, timelines, and assigned responsibilities to ensure accountability and progress tracking.Recognizing the complexity of the identified health issues, Ballad Health emphasizes the importance of collaboration, ensuring that all partners have a seat at the table. This inclusive approach is essential for addressing the multifaceted health challenges that no single entity can manage alone. By fostering strong partnerships and collective action, Ballad Health aims to create effective and sustainable health improvement strategies for the community. Furthermore, the CHIPs will include regular progress reviews and updates to adapt to emerging needs and challenges. This dynamic process ensures that the plans remain relevant and effective over time, continually improving health outcomes in the community. Through these comprehensive and collaborative efforts, Ballad Health is committed to making meaningful and lasting improvements in community health. Facility Reporting Group - A Part V, Section B, line 13h: Ballad Health's financial assistance policy allows for some exceptions to strictly adhering to federal poverty guidelines when awarding financial assistance. Unique circumstances may be weighed and assessed for financial assistance consideration on a case-by-case basis. Also, there are some services where financial assistance may be provided outside of federal poverty guidelines. These are noted in the Ballad Health's financial assistance policy. Part I, Line 3c: Financial assistance approval can apply to an assortment of patients such as those who have exhausted their Medicaid/Tenncare benefits, those who qualified for Medicaid/TennCare after the date of service, deceased patients with no estate or assets, uninsured patients, and underinsured patients. While Ballad Health's qualifications for financial assistance is based on federal poverty guidelines, asset values may also be used to determine financial assistance eligibility. Unique circumstances may be assessed on a case-by-case basis. Charity approval covers current or active patient balances when they are approved and there is no limitation or cap on the amount of charity that a patient may receive. Ballad Health hospitals do not stop approving financial assistance for patient accounts if a hospital's charity write-offs exceed the hospital's charity budget. All Ballad Health hospitals provide an uninsured discount; the current uninsured discount is 85% for all acute facilities and 77% for all critical access facilities. In addition to the uninsured discount, many patients will further qualify for additional financial assistance. All patients seeking financial assistance must submit an application for financial assistance and submit documents in support of the information on the application, unless specifically excluded according to policy guidelines. Medicaid eligible patients will qualify for 100% financial assistance and not be required to complete the required documentation when: a) Medicaid eligibility requirements are met after the service is provided, b) non-covered charges occur on a Medicaid eligible encounter, or c) benefits have been exhausted. Deceased patients with no estate also qualify for 100% financial assistance.Financial assistance determinations may be retroactive for all outstanding balances. In addition, Ballad Health offers a number of programs with special discounts such as lactation consultation services, oncology treatment regimens, enrollment in various community programs and prescription drugs filled post-discharge. Part I, Line 7: The cost to charge ratio (worksheet 2 "ratio of patient care cost to charges") was used to calculate line 7a financial assistance at cost, which includes charity and uninsured discounts. WHS's cost accounting system was used to report Tenncare and Medicaid on line 7b. Line 7e community health improvement includes costs that are taken directly from departmental operating reports or expenses specific to a community health event, with no additional overhead included in the cost. Line 7f health professions education is comprised of internships (primarily internal medicine residents, nursing, pharmacy, and therapy students) with schools and universities, allowing their health profession students to receive hands-on training in a hospital setting. WHS's Medicare-approved programs include medical residents, pharmacy and pastoral care. For these programs, Medicare-approved costs and Medicare reimbursement comes from filed Medicare cost reports. Ballad Health maintains records for the non-Medicare programs. Only labor costs are included for WHS team members that provide training (no overhead is applied) and only a percentage of team members' time is attributed to actual training. For line 7g subsidized health care services, WHS's cost accounting system is used because WHS has established standard costing reports for these services. Although there are other service lines within WHS hospitals that incur losses, WHS does not report services that hospitals are required by state licensure to provide, routine services or ancillary services. Line 7g also includes $29,354,184 of actual cost WHS incurred that is attributable to physician clinics. Services are being subsidized at these clinics in order to maintain access and service in rural areas that would otherwise be unavailable to the community or below the community's need if not provided. WHS is careful to ensure no double counting of costs. Line 7h research represents WHS's expense allocation from Ballad Health for research. Line 7i cash and in-kind contributions includes cash disbursements and in-kind donations of medications to local nonprofit rescue squads and fire departments. In-kind donations of medications are based on actual cost for these items. Part II, Community Building Activities: WHS leaders support and encourage all team members to volunteer time, money and skills to community service projects and charitable organizations. Senior leaders and board members set a positive example for WHS team members, serving voluntarily on committees and boards of local service and nonprofit organizations. Some also serve as members and consultants on professional committees and task forces that affect regional development in healthcare and education. WHS does not capture costs associated with team members that serve on other nonprofit boards or provide services to other nonprofits.WHS, in collaboration with area health agencies and providers, offers assistance with coordination, advocacy, or contribute supplies to support groups for their program activities that serve to assist special populations within the area. Most of these organizations work to improve the lives of community members that have limited, or no, financial resources.Line 3 - Community SupportBristol Regional Medical Center provided support to the YWCA of NETN and SWVA for their 2024 Turkey Trot Run/Walk that helps sustain vital programs in the community such as child care, teen pregnancy support, victim advocacy and after school programs.Norton Community Hospital provided support to the City of Norton for their Shop With A Cop Program, a program for underprivileged children, Town of Wise, VA for the Farmers Market Kids Bucks, Wise County, VA Sheriff's Office for their community outreach program, along with other contributions for community building projects. Part III, Line 2: Self-pay balances include accounts after payments and contractual adjustments (discounts) have been applied from all third-party payers such as Medicare, TennCare/Medicaid, commercial insurers, and others - generally leaving the patient responsible for any remaining deductible and/or co-payment. Other self-pay accounts are from patients with no insurance or other third-party coverage. Under Ballad Health's system-wide self-pay policy, any patient who has no insurance and is ineligible for any government assistance program receives an 85% discount, with the exception of critical access hospitals, where it is 77%. Many self-pay patients will further qualify for financial assistance (sometimes referred to as charity care) if they provide the financial information needed to deem them eligible or upon determination of presumptive charity eligibility.After the normal collection process has indicated an account is uncollectible, WHS writes the account off to bad debt. The overall self-pay accounts receivable balance is evaluated on an ongoing basis to evaluate the age of accounts receivable, historical write-offs and recoveries and any unusual instances (such as local, regional or national economic conditions) which affect the collectability of receivables. Part III, Line 3: Ballad Health estimates that approximately 5% of WHS's bad debt would have qualified for financial assistance if patients had provided a financial assistance application and required documentation. Pursuant to the merger, WHS has begun to score accounts using a presumptive eligibility tool. This tool utilizes various data points for a proprietary algorithm operated by an outside vendor to provide an individual's score which is then relied upon to assign presumptive charity eligibility. There are many instances of patients with large account balances and no health insurance coverage that WHS believes would qualify for financial assistance. Although patients are encouraged to apply for assistance, many will not do so. WHS would prefer for patients to submit completed financial assistance applications given that historical data clearly indicates that most uninsured patients and many underinsured patients will qualify for financial assistance under WHS's program. Without a completed application or approval through the presumptive charity eligibility review, these are recorded as bad debt instead of charity care. Part III, Line 4: Ballad Health's audited financial statements include a footnote on page 15 that describes bad debt. WHS is included in the June 30, 2025 audited financial statements of Ballad Health (attached). Part III, Line 8: Excluding Medicare losses reported in Part I subsidized health, the Part III Medicare allowable costs are reported using WHS's filed Medicare cost report (C/R). The C/R uses a cost to charge ratio based on a step-down allocation methodology. Part III, Line 9b: Requests for financial assistance are evaluated using established guidelines, while allowing for unique financial circumstances - for example, medically indigent patients with catastrophic medical costs that would threaten the patient's household financial viability. When a patient requests financial assistance or when an application has been received, the patient's account is placed in a hold status to prevent further collection activities until financial assistance eligibility is determined. All Ballad Health hospitals comply with IRS 501(r) regulatory guidelines.Ballad Health's collection policy clearly states that all patients are treated equally - with dignity and respect. Ballad Health ensures that outside collection agencies adhere to Ballad Health billing and collection guidelines. The collection program includes communicating expected financial responsibility prior to service. WHS hospitals provide assistance to help underinsured and uninsured patients determine sources of payment for medical bills and to help patients determine eligibility for programs such as TennCare or Medicaid.After insurance benefit verification, WHS hospitals bill insurance carriers. If the insurance carrier denies payment of the service/procedure as non-covered or the patient has exceeded their maximum benefits, the service/procedure will qualify for the uninsured discount.Financial counselors are available to discuss financial assistance with patients and their families. WHS hospitals provided a number of payment options:- a pre-service discount may be offered- a discount in excess of established discounting rates may be granted for catastrophic high dollar accounts- WHS hospitals accept all non-contracted and out-of-network payers and will make attempts to work with these payers regarding appropriate reimbursement and billing to their members- as part of Ballad Health's commitments to the State of Tennessee and Commonwealth of Virginia to form Ballad Health, not-in-network discounts are applied per policies in place for WHS hospitals- payment arrangements are available so long as the account is not with a collection agencyReasonable efforts are made to determine if a patient is eligible for financial assistance - see Schedule H, Part VI, line 3 for information on how patients are informed about Ballad Health's financial assistance policy. Part VI, Line 2: Ballad Health and its hospitals have pledged to improve the health of our service area counties by focusing on access, quality and population health measures. These metrics enable Ballad Health to collaborate with our communities and address the region's health disparities and access challenges. Through the Community Health Needs Assessment (CHNA) process, we have gained valuable insights into the health disparities within our communities and prioritized the most pressing issues in each hospital's service area. This collaborative approach helps us educate and drive meaningful change, ensuring better health outcomes for all.The community health needs assessment identified chronic disease, behavioral and mental health, and obesity and overweight as the top three health priorities for the hospital service area. These issues emerged as the most pressing health concerns based on data from various sources, including local perspectives and community surveys. Addressing these critical areas allows us to focus efforts on improving overall health outcomes and quality of life in the region. Part VI, Line 3: Consistent with the Ballad Health financial assistance policy, WHS communicates with and provides education to patients through various avenues regarding governmental assistance programs and hospital financial assistance. Various educational and application documents related to obtaining financial assistance are widely available at WHS and all documents are available on the Ballad Health website. Printed financial assistance educational materials are part of each registration packet and posters are displayed in highly visible areas of the hospitals. The financial assistance policy and documents are available in emergency departments and admitting areas. WHS is also happy to mail all documents to patients and offers a plain language summary. All of the documents are available in English and Spanish. Financial assistance information is available during pre-registration, registration and/or during financial counseling. WHS offers governmental program eligibility representatives to assist patients in securing eligibility for TennCare or Medicaid, federal disability and other governmental assistance programs. Additionally, if a patient or community resident expresses an interest in the Affordable Care Act healthcare exchange, WHS representatives have the qualifications and experience to assist them through the entire process. Financial counselors offer financial assistance applications to patients who do not qualify for governmental assistance programs and are unable to pay for some or all of their healthcare.All patient billing statements have verbiage discussing financial assistance along with contact information. The last letter to the patient displays the plain language summary. In all oral correspondences with a patient, if it is identified the patient cannot meet payment requirements on their account, financial assistance is discussed as an option. Applicants are notified of financial assistance determination in writing. Part VI, Line 4: WHS serves the healthcare needs of 29 Appalachian counties in Northeast Tennessee, Southwest Virginia, Southeast Kentucky, and Northwest North Carolina. All of the counties WHS serves are federally designated as medically underserved areas. WHS's largest hospital, Holston Valley Medical Center, is a tertiary referral center and one of the nation's 50 top cardiovascular hospitals. Medically underserved areas are designated by the U.S. Department of Health and Human Services. Shortage areas are identified through analysis of physician to population ratios depending on whether an area is considered to have a high need. Criteria used to determine high need are poverty rates, the percent of the population over age 65, infant mortality rates and fertility rates. WHS operates 1 critical access hospital: Hancock County Hospital in Tennessee. Additionally, according to County Health Rankings, counties where WHS hospitals are located consistently rank poorly for both health outcomes and health factors. Part VI, Line 5: WHS is dedicated to operating efficiently so that waste is minimized. WHS's leadership remains mindful of managing limited resources so that adequate facilities and equipment are available for the care of their patients. Surplus funds are invested into improving treatment options for patients through new technologies, recruiting physicians and trained staff in shortage areas, and improving WHS facilities. Various checks and balances are established to ensure that expenditures for operating expenses and capital costs are reasonable and necessary. WHS has several hospitals with Medicare-approved health profession education programs. In addition, WHS hospitals serve as training sites for many types of health professions: nursing, pharmacy, psychology, lab, respiratory therapy, EMT, public health, etc. Students from several colleges, universities, and programs receive training and hands-on experience in WHS hospitals. WHS resources are devoted to health conferences for local health professionals and offer other programs focused on improving the health of residents. While WHS operates in a predominantly low-income, rural and isolated areas, WHS continues to offer services that operate at a loss because residents would otherwise need to leave their hometown or county to receive needed care.Wellmont Health System merged with Mountain States Health Alliance in February 2018 to form Ballad Health healthcare system. WHS and Mountain States Health Alliance still exist as legal entities and continue to operate multiple hospitals. WHS's governing body is comprised of persons who reside in the organization's primary service areas.Physicians that request privileges who are qualified and credentialed are extended privileges by WHS. Part VI, Line 6: WHS's merger with Mountain States Health Alliance opened up many opportunities not previously available to two competing health systems. Collaboration started post-merger and Ballad Health continues to see progress towards improving efficiencies within our health system, activities consistent with Ballad Health's population health initiative, sharing best practice quality improvements, and other benefits related to operating as one rather than operating in a competitive environment. A new clinical council was formed immediately following the merger. The council includes physicians nominated from the leadership of all Ballad hospitals. A new Community Benefit and Population Health Committee of the board was established and various other infrastructures have been established since the merger.WHS is a Tennessee non-profit corporation and a premier provider of healthcare services in Northeast Tennessee and Southwest Virginia. WHS includes eight hospitals (five included in this return), an integrated physician network, and several ambulatory sites. WHS hospitals offer a broad scope of services ranging from community based acute care to highly specialized tertiary services including a trauma center, comprehensive heart care, and cancer care.WHS owns and operates an integrated health care delivery system providing inpatient, outpatient, and other health care services at multiple locations in Northeast Tennessee and Southwest Virginia. Currently, WHS owns and operates seven acute care hospital facilities and one critical access hospital. The acute care facilities owned by WHS include Holston Valley Medical Center in Kingsport, Tennessee, Bristol Regional Medical Center in Bristol, Tennessee, Lonesome Pine Hospital in Big Stone Gap, Virginia, Norton Community Hospital in Norton, Virginia, Dickenson Community Hospital in Clintwood, Virginia, Hawkins County Memorial Hospital in Rogersville, Tennessee, Takoma Regional Hospital, Inc. d/b/a Greeneville Community Hospital in Greeneville, Tennessee, and the critical access hospital, Hancock County Hospital in Sneedville, Tennessee.Across WHS's hospitals, there were many projects, programs and collaborative efforts that took place during the year. Some examples include:- Opioid prescribing reduction across all WHS hospitals- WHS hospitals shared successful achievements from value optimization team projectsSince the Ballad Health system is both horizontally and vertically integrated, patients can be efficiently moved along an integrated, comprehensive continuum of care as their health dictates. If needed, patients can be moved to one of Ballad Health's tertiary care facilities providing advanced treatment options.Hospitals in the Ballad Health system work closely with one another to share expertise and resources. Part VI, Line 7, Reports Filed With States TN,VA Part VI, Additional Information Ballad Health is required to report community benefit estimates on a quarterly basis with the states of Tennessee and Virginia. The reporting includes all of Ballad Health's hospital organizations and is reported using IRS Form 990, Schedule H instructions for reporting community benefit. Ballad Health operates under a Cooperative Agreement (CA) in Virginia and a Certificate of Public Advantage (COPA) in Tennessee as obligated by agreements between Ballad Health and the two states to allow Mountain States Health Alliance and Wellmont Health System to merge. 1 Appalachian School of Law 1169 Edgewater Drive Grundy VA 24614 541743079 501c3 390000 0 Student Community Service Program Virginia Polytechnic Institute and State Univ 201 Southgate Center Blacksburg VA 24061 546001805 501c3 240000 0 Student Community Service Program Southwest Va Higher Education Fndtn 1 Partnership Circle PO Box 1987 Abingdon VA 24212 800232306 501c3 54648 0 SWVA Regional Simulation Lab for Nursing & Allied Health Niswonger Foundation Inc c/o Tusculum College PO 5112 Greeneville TN 37743 621871605 501c3 35000 0 Program Support Emory & Henry College PO Box 950 Emory VA 24327 540505892 501c3 33179 0 Program Support-College of Nursing Crumley House Brain Injury Rehabilitation Center 300 Urbana Road Limestone TN 37681 581988511 501c3 27500 0 Rehabilitation of traumatic brain injury victims University of Virginia at Wise Foundation P O Box 40021 Charlottsville VA 229044201 546001796 501c3 24996 0 Athletics Program King University 1350 King College Road Bristol TN 37620 581363100 501c3 22900 0 School of Nursing patient simulators Barter Theatre PO Box 867 Abingdon VA 24212 546000120 501c3 15000 0 Program Support ALS Association 1300 Wilson Blvd Ste 600 Arlington VA 22209 133271855 501c3 10000 0 Program Support American Heart Association 4708 Papermill Drive Knoxville TN 37909 135613797 501c3 10000 0 Program Support Crossroads Medical Mission P O Box 16852 Bristol VA 24209 542038877 501c3 10000 0 Healthcare for underinsured & uninsured Make-A-Wish Greater Virginia 2810 N Parham Rd Ste 302 Richmond VA 23294 541429614 501c3 10000 0 Program Support Healing Hands Health Center 245 Midway Medical Park Bristol TN 37620 621677000 501c3 8250 0 Program Support Tennessee Charitable Care Network 1515 B Hayden Dr Nashville TN 37206 464916133 501c3 5500 0 Programs for free/reduced healthcare American Cancer Society 250 Williams St NW Ste 400 Atlanta GA 30303 460358360 501c3 5500 0 Program Support Clintwood Volunteer Rescue Squad P O Box 484 Clintwood VA 24228 541096326 501c3 0 6395 Cost EMS supplies Donate supplies 17 Part I, Line 2: The Ballad Health Community Benefit and Population Health Committee is a collective group of members from both Tennessee and Virginia. These members bring a variety of insights into community health improvement, striving to cultivate an understanding of population health, community benefit obligations, and the integral role that Ballad Health plays in enhancing health access. Senior leadership of Ballad Health, including the President and CEO and the COO, are present at these meetings. One of the committee's key duties is to ensure that charitable donations are in line with the policies set by the Ballad Health Board. All applications for assistance are completed with the necessary information to assess eligibility, and reviewed and approved by an administrative committee which includes members from the Community Benefit and Population Health Committee. In addition, community health improvement applications and recommendations are reviewed by the Community Benefit and Population Health Committee annually. Following a thorough review of all applications, approval must be obtained from various levels, including the Ballad Health CEO or the Ballad Health Board, depending on the level of commitment required. For those seeking funding for a specific event or program, the application should include the following details: - Mission statement of organization - Year organization was founded - Tax status and federal taxpayer ID number - Website - Description of the event/program - Event/program budget - Other sources of income - Impact of the event/program on the health of residents in our region - Beneficiaries of contribution - Number of people served annually - Event/program accomplishments - Measure of accomplishments 0 1 0 0 0 0 0 0 0 Alan Levine BH PresCEO Director/Chair 0 1520581 0 2128611 0 199684 0 253530 0 32616 0 4135022 0 0 Eric Deaton BH EVPCOO Director 0 894611 0 604644 0 248443 0 110198 0 27202 0 1885098 0 0 Marvin Eichorn BH EVPCAO Director 0 805288 0 598349 0 42074 0 20040 0 33503 0 1499254 0 0 Lynn Krutak Former Officer 0 414747 0 526405 0 160110 0 53781 0 22403 0 1177446 0 0 Shane Hilton BH EVP/CFO 0 615030 0 366316 0 6817 0 80643 0 32416 0 1101222 0 0 Julie Bennett CLOGovnc Offcr Director/Secretary 0 564044 0 403122 0 9523 0 78804 0 23482 0 1078975 0 0 Chad Couch MD Regional President 525063 0 335467 0 20975 0 72251 0 32376 0 986132 0 0 0 Lisa Smithgall Former Key Employee/CNE 0 472618 0 136871 0 19305 0 68259 0 24007 0 721060 0 0 John Morehead MD Physician 586747 0 18376 0 14483 0 0 0 23542 0 643148 0 0 0 John Jeter CEO BRMC/JMH 0 409518 0 102714 0 14025 0 20053 0 30684 0 576994 0 0 Rebecca Beck CEO HVMC 400901 0 99338 0 12478 0 20615 0 25835 0 559167 0 0 0 Sean Mills CFO Acute Svcs Reg Operations 368562 0 75836 0 54469 0 12692 0 31797 0 543356 0 0 0 Andrew Wampler BH SVPGen Cnsl Former Officer 0 320716 0 93811 0 49530 0 52740 0 25147 0 541944 0 0 James Price MD Physician 423897 0 22500 0 21509 0 19800 0 26269 0 513975 0 0 0 Donovan Mabe MD Physician 428338 0 25500 0 4937 0 12555 0 31051 0 502381 0 0 0 Shannon Showalter CEO Wise County 0 319502 0 80105 0 30209 0 20212 0 31332 0 481360 0 0 Elie Nader MD Physician 432353 0 0 0 985 0 18850 0 26375 0 478563 0 0 0 Tim Belisle Former Officer 0 0 0 0 0 448129 0 0 0 0 0 448129 0 448129 Dale Clark CEO SCCH Former CEO Wise County 0 306757 0 75392 0 34664 0 19144 0 10115 0 446072 0 0 Jamie Bartley DO CMO BRMC 305938 0 58919 0 6742 0 13728 0 33325 0 418652 0 0 0 Robert Bender CFO BRMC 284715 0 69828 0 9536 0 15487 0 28574 0 408140 0 0 0 Bobbie Murphy Regional CNO 268669 0 68603 0 8867 0 0 0 32605 0 378744 0 0 0 Chris Miller COO BRMC 250420 0 64047 0 13390 0 15875 0 32084 0 375816 0 0 0 Robert Kennedy COO HVMC 244931 0 62840 0 18642 0 16351 0 32897 0 375661 0 0 0 Phillip Childree CFO Wise, Lee & Dickenson 0 160906 0 0 0 15745 0 17826 0 0 0 194477 0 0 Part I, Line 4b 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 Ballad Health 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 $233,490 Eric Deaton $90,158 Shane Hilton $60,603 Julie Bennett $56,613 Chad Couch $53,708 Lisa Smithgall $47,625 Lynn Krutak $38,666 Andrew Wampler $32,739 Sean Mills $12,692 Upon meeting the Substantial Risk of Forfeiture provisions of the Ballad Health 457(f) Plan mentioned above, the following former executive received his deferred compensation plan balance during the year. Tim Belisle $448,129 A The Health Educational & Housing Facilities Board of Sullivan County TN 621256662 865293AF1 2016-09-01 180420000 Construction @ HVMC 0 0 0 B The Health Educational & Housing Facilities Board of Sullivan County TN 621256662 865293AH7 2016-04-20 73240000 Refund 2006A Bond 0 0 0 A 32695000 180420000 180420000 2011 1 0 1 1 B 30300000 73240000 73240000 2011 1 0 1 1 A 0 0 1 1 0 0.00990 0.00990 0 0 1 B 0 1 1 1 0 0.01990 0.01990 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 1 0 0 0 0 0 1 A 1 B 1 Date Rebate Computation Performed Issuer Name: The Health, Educational & Housing Facilities Board of Sullivan Date the Rebate Computation was Performed: 10/31/2021 Schedule K, Part I(f), Description of Purpose: Both listed bond issues were amended in 2016. Although such issues might not be treated as reissued under applicable regulations, the issuer took a conservative position and filed Form 8038 upon the assumption that the bond issues may be treated as reissued. Therefore, for purposes of this Schedule, the listed bond issues are treated as reissued when amended in 2016 and are being treated as refundings for purposes of this form. Part III, Line 4a Program Service Accomplishments Ballad Health (Ballad) is an integrated healthcare delivery system consisting of 20 hospitals in Northeast Tennessee and Southwest Virginia, including a Level 1 Trauma Center, dedicated children's hospital, several community hospitals, four critical access hospitals, a behavioral health hospital, an addiction treatment facility, long-term care facilities, home care and hospice services, retail pharmacies, outpatient services and a comprehensive medical management corporation. Ballad works closely with an active independent medical community and community stakeholders to improve the health and well-being of over one million people in 29 counties of the Appalachian Highlands in Northeast Tennessee, Southwest Virginia, Northwest North Carolina, and Southeast Kentucky. Ballad is a Tennessee non-profit corporation and is the main provider of healthcare services in Northeast Tennessee and Southwest Virginia. Ballad Health is a tax-exempt entity and the parent corporation of both Mountain States Health Alliance (MSHA) and Wellmont Health System (WHS). On February 1, 2018, Ballad was formed through a merger of two legacy systems, Mountain States Health Alliance and Wellmont Health System. Ballad was formed under state-action immunity in compliance with federal antitrust law, to create a healthier region and keep healthcare local. The action approving the merger was officially taken through the agreements made between Ballad and the State of Tennessee in the Certificate of Public Advantage (the "COPA") and the Letter Authorizing the Cooperative Agreement (the "CA") in Virginia. Pursuant to the COPA and CA, Ballad must fulfill certain obligations, commitments, and covenants. Tennessee and Virginia, through their respective health departments, supervise specific aspects of Ballad's operations under certain conditions of the COPA and the CA. The COPA and amendments are publicly available on the website of the Tennessee Department of Health, at https://www.tn.gov/health/copa.html. The Cooperative Agreement is available on the website of the Virginia Department of Health, at https://www.vdh.virginia.gov/licensure-and- certification/cooperative-agreement/. Form 990 for Wellmont Health System (WHS) includes five wholly owned hospitals, including two tertiary hospitals, while three wholly owned hospitals file separate returns. In addition to the acute care hospitals, WHS wholly owns or has ownership interest in a nursing home, an assisted living facility, physician practice organizations, ambulatory surgery centers and other health care businesses. Specific to the hospitals included in this Form 990, services were provided to: 33,192 inpatients 502,767 outpatient visits 125,753 emergency visits 1,877 deliveries 22,281 surgeries SULLIVAN COUNTY, TN: BRISTOL REGIONAL MEDICAL CENTER (BRMC) - 348-bed tertiary hospital located in Bristol, Tennessee has served the community since 1925. - Provides cardiac and neurological care, diabetes treatment, emergency and trauma (Level III) care, inpatient and outpatient hospice care, oncology, occupational health, outpatient, psychiatric, rehabilitation, surgical and women's health services. - Centers of Excellence include the Ballad CVA Heart Institute, J.D. and Lorraine Nicewonder Cancer Center, Deborah H. Quillen Birthing Center, Primary Stroke Center, and the Leonard Family Comprehensive Breast Center. - The J.D. Nicewonder Family Pediatric Emergency Department is part of a regional system of care for children, including pediatric surgery, trauma and Level III NICU services at Niswonger Children's Hospital in Johnson City. - U.S. News recognized BRMC in 2025 for excellence in cardiac, pulmonary and surgical care. - Earned the Platinum Performance Achievement Award from the American College of Cardiology for excellence in heart attack care. SULLIVAN COUNTY, TN: HOLSTON VALLEY MEDICAL CENTER (HVMC) - 505-bed tertiary hospital located in Kingsport, Tennessee has served the community since 1935. - Provides diagnostic imaging, surgical, neuroscience, rehabilitation, women's health, outpatient services, emergency and trauma (Level III) care. - Centers of Excellence include the Ballad CVA Heart Institute, the Christine LaGuardia Phillips Cancer Center, Comprehensive Breast Cancer Center, Advanced Primary Stroke Center, and Every Step joint replacement center. - Named by U.S. News' annual "Best Hospital" study as the ninth-ranked hospital in the State of Tennessee and "high-performing distinction for knee replacement procedures, heart attack care and treatment, heart failure and treatment, transcatheter aortic valve replacement, care of stroke patients, pulmonary disease care and inpatient care for kidney failure patients. - Healthgrades named Holston Valley Medical Center one of America's 50 Best Hospitals for Vascular Surgery for the sixth consecutive year and ranked it first in Tennessee for vascular surgery. - Earned the Platinum Performance Achievement Award from the American College of Cardiology for excellence in heart attack care. HANCOCK COUNTY, TN: HANCOCK COUNTY HOSPITAL (HCH) - 10-bed federally designated critical access hospital located in Sneedville, Tennessee opened in 2005 through a partnership with the Hancock County Commission. - Provides inpatient and outpatient acute care, emergency care, radiology, laboratory, respiratory therapy and physical therapy services. WISE COUNTY, VA: LONESOME PINE HOSPITAL (LPH) - 60-bed community hospital located in Big Stone Gap, Virginia has served the community since 1973. - Provides emergency care, medical, and oncology services. - Southwest Virginia Cancer Center in Norton, Virginia and Ballad Cancer Institute in Bristol, Virginia serve medical and radiation oncology patients as part of LPH operations. WISE COUNTY, VA: NORTON COMMUNITY HOSPITAL (NCH) - 120-bed acute care facility located in Norton, Virginia serving the community since 1949. On February 28, 2021, NCH merged with WHS and still does business under the name "Norton Community Hospital". - Provides a wide array of services including primary care, surgical pulmonology, urology, obstetrics, emergency, radiology, and laboratory services. - Accredited by the American Osteopathic Association ("AOA") and was the first AOA accredited teaching facility in Virginia. Ballad Health is in its seventh full year of operation under active supervision by the State of Tennessee and the Commonwealth of Virginia. Fiscal Year 2025 was marked by resilience, innovation, and a deepened commitment to improving health outcomes across Northeast Tennessee and Southwest Virginia. Throughout the period, Ballad Health continued to maintain and expand access to essential care and services, delivering high quality care, and reducing the cost of care for the people we are entrusted to serve. Over the past seven years, Ballad Health has made significant strides in regional healthcare. The organization successfully reopened a previously closed hospital in Southwest Virginia, invested capital in critical infrastructure, expanded services where needed, and consolidated others where appropriate. We met the challenges of a global pandemic that claimed thousands of lives in our region and severely disrupted hospital operations. We coordinated care in the wake of Hurricane Helene and its devastating aftermath and worked closely with both the Tennessee Department of Health and Virginia Department of Health to respond to the evolving needs of the region. Notable examples include investments in mental health services, the opening of high-quality childcare centers, the creation of the Quillen Center for Urological Services, and the launch of a new dental clinic that has served thousands of uninsured Virginians. Ballad Health has achieved these milestones while navigating national challenges, often responding faster and more effectively than other well-regarded hospitals and health systems. Similarly, our emergency department performance outpaces other peer hospitals on publicly reported metrics. Furthermore, a recent independent evaluation of physician access revealed that, while the rest of the nation has experienced a decline in physician supply, Ballad Health's rural region has either maintained or improved access in many specialties. In FY25, Ballad Health continued to demonstrate its commitment to improving the health of the Appalachian Highlands region through investments in its people, COPA Plan spending commitments, and capital. These investments included: - Partnering with the Tennessee Center for Nursing Advancement, the ETSU Research Corporation, East Tennessee State University (ETSU) College of Nursing, and StoryCollab on the Nursing Narrative Initiative. This project highlights the voices and experiences of nurses across the region, aiming to inspire future professionals and support current staff through storytelling and reflection. Additionally, investing in Ballad Health team members by launching B Excellent to strengthen our culture through continuous learning, skill-building, and team member engagement. - More than $65 million in new investments for rural health, behavioral health, children's health, population health, health research and graduate medical education, and health information exchange. - Capital spend of over $128 million, the highest level in our history. This included investments in new diagnostic and treatment technology, equipment upgrades, facility improvements, information technology, and the continued expansion of Niswonger Children's Hospital. Hurricane Helene Hurricane Helene tragically struck on September 27, 2024, causing catastrophic flooding throughout the Appalachian Highlands. Floodwater from Hurricane Helene permanently destroyed Unicoi County Hospital and caused significant disruption to several other facilities. At Greeneville Community Hospital, Sycamore Shoals Hospital, Johnson County Hospital and Laughlin Healthcare services had to be suspended and patients relocated due to flood-related damage and safety concerns. Thanks to Ballad Health's integrated system, coordinated emergency response, and the dedication of our team members, all patients were safely evacuated to other facilities. In response, Ballad Health quickly established a 24/7 advanced urgent care clinic in Erwin, Tennessee, to ensure continued access to critical healthcare services for the community. Strengthening Rural Access Through Strategic Workforce Planning Ballad Health is taking a proactive approach to protecting care in rural Appalachia. To guide this effort, Ballad Health engaged a nationally recognized healthcare consulting firm to conduct a detailed provider needs assessment. This process closely examines the supply and demand for physicians and advanced practice providers in the region and helps guide recruitment where shortages are most severe, and ensures we meet federal requirements. Nationally, the projected shortage of primary care physicians by 2030 ranges from 27,300 to 40,300, according to the Association of American Medical Colleges (AAMC) and other workforce studies. This makes Ballad Health's forward-looking strategy especially critical for rural regions. Since 2018, Ballad Health has recruited more than 800 providers to help close important gaps across the region. Between 2022 and 2025, general primary care adequacy improved from 62% to 72%, and 8 of 12 specialties also showed measurable progress. Ballad Health's access and quality metrics now outperform many national peers. Only 1% of emergency room patients leave before being seen, compared to 6 to 8% at other emergency rooms. Discharge times are up to 100 minutes faster than leading academic medical centers and sepsis care compliance ranks among the best in the country. Quality of Care - Recognition from Independent Organizations: Ballad Health hospitals achieved national recognition for quality and safety from several respected national organizations, including U.S. News & World Report, the American Medical Association, and the American Heart Association. The Blue Cross and Blue Shield Association designated multiple Ballad Health hospitals as "Blue Distinction Centers" in service areas such as cardiology, hip and knee replacement, and maternity care. In addition, they highlight only five hospitals in Tennessee as "Blue Distinction Centers in Quality and Value" for cardiology services, with two of the five hospitals being Ballad Health facilities. Leading Innovation in Physician Well-Being Ballad Health Medical Associates has earned bronze-level national recognition from the American Medical Association as a Joy in Medicine Health System organization for taking meaningful steps to address physician burnout and promote well-being across the Appalachian Highlands. Ballad Health Medical Associates is the only organization in Tennessee to receive Joy in Medicine recognition for the 2025-2026 cycle, with only four organizations in Virginia achieving this distinction. Cardiovascular Excellence Continues to Set National Standards Holston Valley Medical Center continues to lead the nation in cardiovascular care, cementing Ballad Health's reputation as a destination for exceptional cardiac treatment. For 2025, Healthgrades named Holston Valley one of America's 50 Best Hospitals for Vascular Surgery for the sixth consecutive year and ranked it No. 1 in Tennessee for vascular surgery. Holston Valley also earned the Vascular Surgery Excellence Award and received five-star ratings for several critical procedures, including abdominal aorta repair, carotid surgery (achieving this distinction for the 16th year in a row), and peripheral vascular bypass. Holston Valley and Bristol Regional Medical Center earned the Platinum Performance Achievement Award from the American College of Cardiology (ACC) for excellence in heart attack care through the chest pain - MI Registry. Johnston Memorial Hospital received the Silver Performance Achievement Award, recognizing its commitment to evidence-based care and improved outcomes for patients experiencing acute myocardial infarction. These honors reflect the dedication of Ballad Health's clinical teams to consistently deliver high-quality, guideline-driven care that improves survival rates and long-term outcomes for heart patients across the Appalachian Highlands. This recognition reflects Ballad Health's commitment to creating a supportive and efficient work environment for physicians and advanced practice providers, an essential strategy for improving care quality and access in rural communities. These results show Ballad Health's commitment to listening to our communities, recruiting where it matters most, and building the strong healthcare workforce the Appalachian Highlands relies on. Recognition Spanning Our Entire Health System U.S. News & World Report 2025-2026 National and Regional Distinctions: - Holston Valley Medical Center was named a "Best Regional Hospital and ranked No. 9 in Tennessee, earning "high performing distinctions in 10 different clinical areas. - Bristol Regional Medical Center, Indian Path Community Hospital, and Johnson City Medical Center were recognized for excellence in cardiac, pulmonary, and surgical care. - Specific clinical honors include high-performance ratings in hip fracture and hip replacement care, gynecological cancer treatment, aortic valve surgery, abdominal aortic aneurysm repair, pacemaker implantation, pneumonia care, spinal fusion, colon cancer surgery, transcatheter aortic valve replacement, and diabetes care. Charity Care Update Ballad Health maintained increased patient eligibility for charity care at 225% of the federal poverty guidelines (up from 200% before the merger in 2018). In FY25, Ballad Health provided over $65 million for charity care, the highest since its formation. Notably, the weighted average median household income in the region is approximately $51,000 with some communities falling below that level. Ballad Health's threshold for free charity care for a family of 2.5 people is approximately $54,000 based on 225% of the Federal Poverty Level. This positions Ballad Health as having one of the most generous charity care policies in the nation. Ballad Health continued its efforts to reduce the number of preventable hospitalizations and emergency department visits. Ballad Health also remained committed to advancing value-based initiatives, such as the Appalachian Highlands Care Network (AHCN). The AHCN connects uninsured patients and their families with free or low-cost clinics, dental services, financial counseling, and preventative care services. The AHCN is recognized as a national model for partnership programs between a health system and local organizations, outpatient clinics and providers working together to deliver a more supportive system of care for the uninsured population. These efforts to provide cost efficient care benefit the taxpayers, patients, and hospitals. By the end of the period, the AHCN had enrolled over 11,100 uninsured individuals, demonstrating its growing impact across the Appalachian Highlands. Progress in Target Areas Ballad Health achieved improvements in the target areas of expanding access to care, improving quality of care, and lowering the cost of care. I. Access to Care & Population Health Access to Care Metrics: Ballad Health achieved improvements in 20 of 25 access measures over the pre-merger baseline. Notable areas of improvement since FY24 include appropriate emergency department wait times, asthma emergency department visits, diabetes screening, and rate of SBIRT administration during emergency department visits. The virtual urgent care platform is available 24/7 and accessible via smartphone or internet, and Ballad Health is the only regional provider offering this service. II. Improving Quality of Care, Patient Experience & Staff Experience a. Quality of Care Metrics: Ballad Health publishes its quality data on its website. The currently reported baselines are pre-COVID. Notable highlights include the following: i. Ballad Health improved in 10 of the 17 target measures for FY25 using the pre-COVID baselines. ii. Emergency Department throughput metrics have shown improvement. Notably, OP22 Left Without Being Seen decreased by 33.8% compared to FY24. The median time from ED arrival to transport for admitted patients and the ED2b ED Decision to Transport (ED1) also improved. iii. Ballad Health implemented a standardized mortality case review process, supported by predictive analytic tools to help caregivers identify and act on early signs of deterioration. These efforts contributed to measurable reductions in mortality from FY23 to FY25, across various conditions, including Heart Failure (25%), Pneumonia (18%), and Sepsis (14%). iv. Among the hospital infection indicators, Ballad Health is performing as expected or meeting the measure in all but one measure when using the Centers for Disease Control and Prevention's recommended adjustment methodology accounting for differences in patient population. b. Clinical Council: The Clinical Council (the Council) is aligned with the Ballad Health Board of Directors and the Board's Quality, Service and Safety Committee (QSSC). During FY25, the Council was comprised of 27 physicians from many backgrounds and specialties. Of those physicians, nearly half were independent. The Council continued to assist in establishing key quality and patient safety priorities with consideration to risk, volume, propensity for problems (including incidence, prevalence, and severity), impact on health outcomes, patient safety and quality across all areas of care. Key accomplishments in FY25 included: i. enhancements in electronic health record workflows, ii. standardization of a variety of high-value care initiatives, iii. implementation of projects for provider wellbeing and workforce support, iv. updates to medication use processes, and v. improvements to children's and women's care standards. c. Patient Experience: In the aggregate, 90% of patients surveyed by Press-Ganey, the nation's most credible firm for tracking patient and employee experience, would recommend Ballad Health's hospitals. In some Ballad Health hospitals, that number reaches as high as 97%. While emergency department wait times remain a concern, it should be noted that the metrics for Ballad Health outperform national averages, and some of America's, Tennessee's, and Virginia's most well-respected health systems in areas such as patients who leave without being seen, time from presentation to discharge, and sepsis care. III. Lowering Cost of Care Ballad Health and community physicians continue to reduce the cost of care to patients, employers, and government payors through value-based care. a. Price Transparency: Ballad Health continued to meet the Centers for Medicare & Medicaid Services hospital price transparency requirements under section 2718(e) of the Public Health Service Act. As such, Ballad Health's gross charges, discounted cash prices, payer-specific negotiated rates, and de-identified minimum and maximum negotiated rates for all hospital items and services as well as a consumer-friendly estimator tool and other pricing information are publicly available on its website. b. Cost-Efficiency Measures: According to countyhealthrankings.org, Ballad Health and community physicians have reduced preventable hospitalizations in our region by 50% since 2017. This has resulted in over $200 million of annual recurring savings to taxpayers, employers, and patients. Our region's preventable hospitalization rate is as low, or lower than, communities like Nashville - a stunning result given the magnitude of resources available in those communities. In FY25, Ballad Health saw more than $45 million (for projects greater than $200,000) in savings due to cost-efficiency measures taken across the areas of contract labor, supplies, and pharmacy efficiency. Through the work of the AHCN, Ballad Health has helped reduce preventable hospitalizations for the uninsured population, reducing the cost to taxpayers of charity care, and improving patient safety by avoidance of hospitalization. Form 990, Part V, line 1a Ballad Health (BH), WHS's parent organization, filed Form 1096 on a consolidated basis for all subsidiaries that were required to file Forms 1099-MISC/NEC. WHS reimburses BH for all expenses related to vendor payments and the expenses are recorded on WHS's books. Form 990, Part VI, Section A, line 6 Wellmont Health System is a Tennessee non-stock, nonprofit organization with Ballad Health as its sole member. Form 990, Part VI, Section A, line 7a Ballad Health has the authority to appoint Wellmont Health System board members. The President and CEO of Ballad Health serves as the President and CEO for Wellmont Health System. Form 990, Part VI, Section A, line 7b Decisions of the Wellmont Health System Board of Directors are subject to approval by the Ballad Health Board of Directors. 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 EVP/CFO 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 VII, Section A, Line 2 Line 2 does not include W-2's processed by our parent organization, Ballad Health, on behalf of WHS. Team members' reportable compensation, if included in Part VII, Section A, is reported as compensation from related organizations. Form 990, Part IX, line 11g Collection Services: Program service expenses 0. Management and general expenses 35,843,462. Fundraising expenses 0. Total expenses 35,843,462. Consulting Fees: Program service expenses 409,421. Management and general expenses 969,700. Fundraising expenses 0. Total expenses 1,379,121. Contract Labor: Program service expenses 26,931,723. Management and general expenses 2,166,354. Fundraising expenses 0. Total expenses 29,098,077. Dietary Services: Program service expenses 9,072,487. Management and general expenses 0. Fundraising expenses 0. Total expenses 9,072,487. Environmental Services: Program service expenses 10,151,187. Management and general expenses 0. Fundraising expenses 0. Total expenses 10,151,187. Hospital Supported Clinics: Program service expenses 84,924,610. Management and general expenses 0. Fundraising expenses 0. Total expenses 84,924,610. Laboratory Services: Program service expenses 2,768,721. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,768,721. Laundry: Program service expenses 2,876,212. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,876,212. Other: Program service expenses 12,479,887. Management and general expenses 1,314,616. Fundraising expenses 0. Total expenses 13,794,503. Physician Fees: Program service expenses 46,219,595. Management and general expenses 0. Fundraising expenses 0. Total expenses 46,219,595. Form 990, Part XI, line 9: Alternative Investment Income Not on Books -104,234. Close out Bristol Surgery Center Balance Sheet 1,157,974. Intercompany Transfers 14,197,305. Pension Plan Adjustment 647,000. Temporarily Restricted Grants 29,246. Norton Community Physician Services LLC 96 15th Street NW Norton VA 24273 260868690 Medical Services VA 14088034 1110044 WHS Wellmont Health Management Services LLC 1905 American Way Kingsport TN 37660 621825259 Healthcare TN 0 0 WHS 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 Ballad Health Auxiliary 400 N State of Franklin Road Johnson City TN 37604 581418345 Supporting Organization TN 501c3 12a Ballad Health 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 Ballad Health Foundation 1019 West Oakland Ave Suite 2 Johnson City TN 37604 581594191 Fundraiser TN 501c3 Line_7_Organization_ Ballad Health 1 Dickenson Community Hospital 312 Hospital Drive Clintwood VA 24228 770599553 Hospital VA 501c3 Line_3_Hospital_Coop WHS 0 East TN Healthcare Holdings Inc 203 Gray Commons Circle Suite 110 Gray TN 37615 815475903 Opioid Treatment TN 501c3 Line_10_Organization N/A 0 Johnston Memorial Hospital 16000 Johnston Memorial Drive Abingdon VA 24211 540544705 Hospital VA 501c3 Line_3_Hospital_Coop MSHA 0 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 Smyth County Community Hospital 245 Medical Park Drive Marion VA 24354 540794913 Hospital VA 501c3 Line_3_Hospital_Coop MSHA 0 Takoma Regional Hospital Inc DBA GCH 1420 Tusculum Boulevard Greeneville TN 37745 510603966 Hospital TN 501c3 Line_3_Hospital_Coop WHS 1 Wellmont Cardiology Services 303 Med Tech Parkway Ste 220B Johnson City TN 37604 263557623 Medical Services TN 501c3 Line_10_Organization WHS 1 Wellmont Hawkins Co Memorial Hosp Inc 851 Locust Street Rogersville TN 37857 621816368 Hospital TN 501c3 Line_3_Hospital_Coop WHS 1 Wellmont Madison House 2000 Greenway Street Kingsport TN 37660 621308216 Assisted Living TN 501c3 Line_10_Organization WHS 1 Wellmont Medical Associates Inc 303 Med Tech Parkway Ste 220B Johnson City TN 37604 270898372 Medical Services TN 501c3 Line_10_Organization WHS 1 Wellmont Wexford House 2421 North John B Dennis Highway Kingsport TN 37660 581859039 Nursing Home TN 501c3 Line_10_Organization WHS 1 East Tennessee Ambulatory Surgery Center 701 Med Tech Parkway Suite 100 Johnson City TN 37604 621787537 Medical Services TN N/A 0 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 St Ste 2 Johnson City TN 37601 272199037 Medical Services TN N/A 0 0 Quality Improvement Ptrs LLC 2528 Wesley St Suite 2 Johnson City TN 37601 861932106 Healthcare TN N/A 0 0 Ballad Health Development Corporation 400 N State of Franklin Road Johnson City TN 37604 883118592 Investments TN N/A C 0 Ballad Ventures LLC 400 N State of Franklin Road Johnson City TN 37604 844214681 Investments 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 Community Home Care Inc 1490 Park Avenue NW Suite B Norton VA 24273 541453810 Durable Medical Equipment VA WHS C 1.00000 0 Mediserve Medical Equipment of Kpt Inc 303 Med Tech Parkway Ste 220B Johnson City TN 37604 621212286 Durable Medical Equipment TN N/A C 0 Mountain States Physician Grp Inc 303 Med Tech Parkway Ste 220B Johnson City TN 37604 621700412 Medical Services TN N/A C 0 Mountain States Properties Inc 303 Med Tech Parkway Ste 220B Johnson City TN 37604 621845895 Property Management TN N/A C 0 Nolichuckey Management Services Inc 1420 Tusculum Boulevard Greeneville TN 37745 621776681 Medical Services TN TRH C -229519 1.00000 0 Wellmont Health Services Inc 303 Med Tech Parkway Ste 220B Johnson City TN 37604 621254373 Medical Services TN Wellmont Inc C 1268627 9476192 1.00000 0 Wellmont Insurance Co SPC LTD PO Box 30600 Grand Cayman CJ KY1-1203 981195624 Insurance CJ WHS C 2532874 39984969 1.00000 0 Wellmont Physician Services Inc 303 Med Tech Parkway Ste 220B Johnson City TN 37604 621567353 Medical Services TN Wellmont Inc C 1.00000 0 Wellmont Inc 303 Med Tech Parkway Ste 220B Johnson City TN 37604 621320035 Medical Services TN WHS C 35697936 -89309121 1.00000 0 Wilson Pharmacy Inc 303 Med Tech Parkway Ste 220B Johnson City TN 37604 620329587 Pharmacy TN N/A C 0 WPS Providers Inc 303 Med Tech Parkway Ste 220B Johnson City TN 37604 205564642 Medical Services TN Wellmont Inc C 34429309 2749336 1.00000 0 1 0 1 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 Wellmont Cardiology Services J 84729 FMV Wellmont Cardiology Services Q 27863181 Cost Wellmont Medical Associates Inc J 1123362 FMV Wellmont Medical Associates Inc L 110461 Cost Wellmont Medical Associates Inc P 40771110 Cost Wellmont Medical Associates Inc S 188974 FMV WPS Providers Inc J 372031 FMV WPS Providers Inc Q 13932038 Cost