Form 990 for tax year 2023
Filed by WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL INC.
Totals
- Total revenue
- $14,653,446
- Total expenses
- $14,822,981
- Contributions and grants received
- $441,798
- Grants paid
- $8,700
- Program service revenue
- $14,178,731
- Investment income
- $6,770
- Other revenue
- $26,147
- Total assets, end of year
- $3,838,960
- Total liabilities, end of year
- $2,469,825
- Net assets or fund balances, end of year
- $1,369,135
- Program services expenses (Part IX)
- $11,599,976
- Management and general expenses
- $3,223,005
- Fundraising expenses
- $0
- Program service expenses (Part III)
- $11,599,976
Program services were 78.3% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.
Line items
Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.
Revenue
Part VIII, the statement of revenue.
-
1e · Government grants (contributions)
$441,798
-
2a · Program service revenue: Patient Care Revenue
total $14,143,661 · related or exempt $14,143,661
-
2b · Program service revenue: Rent to Exempt Affiliates
total $35,070 · related or exempt $35,070
-
3 · Investment income
total $4,408 · excluded $4,408
-
7a · Gross sales of assets other than inventory
other assets $2,362
-
7b · Less cost or other basis and sales expenses
other assets $0
-
7c · Gain or loss
other assets $2,362
-
7d · Net gain or loss
total $2,362 · related or exempt $2,362
-
11a · Other revenue: Opioid Lawsuit Settlement
total $13,114 · excluded $13,114
-
11b · Other revenue: Cafeteria and Vending
total $9,876 · excluded $9,876
-
11c · Other revenue: Facilities & Constr. Mgmt Rev
total $3,082 · excluded $3,082
-
11d · All other revenue
total $75 · related or exempt $8 · excluded $67
-
11e · Other revenue, total
$26,147
Functional expenses
Part IX, the statement of functional expenses.
-
1 · Grants to domestic organizations and governments
total $8,700 · program services $8,700
-
5 · Compensation of officers, directors and key employees
total $313,072 · management and general $313,072
-
7 · Other salaries and wages
total $5,734,577 · program services $4,692,166 · management and general $1,042,411
-
8 · Pension plan contributions
total $204,704 · program services $164,397 · management and general $40,307
-
9 · Other employee benefits
total $966,514 · program services $658,080 · management and general $308,434
-
10 · Payroll taxes
total $362,695 · program services $339,847 · management and general $22,848
-
11g · Fees: other
total $2,989,328 · program services $2,159,605 · management and general $829,723
-
12 · Advertising and promotion
total $6,920 · program services $456 · management and general $6,464
-
13 · Office expenses
total $311,717 · program services $263,031 · management and general $48,686
-
14 · Information technology
total $271,483 · program services $216,499 · management and general $54,984
-
16 · Occupancy
total $611,221 · program services $611,221
-
17 · Travel
total $46,983 · program services $43,181 · management and general $3,802
-
20 · Interest
total $332,726 · program services $329,062 · management and general $3,664
-
22 · Depreciation, depletion and amortization
total $442,857 · program services $419,477 · management and general $23,380
-
23 · Insurance
total $184,783 · program services $182,314 · management and general $2,469
-
24a · Other expenses: Medical Supplies
total $1,009,398 · program services $1,009,398
-
24b · Other expenses: Support Services
total $451,608 · program services $1,766 · management and general $449,842
-
24c · Other expenses: Maintenance
total $383,456 · program services $382,729 · management and general $727
-
24d · Other expenses: Food Service
total $65,736 · program services $36,968 · management and general $28,768
-
24e · All other expenses
total $124,503 · program services $81,079 · management and general $43,424
Balance sheet
Part X, book values.
-
1 · Cash, non-interest-bearing
beginning of year $51,974 · end of year $42,325
-
3 · Pledges and grants receivable
beginning of year $44,520 · end of year $57,991
-
4 · Accounts receivable
beginning of year $1,233,734 · end of year $1,486,625
-
8 · Inventories for sale or use
beginning of year $157,268 · end of year $163,096
-
9 · Prepaid expenses and deferred charges
beginning of year $40,424 · end of year $10,449
-
10a · Land, buildings and equipment: cost or other basis
$16,586,187
-
10b · Land, buildings and equipment: accumulated depreciation
$14,656,782
-
10c · Land, buildings and equipment, net
beginning of year $2,016,837 · end of year $1,929,405
-
15 · Other assets
beginning of year -$399,803 · end of year $149,069
-
17 · Accounts payable and accrued expenses
beginning of year $1,247,050 · end of year $840,996
-
25 · Other liabilities
beginning of year $359,234 · end of year $1,628,829
-
27 · Net assets without donor restrictions
beginning of year $1,538,670 · end of year $1,369,135
Mission and programs · 2023
Mission
Honor those we serve by delivering the best possible care.Ballad Health is dedicated to improving the health of the 29-county Appalachian Highlands region.
Activities or mission (Part I)
Honor those we serve by delivering the best possible care.
-
See Schedule O
Expenses $11,599,976 · Grants $8,700 · Revenue $14,181,101
As filed on the 2023 return. The filer continues this part on Schedule O, which is not shown here.
Listed in Part VII
-
Alan Levine BH PresCEO
Director, Chair
- Total calculated
- $2,247,795
- From this org
- $0
- From related orgs
- $1,983,279
- Other
- $264,516
- Hours/week
- 1 + 64 related
Schedule J breakdown matched by us
- Base
- $0 + $1,451,380 related
- Bonus
- $0 + $495,018 related
- Other
- $0 + $36,881 related
- Deferred
- $0 + $233,996 related
- Nontaxable benefits
- $0 + $30,520 related
- Filer's total
- $0 + $2,247,795 related
-
Marvin Eichorn BH EVPCAO
Director
- Total calculated
- $1,124,281
- From this org
- $0
- From related orgs
- $1,073,543
- Other
- $50,738
- Hours/week
- 1 + 64 related
Schedule J breakdown matched by us
- Base
- $0 + $782,057 related
- Bonus
- $0 + $240,415 related
- Other
- $0 + $51,071 related
- Deferred
- $0 + $19,805 related
- Nontaxable benefits
- $0 + $30,933 related
- Filer's total
- $0 + $1,124,281 related
-
Eric Deaton BH EVPCOO
Director
- Total calculated
- $1,245,541
- From this org
- $0
- From related orgs
- $1,121,768
- Other
- $123,773
- Hours/week
- 1 + 64 related
Schedule J breakdown matched by us
- Base
- $0 + $851,884 related
- Bonus
- $0 + $253,329 related
- Other
- $0 + $16,555 related
- Deferred
- $0 + $98,731 related
- Nontaxable benefits
- $0 + $25,042 related
- Filer's total
- $0 + $1,245,541 related
-
Julie Bennett CLOGovnc Offcr
Director, Secretary
- Total calculated
- $624,827
- From this org
- $0
- From related orgs
- $567,016
- Other
- $57,811
- Hours/week
- 1 + 64 related
Schedule J breakdown matched by us
- Base
- $0 + $463,475 related
- Bonus
- $0 + $100,000 related
- Other
- $0 + $3,541 related
- Deferred
- $0 + $41,515 related
- Nontaxable benefits
- $0 + $16,296 related
- Filer's total
- $0 + $624,827 related
-
Regina Day
Administrator - HCMH/HCH (End 12/23)
- Total calculated
- $233,198
- From this org
- $221,763
- From related orgs
- $0
- Other
- $11,435
- Hours/week
- 36 + 9 related
Schedule J breakdown matched by us
- Base
- $174,232
- Bonus
- $38,305
- Other
- $9,226
- Deferred
- $10,555
- Nontaxable benefits
- $880
- Filer's total
- $233,198
-
Shane Hilton BH EVPCFO
(Beg. Jan. 2024)
- Total calculated
- $730,218
- From this org
- $0
- From related orgs
- $630,028
- Other
- $100,190
- Hours/week
- 1 + 64 related
Schedule J breakdown matched by us
- Base
- $0 + $492,543 related
- Bonus
- $0 + $130,683 related
- Other
- $0 + $6,802 related
- Deferred
- $0 + $69,984 related
- Nontaxable benefits
- $0 + $30,206 related
- Filer's total
- $0 + $730,218 related
-
Lynn Krutak BH EVPCFO
(End June 2024)
- Total calculated
- $1,115,237
- From this org
- $0
- From related orgs
- $994,595
- Other
- $120,642
- Hours/week
- 1 + 64 related
Schedule J breakdown matched by us
- Base
- $0 + $751,345 related
- Bonus
- $0 + $230,794 related
- Other
- $0 + $12,456 related
- Deferred
- $0 + $90,747 related
- Nontaxable benefits
- $0 + $29,895 related
- Filer's total
- $0 + $1,115,237 related
-
Hunter Hamilton
Administrator & CNO - HCMH/HCH
- Total calculated
- $149,299
- From this org
- $120,637
- From related orgs
- $0
- Other
- $28,662
- Hours/week
- 36 + 9 related
-
Chase Wilson
CFO
- Total calculated
- $320,204
- From this org
- $0
- From related orgs
- $278,455
- Other
- $41,749
- Hours/week
- 4.5 + 40.5 related
Schedule J breakdown matched by us
- Base
- $0 + $216,567 related
- Bonus
- $0 + $61,672 related
- Other
- $0 + $216 related
- Deferred
- $0 + $13,590 related
- Nontaxable benefits
- $0 + $28,159 related
- Filer's total
- $0 + $320,204 related
-
Georgia Shuck
Pharmacist, Clinical
- Total calculated
- $147,018
- From this org
- $135,676
- From related orgs
- $0
- Other
- $11,342
- Hours/week
- 40
-
Ashley Tackett
RN - Nurse Manager
- Total calculated
- $110,577
- From this org
- $101,510
- From related orgs
- $0
- Other
- $9,067
- Hours/week
- 40
-
Tim Belisle
Former Officer
- Total calculated
- $165,050
- From this org
- $0
- From related orgs
- $162,508
- Other
- $2,542
- Hours/week
- 0
Schedule J breakdown matched by us
- Base
- $0
- Bonus
- $0
- Other
- $0 + $162,508 related
- Deferred
- $0
- Nontaxable benefits
- $0 + $2,542 related
- Filer's total
- $0 + $165,050 related
-
Andrew Wampler BH Gen Cnsl
Former Officer
- Total calculated
- $461,439
- From this org
- $0
- From related orgs
- $398,602
- Other
- $62,837
- Hours/week
- 1 + 54 related
Schedule J breakdown matched by us
- Base
- $0 + $311,946 related
- Bonus
- $0 + $79,268 related
- Other
- $0 + $7,388 related
- Deferred
- $0 + $45,089 related
- Nontaxable benefits
- $0 + $17,748 related
- Filer's total
- $0 + $461,439 related
-
Frank Canova BH Regional CFO
Former Officer
- Total calculated
- $435,199
- From this org
- $0
- From related orgs
- $401,788
- Other
- $33,411
- Hours/week
- 0 + 45 related
Schedule J breakdown matched by us
- Base
- $0 + $313,954 related
- Bonus
- $0 + $82,907 related
- Other
- $0 + $4,927 related
- Deferred
- $0 + $9,600 related
- Nontaxable benefits
- $0 + $23,811 related
- Filer's total
- $0 + $435,199 related
-
David Mooney Dir Rehab Svcs HVMC
Former Highest Compensated
- Total calculated
- $152,725
- From this org
- $0
- From related orgs
- $119,657
- Other
- $33,068
- Hours/week
- 0 + 40 related
Schedule J breakdown matched by us
- Base
- $0 + $119,072 related
- Bonus
- $0
- Other
- $0 + $585 related
- Deferred
- $0 + $7,595 related
- Nontaxable benefits
- $0 + $25,473 related
- Filer's total
- $0 + $152,725 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, and on a Form 990-PF Part VIII's — 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 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 $214,191 Eric Deaton $78,933 Lynn Krutak $70,942 Shane Hilton $50,175 Julie Bennett $41,515 Andrew Wampler $25,902 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 $161,641
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
-
Program Sponsorships
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 BALLAD
-
Smyth County Community Hospital
501c3 · Hospital · VA
Directly controlled by MSHA
-
Dickenson Community Hospital Inc
501c3 · Hospital · VA
Directly controlled by WHS
-
Johnston Memorial Hospital Inc
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
-
Takoma Regional Hospital Inc DBA GCH
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 · Assisted Living · TN
Directly controlled by WHS
-
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
Taxable family on this return
Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.
Related partnerships
Part III: related organizations taxable as a partnership, with the filer's share.
-
Emmaus Community Healthcare PLLC
Medical Services · TN
-
Medical Specialists of JC LLC
Medical Services · TN
-
East Tennessee Ambulatory Surgery Center
Medical Services · TN
-
Quality Improvement Ptrs LLC
Healthcare · TN
Related corporations and trusts
Part IV: related organizations taxable as a corporation or trust.
-
Wellmont Inc
C · Medical Services · TN
-
Wellmont Physician Services Inc
C · Medical Services · TN
-
WPS Providers Inc
C · Medical Services · TN
-
Wellmont Health Services Inc
C · Medical Services · TN
-
Wellmont Insurance Co SPC LTD
C · Insurance · CJ
-
Blue Ridge Medical Management Corp
C · Medical Services · TN
-
Mediserve Medical Equipment of Kingsport Inc
C · Durable Medical Equipment · TN
-
Mountain States Properties Inc
C · Property Management · TN
-
Mountain States Physician Group Inc
C · Medical Services · TN
-
Community Home Care Inc
C · Durable Medical Equipment · VA
-
Wilson Pharmacy Inc
C · Pharmacy · TN
-
Nolichuckey Management Svcs Inc
C · Medical Services · TN
-
Ballad Ventures LLC
C · Investments · TN
-
Ballad Health Development Corporation
C · Investments · TN
Provenance
- Return type
- form_990
- Tax year
- 2023
- Filed
- 8 May 2025
- IRS schema version
- 2023v6.0
- Source object
- 202521289349301137
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