SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
WELLMONT HEALTH SYSTEM
 
Employer identification number

62-1636465
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
 
No
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		    17,647,003   17,647,003 2.720 %
b Medicaid (from Worksheet 3, column a) . . . . .     78,922,873 57,445,956 21,476,917 3.320 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     96,569,876 57,445,956 39,123,920 6.040 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4). 203 145,624 5,120,019 1,005,690 4,114,329 0.640 %
f Health professions education (from Worksheet 5) . . . 12,011 14,024 10,593,665 5,564,036 5,029,629 0.780 %
g Subsidized health services (from Worksheet 6) . . . .            
h Research (from Worksheet 7) . 117 499 59,127 36,234 22,893  
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . . 55 949 218,645   218,645 0.030 %
j Total. Other Benefits . . 12,386 161,096 15,991,456 6,605,960 9,385,496 1.450 %
k Total. Add lines 7d and 7j . 12,386 161,096 112,561,332 64,051,916 48,509,416 7.490 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support 1   5,320   5,320  
4 Environmental improvements            
5 Leadership development and
training for community members		            
6 Coalition building            
7 Community health improvement advocacy 68 19,079 14,882   14,882  
8 Workforce development            
9 Other            
10 Total 69 19,079 20,202   20,202  
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
10,423,552
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
143,882,369
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
140,445,152
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
3,437,217
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1HOLSTON VALLEY AMBUL
  		SURGICAL SERVICES 52.000 %   48.000 %
2SAPLING GROVE AMBULA
  		SURGICAL SERVICES 65.000 %   35.000 %
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?5
Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 HOLSTON VALLEY MEDICAL CENTER
130 RAVINE STREET
KINGSPORT,TN37660 		X X   X     X     A
2 BRISTOL REGIONAL MEDICAL CENTER
1 MEDICAL PARK BLVD
BRISTOL,TN37620 		X X   X     X     A
3 LONESOME PINE HOSPITAL
1990 HOLTON AVENUE
BIG STONE GAP,VA24219 		X X   X     X     A
4 MOUNTAIN VIEW REGIONAL MEDICAL CTR
310 3RD STREET NE
NORTON,VA24273 		X X         X     A
5 HANCOCK COUNTY HOSPITAL
1519 MAIN STREET
SNEEDVILLE,TN37869 		X       X   X     A
Schedule H (Form 990) 2015
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Schedule H (Form 990) 2015
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Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
A
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		12345
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 16
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 16
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): WWW.WELLMONT.ORG
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2015
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Schedule H (Form 990) 2015
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Part VFacility Information (continued)

Financial Assistance Policy (FAP)
A
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14   No
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
WWWWELLMONTORG
b
WWWWELLMONTORG
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
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Schedule H (Form 990) 2015
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Part VFacility Information (continued)

A
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19 Yes  
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
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Schedule H (Form 990) 2015
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Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
GROUP A, FACILITY 1, HOLSTON VALLEY MEDICAL CENTER - PART V, LINE 5 INFORMATION FOR THE CHNA ASSESSMENT WAS GATHERED FROM A VARIETY OF SOURCES, INCLUDING: -PHYSICIAN NEEDS ASSESSMENT -COMMUNITY HEALTH FACILITY ASSESSMENT -MENTAL HEALTH NEEDS ASSESSMENT -PUBLICLY AVAILABLE POPULATION AND DEMOGRAPHIC INFORMATION -PUBLICLY AVAILABLE POPULATION HEALTH INFORMATION, INCLUDING AMERICA'S HEALTH RANKINGS AND THE COUNTY HEALTH RANKINGS -STATE AND REGIONAL HEALTH DEPARTMENT DATA -THE SOUTHWEST VIRGINIA HEALTH AUTHORITY'S BLUEPRINT FOR HEALTH ENABLED PROSPERITY -THE ETSU, WELLMONT, MOUNTAIN STATES COMMUNITY WORK GROUP PROJECT -OTHER STUDIES SIGNIFICANT INFORMATION WAS GLEANED FROM A PROCESS CONDUCTED BY THE ETSU COLLEGE OF PUBLIC HEALTH AND SUPPORTED BY BOTH WELLMONT HEALTH SYSTEM AND MOUNTAIN STATES HEALTH ALLIANCE. COMMUNITY WORKGROUPS WERE FORMED, INVOLVING A CROSS SECTION OF SUBJECT MATTER EXPERTS TO ASSESS REGIONAL HEALTH NEEDS, INCLUDING THOSE OF UNDERSERVED PEOPLE, FAMILIES, CHILDREN AND THOSE SUFFERING FROM MENTAL HEALTH AND SUBSTANCE ABUSE CHALLENGES. REGIONAL MEETINGS WERE ALSO HELD WHICH INCLUDED REPRESENTATIVES OF THE COMMUNITY AT LARGE, PATIENTS AND MINORITIES OR AGENCIES SERVING THEM. FINDINGS FROM THIS WORK WERE TAKEN INTO ACCOUNT IN BOTH THE ASSESSMENT AND IMPLEMENTATION PLAN. THE INFORMATION WAS THEN COLLATED AND ASSESSED TO DETERMINE THE GREATEST UNMET HEALTH NEEDS FACING OUR REGION. STRATEGIES TO ADDRESS THESE NEEDS WERE THEN DEVELOPED, UTILIZING INTERNAL RESOURCES AND PARTNERSHIPS WITH OTHER HEALTH CARE ORGANIZATIONS AND PHYSICIANS.
GROUP A, FACILITY 1, HOLSTON VALLEY MEDICAL CENTER - PART V, LINE 6A - BRISTOL REGIONAL MEDICAL CENTER - LONESOME PINE HOSPITAL - HAWKINS COUNTY MEMORIAL HOSPITAL - HANCOCK COUNTY HOSPITAL - MOUNTAIN VIEW REGIONAL MEDICAL CENTER
GROUP A, FACILITY 1, HOLSTON VALLEY MEDICAL CENTER - PART V, LINE 11 KEY FINDINGS NOTED DURING THE CHNA WERE THE LOW RANKINGS OF THE COUNTIES WE SERVE IN SEVERAL CATEGORIES RELATED TO HEALTH AND WELLNESS, INCLUDING PREVALENCE OF CHRONIC DISEASE MANAGEMENT, TOBACCO USE, DIET AND EXERCISE, AS WELL AS A NEED FOR EXPANDED AND ENHANCED MENTAL SERVICES. THEY ALSO EMPHASIZED THE VULNERABILITY OF OUR UNDERINSURED AND UNINSURED POPULATIONS, AND THAT IF OUR COMMUNITIES ARE TO THRIVE, WE MUST FOCUS ON ENCOURAGING HEALTHY CHILDREN AND FAMILIES. TO HELP MEET THESE NEEDS, WELLMONT WILL CONTINUE TO STRENGTHEN OUR PARTNERSHIPS AND CONTINUUM OF CARE OPPORTUNITIES WITH AREA HEALTH DEPARTMENTS, FEDERALLY QUALIFIED HEALTH CENTERS AND FRONTIER HEALTH, THE REGION'S LEADING PROVIDER OF BEHAVIORAL HEALTH SERVICES.
GROUP A, FACILITY 1, HOLSTON VALLEY MEDICAL CENTER - PART V, LINE 22D HOLSTON VALLEY MEDICAL CENTER FOLLOWS TENNESSEE STATUTE WHICH IS 175% OF AVERAGE COST FOR ITS HOSPITAL (IN THE ABSENCE OF VIRGINIA STATUTE).
GROUP A, FACILITY 2, BRISTOL REGIONAL MEDICAL CENTER - PART V, LINE 5 INFORMATION FOR THE CHNA ASSESSMENT WAS GATHERED FROM A VARIETY OF SOURCES, INCLUDING: -PHYSICIAN NEEDS ASSESSMENT -COMMUNITY HEALTH FACILITY ASSESSMENT -MENTAL HEALTH NEEDS ASSESSMENT -PUBLICLY AVAILABLE POPULATION AND DEMOGRAPHIC INFORMATION -PUBLICLY AVAILABLE POPULATION HEALTH INFORMATION, INCLUDING AMERICA'S HEALTH RANKINGS AND THE COUNTY HEALTH RANKINGS -STATE AND REGIONAL HEALTH DEPARTMENT DATA -THE SOUTHWEST VIRGINIA HEALTH AUTHORITY'S BLUEPRINT FOR HEALTH ENABLED PROSPERITY -THE ETSU, WELLMONT, MOUNTAIN STATES COMMUNITY WORK GROUP PROJECT -OTHER STUDIES SIGNIFICANT INFORMATION WAS GLEANED FROM A PROCESS CONDUCTED BY THE ETSU COLLEGE OF PUBLIC HEALTH AND SUPPORTED BY BOTH WELLMONT HEALTH SYSTEM AND MOUNTAIN STATES HEALTH ALLIANCE. COMMUNITY WORKGROUPS WERE FORMED, INVOLVING A CROSS SECTION OF SUBJECT MATTER EXPERTS TO ASSESS REGIONAL HEALTH NEEDS, INCLUDING THOSE OF UNDERSERVED PEOPLE, FAMILIES, CHILDREN AND THOSE SUFFERING FROM MENTAL HEALTH AND SUBSTANCE ABUSE CHALLENGES. REGIONAL MEETINGS WERE ALSO HELD WHICH INCLUDED REPRESENTATIVES OF THE COMMUNITY AT LARGE, PATIENTS AND MINORITIES OR AGENCIES SERVING THEM. FINDINGS FROM THIS WORK WERE TAKEN INTO ACCOUNT IN BOTH THE ASSESSMENT AND IMPLEMENTATION PLAN. THE INFORMATION WAS THEN COLLATED AND ASSESSED TO DETERMINE THE GREATEST UNMET HEALTH NEEDS FACING OUR REGION. STRATEGIES TO ADDRESS THESE NEEDS WERE THEN DEVELOPED, UTILIZING INTERNAL RESOURCES AND PARTNERSHIPS WITH OTHER HEALTH CARE ORGANIZATIONS AND PHYSICIANS.
GROUP A, FACILITY 2, BRISTOL REGIONAL MEDICAL CENTER - PART V, LINE 6A - HOLSTON VALLEY MEDICAL CENTER - LONESOME PINE HOSPITAL - HAWKINS COUNTY MEMORIAL HOSPITAL - HANCOCK COUNTY HOSPITAL - MOUNTAIN VIEW REGIONAL MEDICAL CENTER
GROUP A, FACILITY 2, BRISTOL REGIONAL MEDICAL CENTER - PART V, LINE 11 KEY FINDINGS NOTED DURING THE CHNA WERE THE LOW RANKINGS OF THE COUNTIES WE SERVE IN SEVERAL CATEGORIES RELATED TO HEALTH AND WELLNESS, INCLUDING PREVALENCE OF CHRONIC DISEASE MANAGEMENT, TOBACCO USE, DIET AND EXERCISE, AS WELL AS A NEED FOR EXPANDED AND ENHANCED MENTAL SERVICES. THEY ALSO EMPHASIZED THE VULNERABILITY OF OUR UNDERINSURED AND UNINSURED POPULATIONS, AND THAT IF OUR COMMUNITIES ARE TO THRIVE, WE MUST FOCUS ON ENCOURAGING HEALTHY CHILDREN AND FAMILIES. TO HELP MEET THESE NEEDS, WELLMONT WILL CONTINUE TO STRENGTHEN OUR PARTNERSHIPS AND CONTINUUM OF CARE OPPORTUNITIES WITH AREA HEALTH DEPARTMENTS, FEDERALLY QUALIFIED HEALTH CENTERS AND FRONTIER HEALTH, THE REGION'S LEADING PROVIDER OF BEHAVIORAL HEALTH SERVICES.
GROUP A, FACILITY 2, BRISTOL REGIONAL MEDICAL CENTER - PART V, LINE 22D BRISTOL REGIONAL MEDICAL CENTER FOLLOWS TENNESSEE STATUTE WHICH IS 175% OF AVERAGE COST FOR ITS HOSPITAL (IN THE ABSENCE OF VIRGINIA STATUTE).
GROUP A, FACILITY 3, LONESOME PINE HOSPITAL - PART V, LINE 5 INFORMATION FOR THE CHNA ASSESSMENT WAS GATHERED FROM A VARIETY OF SOURCES, INCLUDING: -PHYSICIAN NEEDS ASSESSMENT -COMMUNITY HEALTH FACILITY ASSESSMENT -MENTAL HEALTH NEEDS ASSESSMENT -PUBLICLY AVAILABLE POPULATION AND DEMOGRAPHIC INFORMATION -PUBLICLY AVAILABLE POPULATION HEALTH INFORMATION, INCLUDING AMERICA'S HEALTH RANKINGS AND THE COUNTY HEALTH RANKINGS -STATE AND REGIONAL HEALTH DEPARTMENT DATA -THE SOUTHWEST VIRGINIA HEALTH AUTHORITY'S BLUEPRINT FOR HEALTH ENABLED PROSPERITY -THE ETSU, WELLMONT, MOUNTAIN STATES COMMUNITY WORK GROUP PROJECT -OTHER STUDIES SIGNIFICANT INFORMATION WAS GLEANED FROM A PROCESS CONDUCTED BY THE ETSU COLLEGE OF PUBLIC HEALTH AND SUPPORTED BY BOTH WELLMONT HEALTH SYSTEM AND MOUNTAIN STATES HEALTH ALLIANCE. COMMUNITY WORKGROUPS WERE FORMED, INVOLVING A CROSS SECTION OF SUBJECT MATTER EXPERTS TO ASSESS REGIONAL HEALTH NEEDS, INCLUDING THOSE OF UNDERSERVED PEOPLE, FAMILIES, CHILDREN AND THOSE SUFFERING FROM MENTAL HEALTH AND SUBSTANCE ABUSE CHALLENGES. REGIONAL MEETINGS WERE ALSO HELD WHICH INCLUDED REPRESENTATIVES OF THE COMMUNITY AT LARGE, PATIENTS AND MINORITIES OR AGENCIES SERVING THEM. FINDINGS FROM THIS WORK WERE TAKEN INTO ACCOUNT IN BOTH THE ASSESSMENT AND IMPLEMENTATION PLAN. THE INFORMATION WAS THEN COLLATED AND ASSESSED TO DETERMINE THE GREATEST UNMET HEALTH NEEDS FACING OUR REGION. STRATEGIES TO ADDRESS THESE NEEDS WERE THEN DEVELOPED, UTILIZING INTERNAL RESOURCES AND PARTNERSHIPS WITH OTHER HEALTH CARE ORGANIZATIONS AND PHYSICIANS.
GROUP A, FACILITY 3, LONESOME PINE HOSPITAL - PART V, LINE 6A - BRISTOL REGIONAL MEDICAL CENTER - HOLSTON VALLEY MEDICAL CENTER - HAWKINS COUNTY MEMORIAL HOSPITAL - HANCOCK COUNTY HOSPITAL - MOUNTAIN VIEW REGIONAL MEDICAL CENTER
GROUP A, FACILITY 3, LONESOME PINE HOSPITAL - PART V, LINE 11 KEY FINDINGS NOTED DURING THE CHNA WERE THE LOW RANKINGS OF THE COUNTIES WE SERVE IN SEVERAL CATEGORIES RELATED TO HEALTH AND WELLNESS, INCLUDING PREVALENCE OF CHRONIC DISEASE MANAGEMENT, TOBACCO USE, DIET AND EXERCISE, AS WELL AS A NEED FOR EXPANDED AND ENHANCED MENTAL SERVICES. THEY ALSO EMPHASIZED THE VULNERABILITY OF OUR UNDERINSURED AND UNINSURED POPULATIONS, AND THAT IF OUR COMMUNITIES ARE TO THRIVE, WE MUST FOCUS ON ENCOURAGING HEALTHY CHILDREN AND FAMILIES. TO HELP MEET THESE NEEDS, WELLMONT WILL CONTINUE TO STRENGTHEN OUR PARTNERSHIPS AND CONTINUUM OF CARE OPPORTUNITIES WITH AREA HEALTH DEPARTMENTS, FEDERALLY QUALIFIED HEALTH CENTERS AND FRONTIER HEALTH, THE REGION'S LEADING PROVIDER OF BEHAVIORAL HEALTH SERVICES.
GROUP A, FACILITY 3, LONESOME PINE HOSPITAL - PART V, LINE 22D LONESOME PINE HOSPITAL FOLLOWS TENNESSEE STATUTE WHICH IS 175% OF AVERAGE COST FOR ITS HOSPITAL (IN THE ABSENCE OF VIRGINIA STATUTE).
GROUP A, FACILITY 4, MOUNTAIN VIEW REGIONAL MEDICAL CTR - PART V, LINE 5 INFORMATION FOR THE CHNA ASSESSMENT WAS GATHERED FROM A VARIETY OF SOURCES, INCLUDING: -PHYSICIAN NEEDS ASSESSMENT -COMMUNITY HEALTH FACILITY ASSESSMENT -MENTAL HEALTH NEEDS ASSESSMENT -PUBLICLY AVAILABLE POPULATION AND DEMOGRAPHIC INFORMATION -PUBLICLY AVAILABLE POPULATION HEALTH INFORMATION, INCLUDING AMERICA'S HEALTH RANKINGS AND THE COUNTY HEALTH RANKINGS -STATE AND REGIONAL HEALTH DEPARTMENT DATA -THE SOUTHWEST VIRGINIA HEALTH AUTHORITY'S BLUEPRINT FOR HEALTH ENABLED PROSPERITY -THE ETSU, WELLMONT, MOUNTAIN STATES COMMUNITY WORK GROUP PROJECT -OTHER STUDIES SIGNIFICANT INFORMATION WAS GLEANED FROM A PROCESS CONDUCTED BY THE ETSU COLLEGE OF PUBLIC HEALTH AND SUPPORTED BY BOTH WELLMONT HEALTH SYSTEM AND MOUNTAIN STATES HEALTH ALLIANCE. COMMUNITY WORKGROUPS WERE FORMED, INVOLVING A CROSS SECTION OF SUBJECT MATTER EXPERTS TO ASSESS REGIONAL HEALTH NEEDS, INCLUDING THOSE OF UNDERSERVED PEOPLE, FAMILIES, CHILDREN AND THOSE SUFFERING FROM MENTAL HEALTH AND SUBSTANCE ABUSE CHALLENGES. REGIONAL MEETINGS WERE ALSO HELD WHICH INCLUDED REPRESENTATIVES OF THE COMMUNITY AT LARGE, PATIENTS AND MINORITIES OR AGENCIES SERVING THEM. FINDINGS FROM THIS WORK WERE TAKEN INTO ACCOUNT IN BOTH THE ASSESSMENT AND IMPLEMENTATION PLAN. THE INFORMATION WAS THEN COLLATED AND ASSESSED TO DETERMINE THE GREATEST UNMET HEALTH NEEDS FACING OUR REGION. STRATEGIES TO ADDRESS THESE NEEDS WERE THEN DEVELOPED, UTILIZING INTERNAL RESOURCES AND PARTNERSHIPS WITH OTHER HEALTH CARE ORGANIZATIONS AND PHYSICIANS.
GROUP A, FACILITY 4, MOUNTAIN VIEW REGIONAL MEDICAL CTR - PART V, LINE 6A - BRISTOL REGIONAL MEDICAL CENTER - HOLSTON VALLEY MEDICAL CENTER - LONESOME PINE HOSPITAL - HAWKINS COUNTY MEMORIAL HOSPITAL - HANCOCK COUNTY HOSPITAL
GROUP A, FACILITY 4, MOUNTAIN VIEW REGIONAL MEDICAL CTR - PART V, LINE 11 KEY FINDINGS NOTED DURING THE CHNA WERE THE LOW RANKINGS OF THE COUNTIES WE SERVE IN SEVERAL CATEGORIES RELATED TO HEALTH AND WELLNESS, INCLUDING PREVALENCE OF CHRONIC DISEASE MANAGEMENT, TOBACCO USE, DIET AND EXERCISE, AS WELL AS A NEED FOR EXPANDED AND ENHANCED MENTAL SERVICES. THEY ALSO EMPHASIZED THE VULNERABILITY OF OUR UNDERINSURED AND UNINSURED POPULATIONS, AND THAT IF OUR COMMUNITIES ARE TO THRIVE, WE MUST FOCUS ON ENCOURAGING HEALTHY CHILDREN AND FAMILIES. TO HELP MEET THESE NEEDS, WELLMONT WILL CONTINUE TO STRENGTHEN OUR PARTNERSHIPS AND CONTINUUM OF CARE OPPORTUNITIES WITH AREA HEALTH DEPARTMENTS, FEDERALLY QUALIFIED HEALTH CENTERS AND FRONTIER HEALTH, THE REGION'S LEADING PROVIDER OF BEHAVIORAL HEALTH SERVICES.
GROUP A, FACILITY 4, MOUNTAIN VIEW REGIONAL MEDICAL CTR - PART V, LINE 22D MOUNTAIN VIEW REGIONAL MEDICAL CENTER FOLLOWS TENNESSEE STATUTE WHICH IS 175% OF AVERAGE COST FOR ITS HOSPITAL (IN THE ABSENCE OF VIRGINIA STATUTE).
GROUP A, FACILITY 5, HANCOCK COUNTY HOSPITAL - PART V, LINE 5 INFORMATION FOR THE CHNA ASSESSMENT WAS GATHERED FROM A VARIETY OF SOURCES, INCLUDING: -PHYSICIAN NEEDS ASSESSMENT -COMMUNITY HEALTH FACILITY ASSESSMENT -MENTAL HEALTH NEEDS ASSESSMENT -PUBLICLY AVAILABLE POPULATION AND DEMOGRAPHIC INFORMATION -PUBLICLY AVAILABLE POPULATION HEALTH INFORMATION, INCLUDING AMERICA'S HEALTH RANKINGS AND THE COUNTY HEALTH RANKINGS -STATE AND REGIONAL HEALTH DEPARTMENT DATA -THE SOUTHWEST VIRGINIA HEALTH AUTHORITY'S BLUEPRINT FOR HEALTH ENABLED PROSPERITY -THE ETSU, WELLMONT, MOUNTAIN STATES COMMUNITY WORK GROUP PROJECT -OTHER STUDIES SIGNIFICANT INFORMATION WAS GLEANED FROM A PROCESS CONDUCTED BY THE ETSU COLLEGE OF PUBLIC HEALTH AND SUPPORTED BY BOTH WELLMONT HEALTH SYSTEM AND MOUNTAIN STATES HEALTH ALLIANCE. COMMUNITY WORKGROUPS WERE FORMED, INVOLVING A CROSS SECTION OF SUBJECT MATTER EXPERTS TO ASSESS REGIONAL HEALTH NEEDS, INCLUDING THOSE OF UNDERSERVED PEOPLE, FAMILIES, CHILDREN AND THOSE SUFFERING FROM MENTAL HEALTH AND SUBSTANCE ABUSE CHALLENGES. REGIONAL MEETINGS WERE ALSO HELD WHICH INCLUDED REPRESENTATIVES OF THE COMMUNITY AT LARGE, PATIENTS AND MINORITIES OR AGENCIES SERVING THEM. FINDINGS FROM THIS WORK WERE TAKEN INTO ACCOUNT IN BOTH THE ASSESSMENT AND IMPLEMENTATION PLAN. THE INFORMATION WAS THEN COLLATED AND ASSESSED TO DETERMINE THE GREATEST UNMET HEALTH NEEDS FACING OUR REGION. STRATEGIES TO ADDRESS THESE NEEDS WERE THEN DEVELOPED, UTILIZING INTERNAL RESOURCES AND PARTNERSHIPS WITH OTHER HEALTH CARE ORGANIZATIONS AND PHYSICIANS.
GROUP A, FACILITY 5, HANCOCK COUNTY HOSPITAL - PART V, LINE 6A - BRISTOL REGIONAL MEDICAL CENTER - HOLSTON VALLEY MEDICAL CENTER - LONESOME PINE HOSPITAL - HAWKINS COUNTY MEMORIAL HOSPITAL - MOUNTAIN VIEW REGIONAL MEDICAL CENTER
GROUP A, FACILITY 5, HANCOCK COUNTY HOSPITAL - PART V, LINE 11 KEY FINDINGS NOTED DURING THE CHNA WERE THE LOW RANKINGS OF THE COUNTIES WE SERVE IN SEVERAL CATEGORIES RELATED TO HEALTH AND WELLNESS, INCLUDING PREVALENCE OF CHRONIC DISEASE MANAGEMENT, TOBACCO USE, DIET AND EXERCISE, AS WELL AS A NEED FOR EXPANDED AND ENHANCED MENTAL SERVICES. THEY ALSO EMPHASIZED THE VULNERABILITY OF OUR UNDERINSURED AND UNINSURED POPULATIONS, AND THAT IF OUR COMMUNITIES ARE TO THRIVE, WE MUST FOCUS ON ENCOURAGING HEALTHY CHILDREN AND FAMILIES. TO HELP MEET THESE NEEDS, WELLMONT WILL CONTINUE TO STRENGTHEN OUR PARTNERSHIPS AND CONTINUUM OF CARE OPPORTUNITIES WITH AREA HEALTH DEPARTMENTS, FEDERALLY QUALIFIED HEALTH CENTERS AND FRONTIER HEALTH, THE REGION'S LEADING PROVIDER OF BEHAVIORAL HEALTH SERVICES.
GROUP A, FACILITY 5, HANCOCK COUNTY HOSPITAL - PART V, LINE 22D HANCOCK COUNTY HOSPITAL FOLLOWS TENNESSEE STATUTE WHICH IS 175% OF AVERAGE COST FOR ITS HOSPITAL (IN THE ABSENCE OF VIRGINIA STATUTE).
   
   
   
   
   
   
   
Schedule H (Form 990) 2015
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Schedule H (Form 990) 2015
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Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?  
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2015
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Schedule H (Form 990) 2015
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Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATION PART I, LINE 6A: WELLMONT HEALTH SYSTEM PREPARES A CONSOLIDATED COMMUNITY BENEFIT REPORT WHICH INCLUDES THE ACTIVITIES OF ALL ITS OPERATIONS AND AFFILIATES. IN CONTRAST, AN IRS FORM 990 IS FILED FOR EACH TAX EXEMPT CORPORATION (7 SEPARATE FORM 990S) AND THERE IS NO SUCH IRS FORM FOR THE TAXABLE CORPORATIONS. IN ADDITION, THE IRS INSTRUCTIONS TO FORM 990 HAVE SPECIFIC DEFINITIONS, METHODS AND WORKSHEETS TO CALCULATE THE COMMUNITY BENEFITS TO BE INCLUDED ON THE FORM 990. AS A RESULT, THERE ARE SIGNIFICANT DIFFERENCES BETWEEN THE COMMUNITY BENEFITS REPORTED IN THE CONSOLIDATED COMMUNITY BENEFIT REPORT AND THE VARIOUS FORM 990S. THERE ARE ALSO FUNDS AND SERVICES THAT ARE PROVIDED THAT DO NOT MEET THE SPECIFIC DEFINITIONS OF THE IRS INSTRUCTIONS, SUCH AS CONTRIBUTIONS TO COMMUNITY ORGANIZATIONS THAT DO NOT MEET THE DEFINITION OF "RESTRICTED TO ONE OR MORE OF THE ACTIVITIES DESCRIBED IN THE TABLE IN PART I, LINE 7...".
PART I, LINE 7, COLUMN (F) - EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE THE BAD DEBT EXPENSE OF 42,779,599 WAS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT WAS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN.
PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION RATIO OF PATIENT CARE COST-TO-CHARGES, WAS USED TO DETERMINE THE COSTS FOR AMOUNTS IN LINE 7A AND 7B, COL (C) BY FACILITY. THE COSTS INCLUDED IN THE COST-TO-CHARGE RATIO INCLUDED THE COSTS FROM ALL PATIENT SEGMENTS. ACTUAL COSTS FROM THE GENERAL LEDGER WERE USED FOR AMOUNTS IN LINE 7F AND 7I, COL.(C).
PART II - COMMUNITY BUILDING ACTIVITIES WELLMONT HEALTH SYSTEM PROMOTED THE HEALTH OF THE COMMUNITIES IT SERVES IN A VARIETY OF WAYS. COMMUNITY SUPPORT BRISTOL REGIONAL MEDICAL CENTER (BRMC) ADMINISTRATION AND LEADERS HAD 48 PEOPLE VOLUNTEER DURING UNITED WAY WEEK OF CARING. BRMC STAFF ALSO PARTICIPATED IN THE FOLLOWING PROJECTS DURING THE FISCAL YEAR - FAMILY PROMISE, FISH BOWLING WITH GIRLS, INC., SALVATION ARMY, FRONTIER INDUSTRIES, HEALING HANDS, TECHGYRLS, AND GIRLS, INC. REWARD DRIVE. COMMUNITY HEALTH IMPROVEMENT ADVOCACY TO PROMOTE COMMUNITY HEALTH IMPROVEMENTS AND SAFETY, HOLSTON VALLEY MEDICAL CENTER (HVMC) SET UP AN INJURY PREVENTION BOOTH AT THE UNICOI COUNTY APPLE FESTIVAL SERVING 15,000 PEOPLE. HVMC PROVIDED RESOURCES TO CONDUCT VARIOUS PRESENTATIONS TO THE COMMUNITY SUCH AS TRAUMA NURSES TALK TOUGH, TRAUMA ROLLOVER SIMULATOR, DRIVER SAFETY, AND A TOUGH PILL TO SWALLOW.
PART VI, LINE 2 - NEEDS ASSESSMENT WELLMONT HEALTH SYSTEM EXAMINES THE HEALTHCARE NEEDS OF THE COMMUNITIES IT SERVES BY CONDUCTING PHYSICIAN NEEDS ASSESSMENTS FOR ITS HOSPITALS. AS PART OF THIS EFFORT, WELLMONT REVIEWS ITS SERVICE AREA AND DEMOGRAPHICS, EXAMINES PHYSICIAN DEMOGRAPHICS AND CONDUCTS FOCUS GROUPS. IT MAKES A DETERMINATION OF PHYSICIAN NEED WHILE CALCULATING ITS PHYSICIAN SURPLUSES AND DEFICITS AND HIGHLIGHTING ITS RECRUITMENT PRIORITIES AND PLANS. WELLMONT ANNUALLY DETERMINES ITS PRIMARY, SECONDARY AND TERTIARY MARKETS THROUGH THE USE OF COUNTY-BY-COUNTY ANALYSIS TO IDENTIFY THE FOLLOWING CUSTOMER GROUPS: PATIENTS AND POTENTIAL PATIENTS, COMMUNITY/EMPLOYER GROUPS AND LOCAL PHYSICIANS. THE HEALTH SYSTEM ALSO RELIES ON THE EXPERTISE OF CONSULTANTS TO PERIODICALLY REVIEW ALL FACETS OF OPERATIONS AND MAKE RECOMMENDATIONS FOR CHANGES.
PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE WELLMONT HEALTH SYSTEM PROACTIVELY INFORMS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY BY POSTING THE POLICY ON ITS WEB SITE AS WELL AS POSTING THE POLICY AT POINTS OF REGISTRATION IN THE HOSPITALS. WELLMONT HEALTH SYSTEM USES PROGRAM ELIGIBILITY SPECIALISTS WHO CONTACT THE UNINSURED PATIENT POPULATION. THESE SPECIALISTS DISCUSS THE VARIOUS GOVERNMENTAL ASSISTANCE PROGRAMS THAT ARE AVAILABLE TO PATIENTS IN ORDER TO DETERMINE IF THE PATIENT WOULD QUALIFY FOR ANY OF THESE PROGRAMS. THE SPECIALISTS WILL WORK WITH THE PATIENTS TO COMPLETE ANY NECESSARY APPLICATIONS AND WILL HELP THEM THROUGH THE QUALIFICATION PROCESS.
PART VI, LINE 4 - COMMUNITY INFORMATION WELLMONT HEALTH SYSTEM'S SERVICE AREA IS DEFINED BY MANAGEMENT AT THE COUNTY LEVEL BASED ON PATIENT ACTIVITY AND LOCATIONS OF OUR CAMPUSES. THE PRIMARY SERVICE AREA ("PSA") INCLUDES THE TENNESSEE COUNTIES OF SULLIVAN, HAWKINS, AND HANCOCK, AND THE VIRGINIA COUNTIES OF WASHINGTON, WISE, LEE, AND SCOTT. THE SECONDARY SERVICE AREA ("SSA") IS DEFINED AS WASHINGTON, GREENE, CARTER, JOHNSON, AND UNICOI COUNTIES OF TENNESSEE, AND RUSSELL, BUCHANAN, SMYTH, TAZEWELL, DICKENSON, AND WYTHE COUNTIES OF VIRGINIA. THE DEMOGRAPHICS OF THESE AREAS ARE AS FOLLOWS: PSA- POPULATION 359,358; MEDIAN HOUSEHOLD INCOME 38,875 SSA- POPULATION 454,774; MEDIAN HOUSEHOLD INCOME 37,317 APPROXIMATELY 18.37% OF OUR PATIENTS ARE MEDICAID RECIPIENTS, AND 9.26% ARE UNINSURED AND TWO OF THE PSA COUNTIES ARE DESIGNATED AS MEDICALLY UNDERSERVED AREAS (HAWKINS COUNTY, TENNESSEE, AND LEE COUNTY, VIRGINIA).
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH WELLMONT HEALTH SYSTEM'S HOSPITALS AND OTHER HEALTHCARE FACILITIES FURTHER THEIR EXEMPT PURPOSE BY PROVIDING MILLIONS IN UNCOMPENSATED CARE AND OTHER CHARITABLE DONATIONS. IN FISCAL YEAR 2016, WELLMONT PROVIDED 64,786,035 IN UNCOMPENSATED CARE. THE HEALTH SYSTEM ALSO DONATED 991,662 TO COMMUNITY ORGANIZATIONS SUCH AS CHILDREN'S MIRACLE NETWORK, UNITED WAY, SUSAN G. KOMEN FOR THE CURE, AND THE AMERICAN CANCER SOCIETY. WELLMONT PROVIDED 5,223,537 FOR COMMUNITY HEALTH AND OUTREACH, 13,521 FOR COMMUNITY BENEFIT OPERATIONS, 23,518 FOR COMMUNITY BUILDING ACTIVITIES, 5,088,066 FOR TRAINING AND EDUCATION OF HEALTHCARE PROFESSIONALS AND 22,983 FOR CLINICAL TRIALS AND RESEARCH. EMPLOYEES, PHYSICIANS, AND VOLUNTEERS DONATED IN EXCESS OF 76,294 HOURS OF COMMUNITY SERVICE.
PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM WELLMONT HEALTH SYSTEM("WELLMONT") IS A TENNESSEE NON-PROFIT CORPORATION, BASED IN KINGSPORT, TENNESSEE,AND A PREMIER PROVIDER OF HEALTHCARE SERVICES IN NORTHEAST TENNESSEE AND SOUTHWEST VIRGINIA. WELLMONT WAS FORMED IN JULY, 1996, WITH THE MERGER OF BRISTOL MEMORIAL HOSPITAL IN BRISTOL, TENNESSEE, AND HOLSTON VALLEY MEDICAL CENTER IN KINGSPORT, TENNESSEE. OVER THE PAST 18 YEARS, WELLMONT HAS GROWN TO INCLUDE FIVE ADDITIONAL HOSPITALS, AN INTEGRATED PHYSICIAN NETWORK, AND SEVERAL AMBULATORY SITES. WELLMONT HOSPITALS OFFER A BROAD SCOPE OF SERVICES RANGING FROM COMMUNITY BASED ACUTE CARE TO HIGHLY SPECIALIZED TERTIARY SERVICES INCLUDING TWO TRAUMA CENTERS, COMPREHENSIVE HEART CARE, AND CANCER CARE. WELLMONT 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, WELLMONT OWNS AND OPERATES FIVE ACUTE CARE HOSPITAL FACILITIES AND ONE CRITICAL ACCESS HOSPITAL WITH A TOTAL OF 1,091 LICENSED BEDS. THE ACUTE CARE FACILITIES OWNED BY WELLMONT INCLUDE HOLSTON VALLEY MEDICAL CENTER, BRISTOL REGIONAL MEDICAL CENTER, MOUNTAIN VIEW REGIONAL MEDICAL CENTER IN NORTON, VIRGINIA, LONESOME PINE HOSPITAL IN BIG STONE GAP, VIRGINIA, HAWKINS COUNTY MEMORIAL HOSPITAL IN ROGERSVILLE, TENNESSEE, AND THE CRITICAL ACCESS HOSPITAL, HANCOCK COUNTY HOSPITAL IN SNEEDVILLE, TENNESSEE. WELLMONT ALSO, DIRECTLY OR INDIRECTLY, CONTROLS, OWNS, OR IS AFFILIATED WITH VARIOUS NON-PROFIT AND FOR-PROFIT CORPORATIONS AND OTHER ORGANIZATIONS THAT CURRENTLY PROVIDE HEALTH CARE AND HEALTH CARE-RELATED SERVICES THROUGHOUT THE SERVICE AREA. IN ADDITION TO THE HOSPITAL CAMPUSES AND AMBULATORY CARE CENTERS DESCRIBED ABOVE, WELLMONT ALSO OPERATES MEDICAL CLINICS, AMBULATORY SURGERY CENTERS, COMPREHENSIVE CANCER CARE CENTERS, AND IMAGING FACILITIES.
PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT TENNESSEE
ADDITIONAL INFORMATION PART III, LINE 4: THE COST REPORTED ON LINE 2 IS CALCULATED AS THE BAD DEBT EXPENSE FROM THE GENERAL LEDGER TIMES THE RATIO OF COST TO CHARGES AS CALCULATED ON WORKSHEET 2 BY FACILITY. THERE ARE NO AMOUNTS REPORTED ON LINE 3. DISCOUNTS ON PATIENT ACCOUNTS ARE NOT INCLUDED IN BAD DEBT EXPENSE. PAYMENTS ON PATIENT ACCOUNTS THAT HAVE BEEN PREVIOUSLY WRITTEN OFF AS BAD DEBT ARE USED TO REDUCE BAD DEBT EXPENSE. A THIRD PARTY VENDOR IS USED TO HELP DETERMINE THE AMOUNT THAT COULD REASONABLY BE ATTRIBUTABLE TO PATIENTS WHO LIKELY COULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE CHARITY CARE POLICY. TEXT OF NOTE TO FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE: NET PATIENT SERVICE REVENUE IS REPORTED ON THE ACCRUAL BASIS IN THE PERIOD IN WHICH SERVICES ARE PROVIDED AT THE NET REALIZABLE AMOUNTS EXPECTED TO BE COLLECTED. NET PATIENT SERVICE REVENUE INCLUDES AMOUNTS ESTIMATED BY MANAGEMENT TO BE REIMBURSABLE BY PATIENTS AND VARIOUS THIRD-PARTY PAYORS UNDER PROVISIONS OF REIMBURSEMENT FORMULAS IN EFFECT, INCLUDING RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS. ESTIMATED RETROACTIVE ADJUSTMENTS ARE ACCRUED IN THE PERIOD RELATED SERVICES ARE RENDERED AND ADJUSTED IN PERIODS AS FINAL AND OTHER SETTLEMENTS ARE DETERMINED. WELLMONT PROVIDES CARE TO PATIENTS WHO MEET CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE WELLMONT DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT INCLUDED IN NET PATIENT SERVICE REVENUE. PATIENT ACCOUNTS RECEIVABLE ARE REPORTED NET OF BOTH AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS. THE CONTRACTUAL ALLOWANCE REPRESENTS THE DIFFERENCE BETWEEN ESTABLISHED BILLING RATES AND ESTIMATED REIMBURSEMENT FROM MEDICARE, TENNCARE, MEDICAID, AND OTHER THIRD-PARTY PAYMENT PROGRAMS. WELLMONT'S POLICY DOES NOT REQUIRE COLLATERAL OR OTHER SECURITY FOR PATIENT ACCOUNTS RECEIVABLE. WELLMONT ROUTINELY OBTAINS ASSIGNMENT OF, OR IS OTHERWISE ENTITLED TO RECEIVE, PATIENT BENEFITS PAYABLE UNDER HEALTH INSURANCE PROGRAMS, PLANS, OR POLICIES. THE MEDICARE COST REPORT COST FINDING METHODOLOGY AND COST TO CHARGE RATIOS WERE USED TO DETERMINE THE AMOUNT REPORTED ON LINE 6. LINE 7 IS A SURPLUS, SO IT IS NOT INCLUDED AS COMMUNITY BENEFIT. THE IRS INSTRUCTIONS FOR SCHEDULE H, PART III, SECTION B, LINES 5-7, SPECIFICALLY INDICATE TO INCLUDE ONLY THOSE APPLICABLE COSTS AND MEDICARE REIMBURSEMENTS THAT ARE REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT FOR THE YEAR. THIS REPORTING DOES NOT TAKE INTO ACCOUNT THOSE COSTS AND REVENUES ASSOCIATED WITH PHYSICIANS WHO ARE TREATING MEDICARE PATIENTS AT HOSPITAL-OWNED CLINIC AND PHYSICIAN PRACTICE SITES. ACCORDINGLY, THE RESULT OF TREATING MEDICARE PATIENTS FROM A FINANCIAL PERSPECTIVE MAY DIFFER AS REPORTED FOR FINANCIAL REPORTING PURPOSES AND COMMUNITY BENEFIT REPORTING PURPOSES FROM THE SURPLUS OR SHORTFALL SHOWN ON LINE 7 OF SECTION B OF PART III OF SCHEDULE H. PART III, LINE 9B: A THIRD PARTY VENDOR IS USED TO HELP DETERMINE THE AMOUNT THAT COULD REASONABLY BE ATTRIBUTABLE TO PATIENTS WHO LIKELY COULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE CHARITY CARE POLICY.
Schedule H (Form 990) 2015
Additional Data


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