Civic Intelligence

Wellmont Imaging Services Inc

990 • Fiscal year 2015 • EIN 86-1103148

Jan 01, 2015 to Dec 31, 2015 • Filed on Aug 15, 2016

1905 American WayKingsport, TN 37660

(423) 230-8200

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

Score unavailable

No value available

Liabilities-to-assets requires both liabilities and assets on this filing.

Source year 2015

Liabilities / Revenue

Score unavailable

No value available

Liabilities-to-revenue requires both liabilities and revenue on this filing.

Source year 2015

Net Margin

Score unavailable

No value available

Net margin requires both revenue and expenses on this filing.

Source year 2015

Top Officer Pay

100th percentile

$652,965

Higher top officer pay than 100% of similar nonprofits.

2015 filings • 501(c)3 • <$500k nonprofits • Source year 2015

Asset Growth

Score unavailable

No value available

A valid growth rate could not be computed from the available filing history.

Annualized from 2014 to 2015

Revenue Growth

1st percentile

-100%

Faster revenue growth than 1% of similar nonprofits.

2015 filings • 501(c)3 • <$500k nonprofits • Annualized from 2014 to 2015

Assets

Flat

$0

Flat from 2014

Net Assets

Flat

$0

Flat from 2014

Liabilities

Flat

$0

Flat from 2014

Revenue

Down

$0

Down $2,751,106 (-100%) from 2014

Expenses

Down

$0

Down $623,292 (-100%) from 2014

Net Income

Down

$0

Down $2,127,814 (-100%) from 2014

Historical Trend

Balance Sheet Trend

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$6.0M$4.0M$2.0M$0Assets 2010: $5,127,624Liabilities 2010: $0Net Assets 2010: $5,127,6242010Assets 2011: $5,101,349Liabilities 2011: $0Net Assets 2011: $5,101,3492011Assets 2012: $4,682,406Liabilities 2012: $0Net Assets 2012: $4,682,4062012Assets 2013: $4,138,405Liabilities 2013: $0Net Assets 2013: $4,138,4052013Assets 2014: $0Liabilities 2014: $0Net Assets 2014: $02014Assets 2015: $0Liabilities 2015: $0Net Assets 2015: $02015

Highlighted filing

2015

Assets$0
Liabilities$0
Net Assets$0

Operations Trend

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$6.0M$4.0M$2.0M$0-$2.0MExpenses 2010: $5,775,7702010Revenue 2011: $4,445,620Expenses 2011: $4,471,895Net Income 2011: -$26,2752011Expenses 2012: $5,076,3952012Revenue 2013: $3,171,521Expenses 2013: $3,715,522Net Income 2013: -$544,0012013Revenue 2014: $2,751,106Expenses 2014: $623,292Net Income 2014: $2,127,8142014Revenue 2015: $0Expenses 2015: $0Net Income 2015: $02015

Highlighted filing

2015

Revenue$0
Expenses$0
Net Income$0
Jump To
Filing Snapshot
Filing Period
Jan 1, 2015 to Dec 31, 2015
Signed
Aug 15, 2016
Return Version
2015v2.1
Gross Receipts
$0
Mission and Program Overview

Mission

Advance the health status of the region by offering radiology services in an outpatient setting, to better and more efficiently serve patient needs and to provide support to the wellmont health system hospitals.

Balance Sheet Detail
LineBeginningEndChange
Assets
Total Assets$0$0→ $0
Liabilities
Total Liabilities$0$0→ $0
Net Assets / Fund Balance
Total Net Assets Fund Balance$0$0→ $0
Total Liabilities and Net Assets / Fund Balance$0$0→ $0
Compensation and Service Providers

Employees

NameTitleOtherTotal
Alice H PopeExec VP/CFO-$652,965$652,965
Gary D MillerSEC-WIS;SR V$496,471$496,471
Timothy W AtteberyPRES-WIS; PR$482,291$482,291
Bradley H PriceSr VP-resour$402,431$402,431

Board Members and Trustees

NameTitle
Alice H PopeExec VP/CFO-whs
Timothy W AtteberyPRES-WIS; PRES-HVMC
Gary D MillerSEC-WIS;SR VP GEN CO
Bradley H PriceSr VP-resource Mgmt
William T Clark Resigned 121214VP/COO-hvmc
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$0
Investment Income
$0
Other Revenue
$0
Change in Net Assets
$0
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Grants and Similar Amounts Paid$0
Other Expenses$0
Professional Fundraising Fees$0
Salaries, Compensation, and Employee Benefits$0
Total Fundraising Expense$0
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
Yes
Other officer compensation reviewed
Yes
Conflict-of-interest policy
Yes
Audited financial statements prepared
Yes
Key decisions subject to board approval
Yes
Management duties delegated
No

Governance Explanations

Form 990, Part VI

Participation in joint ventures or similar arrangements wellmont imaging services, inc. Does not have a written policy or procedure requiring the organization to evaluate its participation in such arrange- ments. However, wellmont imaging services, inc. Has taken steps to safe- guard the organization's exempt status. The wellmont health system legal department reviews all joint venture relations and determines if the rela- tionship meets wellmont health system's exempt purpose. If the relationship meets wellmont health system's exempt purpose, the board of directors will approve the relationship. Any ongoing relationship is then monitored and reviewed during the annual audit of the consolidated wellmont health system group.

Form 990, Page 6, Part VI, Line 6

The business and affairs of wellmont imaging services, inc. (the corporation) shall be governed exclusively by the board of directors. The corporation's board of directors is designated by wellmont health system, the sole member of the corporation. In addition to such rights of approval and consent as may be reserved to the sole member of the corporation pursuant to applicable law, transactions of the following matters by the corporation shall require the prior approval of wellmont health system, the sole member of the corporation: (a)implementation of corporation's annual budget, (b)incurring any loan or other indebtedness for borrowed money, (c)acquisition of any equipment or personal property for a purchase price in excess of 50,000 or the acquisition of any real estate, regardless of purchase price, (d)the undertaking of certain contractual commitments, (e)entering into any plan of merger or consolidation, (f)acquisition of substantially all of the assets of any other legal entity, and (g)institution of any litigation by or on behalf of corporation.

Form 990, Page 6, Part VI, Line 7B

See form 990, part vi, section a, line 6 explanation.

Form 990, Page 6, Part VI, Line 9

William t. Clark (resigned 12/12/14) 1905 american way kingsport, tn 37660

Form 990, Page 6, Part VI, Line 11B

Wellmont imaging services, inc.'s form 990 is reviewed by three individuals of wellmont health system (the senior vice president of finance, the corporate controller, and the manager of accounting) and the board of directors of wellmont imaging services, inc. Any questions or comments arising from the initial review are addressed to ensure the return is complete and accurate. Any changes or corrections are identified, revised in the return, and reviewed by the individuals listed above prior to filing with the internal revenue service.

Form 990, Page 6, Part VI, Line 12C

Officers, directors and key employees are required to sign a conflict of interest policy acknowledgement. Any potential conflicts are discussed with the compliance and audit services department as they arise. Wellmont health system also has a policy on business practices that discusses conflict of interest and informs the workforce to disclose any issues to the compliance and audit services department, for resolution. Wellmont health system also uses a hotline that allows anonymous reports of possible conflict of interest situations for investigation by the compliance and audit service department.

Form 990, Page 6, Part VI, Line 15A

The compensation of timothy w. Attebery, president of holston valley medical center and wellmont imaging services, inc., is reviewed, approved and documented by the wellmont health system personnel committee and board of directors. In addition, these bodies use comparability data to determine the appropriate compensation. All compensation deliberations and reviews are contemporaneously documented. This process is completed on an annual basis. The human resources committee of the board of directors reviewed the salary and market compensation data for timothy w. Attebery on december 10, 2013.

Form 990, Page 6, Part VI, Line 15B

The compensation of the other officers or key employees of wellmont health system are reviewed, approved and documented by the wellmont health system personnel committee and board of directors. Other officers and key employees of the organization have written employment contracts and compensation is based on surveys/studies and then approved by the wellmont health system ceo. In addition, these bodies use comparability data to determine the appropriate compensation. All compensation deliberations and reviews are contemporaneously documented. This process is completed on an annual basis. The human resources committee of the board of directors reviewed the salary and market compensation data for the following other officers on december 10, 2013. Wellmont health system executive vp and chief financial officer - alice h. Pope wellmont health system uses one or more of the methods described to establish the compensation of the following other officers. Wellmont health system sr vp general counsel - gary d. Miller wellmont health system sr vp resource management - bradley h. Price holston valley medical center - vp and chief operating officer - william t. Clark

Form 990, Page 6, Part VI, Line 19

Wellmont imaging services, inc.'s governing documents and conflict of interest policies are not available to the public. Wellmont health system's audited financial statements and quarterly unaudited financial statements are available through the electronic municipal market access website.

Filing and Contact Details

Filer

Filer Name
Wellmont Imaging Services Inc
EIN
86-1103148
Phone
4232308200
Address
1905 AMERICAN WAY, KINGSPORT, TN 37660

Signing Officer

Name
Todd J Dougan
Title
Sr VP of Finance
Phone
4232308200
Signed
2016-08-15

Organization Details

Principal Officer
Todd J Dougan
Formed
2004
Legal Domicile
Tn
Voting Board Members
3
Independent Board Members
0
Employees
0
Supplemental Narrative

Additional Explanations

Form 990, Page 2, Part III, Line 3

Wellmont imaging services, inc. Owned a 99.9% interest in holston valley imaging center, which operated an outpatient radiology center through september 30, 2014. On october 1, 2014, the assets and liabilities of holston valley imaging center were transfered at fair market value to wellmont health system, the sole member of wellmont imaging services.

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IRS990ScheduleJ/SupplementalInformationDetail/ExplanationTxt0WELLMONT HEALTH SYSTEM HAS AN EXECUTIVE RETIREMENT PROGRAM THAT INCLUDED ALICE POPE FOR THE CALENDAR YEAR ENDING DECEMBER 31, 2015. THIS PROGRAM HAS A TARGET BENEFIT OF 60% OF THE HIGHEST THREE YEAR AVERAGE SALARY (LESS EMPLOYER PROVIDER BENEFITS) AND THE EXECUTIVE MUST HAVE TWENTY YEARS OF SERVICE TO RECEIVE THE FULL BENEFIT. THE EXECUTIVE MAY RETIRE EARLY AT AGE 60 AND RECEIVE REDUCED BENEFITS. THERE WERE NO PAYMENTS MADE UNDER THIS PROGRAM FOR THE CALENDAR YEAR ENDING DECEMBER 31, 2015.
IRS990ScheduleJ/SupplementalInformationDetail/FormAndLineReferenceDesc0SCHEDULE J, PART III
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IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/DistributionDt02014-10-01
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IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/AddressLine1Txt01905 AMERICAN WAY
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IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0WELLMONT IMAGING SERVICES, INC. OWNED A 99.9% INTEREST IN HOLSTON VALLEY IMAGING CENTER, WHICH OPERATED AN OUTPATIENT RADIOLOGY CENTER THROUGH SEPTEMBER 30, 2014. ON OCTOBER 1, 2014, THE ASSETS AND LIABILITIES OF HOLSTON VALLEY IMAGING CENTER WERE TRANSFERED AT FAIR MARKET VALUE TO WELLMONT HEALTH SYSTEM, THE SOLE MEMBER OF WELLMONT IMAGING SERVICES.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1PARTICIPATION IN JOINT VENTURES OR SIMILAR ARRANGEMENTS WELLMONT IMAGING SERVICES, INC. DOES NOT HAVE A WRITTEN POLICY OR PROCEDURE REQUIRING THE ORGANIZATION TO EVALUATE ITS PARTICIPATION IN SUCH ARRANGE- MENTS. HOWEVER, WELLMONT IMAGING SERVICES, INC. HAS TAKEN STEPS TO SAFE- GUARD THE ORGANIZATION'S EXEMPT STATUS. THE WELLMONT HEALTH SYSTEM LEGAL DEPARTMENT REVIEWS ALL JOINT VENTURE RELATIONS AND DETERMINES IF THE RELA- TIONSHIP MEETS WELLMONT HEALTH SYSTEM'S EXEMPT PURPOSE. IF THE RELATIONSHIP MEETS WELLMONT HEALTH SYSTEM'S EXEMPT PURPOSE, THE BOARD OF DIRECTORS WILL APPROVE THE RELATIONSHIP. ANY ONGOING RELATIONSHIP IS THEN MONITORED AND REVIEWED DURING THE ANNUAL AUDIT OF THE CONSOLIDATED WELLMONT HEALTH SYSTEM GROUP.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2THE BUSINESS AND AFFAIRS OF WELLMONT IMAGING SERVICES, INC. (THE CORPORATION) SHALL BE GOVERNED EXCLUSIVELY BY THE BOARD OF DIRECTORS. THE CORPORATION'S BOARD OF DIRECTORS IS DESIGNATED BY WELLMONT HEALTH SYSTEM, THE SOLE MEMBER OF THE CORPORATION. IN ADDITION TO SUCH RIGHTS OF APPROVAL AND CONSENT AS MAY BE RESERVED TO THE SOLE MEMBER OF THE CORPORATION PURSUANT TO APPLICABLE LAW, TRANSACTIONS OF THE FOLLOWING MATTERS BY THE CORPORATION SHALL REQUIRE THE PRIOR APPROVAL OF WELLMONT HEALTH SYSTEM, THE SOLE MEMBER OF THE CORPORATION: (A)IMPLEMENTATION OF CORPORATION'S ANNUAL BUDGET, (B)INCURRING ANY LOAN OR OTHER INDEBTEDNESS FOR BORROWED MONEY, (C)ACQUISITION OF ANY EQUIPMENT OR PERSONAL PROPERTY FOR A PURCHASE PRICE IN EXCESS OF 50,000 OR THE ACQUISITION OF ANY REAL ESTATE, REGARDLESS OF PURCHASE PRICE, (D)THE UNDERTAKING OF CERTAIN CONTRACTUAL COMMITMENTS, (E)ENTERING INTO ANY PLAN OF MERGER OR CONSOLIDATION, (F)ACQUISITION OF SUBSTANTIALLY ALL OF THE ASSETS OF ANY OTHER LEGAL ENTITY, AND (G)INSTITUTION OF ANY LITIGATION BY OR ON BEHALF OF CORPORATION.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3SEE FORM 990, PART VI, SECTION A, LINE 6 EXPLANATION.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt4WILLIAM T. CLARK (RESIGNED 12/12/14) 1905 AMERICAN WAY KINGSPORT, TN 37660
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt5WELLMONT IMAGING SERVICES, INC.'S FORM 990 IS REVIEWED BY THREE INDIVIDUALS OF WELLMONT HEALTH SYSTEM (THE SENIOR VICE PRESIDENT OF FINANCE, THE CORPORATE CONTROLLER, AND THE MANAGER OF ACCOUNTING) AND THE BOARD OF DIRECTORS OF WELLMONT IMAGING SERVICES, INC. ANY QUESTIONS OR COMMENTS ARISING FROM THE INITIAL REVIEW ARE ADDRESSED TO ENSURE THE RETURN IS COMPLETE AND ACCURATE. ANY CHANGES OR CORRECTIONS ARE IDENTIFIED, REVISED IN THE RETURN, AND REVIEWED BY THE INDIVIDUALS LISTED ABOVE PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt6OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO SIGN A CONFLICT OF INTEREST POLICY ACKNOWLEDGEMENT. ANY POTENTIAL CONFLICTS ARE DISCUSSED WITH THE COMPLIANCE AND AUDIT SERVICES DEPARTMENT AS THEY ARISE. WELLMONT HEALTH SYSTEM ALSO HAS A POLICY ON BUSINESS PRACTICES THAT DISCUSSES CONFLICT OF INTEREST AND INFORMS THE WORKFORCE TO DISCLOSE ANY ISSUES TO THE COMPLIANCE AND AUDIT SERVICES DEPARTMENT, FOR RESOLUTION. WELLMONT HEALTH SYSTEM ALSO USES A HOTLINE THAT ALLOWS ANONYMOUS REPORTS OF POSSIBLE CONFLICT OF INTEREST SITUATIONS FOR INVESTIGATION BY THE COMPLIANCE AND AUDIT SERVICE DEPARTMENT.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt7THE COMPENSATION OF TIMOTHY W. ATTEBERY, PRESIDENT OF HOLSTON VALLEY MEDICAL CENTER AND WELLMONT IMAGING SERVICES, INC., IS REVIEWED, APPROVED AND DOCUMENTED BY THE WELLMONT HEALTH SYSTEM PERSONNEL COMMITTEE AND BOARD OF DIRECTORS. IN ADDITION, THESE BODIES USE COMPARABILITY DATA TO DETERMINE THE APPROPRIATE COMPENSATION. ALL COMPENSATION DELIBERATIONS AND REVIEWS ARE CONTEMPORANEOUSLY DOCUMENTED. THIS PROCESS IS COMPLETED ON AN ANNUAL BASIS. THE HUMAN RESOURCES COMMITTEE OF THE BOARD OF DIRECTORS REVIEWED THE SALARY AND MARKET COMPENSATION DATA FOR TIMOTHY W. ATTEBERY ON DECEMBER 10, 2013.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt8THE COMPENSATION OF THE OTHER OFFICERS OR KEY EMPLOYEES OF WELLMONT HEALTH SYSTEM ARE REVIEWED, APPROVED AND DOCUMENTED BY THE WELLMONT HEALTH SYSTEM PERSONNEL COMMITTEE AND BOARD OF DIRECTORS. OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION HAVE WRITTEN EMPLOYMENT CONTRACTS AND COMPENSATION IS BASED ON SURVEYS/STUDIES AND THEN APPROVED BY THE WELLMONT HEALTH SYSTEM CEO. IN ADDITION, THESE BODIES USE COMPARABILITY DATA TO DETERMINE THE APPROPRIATE COMPENSATION. ALL COMPENSATION DELIBERATIONS AND REVIEWS ARE CONTEMPORANEOUSLY DOCUMENTED. THIS PROCESS IS COMPLETED ON AN ANNUAL BASIS. THE HUMAN RESOURCES COMMITTEE OF THE BOARD OF DIRECTORS REVIEWED THE SALARY AND MARKET COMPENSATION DATA FOR THE FOLLOWING OTHER OFFICERS ON DECEMBER 10, 2013. WELLMONT HEALTH SYSTEM EXECUTIVE VP AND CHIEF FINANCIAL OFFICER - ALICE H. POPE WELLMONT HEALTH SYSTEM USES ONE OR MORE OF THE METHODS DESCRIBED TO ESTABLISH THE COMPENSATION OF THE FOLLOWING OTHER OFFICERS. WELLMONT HEALTH SYSTEM SR VP GENERAL COUNSEL - GARY D. MILLER WELLMONT HEALTH SYSTEM SR VP RESOURCE MANAGEMENT - BRADLEY H. PRICE HOLSTON VALLEY MEDICAL CENTER - VP AND CHIEF OPERATING OFFICER - WILLIAM T. CLARK
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt9WELLMONT IMAGING SERVICES, INC.'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE NOT AVAILABLE TO THE PUBLIC. WELLMONT HEALTH SYSTEM'S AUDITED FINANCIAL STATEMENTS AND QUARTERLY UNAUDITED FINANCIAL STATEMENTS ARE AVAILABLE THROUGH THE ELECTRONIC MUNICIPAL MARKET ACCESS WEBSITE.
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0FORM 990, PAGE 2, PART III, LINE 3
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1FORM 990, PART VI
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2FORM 990, PAGE 6, PART VI, LINE 6
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc3FORM 990, PAGE 6, PART VI, LINE 7B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc4FORM 990, PAGE 6, PART VI, LINE 9
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc5FORM 990, PAGE 6, PART VI, LINE 11B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc6FORM 990, PAGE 6, PART VI, LINE 12C
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc7FORM 990, PAGE 6, PART VI, LINE 15A
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc8FORM 990, PAGE 6, PART VI, LINE 15B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc9FORM 990, PAGE 6, PART VI, LINE 19
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