Form 990 for tax year 2022
Filed by WELLMONT-MADISON HOUSE ALZHEIMERS CENTER OF UPPER E TENNESSEE.
Totals
- Total revenue
- $897,212
- Total expenses
- $1,543,514
- Contributions and grants received
- $2,064
- Grants paid
- $0
- Program services expenses (Part IX)
- $1,398,375
- Management and general expenses
- $145,139
- Fundraising expenses
- $0
- Program service expenses (Part III)
- $1,398,375
Program services were 90.6% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.
Listed in Part VII
-
Eric Deaton BH EVPCOO
Director
- Total calculated
- $1,375,496
- From this org
- $0
- From related orgs
- $1,268,808
- Other
- $106,688
- Hours/week
- 0.1 + 64.9 related
Schedule J breakdown matched by us
- Base
- $0 + $720,293 related
- Bonus
- $0 + $530,145 related
- Other
- $0 + $18,370 related
- Deferred
- $0 + $84,013 related
- Nontaxable benefits
- $0 + $22,675 related
- Filer's total
- $0 + $1,375,496 related
-
Alan Levine BH PresCEO
Director, Chair
- Total calculated
- $3,804,451
- From this org
- $0
- From related orgs
- $3,557,360
- Other
- $247,091
- Hours/week
- 0.1 + 64.9 related
Schedule J breakdown matched by us
- Base
- $0 + $1,351,717 related
- Bonus
- $0 + $2,162,808 related
- Other
- $0 + $42,835 related
- Deferred
- $0 + $218,859 related
- Nontaxable benefits
- $0 + $28,232 related
- Filer's total
- $0 + $3,804,451 related
-
Marvin Eichorn BH EVPCAO
Director
- Total calculated
- $3,152,666
- From this org
- $0
- From related orgs
- $3,107,146
- Other
- $45,520
- Hours/week
- 0.1 + 64.9 related
Schedule J breakdown matched by us
- Base
- $0 + $752,788 related
- Bonus
- $0 + $598,921 related
- Other
- $0 + $1,755,437 related
- Deferred
- $0 + $17,400 related
- Nontaxable benefits
- $0 + $28,120 related
- Filer's total
- $0 + $3,152,666 related
-
Andrew Wampler BH Gen Gnsl
Director, Secretary End April 2023
- Total calculated
- $248,146
- From this org
- $0
- From related orgs
- $207,386
- Other
- $40,760
- Hours/week
- 0.1 + 49.9 related
Schedule J breakdown matched by us
- Base
- $0 + $202,835 related
- Bonus
- $0 + $1,250 related
- Other
- $0 + $3,301 related
- Deferred
- $0 + $30,762 related
- Nontaxable benefits
- $0 + $9,998 related
- Filer's total
- $0 + $248,146 related
-
Tim Belisle BH EVPGen Cnsl
Director, Secretary End July 2022
- Total calculated
- $883,358
- From this org
- $0
- From related orgs
- $827,127
- Other
- $56,231
- Hours/week
- 0.1 + 64.9 related
Schedule J breakdown matched by us
- Base
- $0 + $277,977 related
- Bonus
- $0 + $310,583 related
- Other
- $0 + $238,567 related
- Deferred
- $0 + $29,779 related
- Nontaxable benefits
- $0 + $26,452 related
- Filer's total
- $0 + $883,358 related
-
Julie Bennett CLOGovnc Offcr
Director, Secretary Start April 2023
- Total calculated
- $0
- Hours/week
- 0.1 + 64.9 related
-
Michele Rusek
Sr Dir L/T Care
- Total calculated
- $180,182
- From this org
- $0
- From related orgs
- $151,390
- Other
- $28,792
- Hours/week
- 5 + 35 related
Schedule J breakdown matched by us
- Base
- $0 + $146,536 related
- Bonus
- $0 + $1,250 related
- Other
- $0 + $3,604 related
- Deferred
- $0 + $8,520 related
- Nontaxable benefits
- $0 + $20,272 related
- Filer's total
- $0 + $180,182 related
-
Mark Chappell CFO HH
MH CFO
- Total calculated
- $204,309
- From this org
- $0
- From related orgs
- $168,692
- Other
- $35,617
- Hours/week
- 0.1 + 44.9 related
Schedule J breakdown matched by us
- Base
- $0 + $133,297 related
- Bonus
- $0 + $29,987 related
- Other
- $0 + $5,408 related
- Deferred
- $0 + $8,870 related
- Nontaxable benefits
- $0 + $26,747 related
- Filer's total
- $0 + $204,309 related
-
Lynn Krutak
BH EVP/CFO
- Total calculated
- $1,319,206
- From this org
- $0
- From related orgs
- $1,209,478
- Other
- $109,728
- Hours/week
- 0.1 + 64.9 related
Schedule J breakdown matched by us
- Base
- $0 + $682,629 related
- Bonus
- $0 + $520,077 related
- Other
- $0 + $6,772 related
- Deferred
- $0 + $82,332 related
- Nontaxable benefits
- $0 + $27,396 related
- Filer's total
- $0 + $1,319,206 related
-
Lindy White
Former Officer
- Total calculated
- $393,161
- From this org
- $0
- From related orgs
- $363,355
- Other
- $29,806
- Hours/week
- 0 + 45 related
Schedule J breakdown matched by us
- Base
- $0 + $220,967 related
- Bonus
- $0 + $125,400 related
- Other
- $0 + $16,988 related
- Deferred
- $0 + $16,253 related
- Nontaxable benefits
- $0 + $13,553 related
- Filer's total
- $0 + $393,161 related
Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.
Schedule J
Answered yes
- 4a · Severance or change-of-control payment
- 4b · Supplemental nonqualified retirement plan
Answered no
- 4c · Equity-based compensation arrangement
- 5a · Pay contingent on this organization's revenues
- 5b · Pay contingent on a related organization's revenues
- 6a · Pay contingent on this organization's net earnings
- 6b · Pay contingent on a related organization's net earnings
- 7 · Other non-fixed payments
- 8 · Paid under the initial-contract exception
The filer's explanations (Part III)
- 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 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 $201,459 Eric Deaton $66,613 Lynn Krutak $64,932 Tim Belisle $22,233 Andrew Wampler $18,111 Linda White $10,176 The following executives 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
Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.
Grants on this return
No itemized grants to organizations on this return.
Related organizations on this return
Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.
-
Mountain States Health Alliance
501c3 · Hospital System · TN
Directly controlled by BALLAD
-
501c3 · Supporting Organization · TN
Directly controlled by MSHA
-
Smyth County Community Hospital
501c3 · Hospital · VA
Directly controlled by MSHA
-
501c3 · Hospital · VA
Directly controlled by WHS
-
501c3 · Hospital · VA
Directly controlled by MSHA
-
501c3 · Medical Services · VA
Directly controlled by JMH
-
501c3 · Supporting Organization · TN
-
East TN Healthcare Holdings Inc
501c3 · Opioid Treatment · TN
Directly controlled by MSHA
-
501c3 · Hospital System · TN
Directly controlled by BALLAD
-
Wellmont Hawkins Co Memorial Hosp Inc
501c3 · Hospital · TN
Directly controlled by WHS
-
Takoma Regional Hospital Inc dba Gre
501c3 · Hospital · TN
Directly controlled by WHS
-
501c3 · Medical Services · TN
Directly controlled by WHS
-
Wellmont Medical Associates Inc
501c3 · Medical Services · TN
Directly controlled by WHS
-
501c3 · Fundraiser · TN
Directly controlled by BALLAD
-
501c3 · Nursing Home · TN
Directly controlled by WHS
-
501c3 · Healthcare · TN
Directly controlled by WHS
-
Ballad Health Center for Early Learning
501c3 · Child Day Care Services · TN
Directly controlled by BALLAD
Provenance
- Return type
- form_990
- Tax year
- 2022
- Filed
- 6 May 2024
- IRS schema version
- 2022v5.0
- Source object
- 202441279349301859
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