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Nonprofiteer
← WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL INC

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

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.

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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