MOUNTAIN STATES HEALTH ALLIANCE: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- MOUNTAIN STATES HEALTH ALLIANCE (EIN 62-0476282)
- Tax period
- 2018-07-01 to 2019-06-30
- Filed
- 2020-07-09
- IRS object ID
- 202001919349300725
- Schema version
- 2018v3.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-07-09T06:51:22-07:00 | ReturnTs |
| Tax Period End | 2019-06-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 620476282 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mountain States Health Alliance | BusinessNameLine1Txt |
| Business Name Line2 | dba Johnson City Medical Center | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MOUN | BusinessNameControlTxt |
| Phone | 4233023774 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1021 W Oakland Avenue | AddressLine1Txt |
| City | Johnson City | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37604 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Lynn Krutak | PersonNm |
| Person Title | BH EVP/CFO | PersonTitleTxt |
| Signature | 2020-07-09 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Alan Levine BH PresidentCEO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 303 Med Tech Parkway Ste 300 | AddressLine1Txt |
| City | Johnson City | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37604 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $747,739,877 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| All Affiliates Included | false | AllAffiliatesIncludedInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | balladhealth.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1945 | FormationYr |
| Legal Domicile State | TN | LegalDomicileStateCd |
| Activity Or Mission | Our mission: Honor those we serve by delivering the best possible care. Our vision: To build a legacy of superior health by listening to and caring for those we serve. | ActivityOrMissionDesc |
| Voting Members Governing Body | 4 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 8880 | TotalEmployeeCnt |
| Total Volunteers | 1007 | TotalVolunteersCnt |
| Total Gross UBI | $1,452,155 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $434,941 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,818,566 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,375,070 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $704,253,585 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $739,728,327 | CYProgramServiceRevenueAmt |
| PY Investment Income | $16,903,072 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,668,201 | CYInvestmentIncomeAmt |
| PY Other Revenue | $5,510,600 | PYOtherRevenueAmt |
| CY Other Revenue | $3,618,374 | CYOtherRevenueAmt |
| PY Total Revenue | $729,485,823 | PYTotalRevenueAmt |
| CY Total Revenue | $746,389,972 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $978,764 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,411,256 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $309,858,627 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $287,123,848 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $417,612,646 | PYOtherExpensesAmt |
| CY Other Expenses | $430,950,718 | CYOtherExpensesAmt |
| PY Total Expenses | $728,450,037 | PYTotalExpensesAmt |
| CY Total Expenses | $719,485,822 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,035,786 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $26,904,150 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,534,285,953 | TotalAssetsBOYAmt |
| Total Assets EOY | $545,631,938 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $992,458,877 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $93,749,190 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $541,827,076 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $451,882,748 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Our mission: Honor those we serve by delivering the best possible care. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $591,962,043 | ExpenseAmt |
| Grant | $1,411,256 | GrantAmt |
| Revenue | $741,210,284 | RevenueAmt |
| Desc | See Schedule O | Desc |
| Total Program Service Expenses | $591,962,043 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | Yes (true) | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 678 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 8880 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Form8282 Filed | 0 | Form8282FiledCnt |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| DAF Excess Business Holdings | false | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | false | TaxableDistributionsInd |
| Distribution To Donor | false | DistributionToDonorInd |
| Org Filed In Lieu Of Form1041 | false | OrgFiledInLieuOfForm1041Ind |
| Licensed More Than One State | false | LicensedMoreThanOneStateInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | Yes (true) | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 4 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (true) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | TN | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | VA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Lynn Krutak | PersonNm |
| Phone | 4233023374 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 303 Med Tech Parkway Suite 300 | AddressLine1Txt |
| City | Johnson City | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37604 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Alan Levine BH PresidentCEO | |||||||||
| Director | 1.00 | 59.00 | Yes (X) | Yes (X) | $2,032,246 | $0 | $193,444 | ||
| Marvin Eichorn BH EVPCAO | |||||||||
| Director | 1.00 | 59.00 | Yes (X) | Yes (X) | $1,011,865 | $0 | $36,694 | ||
| Eric Deaton BH EVPCOO | |||||||||
| Director | 1.00 | 59.00 | Yes (X) | Yes (X) | $0 | $570,270 | $42,955 | ||
| Tim Belisle BH EVPGen Cncl | |||||||||
| Director | 1.00 | 59.00 | Yes (X) | Yes (X) | $577,064 | $0 | $79,532 | ||
| Lynn Krutak | |||||||||
| BH EVP/CFO | 1.00 | 59.00 | Yes (X) | $854,023 | $0 | $90,292 | |||
| Dawn Trimbleterm 218 | |||||||||
| CEO Wahington Co. | 45.00 | 0.00 | $720,873 | $0 | $23,575 | Yes (X) | |||
| Monty McLaurin | |||||||||
| CEO NW Mkt | 34.30 | 10.70 | $558,099 | $0 | $42,029 | Yes (X) | |||
| Shane Hilton | |||||||||
| SVP, CFO Mkt Ops | 48.50 | 1.50 | $530,280 | $0 | $73,798 | Yes (X) | |||
| Stan Hickson | |||||||||
| VP SW Mkt | 45.00 | 0.00 | $430,310 | $0 | $34,702 | Yes (X) | |||
| Richard Booneterm 418 | |||||||||
| CFO Washington Co. | 45.00 | 0.00 | $369,130 | $0 | $18,800 | Yes (X) | |||
| Melissa Carr | |||||||||
| SVP Financial Mgmt | 50.00 | 0.00 | $355,904 | $0 | $61,808 | Yes (X) | |||
| Patricia Baise | |||||||||
| VP, CEO Behavioral Health | 44.50 | 0.50 | $306,357 | $0 | $32,602 | Yes (X) | |||
| Lemmie Taylor | |||||||||
| VP, CEO SE Mkt | 45.00 | 0.00 | $287,942 | $0 | $49,220 | Yes (X) | |||
| Andrew Wampler | |||||||||
| VP, CFO NW Mkt | 44.80 | 0.20 | $199,825 | $0 | $31,448 | Yes (X) | |||
| Devin McFall | |||||||||
| VP, CFO SW Mkt | 40.50 | 4.50 | $225,924 | $0 | $36,297 | Yes (X) | |||
| Morgan May | |||||||||
| VP, CNO JCMC | 45.00 | 0.00 | $193,055 | $0 | $25,707 | Yes (X) | |||
| Morris Seligman MDterm 218 | |||||||||
| EVP & CMO | 0.50 | 59.50 | $800,387 | $0 | $24,560 | Yes (X) | |||
| James Parsonsterm 418 | |||||||||
| VP HR | 0.50 | 44.50 | $624,169 | $0 | $23,651 | Yes (X) | |||
| Anthony Keck | |||||||||
| EVP, CPHO | 0.50 | 59.50 | $612,910 | $0 | $70,933 | Yes (X) | |||
| Paul Merrywell | |||||||||
| CIO | 0.50 | 44.50 | $578,081 | $0 | $19,776 | Yes (X) | |||
| Clay Runnels MD | |||||||||
| VP Svc Line Mgmt | 0.50 | 44.50 | $425,903 | $0 | $36,526 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $11,694,347 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $570,270 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,048,349 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 266 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Layton Construction Co LLC | |||||
| 9090 Sandy Parkway | Sandy | UT | 84070 | Construction Service | $11,962,674 |
| Anesthesia & Pain Cnsltnts | |||||
| 1009 Lark St Ste 2 | Johnson City | TN | 37604 | Anesthesia Service | $5,861,327 |
| Advisory Board Co | |||||
| 2445 M Street NW | Washington | DC | 20037 | Data Svcs/Consulting | $3,430,657 |
| Allscripts Healthcare LLC | |||||
| 8529 Six Forks Road | Raleigh | NC | 27615 | Elec Med Recrds/Main | $2,848,247 |
| Change Healthcare LLC | |||||
| PO Box 98347 | Chicago | IL | 606938347 | Hlthcare Tech Mgt | $2,375,368 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 107 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $333,710 | RelatedOrganizationsAmt |
| Government Grants | $592,802 | GovernmentGrantsAmt |
| All Other Contributions | $448,558 | AllOtherContributionsAmt |
| Total Contributions | $1,375,070 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| Hospital Patient Revenue | 900099 | $731,331,937 | $731,331,937 | |
| Lab Outreach Income | 621500 | $816,386 | $816,386 | |
| P/S Ordinary Income | 541900 | $1,498,540 | $1,498,540 | |
| Wellness Revenue | 900099 | $6,081,464 | $6,081,464 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $739,728,327 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $186,244 | TotalRevenueColumnAmt |
| Exclusion | $186,244 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $763,450 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $347,864 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $415,586 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $415,586 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $113,721 | UnrelatedBusinessRevenueAmt |
| Exclusion | $301,865 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $2,483,998 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,002,041 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,481,957 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,481,957 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,481,957 | RelatedOrExemptFuncIncomeAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| Daycare | 624410 | $310,685 | $310,685 |
| Dietary, Security, Engin. | 900099 | $758,282 | $758,282 |
| Revenue from Parent | 900099 | $1,442,862 | $1,442,862 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $690,959 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $522,048 | UnrelatedBusinessRevenueAmt |
| Exclusion | $168,911 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $3,202,788 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $746,389,972 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $740,393,898 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $1,452,155 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,168,849 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,411,256 | TotalAmt |
| Program Services | $1,411,256 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,545,397 | TotalAmt |
| Program Services | $215,928 | ProgramServicesAmt |
| Management And General | $4,329,469 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $225,319,538 | TotalAmt |
| Program Services | $190,257,092 | ProgramServicesAmt |
| Management And General | $35,062,446 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,872,833 | TotalAmt |
| Program Services | $4,897,640 | ProgramServicesAmt |
| Management And General | $975,193 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,543,705 | TotalAmt |
| Program Services | $22,960,283 | ProgramServicesAmt |
| Management And General | $13,583,422 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,842,375 | TotalAmt |
| Program Services | $13,894,070 | ProgramServicesAmt |
| Management And General | $948,305 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $229,041 | TotalAmt |
| Program Services | $1,025 | ProgramServicesAmt |
| Management And General | $228,016 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,021 | TotalAmt |
| Program Services | $5,142 | ProgramServicesAmt |
| Management And General | $29,879 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,000 | TotalAmt |
| Program Services | $7,662 | ProgramServicesAmt |
| Management And General | $2,338 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $125,397,552 | TotalAmt |
| Program Services | $116,354,603 | ProgramServicesAmt |
| Management And General | $9,042,949 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $639,932 | TotalAmt |
| Program Services | $70,624 | ProgramServicesAmt |
| Management And General | $569,308 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,319,263 | TotalAmt |
| Program Services | $4,752,884 | ProgramServicesAmt |
| Management And General | $566,379 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,744,577 | TotalAmt |
| Program Services | $9,616,433 | ProgramServicesAmt |
| Management And General | $1,128,144 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,381,749 | TotalAmt |
| Program Services | $9,579,885 | ProgramServicesAmt |
| Management And General | $801,864 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,396,848 | TotalAmt |
| Program Services | $1,232,383 | ProgramServicesAmt |
| Management And General | $164,465 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,935,067 | TotalAmt |
| Program Services | $1,288,522 | ProgramServicesAmt |
| Management And General | $25,646,545 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,824,269 | TotalAmt |
| Program Services | $31,828,370 | ProgramServicesAmt |
| Management And General | $2,995,899 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $910,373 | TotalAmt |
| Program Services | $79,263 | ProgramServicesAmt |
| Management And General | $831,110 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies and Drugs | $157,971,752 | $157,971,752 | |
| Management Fees | $28,528,349 | $28,528,349 | |
| Maintenance & Repair | $21,676,045 | $21,075,420 | $600,625 |
| Dues & Subscriptions | $2,293,754 | $854,675 | $1,439,079 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,657,126 | TotalAmt |
| Program Services | $3,607,131 | ProgramServicesAmt |
| Management And General | $49,995 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $719,485,822 | TotalAmt |
| Program Services | $591,962,043 | ProgramServicesAmt |
| Management And General | $127,523,779 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,808,245 | BOYAmt |
| EOY | $2,269,056 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,506,817 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $443,373 | BOYAmt |
| EOY | $157,943 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $112,430,519 | BOYAmt |
| EOY | $104,889,743 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,977,590 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,827,128 | BOYAmt |
| EOY | $8,457,586 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,615,225 | BOYAmt |
| EOY | $18,917,882 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,994,594 | BOYAmt |
| EOY | $2,684,840 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,008,986,377 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $613,899,807 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $495,679,035 | BOYAmt |
| EOY | $395,086,570 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $334,991,957 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $339,717,493 | BOYAmt |
| EOY | $1,464,725 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $145,025,185 | BOYAmt |
| EOY | $11,698,593 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,268,792 | BOYAmt |
| EOY | $5,000 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,534,285,953 | BOYAmt |
| EOY | $545,631,938 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,285,014 | BOYAmt |
| EOY | $66,157,491 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,513,039 | BOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $150,252,709 | BOYAmt |
| EOY | $12,716,652 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $737,408,115 | BOYAmt |
| EOY | $14,875,047 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $992,458,877 | BOYAmt |
| EOY | $93,749,190 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $541,800,639 | BOYAmt |
| EOY | $451,809,561 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,437 | BOYAmt |
| EOY | $73,187 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $541,827,076 | BOYAmt |
| EOY | $451,882,748 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,534,285,953 | BOYAmt |
| EOY | $545,631,938 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $26,904,150 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$116,848,478 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form4720 Filed Section4955 Tax | false | Form4720FiledSection4955TaxInd |
| Correction Made | false | CorrectionMadeInd |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (true) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $70,184 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | false | OtherActivitiesInd |
| Total Lobbying Expenditures | $70,184 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
| Form4720 Filed4912 Tax | false | Form4720Filed4912TaxInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1i - Other Activities Description | FormAndLineReferenceDesc |
| Explanation | MSHA had lobbying expenses of $70,184 which represents the portion of dues paid to Tennessee Hospital Association and Virginia Hospital and Healthcare Association attributable to direct lobbying. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $22,004,663 | OtherCostOrOtherBasisAmt |
| Book Value | $22,004,663 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $506,458,801 | OtherCostOrOtherBasisAmt |
| Depreciation | $220,206,884 | DepreciationAmt |
| Book Value | $286,251,917 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,707,359 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,522,504 | DepreciationAmt |
| Book Value | $2,184,855 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $467,578,073 | OtherCostOrOtherBasisAmt |
| Depreciation | $386,353,599 | DepreciationAmt |
| Book Value | $81,224,474 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,237,481 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,816,820 | DepreciationAmt |
| Book Value | $3,420,661 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $395,086,570 | TotalBookValueLandBuildingsAmt |
Invst Program Related Org InvstProgramRelatedOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Investment in CrestPoint | Desc |
| Book Value | $1,464,725 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Due to Affiliates | $6,255,940 |
| Due to Third-Party Payors | $4,887,898 |
| Professional Liabilities & Other | $3,731,209 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $14,875,047 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X : FIN48 Footnote | FormAndLineReferenceDesc |
| Explanation | Mountain States Health Alliance is included in the audited consolidated financial statements of Ballad Health. The footnote explanation relative to income taxes reads: "Ballad is classified as an organization exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code. As such, no provision for federal income taxes is included in the accompanying consolidated financial statements. Taxable subsidiaries are discussed in Note K. No significant uncertain tax positions exist at June 30, 2019. Tax returns for 2016 through 2018 are subject to examination by the Internal Revenue Service." | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 225.000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 450.000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
| Report Publically Available | false | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,312,579 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $10,312,579 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01580 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $121,318,772 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $101,891,812 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $19,426,960 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02970 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $131,631,351 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $101,891,812 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $29,739,539 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04550 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,863,842 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $822,026 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,041,816 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00620 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,901,087 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,207,317 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,693,770 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01630 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,836,629 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,440,686 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,395,943 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00370 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,831 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,831 | NetCommunityBenefitExpnsAmt |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,199,373 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,199,373 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $32,815,762 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,470,029 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $18,345,733 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02800 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $164,447,113 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $116,361,841 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $48,085,272 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07350 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $67,348 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $67,348 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $65,032 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $65,032 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,300 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,300 | NetCommunityBenefitExpnsAmt |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $250 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $250 | NetCommunityBenefitExpnsAmt |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $137,930 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $137,930 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $64,739,783 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $23,953,720 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $159,181,429 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $155,735,748 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $3,445,681 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Medl Spec of JC LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | Medical Services | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.51000 | OrgProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.49000 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 7 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp (7 entries)
| FacilityFacilityNum | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Website AddressWebsiteAddressTxt | State LicenseStateLicenseNum | Licensed HospitalLicensedHospitalInd | General Medical And SurgicalGeneralMedicalAndSurgicalInd | Childrens HospitalChildrensHospitalInd | Teaching HospitalTeachingHospitalInd | Research FacilityResearchFacilityInd | Emergency Room24 HrsEmergencyRoom24HrsInd | OtherOtherDesc | Facility Reporting GroupFacilityReportingGroupCd | Critical Access HospitalCriticalAccessHospitalInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Johnson City Medical Center | |||||||||||||||
| 1 | 400 N State of Franklin Road | Johnson City | TN | 37604 | balladhealth.org | 00000121 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Mental Health | A | |
| Indian Path Community Hospital | |||||||||||||||
| 2 | 2000 Brookside Drive | Kingsport | TN | 37660 | balladhealth.org | 00000134 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | A | ||||
| Franklin Woods Comm Hospital | |||||||||||||||
| 3 | 300 Med Tech Parkway | Johnson City | TN | 37604 | balladhealth.org | 00000123 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | A | ||||
| Sycamore Shoals Hospital | |||||||||||||||
| 4 | 1501 W Elk Avenue | Elizabethton | TN | 37643 | balladhealth.org | 00000012 | Yes (X) | Yes (X) | Yes (X) | A | |||||
| Russell County Hospital | |||||||||||||||
| 5 | 58 Carroll Street | Lebanon | VA | 24266 | balladhealth.org | H 1892 | Yes (X) | Yes (X) | Yes (X) | A | |||||
| Johnson County Comm Hospital | |||||||||||||||
| 6 | 16901 S Shady Street | Mountain City | TN | 37683 | balladhealth.org | 00000039 | Yes (X) | Yes (X) | A | Yes (X) | |||||
| Unicoi County Hospital | |||||||||||||||
| 7 | 100 Greenway Circle | Erwin | TN | 37650 | balladhealth.org | 00000119 | Yes (X) | Yes (X) | Yes (X) | A | |||||
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | A | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 123456 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | balladhealth.org/locations#hospitals | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | false | StrategyPostedWebsiteInd |
| Strategy Attached | Yes (true) | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 225.0000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 450.0000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | balladhealth.org | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | balladhealth.org | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | balladhealth.org | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Facility: A 1,2,3,4,5,6,7 - Part V, Section B, Line 3j | Facility/Group A includes the following facilities:Johnson City Medical Center, Indian Path Community Hospital, Franklin Woods Community Hospital, Sycamore Shoals Hospital, Russell County Hospital, Johnson County Community Hospital and Unicoi County Hospital During FY19, MSHA hospitals were operating under the community health needs assessments (CHNAs) approved by its board of directors at the end of FY18. Priorities established for our CHNAs were determined by the most significant health needs of each community. For the FY18 CHNAs, Ballad Health, our health system's parent, and its hospitals and entities agreed to focus on an index of 25 active population health index measures (plus an additional 31 measures for monitoring). The population health index itself is based on the focus areas outlined in the previous (FY15 for MSHAs hospitals) CHNAs and align with national health improvement efforts, such as Healthy People 2020. MSHA's affiliates, Wellmont Health System and its hospitals, focused on the same population health index measures determined by Ballad Health when completing their individual FY19 CHNA's.To understand each communitys individual needs, Ballad Health conducted a CHNA for each Ballad hospital to profile the health of the residents within its service area. Throughout the CHNA process, high priority was given to determining the health disparities and available resources within each community. Community members from each county met with Ballad representatives to discuss current health priorities and identify potential solutions.The CHNA community members for each facility evaluated measures that make up Ballad Healths population health index and a few additional measures related to access to health screenings. The groups members completed a survey relative to what health priorities should be a focus for their specific community over the next three years. Johnson City Medical Centers (JCMC) CHNA was conducted with Franklin Woods Community Hospital (FWCH). FWCH is located in the same service area as JCMC so the two hospitals community demographics and health needs are the same. JCMC includes Niswonger Childrens Hospital and Woodridge Hospital, a behavioral health facility. After all the details and data collection was complete and interviews with various focus groups were complete, the Washington County representatives identified their top focus areas. Four key priorities were identified:-Smoking-Substance abuse and mental health-Obesity-Early intervention: vaccinations, screenings, third-grade reading level for third-graders, and diabetes counselingAfter all the details and data collection was complete, the Indian Path Community Hospital community board voted to approve their selected priorities. Four key priorities were identified:- Smoking- Substance abuse and mental health- Obesity- Early intervention: vaccinations and third-grade reading level for third-gradersAfter all the details and data collection was complete, the Sycamore Shoals Hospital community board voted to approve their selected priorities.Four key priorities were identified:- Smoking- Substance abuse and mental health- Obesity- Early intervention vaccinations, screenings and diabetes counselingAfter all the details and data collection was complete, the Russell County Hospital community board voted to approve their selected prioritiesFour key priorities were identified:- Smoking- Physical activity/obesity- Screenings for diabetes and cancer- Substance abuseAfter all the details and data collection was complete, the Johnson County Community Hospital community board voted to approve their selected priorities. Three key priorities were identified:- Smoking- Substance abuse/mental health- ObesityAfter all the details and data collection was complete, the Unicoi County Hospital community board voted to approve their selected priorities. Four key priorities were identified:- Obesity- Behavioral/mental health- Smoking- Early intervention; screening rates (mammography, colorectal cancer and lung cancer) and third-grade reading level for third-graders |
| Facility: A 1,2,3,4,5,6,7 - Part V, Section B, Line 5 | Activities associated with the June 2018 assessments took place from the fall of 2017 through the spring of 2018. Ballad conducted localized community focus groups with organization representatives such as those from local health departments, school systems, health clinics, emergency services, businesses, and philanthropic boards. The individuals in each community were selected for participation by the hospitals CEO.Washington County, Tennessee: (Johnson City Medical Center and Franklin Woods Community Hospital)JCMC includes Woodridge Hospital, its behavioral health facility, and Niswonger Childrens Hospital. The JCMC/FWCH focus group members were represented by Washington County Health Department, Johnson City Mayors Office, East Tennessee State University (ETSU) Community Health Center, Ballad Health employees, members of the Washington County Foundation Board, members of the Washington County Community Board, and members of the Washington County Medical Executive Committee. Low income, minority and medically underserved populations were represented by Washington County Health Department and ETSU Community Health Center. ETSUs Community Health Center is an interdisciplinary facility for the delivery of primary health care services and education of ETSU College of Nursing students. The Health Center provides health care to the uninsured, underinsured, TennCare enrollees, a growing Hispanic population and medically indigent individuals.Sullivan County, Tennessee (Indian Path Community Hospital)IPCHs focus group members were represented by Sullivan County Department of Education, Healthy Kingsport, Health Resources Center Kingsport, Sullivan County Health Department, Kingsport Board of Mayor & Aldermen, Kingsport Chamber of Commerce, United Way, Girls Inc., members of IPCH Foundation Board, and members of IPCH Community Board. The Health Resources Center, Sullivan County Health Department, United Way of Kingsport, and Girls Inc. of Kingsport represented low-income, minority and medically underserved populations. Also, between the foundation board and the community board, there are a number of individuals that sit on each of these boards that represent low income, minority populations, and medically underserved.Carter County, Tennessee (Sycamore Shoals Hospital)SSHs focus group members were represented by Signature Healthcare, Carter County Health Department, Carter County EMS, SSH team members, Primary Care (a medical practice), members of the SSH Foundation Board, and members of the SSH Community Board. Low-income, minority and medically underserved populations were represented by Carter County Health Department. Also, between the foundation board and the community board, there are a number of individuals that sit on each of these boards that represent low income, minority populations, and medically underserved.Russell County, Virginia (Russell County Hospital)RCHs focus group members were represented by Virginia Cooperative Extension, Russell County Health Coalition, Cumberland Mountain Community Services, Russell County Health Department Cumberland Plateau, RCH Foundation Board, United Way of Southwest Virginia, Appalachian Agency Senior Citizens, and RCH Community Board. Low-income, minority populations and medically underserved were represented by Cumberland Plateau Health Department, United Way of Southwest Virginia, and Russell County Health Coalition. Also, between the foundation board and the community board, there are a number of individuals that sit on each of these boards that represent low income, minority populations, and medically underserved.Johnson County, Tennessee (Johnson County Community Hospital)JCCHs focus group members were represented by Johnson County Health Department, Johnson County Emergency Medical Services, East Tennessee State Universitys Mountain City Extended Hours Clinic, JCCH team members, members of JCCH Foundation Board, and members of JCCH Community Board. Johnson County Health Department and the ETSU after hours clinic represented low income, medically underserved and minority populations. Johnson Countys MUA (medically underserved area) is 100% according to the U.S. Department of Health & Human Services Health Resources & Services Administration. Also, between the foundation board and the community board, there are a number of individuals that sit on each of these boards that represent low income, minority populations, and medically underserved.Unicoi County, Tennessee (Unicoi County Hospital)UCHs focus group members were represented by Unicoi County Department of Education, Unicoi County Chamber of Commerce, Unicoi County Health Department, Town of Erwin, Telamon Head Start, YMCA, UCH team members, and the UCHs Board. Unicoi County Health Department, YMCA of Erwin, and Telamon Head Start represented low-income, minority and medically underserved populations. Also, between the foundation board and the community board, there are a number of individuals that sit on each of these boards that represent low income, minority populations, and medically underserved. |
| Facility: A 1,2,3,4,5,6,7 - Part V, Section B, Line 6a | Each hospital within Mountain States Health Alliance completed a CHNA. Johnson City Medical Center (includes Niswonger Children's Hospital and Woodridge Hospital), Franklin Woods Community Hospital, Indian Path Community Hospital, Johnson County Community Hospital, Johnston Memorial Hospital, Norton Community Hospital, Dickenson Community Hospital, Russell County Hospital, Smyth County Community Hospital, Sycamore Shoals Hospital, and Unicoi County Hospital. |
| Facility: A 1,2,3,4,5,6,7 - Part V, Section B, Line 11 | During the year, MSHA hospitals continued to focus on their CHNA priorities as identified in their FY18 CHNA report. Many additional community needs exist in the regions we serve. It is fiscally impossible for a hospital to address every health need in a community, which is why the CHNA process is used to identify and prioritize areas of focus. A thoughtful CHNA evaluates overall community health needs to determine which ones the hospital can best influence in a positive way. Consideration is given to other organizations in the hospitals geographic area that already offer services addressing specific health needs. In some cases, it is best to simply support an identified health need through a financial donation to another nonprofit organization skilled in certain areas: teen pregnancy, dental health, fighting homelessness, etc. MSHAs leaders also lend support to other nonprofit organizations by serving on their boards, committees, and assisting with fundraising efforts. HOW MSHA IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN OUR MOST RECENT CHNA's:All MSHA hospitals have been diligent in their goal to ensure appropriate prescribing of opioids and a reduction in opioids in our region. The result is a significant reduction in prescribing rates. Our Health Resources Centers (Johnson City Medical Center and Indian Path Community Hospital) provide numerous health screenings throughout the year and a wide range of free health education classes, most of which target health need priorities identified in the hospitals' CHNAs. For example, many classes and activities focus on healthy eating, obesity, heart health and diabetes. MSHA hospitals offer numerous support groups for various chronic conditions throughout the year.Our hospitals provide diabetes education and support to the community through support groups. Meetings offer participants the opportunity to learn more about how to manage their condition through lifestyle medication, diet and exercise. MSHA hospitals provide smoking cessation counseling to patients that have been admitted as an inpatient, seen in the emergency department or in ambulatory surgery. Patient education is provided through several avenues including in-hospital education, a toll-free number for information and additional counseling, and written material given to patients. The hospitals also provide community education on smoking cessation through events and local schools. The CHNA continues to encourage programmatic investments made by the hospitals such as free low-dose CT lung screening for cancer to detect cancer earlier. During FY19, IPCH provided 387 free lung screening scans; Sycamore Shoals Hospital provided 148 scans. Supporting our CHNA, a focus on cancer rates within our community led to MSHAs cancer navigator program which continues to provide support for patients needing assistance, such as transportation to doctor visits and treatments as well as prescription needs. Free medications were provided to some low-income patients at the time of their discharge from several MSHA hospitals.JCMCs Niswonger Childrens Hospital launched Families Thrive last year. This program is part of our neonatal abstinence syndrome (NAS) program for babies who are exposed to addictive substance before birth. The program provided counseling for addiction recovery, tools for parenting skills and connections to other community services that can assist families after the baby leaves the hospital. The goal is to provide addicted mothers with treatment plans for narcotic recovery if they are not in a program already. JCMC opened a CDU (clinical decision unit) last year. The CDU is an extension of the emergency department specially designed to serve patients needing behavioral health care. Some of these patients may be transitioned to inpatient psychiatric care while others will be discharged to outpatient service once stabilized. JCMC also provided free lab services to a nonprofit clinic that provides primary health care services and engages in many outreach contacts each year to individuals on the street, in shelters and in farm worker camps. Our Parish Nurse program offers health education within places of worship. The nurses also conduct health screenings that detect health issues that need attention.Our Childrens Hospital provides many activities throughout the year to engage children and their families in physical activities. Examples include hosting a race in the fall and organizing a childrens physical activity event at a local festival. In addition, the hospital supports Morning Mile, a partnership with local elementary and middle schools to offer exercise in the mornings before classes begin. Many of our hospitals have now implemented the Morning Mile program in local schools.Indian Path Community Hospital is very active in the community. One example of that is the much-anticipated annual 9-day Fun Fest Festival in Kingsport. Every year, Indian Path is very involved in the festival, offering many activities for children that involve physical activity. Over 1,000 children participated in our Fun Fest activities this year. To better manage certain heart disease patients, last year Indian Path Community Hospital implemented disease managers and a transitional care clinic. Both programs facilitate care for patients that may lack the necessary resources to properly treat their conditions. Sycamore Shoals Hospital provided an RN to work with and role model professional behaviors and life skills to young women in the community that are in recovery from drug and/or alcohol abuse. The RN worked with the participants on health, wellness, career opportunities, and hygiene. The programs goal is to assist the women in re-entering society as drug/alcohol free citizens and to boost their self-confidence. Sycamore Shoals Hospitals lab department provided free lab testing for two local nonprofit organizations. One nonprofit serves two rural impoverished counties in East Tennessee by providing food, health screenings, a dental clinic, and other essential services. The other nonprofit offers medical care to persons with incomes 150% or below the poverty level. Johnson County Community Hospitals rural community suffers from high rates of diabetes, cancer, obesity and tobacco use. And our isolated area poses a challenge to access to health care. In response to the unique challenges of rural life, East Tennessee State University operates an extended hours clinic located inside our hospital, with the hospital providing some financial support. The clinic treats acute and chronic conditions and is open 5 days a week. The hospital also provides telemedicine services for some specialties, further improving access to medical specialists. Our hospital operates an emergency department at a financial loss. We also provide a much-needed outpatient behavioral health program for older adults, which also operates at a loss. Similar to many of Mountain States Health Alliances hospitals, Russell County Hospital in Virginia is located in a medically underserved and rural population. Our community has high rates of obesity, cancer, cardiovascular disease and substance abuse. The hospital works with the Russell County Prevention Coalition, whose mission is to promote wellness within Russell County. The organization works to reduce tobacco use (including e-cigarettes) and reduce underage alcohol and drug abuse. Russell County Hospitals Clearview Behavioral Health Center offers mental and behavioral health care for people in crisis situations at a significant financial loss to the hospital. There is not another inpatient mental health facility in our area. Russell County Hospital continues to hold their annual Health Fair to educate the public on a variety of health topics and perform health screenings. We also established a Celebrate Women Night of Hope to support funding and education for cancer prevention and treatment. The hospital continued its practice of providing medications and supplies to area rescue squads this year. Unicoi County Hospital, along with many MSHA hospitals, is involved with the Morning Mile, a program that encourages physical activity through partnership with local schools. The goal of the program is to reduce childhood obesity, while improving grades and decreasing absenteeism. Kids engaged with Morning Mile are able to exercise before classes begin, which has shown to reduce stress and improve mood. Partnerships are formed with other organizations including the local Chamber of Commerce and Little League with the same goal of increasing physical activity.Our hospitals made financial contributions to other nonprofit organizations providing community services that support our CHNAs. Examples include contributions to organizations addressing the opioid crisis, a significant donation to an organization that provides access to health care for low income residents in Appalachia, an organization focused on expanding health care to all Am |
| Facility: A 1,2,3,4,5,6,7 - Part V, Section B, Line 13h | Ballad Health's financial assistance policy allows for some exceptions to strictly adhering to federal poverty guidelines when awarding financial assistance. Unique circumstances may be weighed and assessed for financial assistance consideration on a case-by-case basis. Also, there are some services where financial assistance may be provided outside of federal poverty guidelines. These are noted in Ballad Health's financial assistance policy. |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| JCMC Ambulatory Surgery Center | ||||
| 400 N State of Franklin Road | Johnson City | TN | 37604 | Licensed Ambulatory Surgery Center |
| Mountain States Imaging Center | ||||
| 301 Med Tech Parkway Suite 100 | Johnson City | TN | 37604 | Licensed Outpatient Diagnostic Center |
| Indian Path Transitional Care | ||||
| 2000 Brookside Drive | Kingsport | TN | 37660 | Licensed Skilled Nursing Facility |
| Medical Cntr Home Care-Johnson City | ||||
| 509 Med Tech Parkway Suite 200 | Johnson City | TN | 37604 | Licensed Home Health Agency |
| Medical Cntr Home Care-Kingsport | ||||
| 2020 Brookside Drive 28 | Kingsport | TN | 37660 | Licensed Home Health Agency |
| Russell Co Home Health & Hospice | ||||
| 116 Flannagan Avenue | Lebanon | VA | 24266 | Licensed Home Health Agency |
| Medical Center Hospice | ||||
| 509 Med Tech Parkway Suite 300 | Johnson City | TN | 37604 | Licensed Hospice Agency |
| Johnson County Home Health | ||||
| 1987 South Shady Street | Mountain City | TN | 37683 | Licensed Home Health Agency |
| Unicoi County Long Term Care | ||||
| 100 Greenway Circle | Erwin | TN | 37650 | Licensed Long Term Care Facility |
| Dickenson Co Home Health & Hospice | ||||
| 312 Hospital Drive Suites 1A 1B | Clintwood | VA | 24228 | Licensed Home Health Agency |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used) | Financial assistance approval can apply to an assortment of patients such as those who have exhausted their TennCare/Medicaid benefits, those who qualified for TennCare/Medicaid after the date of service, deceased patients with no estate or assets, uninsured patients, and underinsured patients. While Ballad Healths qualifications for financial assistance is based on federal poverty guidelines, asset values may also be used to determine eligibility. Unique circumstances may be assessed on a case-by-case basis. Charity approval covers current or active patient balances when they are approved and there is no limitation or cap on the amount of charity that a patient may receive. Ballad Health hospitals do not stop approving financial assistance for patient accounts if a hospitals charity write-offs exceed the hospitals charity budget.All Ballad Health hospitals provide an uninsured discount; the current uninsured discount is 85% with the exception of critical access hospitals. The uninsured discount for Johnson County Community Hospital, a designated Critical Access Hospital, was 71% through 9/30/18, when it increased to 73%. In addition to the uninsured discount, many patients will further qualify for additional financial assistance. All patients seeking financial assistance must submit an application for financial assistance and submit documents in support of the information on the application, unless specifically excluded according to our policy guidelines. Medicaid eligible patients will qualify for 100% financial assistance and not be required to complete the required documentation when: a) Medicaid eligibility requirements are met after the service is provided, b) non-covered charges occur on a Medicaid eligible encounter, or c) benefits have been exhausted. Deceased patients with no estate also qualify for 100% financial assistance.Financial assistance determinations may be retroactive for all outstanding balances. In addition, we have a number of programs with special discounts such as lactation consultation services; oncology treatment regimens; enrollment in various community programs, and prescription drugs filled post-discharge. |
| Part I, Line 7 - Explanation of Costing Methodology | The cost to charge ratio (worksheet 2 "ratio of patient care cost to charges") was used to calculate line 7a financial assistance (charity care) cost. Our cost accounting system was used to determine losses from Tenncare and Medicaid reported on line 7b, with the exception of home health, a small physician clinic and UCH we used the cost to charge ratio for their data because these are smaller divisions not available in our cost accounting software. Line 7e community health improvement includes costs that are taken directly from departmental operating reports or expenses specific to a community health event, with no additional overhead included in the cost. Line 7f health professions education is comprised of internships (primarily internal medicine residents, nursing, pharmacy, and therapy students) with schools and universities, allowing their health profession students to get hands-on training in a hospital setting. Our Medicare-approved programs include medical residents, pharmacy and pastoral care at JCMC and IPCH. For these programs, Medicare-approved costs and Medicare reimbursement comes from filed Medicare cost reports. The Ballad Health Organizational Development Department (OD) maintains records for the non-Medicare programs. OD keeps records of the number of students receiving training at our hospitals and the amount of hours the students spend at our hospitals. Hours may differ based on the school and the type of program (RN, radiology, lab, etc.). The number of team members that provide training to students will also vary based on where the student is training. For example, an RN trainer on a medical floor may have 3 or 4 students under his/her direction, while an RN trainer in a specialty area such as ICU or the ER may be training one-on-one with a single student. We only include labor costs for our hospital team members that provide training (i.e. no overhead is applied) and we only attribute a percentage of our team members time to actual training. For line 7g subsidized health care services, we use our cost accounting system because we have established, standard costing reports for these services. There are three exceptions where we do not use our cost accounting system. We have a small clinic inside JCCH, a federally designated critical access hospital. JCCH subsidizes the clinic and we use the clinics departmental operating report to compute the clinics community benefit. The second exception is a palliative care program. For this program, we use the departments operating report. The third exception relates to low-dose CT scans for lung cancer. Patient charges for this screening event were written-off as an administrative adjustment (not as charity). We used the cost to charge ratio to determine the cost of the free scans. The scans were performed in support of our cancer CHNA priority. We are careful to ensure no double counting of cost. Although we have other service lines within our hospital that lose money, we do not report services that hospitals are required by state licensure to provide, routine services or ancillary services. Line 7h research represents MSHA's expense allocation from Ballad Health for research. Line 7i cash and in-kind contributions include cash disbursements and in-kind donations of medications to local nonprofit rescue squads and fire departments. In-kind donations of medications are based on our actual cost for these items. |
| Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense | Self-pay balances include accounts after payments and contractual adjustments (discounts) have been applied from all third-party payers such as Medicare, TennCare, commercial insurers, and others - generally leaving the patient responsible for any remaining deductible and/or co-payment. Other self-pay accounts are from patients with no insurance or other third-party coverage. Under Ballad Healths system-wide self-pay policy, any patient who has no insurance and is ineligible for any government assistance program received an 80% discount until September 30, 2018, at which time the uninsured discount increased to 85%. Many self-pay patients will further qualify for financial assistance (sometimes referred to as charity care) if they provide the financial information we need to deem them eligible.After the normal collection process has indicated an account is uncollectible, MSHA writes the account off to bad debt. The hospital's overall self-pay accounts receivable balance is evaluated on an ongoing basis to evaluate the age of accounts receivable, historical write-offs and recoveries and any unusual instances (such as local, regional or national economic conditions) which affect the collectability of receivables. |
| Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit | Our primary external collection agency estimates that 37% of MSHAs bad debt would likely qualify for financial assistance if patients had provided our hospitals with a financial assistance application and required documentation. The agency based their likely eligible for charity assumption on individuals with a low score. An individuals score is based on an algorithm that includes data points such as FICO credit score, property value, years at current residence, number of times an individual has moved and an individuals propensity to pay score. Just over 94% of completed financial assistance applications processed during FY19 received a full discount (complete write-off). An additional 5% received a partial discount, resulting in an overall approval rate of 99% for completed applications. Therefore, only 1% of completed financial assistance applications were denied. Unfortunately, many patients either do not submit an application for financial assistance or do not provide a complete application. A letter is sent to the patient outlining missing information on incomplete applications. The letter also provides a contact phone number patients may call for assistance in completing the application. All self-pay patients receive follow up calls from a company MSHA pays to process charity care applications for uninsured patients and to offer patients enrollment assistance in TennCare (TN) or Medicaid (VA). The follow up calls are as follows: every 31 days, 31-60 days up to 3 calls are made, after 60 days up to 2 additional calls are made. Our financial counselors follow up with patients that have a balance after insurance has paid. We have many instances of patients with large account balances and no health insurance coverage that we believe would qualify for financial assistance. Although patients are encouraged to apply for assistance, many will not do so. MSHA would prefer for patients to submit completed financial assistance applications given that historical data clearly indicates that most uninsured patients and many underinsured will qualify for financial assistance under our program. Without a completed application, we have no choice other than to record an unpaid account as bad debt instead of charity care. |
| Part III, Line 4 - Bad Debt Expense | Ballad Healths audited financial statements include a footnote on page 13 that describes bad debt. MSHA is included in the June 30, 2019 audited financial statements of Ballad Health (attached). |
| Part III, Line 8 - Explanation Of Shortfall As Community Benefit | Excluding Medicare losses reported in Part I subsidized health, the Part III Medicare gain is reported using MSHA's filed Medicare cost report (C/R). The C/R uses a cost to charge ratio based on a step-down allocation methodology. We believe Medicare losses should be allowed as a reportable community benefit, similar to governmental programs such as Medicaid. As a participating provider in the Medicare program, hospitals are required to provide the full regimen of care for the Medicare population. There are a number of care regimens that are compensated by the Medicare program at levels below cost. Therefore, it is only logical to allow hospitals to report these uncompensated services as a community benefit. By making this change, nonprofit providers will be encouraged to continue important care delivery models for our aging population in spite of the fact it may be economically injurious. |
| Part III, Line 9b - Provisions On Collection Practices For Qualified Patients | Requests for financial assistance are evaluated using established guidelines, while allowing for unique financial circumstances - for example, medically indigent patients with catastrophic medical costs that would threaten the patients household financial viability. When a patient requests financial assistance or when an application has been received, the patient's account is placed in a hold status to prevent further collection activities until financial assistance eligibility is determined. All Ballad Health hospitals comply with IRS 501(r) regulatory guidelines.Our collection policy clearly states that all patients are treated equally - with dignity and respect. We ensure that outside collection agencies used by our hospitals adhere to our billing and collection guidelines. Our collection program includes communicating expected financial responsibility prior to service. Our hospitals provide assistance to help underinsured and uninsured patients determine sources of payment for medical bills and to help patients determine eligibility for programs such as TennCare or Medicaid.After insurance benefit verification, our hospitals bill insurance carriers. If the insurance carrier denies payment of the service/procedure as non-covered or the patient has exceeded their maximum benefits, the service/procedure will qualify for the uninsured discount.Financial counselors are available to discuss financial assistance with patients and their families. Our hospitals provide a number of payment options:- a pre-service discount may be offered- a discount in excess of established discounting rates may be granted for catastrophic high dollar accounts- our hospitals accept all non-contracted and out-of-network payers and will make attempts to work with these payers regarding appropriate reimbursement and billing to their members- payment arrangements are available as long as the account is not with a collection agencyReasonable efforts are made to determine if a patient is eligible for financial assistance - see Schedule H, Part VI, line 3 for information on how patients are informed about our financial assistance policy. |
| Part VI, Line 2 - Needs Assessment | Focusing on 25 active population health index measures allows Ballad Health to further engage the efforts of its hospitals in partnership with communities in our service areas. It has helped Ballad to better identify health disparities that appear across the individual communities and has helped Ballad to prioritize issues that are most important in each hospital's community. Engaging local community organizations will expand partnerships so that organizations work together more to address community health needs.Ballad Health developed a comprehensive process to gather input for and draft a population health plan. An executive steering team was established, aided by national experts with experience in large-scale population health improvement. Because our hospitals are located in a region with many chronic disease challenges, Ballad Health's goal is to target population health issues to make lasting improvements. Ballad conducted approximately 150 interviews and held 40 meetings with external groups, including the regional health departments, United Way agencies, chambers of commerce, schools and community organizations, the regional accountable care community steering committee, as well as internal groups such as our population health and social responsibility committee of the Ballad Health board of directors, the Ballad Health population health clinical committee, and our hospital community boards. |
| Part VI, Line 3 - Patient Education of Eligibility for Assistance | Consistent with the Ballad Health financial assistance policy, MSHA communicates with and provides education to our patients through various avenues regarding governmental assistance programs and hospital financial assistance. Various educational and application documents related to obtaining financial assistance are widely available at MSHA and all documents are available on the Ballad Health website. Printed financial assistance educational materials are part of each registration packet and posters are displayed in highly visible areas of the hospital. Our financial assistance policy and documents are available in our emergency departments and admitting areas. We are also happy to mail all documents to patients. We offer a plain language summary and all of our documents are available in English and Spanish. Financial assistance information is available during pre-registration, registration and/or during financial counseling. We offer governmental program eligibility representatives to assist patients in securing eligibility for TennCare or Medicaid, federal disability and other governmental assistance programs. Additionally, if a patient or community resident expresses an interest in the ACA healthcare exchange, our representatives have the qualifications and experience to assist them through the entire process. Our financial counselors offer financial assistance applications to patients who do not qualify for governmental assistance programs and are unable to pay for some or all of their healthcare.All patient billing statements have verbiage discussing financial assistance along with contact information. Our last letter to the patient displays the plain language summary. In all oral correspondences with a patient, if it is identified the patient cannot meet payment requirements on their account, financial assistance is discussed as an option. Applicants are notified of financial assistance determination in writing. |
| Part VI, Line 4 - Community Information | MSHA serves the healthcare needs of 29 Appalachian counties in Tennessee, Southwest Virginia, Kentucky, and North Carolina. All of the counties MSHA serves are federally designated as medically underserved areas. MSHAs largest hospital, Johnson City Medical Center, is a tertiary referral center and level one trauma center. All of MSHAs wholly owned hospitals are located in federally designated medically underserved areas. Medically underserved areas are designated by the U.S. Department of Health and Human Services. Shortage areas are identified through analysis of physician to population ratios depending on whether an area is considered to have a high need. Criteria used to determine high need are poverty rates, the percent of the population over age 65, infant mortality rates and fertility rates. MSHA operates 2 critical access hospitals: wholly-owned Johnson County Community Hospital in Tennessee and majority-owned Dickenson County Community Hospital in Virginia.Many rural residents must travel a greater distance to access different points of the health care delivery system. Due to geographic distance, sometimes extreme weather conditions, lack of public transportation and challenging roads, rural residents may be limited, and in some instances, even prohibited from accessing health care services. Although 19% of people in the U.S. live in rural areas and 30% of the vehicle miles traveled occur in rural areas, almost half of crash deaths occur there. Within our counties in MSHAs service area, unintentional injury deaths are much higher than the statewide rates. For example, in Tennessee Unicoi County's rate is 35% higher and Johnson County's rate is 13% higher. In Virginia, Russell Countys rate is 48% higher than the statewide rate. A CDC (Centers for Disease Control and Prevention) study demonstrated there is a significant gap in health between rural and urban Americans. The CDC noted that demographic, environmental, economic, and social factors may put rural residents at higher risk of death. Residents in rural areas tend to be older and sicker than their urban counterparts. They have higher rates of cigarette smoking, high blood pressure and obesity. Rural residents also report less leisure-time physical activity and lower seatbelt use. They have higher rates of poverty, less access to healthcare, and are less likely to have health insurance. The CDC study found that unintentional injury deaths were significantly higher in rural areas, partly due to a greater risk of motor vehicle crashes and opioid overdoses. The CDC believes the gaps in health between rural and urban can be addressed by:-Screening patients for high blood pressure-Increasing cancer prevention and early detection-Encouraging physical activity and healthy eating-Promoting smoking cessation - cigarette smoking is the leading cause of preventable disease death in the U.S.-Promoting motor vehicle safety-Engaging providers in safer prescribing of opioids for pain and educating citizens on the risks of opioidsAnd, while our area has generally unfavorable health statistics, there are far fewer primary care physicians per resident in some of our counties than the states average. For example, in Carter County, our ratio of population to primary care physicians is 85% higher than the states average and Unicois ratio is 82% higher. Both of these counties are more than double the ratio of U.S. top performers according to the Robert Wood Johnson Foundations County Health Rankings. Recruiting physicians to rural areas is often challenging due to a myriad of factors, such as geography, economics, culture and education. Geographically, rural communities are often far removed from suburban and urban centers that provide access to educational, cultural and economic opportunities. These limitations influence the relocation decision of the physician candidate and his/her spouse/children to locate to a rural area. The health status of the population in MSHA'S service area is generally poor. A number of factors contribute to a unique and challenging environment that influence the overall health standing for counties included in the MSHA service area. Obesity increases the risk for many health conditions such as coronary heart disease, type 2 diabetes, hypertension, stroke, cancer, sleep apnea and respiratory problems, and osteoarthritis. Evidence indicates physical activity, independent of its effect on weight, has substantial benefits for health. Relative to obesity and physical activity levels, many of our counties have high levels of obesity combined with high levels of physical inactivity as shown below. -The percentages of adult obesity: Johnson County 31%, Unicoi County 34%, Carter County 36%, Sullivan County 33% and Russell County 32%. The adult obesity rate for U.S. top performers is 26% according to the Robert Wood Johnson Foundations County Health Rankings.-The percentages of physical inactivity: Carter County 29%, Sullivan County 28%, Unicoi County 27%, Johnson County 29%, and Russell County 33%. The physical inactivity rate for U.S. top performers is 19% according to the Robert Wood Johnson Foundations County Health Rankings. Our service area extends to some of the poorest rural counties in the region with a poverty rate of almost 30% in some areas. The census bureau estimates county median household incomes are: Johnson County - $34,151; Carter County - $36,589 and Unicoi County - $39,851, averaging approximately 42% below the State of Tennessee median household income. Some of the most well-off counties in MSHA'S service area still have a median household income lower than state and national averages. For instance, Washington Countys median household income is 7.5% below the State of Tennessee and Sullivan Countys is 17.3% below the state. Children in poverty in some areas is approximately 30%. For example, the percentage of children living in poverty in Johnson County is 33%, Carter County is 29%, Unicoi County is 25% and Russell County is 25%. The latest census bureau data estimates the median age of residents of Unicoi County is 46.6, Johnson County is 46.1, and Carter County is 44.9, all significantly older than the median age of 38.9 in Tennessee. All of our communities have a large elderly population, far exceeding that of the country. Persons 65 years and older in the counties MSHAs hospitals are located in range from 18.3% to 23.2% compared to 16.0% for the U.S. |
| Part VI, Line 4 - Community Building Activities | MSHA leaders support and encourage all team members to volunteer time, money and skills to community service projects and charitable organizations. Senior leaders and board members set a positive example for MSHA team members, serving voluntarily on committees and boards of local service and nonprofit organizations. Some also serve as members and consultants on professional committees and task forces that affect regional development in healthcare and education. We do not capture costs associated with team members that serve on other nonprofit boards or provide services to other nonprofits.MSHA, in collaboration with area health agencies and providers, may offer assistance with coordination, advocacy, or contribute supplies to support groups for their program activities that serve to assist special populations within our area. Most of these organizations work to improve the lives of community members that have limited, or no, financial resources. |
| Part VI, Line 5 - Promotion of Community Health | MSHA is dedicated to operating efficiently so that waste is minimized. MSHAs leadership remains mindful of managing limited resources so that adequate facilities and equipment are available for the care of our patients. Surplus funds are invested into improving treatment options for our patients through new technologies, recruiting physicians and trained staff in shortage areas, and improving our facilities. Various checks and balances are established to ensure that expenditures for operating expenses and capital costs are reasonable and necessary.MSHA has several hospitals with Medicare-approved health profession education programs. In addition, our hospitals serve as training sites for many types of health professions: nursing, pharmacy, psychology, lab, respiratory therapy, EMT, public health, etc. Students from numerous colleges, universities, and programs receive training and experience in our hospitals. We devote resources to health conferences for local health professionals, operate two health resources centers conveniently located in a shopping mall and a wellness center; provide for media coverage to educate our residents on health issues; offer events to the public that combine fun activities with health education; and many other programs focused on improving the health of our residents. While we operate hospitals in predominantly low-income, rural and isolated areas, we continue to offer services that operate at a loss to MSHA because residents would otherwise need to leave their home town or county to receive needed care. Mountain States merged with Wellmont Health System in February 2018 to form Ballad Health healthcare system. Mountain States and Wellmont still exist as legal entities and continue to operate multiple hospitals. MSHA's governing body is comprised of persons who reside in the organization's primary service areas. Physicians that request privileges who are qualified and credentialed are extended privileges by MSHA. |
| Part VI, Line 6 - Affilated Health Care System | Mountain States merger with Wellmont opened up many opportunities not previously available to two competing health systems. Collaboration started post-merger and we continue to see progress towards improving efficiencies within our health system, activities consistent with Ballad Healths population health initiative, sharing best practice quality improvements, and other benefits related to operating as one rather than operating in a competitive environment. A new clinical council was formed immediately following the merger. The council includes physicians nominated from the leadership of all Ballad hospitals. A new Community Benefit and Population Health Committee of the board was established and various other infrastructures have been established since the merger.Across MSHAs hospitals, there were many projects, programs, and collaborative efforts that took place during the year. Some examples include:A new hospital was opened in Unicoi County, Tennessee A plan was approved to adopt an integrated technology platform bringing all of our hospitals and points of service together as an integrated system. Consolidation of Level III NICU, Cardiac Cath, and other services to enhance quality of care and patient outcomesOpioid prescribing reduction across all MSHA hospitalsMSHA hospitals shared successful achievements from value optimization team projectsMSHA provides care to people in 29 counties in Tennessee, Virginia, Kentucky and North Carolina. Each hospital is fully accredited by The Joint Commission, with the exception of JCCH. JCCH receives certification through the State of Tennessee since it is a critical access hospital. MSHA, based in Johnson City, Tennessee includes 7 wholly-owned hospitals. In addition to its wholly-owned hospitals, MSHA has majority ownership in 4 hospitals located in Southwest Virginia, each of which file separate returns. In addition to our acute care hospitals, our system includes such services as:primary/specialty physician practices, emergency departments, occupational medicine, rehabilitation, outreach laboratory, mental health, neonatal intensive care, a NACHARI-affiliated children's hospital, renal dialysis, St. Jude's Oncology, inpatient/outpatient surgery, skilled nursing, long-term care, home health, and more. With these additional facilities and services, MSHA extends a highly effective health care delivery system. Since our system is both horizontally and vertically integrated, patients can be efficiently moved along an integrated, comprehensive continuum of care as their health status dictates. Our flagship facility, Johnson City Medical Center is at the core of our system offering full-service tertiary care. In addition to our hospitals, MSHA is the sole member of Blue Ridge Medical Management Corporation (BRMMC). MSHA extends an integrated healthcare delivery system through BRMMC to include multiple primary and specialty care patient access centers and numerous outpatient care sites, including urgent care centers, occupational medicine services, a same day surgery center and rehabilitation.MSHA partnered with East Tennessee State University to open Overmountain Recovery, an opioid addiction recovery facility located in Gray, Tennessee.MSHA is the sole member of Integrated Solutions Health Network, LLC. (ISHN). ISHN operates Anewcare Collaborative, the region's first accountable care organization, bringing together community health care providers to provide better outcomes and improved patient satisfaction at a lower cost.MSHA county-specific operations are governed by a community board of directors. County boards report to a system level board of directors. All boards are primarily composed of local community residents.Hospitals in the Ballad Health system work closely with one another to share expertise and resources. |
| Part VI, Line 7 - States Filing of Community Benefit Report | TN VA |
| Part VI - Additional Information | Ballad Health is required to report community benefit estimates on a quarterly basis with the states of Tennessee and Virginia. The reporting includes all of Ballad's hospital organizations and is reported using IRS Form 990, Schedule H instructions for reporting community benefit. Ballad operates under a Certificate of Public Advantage (COPA) in Tennessee and a Cooperative Agreement (CA) in Virginia as obligated by agreements between Ballad and the two states to allow Mountain States Health Alliance and Wellmont Health System to merge. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (31 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| American Heart Association | ||||||||
| 208 Sunset Drive Suite 113 | Johnson City | TN | 37604 | 135613797 | 501C3 | $25,000 | $0 | Program Support |
| Appalchn Mtn Project Access | ||||||||
| 809 S Roan Street Suite 4 | Johnson City | TN | 37601 | 262102040 | 501C3 | $78,077 | $0 | Health Access |
| Barter Theatre | ||||||||
| PO Box 867 | Abingdon | VA | 24212 | 546000120 | 501C3 | $9,000 | $0 | Sponsorship |
| Blue Plum Organization | ||||||||
| 325 1/2 E Main Street | Johnson City | TN | 37601 | 311704906 | 501C3 | $13,500 | $0 | Sponsorship |
| Boys & Girls Club of Eliz | ||||||||
| 104 Hudson Drive Elizabethton | Elizabethton | TN | 37643 | 620502737 | 501C3 | $7,500 | $0 | Program Support |
| Bristol Family YMCA | ||||||||
| 400 ML King Jr BLVD | Bristol | TN | 37620 | 620521204 | 501C3 | $10,000 | $0 | Annual Donation |
| City of Johnson City | ||||||||
| 601 E Main Street | Johnson City | TN | 37601 | 626000320 | 501C3 | $252,000 | $0 | Physical Hlth/Sprshp |
| Comm in Schools of SW VA | ||||||||
| PO Box 1042 | Johnson City | TN | 37605 | 461775208 | 501C3 | $10,000 | $0 | Education programs |
| Crumley House Brain Injury | ||||||||
| 300 Urbana Road | Limestone | TN | 37681 | 581988511 | 501C3 | $15,500 | $0 | Program Support |
| East Tennessee State Univ | ||||||||
| P O Box 70732 | Johnson City | TN | 37614 | 626021046 | 501C3 | $49,157 | $0 | Health Research |
| Friends in Need Health Center | ||||||||
| 1105 W Stone Dr | Kingsport | TN | 37660 | 621541637 | 501C3 | $30,000 | $0 | Health and Dental Care |
| Governors Fndtn for Health | ||||||||
| 511 Union Street Suite 720 | Nashville | TN | 37219 | 453635908 | 501C3 | $25,000 | $0 | Healthier Tennessee |
| Healing Hands Health Center | ||||||||
| 245 Midway Medical Park | Bristol | TN | 37620 | 621677000 | 501C3 | $9,370 | $0 | Medical & Dental |
| Holy Friendship Summit | ||||||||
| 1241 Volunteer Parkway | Bristol | TN | 37620 | 813718877 | 501C3 | $25,000 | $0 | Sponsorship |
| Junior Achievement Tri-Cities | ||||||||
| 330 Broad Street Suite 1 | Kingsport | TN | 37660 | 841267604 | 501C3 | $10,000 | $0 | Program Support |
| Junior League of Kingsport | ||||||||
| 418 Shelby St | Kingsport | TN | 37660 | 620634742 | 501C3 | $10,000 | $0 | Program Support |
| Kingsport Chamber Foundation | ||||||||
| 400 Clinchfield St Ste 100 | Kingsport | TN | 37660 | 581453565 | 501C3 | $122,800 | $0 | Sponsorship |
| Komen East Tennessee | ||||||||
| 318 Nancy Lynn Lane 13 | Knoxville | TN | 37919 | 752854955 | 501C3 | $20,000 | $0 | Sponsorship |
| K-Play SportsMiracle Field | ||||||||
| 400 Clinchfield St Ste 100 | Kingsport | TN | 37660 | 412045125 | 501C3 | $6,705 | $0 | Adaptive Playground |
| Lipscomb University | ||||||||
| One University Park Drive | Nashville | TN | 37204 | 620485733 | 501C3 | $10,000 | $0 | Sponsorship |
| March of Dimes Foundation | ||||||||
| 1275 Mamaroneck Avenue | White Plains | NY | 10605 | 131846366 | 501C3 | $5,900 | $0 | Sponsorship |
| Milligan College | ||||||||
| PO Box 189 | Mllgn College | TN | 37682 | 620535755 | 501C3 | $13,410 | $0 | Program Support |
| Niswonger Foundation Inc | ||||||||
| Tusculum College PO Box 5112 | Greeneville | TN | 37743 | 621871605 | 501C3 | $15,000 | $0 | Student Career Development |
| Second Harvest Food Bank | ||||||||
| 127 Dillon Court | Gray | TN | 37615 | 621303822 | 501C3 | $28,000 | $0 | Food Pantries |
| Speedway Childrens Charities | ||||||||
| 151 Speedway Boulevard | Bristol | TN | 37620 | 561331429 | 501C3 | $50,000 | $0 | Sponsorship |
| Sullivan Co Anti Drug | ||||||||
| 3193 Highway 126 | Blountville | TN | 37617 | 472607914 | 501C3 | $24,500 | $0 | Prevent Youth Substance Abuse |
| Tennessee Medical Foundation | ||||||||
| 216 Centerview Drive Ste 304 | Brentwood | TN | 37027 | 620541813 | 501C3 | $6,000 | $0 | Program Support |
| TN for Quality Early Educ | ||||||||
| 22 North Front St Ste 670 | Memphis | TN | 38103 | 821352671 | 501C3 | $10,000 | $0 | Sponsorship |
| Town of Lebanon | ||||||||
| PO Drawer 309 | Lebanon | VA | 24266 | 546026883 | 501C3 | $7,500 | $0 | Sponsorship |
| United Way of Southwest VA | ||||||||
| 1096 Ole Berry Dr | Abingdon | VA | 24210 | 540718860 | 501C3 | $50,250 | $0 | Economic Development |
| US of Care | ||||||||
| 1015 15th St NW Ste 600 | Washington | DC | 20005 | 822860302 | 501C3 | $300,000 | $0 | Healthcare Access |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 31 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Grantmaker's Description of How Grants are Used | FormAndLineReferenceDesc |
| Explanation | The Community Benefit and Population Health Committee for Ballad Health is comprised of members from Tennessee and Virginia. Committee members have various perspectives on community health improvement and work to develop an understanding of population health, philanthropy, community benefit obligations and the role Ballad Health plays in health access improvement. The senior leadership for Ballad Health, including the President and CEO and COO, attend the meetings. Among the responsibilities of the committee is ensuring charitable contributions comply with Ballad Health Board policies.All requests are submitted electronically with the required information to determine eligibility. After the committee has reviewed requests, various levels of approval are required, including the Ballad Health CEO or Ballad Health Board, based on the level of commitment. Applicants requesting funding for a specific event or program should include the following information:-Mission statement of organization-Year organization was founded-Tax status and federal taxpayer ID number -Website-Description of the event/program-Event/program budget-Other sources of income-Impact of the event/program on the health of residents in our region-Beneficiaries of contribution-Number of people served annually -Event/program accomplishments-Measure of accomplishments | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Class Or Charter Travel | Yes (X) | FirstClassOrCharterTravelInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
| Rebuttable Presumption Proc | false | RebuttablePresumptionProcInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (21 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Alan Levine BH PresidentCEO | |||||||||||||
| Director | $1,101,957 | $750,000 | $180,289 | $172,174 | $21,270 | $2,225,690 | $150,202 | ||||||
| Andrew Wampler | |||||||||||||
| VP, CFO NW Mkt | $192,873 | $6,952 | $19,327 | $12,121 | $231,273 | ||||||||
| Anthony Keck | |||||||||||||
| EVP, CPHO | $413,343 | $192,790 | $6,777 | $57,114 | $13,819 | $683,843 | |||||||
| Clay Runnels MD | |||||||||||||
| VP Svc Line Mgmt | $391,478 | $30,000 | $4,425 | $13,499 | $23,027 | $462,429 | |||||||
| Dawn Trimbleterm 218 | |||||||||||||
| CEO Wahington Co. | $59,394 | $225,000 | $436,479 | $5,244 | $18,331 | $744,448 | |||||||
| Devin McFall | |||||||||||||
| VP, CFO SW Mkt | $219,445 | $6,479 | $13,970 | $22,327 | $262,221 | ||||||||
| Eric Deaton BH EVPCOO | |||||||||||||
| Director | $497,063 | $40,165 | $33,042 | $26,522 | $16,433 | $613,225 | |||||||
| James Parsonsterm 418 | |||||||||||||
| VP HR | $84,172 | $71,250 | $468,747 | $7,748 | $15,903 | $647,820 | $29,259 | ||||||
| Lemmie Taylor | |||||||||||||
| VP, CEO SE Mkt | $225,731 | $57,837 | $4,374 | $27,921 | $21,299 | $337,162 | |||||||
| Lynn Krutak | |||||||||||||
| BH EVP/CFO | $585,707 | $250,000 | $18,316 | $72,647 | $17,645 | $944,315 | |||||||
| Marvin Eichorn BH EVPCAO | |||||||||||||
| Director | $678,984 | $300,000 | $32,881 | $12,241 | $24,453 | $1,048,559 | |||||||
| Melissa Carr | |||||||||||||
| SVP Financial Mgmt | $289,103 | $62,500 | $4,301 | $42,750 | $19,058 | $417,712 | |||||||
| Monty McLaurin | |||||||||||||
| CEO NW Mkt | $357,053 | $157,624 | $43,422 | $18,299 | $23,730 | $600,128 | $16,160 | ||||||
| Morgan May | |||||||||||||
| VP, CNO JCMC | $187,638 | $5,417 | $5,779 | $19,928 | $218,762 | ||||||||
| Morris Seligman MDterm 218 | |||||||||||||
| EVP & CMO | $53,686 | $250,000 | $496,701 | $9,266 | $15,294 | $824,947 | |||||||
| Patricia Baise | |||||||||||||
| VP, CEO Behavioral Health | $286,466 | $10,000 | $9,891 | $11,358 | $21,244 | $338,959 | |||||||
| Paul Merrywell | |||||||||||||
| CIO | $32,876 | $150,000 | $395,205 | $4,688 | $15,088 | $597,857 | $24,225 | ||||||
| Richard Booneterm 418 | |||||||||||||
| CFO Washington Co. | $87,817 | $70,000 | $211,313 | $3,621 | $15,179 | $387,930 | |||||||
| Shane Hilton | |||||||||||||
| SVP, CFO Mkt Ops | $356,020 | $170,760 | $3,500 | $50,554 | $23,244 | $604,078 | |||||||
| Stan Hickson | |||||||||||||
| VP SW Mkt | $408,432 | $21,878 | $12,307 | $22,395 | $465,012 | ||||||||
| Tim Belisle BH EVPGen Cncl | |||||||||||||
| Director | $400,672 | $161,656 | $14,736 | $56,640 | $22,892 | $656,596 | |||||||
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 1a: Relevant information in regards to selections on 1a. | FormAndLineReferenceDesc |
| Explanation | Unless expressly approved by the Ballad Health Executive Chair/President, first-class transportation is generally not permitted. The Executive Chair/President may utilize first class travel for flights of a long duration. The Vice Chair/Lead Independent Director of the Board of Directors reviews and determines approval for expense reimbursement requests made by the Executive Chair/President. Charter flights must be approved in advance by the Executive Chair/President and are limited to business trips that can be justified based on financial savings, essential time savings and meeting logistics. On an annual basis, the Internal Audit Department of Ballad Health validates all charter travel was for valid business purposes and in compliance with the Ballad Health senior executive travel and business reimbursement policy. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Hlth & Edu Facil Bd 2012 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 621464028 | BondIssuerEIN |
| CUSIP | 478271JV2 | CUSIPNum |
| Bond Issued | 2012-09-18 | BondIssuedDt |
| Issue Price | $94,745,050 | IssuePriceAmt |
| Purpose | Construction & Equip | PurposeDesc |
| Defeased | false | DefeasedInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Pool Financing | false | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $37,880,000 | RetiredAmt |
| Total Proceeds | $95,337,514 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $1,889,665 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $89,474,759 | CapitalExpendituresAmt |
| Substantial Completion | 2016 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | false | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | false | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (true) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (true) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | false | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | Yes (true) | MgmtContractBondFincdPropInd |
| Engage Bond Counsel Contracts | Yes (true) | EngageBondCounselContractsInd |
| Any Research Agreements | false | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | false | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | false | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (true) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiledInd |
| Rebate Not Due Yet | false | RebateNotDueYetInd |
| Exception To Rebate | false | ExceptionToRebateInd |
| No Rebate Due | Yes (true) | NoRebateDueInd |
| Hedge Identified In Bks And Rec | false | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | false | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (true) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (true) | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part VI | FormAndLineReferenceDesc |
| Explanation | Schedule K - Date Rebate Computation Performed Hlth & Edu. Facil. Bd. 2012A&B&C 11/28/17Schedule K - Additional Information Hlth & Edu. Facil. Bd. 2012A&B&CConstruct and equip surgery center at Johnson City Medical Center;Construct and equip hospital facilities, including refinancing of taxble indebtedness relating thereto1. Comment on Part I, Line A.In 2012, when the bonds referenced in Schedule K were issued, Mountain States Health Alliance owned and/or operated hospitals in a number of different locations both in Tennessee and in Virginia. As a result, Mountain States Health Alliance utilized conduit governmental bond issuers in multiple jurisdictions in order to finance improvements to its hospital facilities. In 2012, Mountain States Health Alliance was the conduit borrower of tax-exempt bonds issued by multiple issuers in Tennessee and Virginia. For federal tax purposes, even though different government issuers were involved, these multiple issues in each year were required to be treated, and were treated, as a single "issue" because they met the single "issue" test under the applicable federal tax regulations. Therefore, multiple issuers are listed under Line A because the bonds that were issued were part of a single "issue" for federal tax purposes.Additional Issuer EIN: 54-1276910Additional CUSIP#s: 478271JWO; 977220AA02. Comment on Part II, Line 3. Line 3 for the listed bond issues does not match the applicable issue price for such bond issue because of interest earnings earned on the proceeds of such bonds. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (45 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 4: Description of Significant Changes to Organizational Documents | Mountain States Health Alliance and Wellmont Health System merged on February 1, 2018 to form Ballad Health (BH), a tax-exempt healthcare delivery system. At time of merger, the BH Board of Directors became the directors of Mountain States Health Alliance and Wellmont Health System. BH is the sole member of Mountain States Health Alliance and Wellmont Health System. In FY19, BH appointed four BH officers to serve as the board of directors for Mountain States Health Alliance and Wellmont Health System. |
| Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder | Mountain States Health Alliance is a Tennessee non-stock, nonprofit organization with Ballad Health as its sole member. |
| Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body | Ballad Health has the authority to appoint Mountain States Health Alliance board members. The President and CEO of Ballad Health serves as the President and CEO for Mountain States Health Alliance. |
| Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders | Decisions of the Mountain States Health Alliance Board of Directors are subject to approval by the Ballad Health Board of Directors. |
| Form 990, Part VI, Line 11b: Form 990 Review Process | Ballad Healths EVP/CFO reviewed the Form 990 with the board of directors prior to the return being filed with the IRS. The return was made available to each board member in an electronic format prior to the review. |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | Ballad Health has a conflict of interest policy for all members of the Board of Directors, the Executive Chair/President, Executive Vice Presidents, Senior Vice Presidents, and Vice Presidents, and applies to all Ballad Health organizations. All persons covered by this policy are required to complete a conflict of interest disclosure form on an annual basis. Should a conflict arise, it is the responsibility of the conflicted individual to update his or her disclosure immediately. All meetings of the board or board committees have a standing agenda item first on the agenda titled Conflicts of Interest. If a member of the board or board committee has a conflict of interest involving any issue on the board agenda, he or she must declare the conflict of interest during the period allotted for disclosure. If any issue arises during a meeting in which the board member has a conflict of interest, he or she must immediately declare the conflict. While each member of the board or board committee is responsible for disclosing conflicts of interest, it is also the responsibility of any board member aware of a conflict which has not been disclosed to ensure the board is made aware. The presiding officer of a board or board committee meeting may ask a conflicted member to excuse themselves from the meeting during the discussion related to the issue with which the conflict of interest applies. Under no circumstances shall a member vote on a matter that gives rise to a potential conflict. |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | Governing documents and conflict of interest policy are made available upon request to the appropriate parties requesting them. Financial statements are made available upon request to appropriate parties requesting them, and they are made available to those parties who own indebtedness of the company on a quarterly basis. |
| Other Changes In Net Assets Or Fund Balances - Other Decreases | Capital infusion to parent organization = -$XXX-XX-XXXX |
| Other Changes In Net Assets Or Fund Balances - Other Increases | Elimination of Intercompany Receivable = $1289166 |
| Other Changes In Net Assets Or Fund Balances - Other Increases | Partnership Capital Contributions - not on books = $168694 |
| Other Changes In Net Assets Or Fund Balances - Other Decreases | Partnership Dissolutions = -$1952670 |
| Other Changes In Net Assets Or Fund Balances - Other Decreases | Partnership Interest Income - not on books = -$56860 |
| Other Changes In Net Assets Or Fund Balances - Other Decreases | Partnership Ordinary Income - not on books = -$1605984 |
| Other Changes In Net Assets Or Fund Balances - Other Increases | Temporarily Restricted Grants = $71706 |
| AWARDS AND RECOGNITIONS | Overmountain Recovery achieved a three-year accreditation from the Commission on Accreditation of Rehabilitation Facilities (CARF). This accreditation is a tremendous achievement after one year of operation. Most newly operational addiction treatment facilities are awarded certification for only one year.All the MSHA hospitals are accredited by the Joint Commission (TJC) with many of the hospitals designated with advanced gold seal certifications for various programs. TJC is an independent, not-for-profit organization that accredits and certifies nearly 21,000 health care organizations and programs in the United States. TJC is the nations largest standard-setting and accrediting body in health care. Joint Commission surveyors visit accredited health care organizations a minimum of once every 39 months to evaluate standards compliance. All regular Joint Commission accreditation survey visits are unannounced. Joint Commission accreditation and certification is recognized nationwide as a symbol of quality that reflects on an organizations commitment to meeting certain performance standards. The security, safety & emergency management force at both Ballad Health and MSHA has been recognized by Security magazine as part of the 2018 Security 500 rankings. Security magazine remarked: We are recognizing your organization for your safety and security policies and efforts to keep patients, staff and visitors safe. Our team has been monitoring your work in this area, and we wanted to recognize you.For the second year in a row, Indian Path Community Hospital was named as one of Americas 250 Best Hospitals by Healthgrades. The designation of Americas 250 Best Hospitals is based on clinical quality outcomes for 32 conditions and procedures. This premier distinction rewards hospitals in the top 5% in the nation that consistently exhibit exceptional, comprehensive quality care.For the fourth straight year, Franklin Woods Community Hospital has been selected as one of 100 Great Community Hospitals by Beckers Hospital Review one of only two hospitals in the state to receive this recognition for four consecutive years. Beckers designation is based on outside rankings and awards from organizations such as the IBM Watson Health 100 Top Hospitals, iVantage Health Analytics, The Chartis Center for Rural Healths Top 100 Rural & Community Hospitals, CareChex ratings, Healthgrades awards and CMS stars, Leapfrog Group grades, among other considerations. Beckers defines a community hospital as one with fewer than 550 beds.JCMC achieved U.S. News & World Reports highest rating for the treatment of two conditions in their 2018-2019 best hospital rankings: COPD and Heart Failure. The joint replacement program at Johnson City Medical Center has had phenomenal patient outcomes. For three years, and still counting, there were no knee replacement infections and for two and one-half years there were no hip replacement infections.Blue Cross Blue Shield recognized Indian Path Community Hospital, Johnson City Medical Center and Sycamore Shoals Hospital with Blue Distinction Plus Specialty Care recognition. Blue Distinction Plus facilities are healthcare facilities recognized for their expertise and efficiency in delivering specialty care. IPCH was recognized for maternity care, JCMC for spine surgery and SSH for knee and hip replacement.Consistent with prior years, Mountain States Health Alliance hospitals received excellent 2019 hospital quality ratings from CareChex. CareChex scores, rates, ranks, and compares inpatient quality performance across general, acute, and non-federal hospitals. Hospital ratings incorporate a detailed composite evaluation of clinical outcomes including patient safety indicators, inpatient quality indicators, risk-adjusted mortality, complications, and readmissions. In addition, patient experiences (patient satisfaction scores) are used. An analysis by clinical category, MS-DRG, principal diagnosis and procedure, discharge status, and trends over time are also utilized. MSHA team member recognitions:Dr. Molly Lassiter, cardiovascular clinical pharmacy specialist at Johnson City Medical Center, was awarded recognition as a board-certified cardiology pharmacist (BCCP) by the Board of Pharmacy Specialties. Dr. Lassiter is one of only 182 BCCPs worldwide, and one of 10 in Tennessee. The Board of Pharmacy Specialties (BPS) was established in 1976 to improve patient care and increase awareness of the need for board-certified pharmacists as integral members of multidisciplinary healthcare teams. BPS board certification is considered the gold standard when determining a pharmacists qualifications and capabilities within a specialty area. Dr. Lassiter is the preceptor for the required cardiology rotation for the PGY1 pharmacy residency program and offers an advanced pharmacy practice experience for Doctor of Pharmacy (PharmD) students. She is also a board-certified pharmacotherapy specialist with added qualifications in cardiology and a board-certified critical care pharmacist.Heatherly Sifford, trauma injury prevention program coordinator for Johnson City Medical Center, was recently appointed to the Governors Council on Suicide Prevention. Sifford also serves as the Northeast Regional Chair for the Tennessee Suicide Prevention Network (TSPN). Sifford became a passionate advocate for suicide prevention in part after her best friends son died by suicide. Sifford works to educate young people on the signs to look for in their peers, and how to get involved in preventing suicide. In the U.S. right now, we lose one young person between the ages of 10-24 every 108 minutes, Sifford said. We owe it to our children to do better. Sifford is a certified QPR (Question, Persuade and Refer) trainer. |
| CARTER COUNTY, TN: SYCAMORE SHOALS HOSPITAL (SSH) | 121-bed acute care facility Offers complete inpatient and outpatient surgical services including general surgery, surgical oncology, orthopedics (including hand and extremities), plastic surgery and gynecological surgeryCertified chest pain and heart failure program by the Joint CommissionA certified acute stroke-ready program by the Joint CommissionNew Leaf Senior Care offers inpatient psychiatric treatment to adults 55 and older Campus includes a regional cancer center clinic, an outpatient rehabilitation clinic, and comprehensive primary care and specialist care |
| CHARITY AND OTHER UNREIMBURSED COSTS | While reimbursement for healthcare services rendered is critical to the operation and sustainability of the organization, MSHA recognizes its obligation to provide care to individuals who cannot afford essential medical services, including emergency care. MSHA accepts all patients regardless of their ability to pay. A patient is classified as a charity patient when they meet the established policies of Ballad Health and guidelines outlined by the federal government. However, financial assistance decisions are not solely based on income. Unique financial circumstances are weighed with verified patient assets which can determine financial assistance eligibility. It is not until after verification of income and assets that a decision regarding the amount of financial assistance can be made. In fiscal year 2019, MSHA incurred a loss of $10,312,579 attributable to the provision of charity care. This amount does not include the costs associated with accounts classified as bad debt. TENNCARE/MEDICAID: MSHA provides care to persons covered by governmental programs, such as TennCare (Tennessee residents) and Medicaid. MSHA incurred a loss of $19,426,960 providing care to this population of patients during the year. UNINSURED DISCOUNT: Uninsured patients received an 80% discount through September 30, 2018 and this discount increased to 85% effective October 1. The uninsured discount is applied to all uninsured patients at MSHA hospitals except for the Critical Access designated Johnson County Community Hospital. Johnson County Community Hospitals uninsured discount was 71% through September 30, 2018, and thereafter increased to 73%. Certain elective procedures are not eligible for the uninsured discount. The uninsured discount is calculated each year in accordance with Tennessee regulations and without regard to a patients income or assets. Although the uninsured discount is not required by the Commonwealth of Virginia, Ballad Health applies the same discount to the uninsured patients receiving care in the Virginia hospitals, both wholly and majority owned. The approximate cost (calculated by using a cost to charge ratio) of the uninsured discount in FY19 was $26,030,036 for the hospitals included in this Form 990 return. |
| COMMUNITY CONTRIBUTIONS | As the largest employer in the region, Ballad Health is one of the areas principal benefactors and has made corporate citizenship an integral part of its culture. From system-wide initiatives at Ballad Health and MSHA hospitals to individual efforts of caring team members, the aim is to enrich the communities that are served. This commitment includes direct financial contributions to support community healthcare needs and those to non-profit agencies that advocate the health and well-being of community members.In FY19, MSHA made donations to numerous health and human service organizations, social and well-being non-profits, and others within the service area.Donations to local organizations provide health care, work to increase access to health care and/or conduct research with the aim of improving health, or promote a healthy community included: $78,000 to Appalachian Mountain Project Access (matches low income patients with providers willing to donate their care, offers insurance premium assistance to qualifying individuals, and other programs to increase access to medical services), $15,500 to Crumley House Brain Injury Rehabilitation Center, $30,000 to Friends in Need Healthcare (provides medical and dental care to working uninsured/underinsured), $25,000 to the Governors Foundation for Health & Wellness, $25,000 to Holy Friendship Summit (to fight opioid epidemic/support addiction recovery), $100,000 to the Kingsport Chamber Foundations Healthy Kingsport Initiative, $10,000 to Lipscomb University (Sam Quinones Partnership-addressing the opioid crisis), $23,000 to Second Harvest Food Bank, $24,500 to the Sullivan County Anti-Drug Coalition, and smaller contributions to other local organizations that promote health. MSHA provided medications from our hospital pharmacies to local rescue squads at a cost of $11,795. MSHA also contributed $100,000 to United States of Care (focused on expanding health care to all Americans).Throughout the year, MSHA makes contributions to local schools and organizations that provide educational, health, and social support to youth. Many of the donations to benefit young people are restricted to services focusing on healthy eating and physical activities, after school and summer programs providing at-risk children a safe environment, and literacy programs. Studies show a correlation between literacy and medical compliance/overall health.MSHA donations during FY19 to organizations that provide educational, health, and social support to youth included: $10,000 to Bristol Family YMCA, $10,000 to Communities in Schools in Southwest Virginia (program to connect students with basic needs), $10,000 to Junior Achievement of Tri-Cities TN/VA, $10,000 to Junior League of Kingsport (Children Exceeding Expectations program), $15,000 to Niswonger Foundation (CareerConnect program for students), $5,000 to Second Harvest Food Bank (Food for Kids program in Hancock & Hawkins Counties), $50,000 to Speedway Childrens Charities, $10,000 to Tennesseans for Quality Early Education Policy & Research, $50,000 to United Way of Southwest Virginia (Ignite program providing summer internships for students) and other schools and organizations that promote the health and well-being of youth. MSHA contributes annually to national non-profit organizations whose research focuses on those diseases and conditions most prevalent in our region. In FY19, donations were made as follows: $20,000 to the American Heart Association, $5,000 to the Juvenile Diabetes Research Foundation, $25,000 to Susan G Komen and $5,000 to the March of Dimes Foundation.MSHA also contributes to the arts, festivals, churches/ministries and other organizations in the local communities.MSHA has a long-running program, Servant Heart Award, to recognize MSHA team members, physicians, and volunteers who represent exceptional service to their community. Award recipients select non-profit charities they wish to reward and MSHA makes a charitable contribution to the selected charities on behalf of the servant heart award winners. Memorials are also made routinely. Our board of directors and senior management encourage team members to devote time to local community service projects, task forces, committees, boards, volunteer programs, and other charitable organizations that benefit local communities. Team members are allowed to serve as representatives of MSHA. Team members serve as a healthcare representative on local chamber of commerce boards, local county economic boards, participate in school health programs, assist charitable organizations with fundraising activities, work at food pantries and meal service organizations feeding low income residents, speak at local clubs/churches/groups on healthcare topics, collect and provide supplies to local schools and charities, provide assistance to local organizations at Thanksgiving and Christmas, provide health education and/or first aid at local festivals, and many other predominantly health related activities. The medical oncology team at Johnson City Medical Center helped spearhead a drive at Christmas to buy gifts and vital items needed by their patients, especially some of their youngest patients. The donations were used to purchase clothes, toys, school supplies, coats, blankets and more for 18 children being treated, plus three other patients.There are many other examples of activities performed by the team members at all MSHA hospitals that demonstrate the spirit of giving during the holidays and throughout the year to their patients. |
| COMMUNITY RESOURCES | Ballad Health supports its parish nurse program, which is designed to provide holistic ministry and special promotion services within the faith community. The parish nurse program assists individuals in gaining optimal mental, physical and spiritual health by complementing the ministry provided by pastors and other lay ministers. Some of the services and programs provided include screenings for blood pressure, cholesterol, diabetes, glaucoma and overall fitness, classes for all age groups offered on health related issues (nutrition, exercise, parenting, care for elderly parents, stress management, CPR), hospital, nursing home and home visits for assessment of health care needs, referrals to appropriate community resources and the creation of health tips in congregational newsletters, bulletin boards and other forms of communication. In FY19, MSHAs parish nurse program provided 649 home visits, accompanied community members to 1,772 clinic visits and visited community members while in the hospital or nursing home on 933 occasions. The program offered 243 blood pressure screening clinics, 412 glucose screenings, 80 health fairs and one blood drive, resulting in identification and referral of 296 people with abnormal results to physician services. The program offered health education to parishioners through 329 educational sessions, 233 newsletter articles, 22 church bulletin articles and 110 bulletin board displays. The cost for MSHA to provide this program was $91,492.MSHA operates emergency transport dispatch services as the state designated Regional Medical Communications Center (RMCC) for Tennessee Region 1. As a RMCC, MSHA coordinates hospitals, ambulance services and other medical resources in real time, to optimize emergency patient care in situations where local governments and health care providers request assistance. The communication center is operational 24 hours daily and provides communication services to both air and ground emergency transport systems in the region. MSHAs unreimbursed cost to provide this service during FY19 was $190,847.MSHA gifts a land lease to the Ronald McDonald House at an annual fair market value of $60,000. The Ronald McDonald House, which opened in 1996, sits on the campus of Niswonger Childrens Hospital and Johnson City Medical Center. Though located on campus, the Ronald McDonald House provides a temporary home for children and families of seriously ill children throughout the Southern Appalachian region. Forty counties located throughout Northeast Tennessee, Southwest Virginia and Eastern Kentucky, covering a 125-mile radius outside the city limits of Johnson City, are served by this regional facility. Thousands of children, along with parents and extended family members, have been served at the house. MSHA, in collaboration with area health agencies and providers, helps with coordination, advocacy and publicity; provides space; or contributes supplies to support groups for their program activities.The Health Resources Center (HRC) is a community outreach service provided in two locations. The Johnson City HRC is located inside the Wellness Center. The Kingsport HRC is in the Fort Henry Mall. The centers are staffed by a registered nurse and other health professionals, including a registered dietitian. The HRC offers free classes, screenings, blood pressure checks, support groups, nutritional education, informational materials and resources and other services to meet community members health and health education needs. During FY19, the Johnson City HRC had 5,671 visits to the office, including 59 wig fittings. This HRC also hosted 1,959 attendees who participated in monthly health education or screening programs. The registered dietitian provided 38 individual nutrition education sessions. The center also provided outreach services, connecting with an additional 7,138 community members. The uncompensated cost of the Johnson City HRC in FY19 was $241,408. The HRC in Kingsport had 10,983 office visits and hosted 1,978 attendees at monthly health education or screening programs, 32 individual nutrition sessions with the registered dietitian, and provided outreach services to another 15,320 community members. During FY19, the Kingsport HRCs uncompensated cost was $266,440. The Johnson City Health Resources Center participated in this years pink party to kick off Breast Cancer Awareness Month. This event provided visitors with breast cancer nutrition education, free samples, as well as local vendor booths and information. The team offered information about the HRCs wig service, answered questions regarding mammography and breast cancer and much more. The event attracted more than 250 visitors. The Johnson City Health Resources Center hosted a senior expo this year. More than 250 senior community members took advantage of this free event; which included health and wellness information, free health screenings, such as vision, hearing, allergy, blood pressure, blood sugar and more. There was also dancing, door prizes and giveaways. The Indian Path Medical Center Official Fun Fest Block Party, held at the Kingsport Health Resources Center, had over 250 guests in attendance. Fun Fest is a 9-day festival in Kingsport, Tennessee, with an attendance of over 180,000. The team was very active in the Kids Central Extreme Challenge and during the three-day event engaged over 900 children in physical activity and educated them about meal planning, using the My Plate method. The Kingsport team was also very active with the Feeding America initiative in Southwest Virginia and educated 200-300 community members regarding health and wellness. In addition, the HRC dietitian was involved in the annual Remote Area Medical clinic in Gray, Tennessee. More than 250 community members were present for nutrition education. Examples of the variety of classes, screenings, support groups, and health education events MSHA offered throughout the year include: Taste of the World - a series offered each month highlighting the cuisine of different countries.Savvy Senior - a four-part series to teach seniors how to navigate through their computer and smart phone to gain more functionality with their electronic devices.De-Stress & Worry Less material presented by a registered nurse and a registered dietitian for simple tips on how to slow down and relax. Self Defense for Women a course designed to offer women more confidence and skills to protect themselves. The program offers tips to improve safety awareness to avoid potential attacks plus effective offensive strategies to use when needed. Nail Salon SafetyVarious mental health topics Almost all of these courses are offered free of charge except for a small fee that may be imposed for lab charges or guidebooks. Other classes offered to the public include: diabetes education and management; nutrition and healthy cooking; CPR training; exercise; weight loss; lung health; green cleaning using simple cleaning recipes; avoiding seasonal allergies; glaucoma; colorectal cancer; stress in seniors; elder concerns; sleep health; drug addiction; cancer education; heart health; foot care; safe babysitting; breastfeeding; techniques for managing chronic pain; Medicare information sessions for seniors turning 65; relaxation training; sleep apnea screening; vaccines; balance and falls prevention; child illnesses and special needs programs and classes; suicide prevention; and, many other disease-specific classes and screenings, including stroke risk. Some of the many support groups sponsored by MSHA include: Alzheimers & Dementia, Celiac Disease, Parkinsons disease, cancer, senior caregiver, Better Breathers Club (pulmonary). Classes offered monthly include: arthritis, asthma, atrial fibrillation, blood pressure management, blood clot prevention, cardiomyopathy, chest pain & palpitations, cholesterol management, COPD, heart failure, home safety, medication management, osteoporosis, pneumonia, post-partum recovery, smoking cessation, stress management, and thyroid disorders. Class offerings, along with the presenters and a brief description of the class, are posted each month on the Ballad Health website. On average 45 to 50 events are offered to the public each month. MSHA provided a variety of wellness and health information regarding community-specific health issues throughout the year to educate area residents. Information was provided through printed materials, radio and television, and health events, such as free screenings and health fairs. Some of the topics covered this year included:Breast health & other womens health issuesHealth Watch radio spot Baby and child health events for the publicStroke education/signs and symptoms as outlined by the American Stroke Association (the MSHA service area falls within the U.S. Stroke Belt; Tennessee has the third highest rate of stroke deaths in the country)In addition to our Health Resources Centers in Johnson City and Kingsport, the Ballad Hea |
| d/b/a - Additional names: | Niswonger Children's Hospital;Woodridge Hospital;Franklin Woods Community Hospital;Indian Path Community Hospital;Sycamore Shoals Hospital;Johnson County Community Hospital;Russell County Hospital;Unicoi County Hospital |
| Franklin Woods Community Hospital | Franklin Woods Community Hospital (FWCH) hosted a SAFE (Self-defense Awareness & Familiarization Exchange) seminar for women. The free event, taught by a sergeant of the East Tennessee State University Department of Public Safety, included strategies, techniques and the physical aspects of self-defense and prevention. The seminar was part of the National Self-Defense Institute SAFE program and provides women with solid public safety-awareness information to incorporate into their everyday lives. FWCH became certified this year with The Joint Commission for their Minimally Invasive Colorectal Program; the only hospital in Tennessee and one of five hospitals in the nation to have this disease-specific certification. |
| IMPROVING ACCESS TO HEALTHCARE | OPENING OF NEW RURAL HOSPITAL IN UNICOI COUNTY - Ballad Health officially opened the new Unicoi County Hospital in October 2018. The 40,000-square-foot facility includes a 24-hour emergency department with a telemedicine connection to Niswonger Childrens Hospital; 10 inpatient beds; pulmonary, cardiac and acute care services; a chest pain center; standard and advanced diagnostics, including nuclear medicine; and outpatient services. |
| IMPROVING HEALTHCARE QUALITY | QUALITY METRICS - Ballad Healths Board of Directors has adopted a zero-harm culture for the organization, and processes have commenced to institutionalize this objective. This focused effort on quality improvement significantly benefitted patients. Specific examples include: zero infections for abdominal hysterectomy cases across the system; 47% reduction in pressure injury rate; 42% reduction in clostridium difficile infections; 39% reduction in iatrogenic pneumothorax rate; and 13% reduction in central line bloodstream infections.During FY19, there has been a 10 percent reduction in the hospital readmission rate over the prior year, and a 25 percent reduction among legacy hospitals since 2015 as evidence that physician and administrative partnership is resulting in lower cost and lower risk to patients. Ballad Health achieved the lowest readmission rate in either legacy health systems histories. NATIONAL RECOGNITION FOR QUALITY IMPROVEMENTS U.S. News & World Report named flagship hospitalJohnson City Medical Center as top-performing hospital in Tennessee in several specialties, providing top performing services and programs in heart failure and COPD. Less than 30% of all hospitals had any top-performing programs. And recently, Forbes Magazine named Johnson City Medical Center as one of the best employers in Tennessee among all employers.ONGOING QUALITY IMPROVEMENT PROGRAMS RECEIVE PRAISE FROM NATIONAL EXPERTS - Ballad Health has instituted a comprehensive quality improvement program systemwide based on the FOCUS PDCA modela model designed to empower team members to identify opportunities for improvement and measurably implement those opportunities. These efforts are organic and driven by staff at all levels. The Ballad Health approach to quality improvement was recently praised by national experts who facilitate and assess organizational commitment to quality. For instance, in the past year, a total of 130 quality improvement projects across the system qualified at various levels of improvement for recognition, with 42 national judges evaluating the projects and awarding recognition for the results. Examples of improvement projects include: A 91.6% reduction in restraint use and 18 months of zero restraints for adolescents at the Willow Unit at Woodridge Hospital; a 95% reduction in the amount of oral contrast used for outpatients and inpatients prior to receiving a CT scan at Indian Path Community Hospital, which produced $139,000 in annual cost savings; and a 50% reduction in hospital-acquired Clostridium difficile (C.diff) across all hospitals within three months. |
| IMPROVING THE COMMUNITY'S HEALTH STATUS | Mountain States Health Alliance (Mountain States) is one of only 29 organizations in the country participating in the Centers for Medicare & Medicaid Services (CMS) new initiative, Accountable Health Communities Model (referred to as AHC Program), aimed at improving the health of eligible Medicare and Medicaid beneficiaries. The AHC Program is designed to integrate care for health-related social needs into usual care by implementing systematic screening, referral, and patient navigation services for needs such as food insecurity, housing instability, safety, transportation needs, and utility assistance. Mountain States serves as the Bridge Organization for the AHC Program locally, leading a collaborative of multiple organizations and clinical delivery sites to bring needed services to beneficiaries residing in Southwest Virginia. Full implementation of the AHC Program was achieved during FY19. There are nine full-time team members for the program, whose positions are financed by federal funds, (six Navigators, one Lead Navigator, one Screening and Referral Specialist, and one Program Manager), while two part-time Navigator positions remain open. Fifty-two locations serve as clinical delivery sites in Southwest Virginia and Northeast Tennessee and have processes in place to identify health-related social needs. Patients that screen positive for health-related social needs are given a Community Referral Summary, which contains contact and program information for relevant resources that assist with the needs identified by the screening. Since formal go-live of the AHC Program on November 17, 2018 through June 30, 2019 there have been 61,705 offered screenings, 35,544 answered screenings, 9,050 needs identified, 5,030 Community Referral Summaries given to patients, and 2,142 navigated patients. The stats provided are inclusive of the Ballad Health Virginia hospitals plus three Tennessee hospitals located close to Southwest Virginia. Mountain States also created an internally-produced data system for the screening, referral, and navigation services in lieu of using the CMS AHC Data System. This data system improved operational efficiency by at least five-fold over the CMS Data System. Patient Navigators have been re-deployed from five Virginia Community Services Boards in our service area to hospital emergency departments and primary care offices. This allows the Navigators to establish initial contact with a patient and complete a personal interview and action plan related to the health-related social needs identified by the patient. Laptops and cell phones were purchased for the Navigators to have the ability to work at the clinical delivery sites and from other locations, as needed. |
| Indian Path Community Hospital | Indian Path Community Hospital (IPCH) participates in the American Lung Associations Better Breathers Club. IPCH hosts the monthly support group meetings for patients that have chronic lung disease. Physicians speak on different pulmonary related topics and offer wellness activities to encourage members in their mission to better control disease. The support group is led by a respiratory therapist with extensive experience educating patients with chronic lung disease and is a free service to the community. In order to increase public awareness of early detection for lung cancer, IPCH offered low-dose CT lung screenings at no charge to 387 people. The hospital notified the public and local physician offices of the free lung screenings. Following the screenings at IPCH, other MSHA hospitals now offer free screenings. Sycamore Shoals Hospital offered 148 free low-dose scans in FY19. Last year IPCH began using advanced technology, Helios ultraviolet disinfection system, to clean hospital rooms and better protect patients against potentially deadly infections. The system emits powerful yet safe ultraviolet energy to combat bacteria, spores and viruses, including superbugs. Independent studies have shown the system reduces hospital-acquired infections and significantly lowers infection rates. Ultraviolet energy has been used for decades to kill organisms and the technology is now being used to kill organisms on hospital surfaces, such as bed rails, remotes, patient tray tables, guest chairs, countertops, and bathrooms. MSHA is now incorporating the same technology in all other hospitals. |
| INVESTMENTS | COMMON ELECTRONIC HEALTH RECORD - Ballad Health made progress in FY19 toward establishing a common clinical platform and electronic health record (EHR). An implementation plan was developed to include infrastructure enhancements to support the expansion. A common EHR across the new health system will allow patient information to be shared immediately at the point of service regardless of where a patient enters the Ballad system, providing clinical staff with information to better manage patients in the emergency room, clinics, acute and post-acute settings. |
| Johnson City Medical Center | According to the U.S. Centers for Disease Control and Prevention, every 40 seconds someone in the US has a stroke. The Northeast Tennessee and Southwest Virginia region has one of the highest rates of stroke in the country. Quick access to the best stroke treatment can mean the difference between life and death. According to the American Heart Association, people with hemorrhagic stroke are more likely to survive if they are treated at a comprehensive stroke center. Last year, Johnson City Medical Center (JCMC) earned The Joint Commissions gold seal of approval and the American Heart Association/American Stroke Associations heart-check mark for advanced certification for comprehensive stroke centers. This designation is the highest level of stroke certification available, earned by meeting stringent standards for treatment of the most complex ischemic (clotting) and hemorrhagic (bleeding) stroke cases. With this certification, JCMC joins an elite group of approximately 150 healthcare organizations in the nation able to provide advanced, highly-specialized stroke care. To be eligible, hospitals must demonstrate compliance with stroke-related standards as a primary stroke center and meet additional requirements, including those related to advanced imaging capabilities, 24/7 availability of specialized treatments, and staff with the unique education and competencies to care for complex stroke patients. Mountain States network of stroke centers includes Indian Path Community Hospital and Johnston Memorial Hospital, certified primary stroke centers and Franklin Woods Community Hospital and Sycamore Shoals Hospital, certified as acute stroke ready. By linking our community hospitals and using standardized, evidence-based imaging, treatment and transfer protocols, Mountain States can create a complete continuum of care for stroke patients. The goal of the stroke network is that all Mountain States hospitals comply with a set of strict protocols when patients present with stroke symptoms. JCMC opened its Clinical Decision Unit (CDU) in May 2018. The CDU is an extension of the emergency department specially designed to serve those patients needing behavioral health care. Once medically cleared, JCMC ED patients may be accepted into the unit and will receive care and treatment from Woodridge Hospital (our behavioral health facility) physicians, nurse practitioners, therapists, nurses, behavioral health technicians and discharge planners. Some of these patients may be transitioned to inpatient psychiatric care while others will be discharged to outpatient service once stabilized. Our number one priority for the new unit is safety. If the patient has a medical condition, an attending ED provider will cover the patients medical needs. The CDU provides services to both voluntary and committed patients and is staffed with behavioral health trained nurses and techs 24/7. The staff has extensive training in dealing with behavioral health emergencies. CDU patients will receive discharge planning services, psychiatric consultations, therapeutic counseling, and crisis intervention. The Northeast Tennessee Regional Perinatal Center at JCMC is one of only five state-designated tertiary centers in the State of Tennessee. It is the referral hub for pregnant women in the Northeast Tennessee region who need higher level obstetrical services and/or neonatology services through our Niswonger Childrens Hospital Level III Neonatal Intensive Care Unit. Along with JCMC, Niswonger Childrens Hospital and Franklin Woods Community Hospital also have Perinatal Care Advanced Certification from The Joint Commission the premier healthcare quality improvement and accrediting body in the United States.The perinatal center also provides outreach education - thousands of obstetrics educational hours were provided to patients throughout the region. Over the course of the year, thousands of hours of neonatal education were provided to the region, including high-fidelity patient simulation (HPS). HPS is the use of computerized manikins to simulate real-life scenarios promoting skills acquisition, development of clinical judgement, and simulation of complex clinical situations with lifelike examples. The unreimbursed cost (net of a grant from the State of Tennessee) for these services was $92,602. The Family Birth Centers offer many classes such as: infant care (diapering, swaddling, bathing) proper use of car seats, day care, and choosing a pediatrician; a childbirth preparation multi-week series of classes; a one-day fast-paced childbirth class for those who are unable to attend the series classes; an interactive class to promote family bonding and decrease sibling anxiety; infant CPR; maternal pain management, and postpartum care; and, a class to promote successful newborn breastfeeding. According to the U.S. Department of Health & Human Services, breastfeeding helps protect babies from an array of illnesses. There are also health benefits for the mother including promotion of health and healing after childbirth leading to a lower risk of Type 2 diabetes, certain types of breast cancer, and ovarian cancer. In addition to lactation consultations for inpatients, the JCMC lactation consultants provide education to expectant mothers on benefits of breastfeeding before the delivery at the hospital. Data from a U.S. Department of Health and Human Services Office on Womens Health project in 2013 indicated education to expectant mothers before they come to the hospital for delivery increases the rate of breastfeeding. The lactation consultants strive to reach more women prior to delivery by visiting area OB/GYN practices throughout the year and by engaging in outreach activities such as:Presentations at community breastfeeding conferencesEducation at community health fairsClasses offered at the Health Resources CenterEducation provided for the Nurse-Family Partnership, an East Tennessee State University Department of Nursing program offered to women prior to 28 weeks gestation that follows their children to 2 years of ageBreastfeeding prenatal classes scheduled throughout the year at all Ballad Health hospitalsEducational spots are featured on local television programsStorytelling is proven to improve healing. Based on this evidence, Mountain States Health Alliance started a storytelling program, Healing Moments, at several of the hospitals. The program, produced by International Storytelling Center founder Jimmy Neil Smith, is designed to inspire, relax, and encourage hospital patients and guests with stories from nationally known storytellers and inspiring stories from Ballad Health team members, volunteers and patients. In addition, Conquering Our Challenges includes uplifting stories by Venus Williams, Michael J. Fox and others who are successfully managing or have overcome medical challenges. The program is captioned for the hearing impaired. A JCMC team worked on a process to communicate and educate on palliative care. Palliative care impacts patients by supporting holistic care, symptom management, an improvement in quality of life, and reduces readmissions. The palliative care program works with patients to offer care-planning, complex pain and symptom management and to help patients and their families or significant others navigate difficult situations. Frontline clinical and nonclinical employees complete required education, in the forms of computer-based learnings, staff meetings, handouts and visual aids, to understand palliative care. The team works to help patients and families develop realistic goals for chronic conditions and helps them address the need for a change in treatment philosophy from curative to supportive. Last year, the Regional Cancer Center at JCMC began offering pet therapy for patients. The goal of pet therapy is to ease patients anxiety while receiving chemotherapy. Studies show that dogs reduce fear, pain, anxiety and stress in patients undergoing treatment. All the therapy dogs complete training and receive designation as a certified therapy dog. MSHA offers pet therapy at every hospital. |
| Johnson County Community Hospital | Johnson County Community Hospital (JCCH) is a Critical Access Hospital, a federal designation given to eligible rural hospitals by the Centers for Medicare and Medicaid Services (CMS). Congress created the Critical Access Hospital designation in 1997 in response to a string of rural hospital closures during the 1980s and early 1990s. The designation is designed to reduce the financial vulnerability of rural hospitals and improve access to healthcare by keeping essential services in rural communities. Like many other rural hospitals, JCCH is in a low-income community in one of Tennessees poorest counties. The median income in Johnson County is 35 percent lower than the median income in Tennessee with 33 percent of the children (under 18 years) living in poverty, as contrasted to 42.8 percent of children under 5 years living in poverty, according to U.S. Census 2018 estimates. The county also has an older population with the median age at 46.1 compared to 38.9 for the rest of the state. The primary care physician ratio in Johnson County is 2,960:1 compared to 1,390:1 for the entire state of Tennessee. JCCH operates a rural health and physician specialty clinic inside the hospital. The clinics are a valuable resource to the residents of this rural area. The clinics address transportation issues (other physician offices are located more than an hour away) and access limitations by providing relief to the special health problems of a largely elderly population. The specialty clinic includes oncology and cardiology services. The clinic also provides telemedicine services to include: diabetes, cardiology, and other specialty services. JCCH incurred a loss of $14,390 operating the clinic. The hospital operates, at a loss, an emergency department and a much-needed outpatient behavioral health program for older adults. Outreach programs offered by JCCH include: partnerships with several other organizations, such as GoJoCo, a Johnson County-wide initiative to improve the health of residents by focusing on increasing physical activity, reducing tobacco use, and improving nutrition in the region. JCCH also partnered with A.C.T.I.O.N. to promote education in schools aimed at preventing tobacco and substance use and provided inpatient and outpatient smoking cessation counseling. JCCH sponsored health topics on local radio and supported health fairs and community events. |
| JOHNSON COUNTY, TN: JOHNSON COUNTY COMMUNITY HOSPITAL (JCCH) | Federally designated Critical Access Hospital serving residents of the upper northeast tip of Tennessee, parts of North Carolina and Southwest VirginiaLocated in one of Tennessees poorest counties providing care to the rural and medically underservedOffers 24/7 emergency care, inpatient and outpatient care, cardiac rehabilitation, various diagnostic services, physical therapy, a primary care clinic, and Senior Life Solutions, a behavioral health program for seniors |
| MEDICAL EDUCATION | The Center for Pulmonary Medicine at Johnson City Medical Center presented the annual two-day symposium for respiratory therapists, physicians, nurses, physical therapists, occupational therapists and speech-language pathologists. The event, organized by a multidisciplinary team, was designed to provide the most recent scientific advancements involving the management of pulmonary and critical care patients and futuristic trends. Two tracks were present throughout the two-day conference: one for adult patients and the other for neonatal/pediatrics. Guest speakers covered an array of clinical topics and vendor exhibitors displayed the latest products and technology. The symposium offered continuing education hours for health professionals. MSHA participates in Ballad Healths Nurse Intern II program, overseen by Ballad Healths Clinical Education team. The program pairs each nurse intern with a registered nurse (RN) preceptor on a designated hospital unit. The interns work with their preceptor to gain valuable clinical skills to assist in the transition from nursing student to licensed nurse. The interns are under no obligation to work for Ballad Health although many of them choose to do so. Interns who complete the program become a Nurse Intern III and advance to a Nurse Intern IV upon graduation and move to RN status upon passing of the NCLEX (National Council Licensure Examination). MSHA created an administrative residency program. This program enables recent masters graduates to experience one-on-one training with an administrative leader at Mountain States. The program includes hands-on learning, career planning guidance and practical application of their degree in health administration or business. Each resident has a preceptor for the year-long residency. The residency application process requires letters of recommendation, a high GPA, and phone and panel interviews. The number of graduate applicants was excellent. MSHA serves as an educational environment for the training of medical residents of the James H. Quillen College of Medicine at East Tennessee State University (ETSU). Residents receive supervised, hands-on training in a particular area of expertise, such as primary care or surgery. Hospitals incur significant costs beyond those customarily associated with providing patient care to train residents. In addition to medical residents, MSHA provides training for other Medicare-approved programs including allied health programs for pharmacy and pastoral care. MSHA incurred $6,937,477 in unreimbursed costs for these programs in FY19. MSHA facilities serve as clinical training areas for health professional education students. Dedicated staff work with regional colleges and universities to coordinate the placement of healthcare professional students as part of their educational curriculum. Health care students entering the system are required to have orientation and training. Included in the number of participants receiving clinical experience at MSHA were 1,894 nursing students from various colleges, universities and programs. This nursing clinical experience required extensive MSHA nursing staff involvement at MSHA facilities, with some students also rotating through home health. The clinical setting and hands-on instruction cost MSHA $2,722,675.MSHA provided a clinical setting for another 681 students training in health-related programs such as biomed engineering, radiology, pharmacy, respiratory therapy, physician assistant, nurse practitioner, laboratory, occupational therapy, social work, public health, EMT/paramedic, and other allied-health disciplines. This additional clinical training cost MSHA $1,033,618.Mountain States continues to offer free Certified Nursing Assistant (CNA) classes to the public. The program includes classroom sessions followed by clinical experience. There is no requirement for participants to work for Mountain States upon completion of the program. The training opportunity often leads to job opportunities for graduates of the program. In FY19, over 81 percent of the graduates were hired by MSHA. The Learning Resource Center (LRC), located at Johnson City Medical Center, is a medical library that provides access to medical databases and various print publications. The library subscribes to several online medical databases as well as printed medical education materials, and online journal subscriptions. The medical library is utilized by physicians, nurses, pharmacists, medical residents, nursing students and physical/occupational/speech therapy students. In addition, the LRC provides medical information to patients and patients families, teachers from local schools and to other libraries. The LRC is also available to the general public and responds to many inquiries regarding the hospitals history, physicians histories and the history of medicine for the region as well as the surrounding Appalachian mountain region. Each year, thousands of articles are supplied to numerous patrons. |
| Niswonger Children's Hospital | Niswonger Childrens Hospital (NsCH) continues to offer students virtual access to a physician or nurse practitioner remotely from the school nurses office through Ballad Healths Connected Care telehealth program. More than 100 schools are currently connected to the system to provide care and diagnostics to keep children healthier and in the classroom. Parents enroll their children through their school nurse office. Parents can join the visit through their computer or smartphone, enabling them to be a part of the virtual exam without having to leave work. If a prescription is needed, it is sent electronically to the pharmacy chosen by the parent. The provider and the school nurse will determine if the student needs to recover at home. After the visit is complete, the provider contacts the childs pediatrician or primary care provider to communicate the care provided and determine any necessary follow-up appointments. The program often provides medical services for children who do not normally have access to doctors. Babies born with neonatal abstinence syndrome (NAS) need extra care while they are in the hospital. On average, NAS affects nearly 30 percent of the babies in the neonatal intensive care unit at NsCH. NAS occurs when babies are exposed to addictive substances before birth. Babies with NAS often have high-pitched cries, suffer from tremors and have difficulty eating as they go through withdrawal. To support the parents and relatives of newborns with NAS, NsCH launched its innovative Families Thrive program. The hospital stay at birth offers a unique window of time where mothers are exceptionally focused on their babies needs and futures. Families Thrive offers counseling, a motivational group day, and other activities. Program coordinators facilitate connections to resources that can help mothers and babies after their hospital discharge. The coordinators refer families to programs such as the Tennessee Early Intervention System, as well as outpatient treatment options at local behavioral health centers and pediatricians with NAS expertise. The functions and services of Families Thrive are staffed by Families Free, a local nonprofit organization that provides treatment, intervention services, employment through social enterprise opportunities and support for women and families affected by substance abuse, incarceration and domestic instability. The goal of the program is to provide mothers with treatment plans for narcotic recovery if they are not already in a program. As the babies grow, the goal is that families will continue to connect with ongoing medical and social support to help navigate any challenges associated with NAS.Niswonger Childrens Hospital recognizes that many things influence the health of the people in our region. One of the most important ways to improve the health of the community is through the children. The Childrens Resource Center supports child-related safety, learning, wellness and advocacy. The Center works with many outside groups and organizations, such as the regional Departments of Health in Tennessee and Virginia, to promote comprehensive good health; the school systems and Boys and Girls Clubs to offer additional help in reading skills; and law enforcement, East Tennessee State University and development groups to expose youth to role models and career options to make good life choices. We also collaborate with area organizations working to combat child abuse and address the opioid problem plaguing the service area. Some of our programs include: Dental: a program to increase awareness of the importance of good dental care from birth by collaborating with other dental initiatives. Dental kits including toothbrushes and toothpaste are distributed to resource poor areas and families. Regional School Nursing Conference: co-sponsor, with Kingsport City Schools, annual conference. Local school nurses attend the conference to receive education on various topics, such as diabetes and mental health. Other organizations are invited to participate and promote awareness on services offered to assist school systems. Nurses attending the program receive continuing education credits. Child passenger safety: coordinate with the State of Tennessee through a grant to provide car seats to families receiving government financial assistance within our regionProvided nutrition/health education to kids in a kid-friendly atmosphere of learning at booths at local festivalsThe Morning Mile program is focused on encouraging elementary and middle school students to get in some exercise before classes begin. Exercising before school provides numerous benefits for students such as increased oxygen flow to the brain, reduced stress and improvement in mood. The Childrens Resource Center at NsCH has promoted the Morning Mile for six years. Over 85 schools, throughout Northeast Tennessee and Southwest Virginia, now participate. Partnered with Levis Legacy, a non-profit group, to educate parents and families on water safetyNiswonger Childrens Hospital offers many other programs, activities and events throughout the year. Some of those taking place during FY19 included:Over 200 people attended the fourth annual Scarecrow Skedaddle & Shindig at Founders Park in Johnson City. The day included a 1-mile fun run, a 200-meter modified race and a 5k race. The modified race is designed for those athletes that may require the use of hand-held assistance, walkers, wheelchairs, power chairs or a personal coach. Immediately following the races, the hospital hosted a shindig, including agility challenges, dancing, educational and health-related events, at the parks amphitheater pavilion. Washington County annual Trunk or Treat attracted excited kids in Halloween attire. The event is open to the public and organized by Mountain States team members. Mountain States team members donate candy and treats for the event and volunteer, along with East Tennessee State University students, for the evening event. Patients at NsCH didnt miss Halloween treats and fun. Team members and volunteers throughout our community made sure pediatric patients were not excluded from the holiday festivities. The Spooky Trail, in its eighth year, provided the patients a place to trick-or-treat throughout the hospital. Characters from emojis to super heroes were present. Costumes were donated and made available to ensure each child had a costume. Booths, each with a different fun theme, were present and covered multiple safety topics. The Christmas season was kicked off with the annual tree lighting ceremony, which included storytelling, decorating Christmas ornaments, and Christmas caroling by local talent. An annual toy drive is hosted to ensure children have presents. Thousands of gifts for young patients, including toys for all ages, blankets, books, and even toiletries and necessities for patients parents, were donated by numerous local businesses, schools, and current and former patients and families.Niswonger Childrens Hospital hosts an annual fundraising radiothon. Funds raised have been used to purchase important items such as a pediatric ambulance and incubators as well as the creation of a special unit dedicated to caring for babies born with NAS. Team members, community volunteers, student groups, and community officials come together in the lobby of the hospital to assist with the fundraiser. |
| OTHER ACCOMPLISHMENTS | MSHAs grants and awards department works throughout the year writing grant applications to benefit communities throughout the large service area. Some examples of this reporting period include:Grant renewal to pay the salary and benefits for a medication assistance caseworker to expand a medication assistance program to Norton Community Hospital, serving Wise, Dickenson, and Russell Counties. The program in Southwest Virginia enables the health system to serve uninsured and underinsured patients; thus, playing a significant role in improving patients health, reducing hospital readmissions, and assisting doctors in providing proper treatment to patients who otherwise could be non-compliant with medications due to cost-prohibitive prescriptions.Awarded a grant for Car Seats and Teen Driver Safety to provide car seats to people in the community and to educate teen drivers on safe driving habits (such as dont text and drive). Received a grant that provides funding (in addition to our Ballad Health Cancer Patient Assistance Fund) for 75 additional patients to overcome barriers to breast cancer treatment through meeting their basic needs and/or improving their quality of life (i.e. rent/mortgage, groceries, utilities, transportation vouchers, gas cards, etc.). The Cancer Navigation program provides a single point of contact to help patients coordinate their care and understand their treatment plan. The Navigators often determine obstacles, such as the need for financial assistance, that keep patients from receiving treatment. The Komen/Virginia Blue Ridge Mobile Mammography grant was utilized to provide mammograms to women who may otherwise not receive them due to cost or access issues, along with helping to arrange financial assistance for additional diagnostic studies and further treatment, where applicable. Patients needing additional studies and treatment were assisted by our Cancer Navigators if they did not have a primary care provider.MSHA continues the Value Optimization System (VOS). The goal of the system is to accelerate achievement of patient-centered care to meet patients expectations of high quality, high satisfaction, and efficient care. Each VOS team meets over an intense four-day period to identify waste/inefficiencies, develop an improved work plan, and then implement the plan immediately. The results are referred to as value streams. Specific to FY19, some of the value streams that specifically address improvements in patient health:Franklin Woods Community Hospital (FWCH) worked to implement a process for global communication on inpatient units to expedite the discharge of patients. The team created visual management for the patients journey through the continuum of care. Daily review of the planned discharge date leveraged a multi-disciplinary approach with pharmacy, case management, nursing, and other ancillary departments to ensure the patient is on track for discharge with a coordinated care plan. This plan resulted in a reduction in time from discharge order to patient discharge and improved patient satisfaction. FWCH created a visual management process on the inpatient units to track the status of catheters, oxygen, and central lines. Daily review of these items aided in the reduction of Catheter Associated Urinary Tract Infections and Hospital Acquired Infections. The process reduced potential harm and increased patient safety. The FWCH team created visual management for the patients status and conducted a Room Readiness event to improve communication at the time of patient discharge with Environmental Services (EVS). Standard work was updated for EVS and developed for nursing regarding room prep prior to EVS arrival. Discharge communication was consistently improved by 33%. Time to clean rooms improved dramatically, resulting in decreased hold times for patients being admitted.Indian Path Community Hospital (IPCH) worked to ensure that patients were placed in the right level of care with the Acuity Adjusted Unit (AAU). The project created a unit that housed both the Progressive Care Unit (PCU) and the Intensive Care Unit (ICU) together to better fit the needs of the patients being served. The restructuring of the units ensured the patients were placed in the appropriate level of care upon arrival resulting in less patient movement during the patient stay. The data shows a 600% improvement in the movement within the levels of care within the first 12 hours of admission. IPCH standardized criteria pre-admission testing (PAT) for patients via phone assessments. Pre-admission testing for anesthesia was created for IPCH and Holston Valley Medical Center (HVMC). Prior to this event, IPCH only conducted phone assessments, forcing patients needing an anesthesia consultation prior to surgery to travel to another location. In contrast, HVMC only conducted in-person assessments. The new process provides the same level of care at both facilities, timely flow of care for the patient, and avoids unnecessary patient visits to the hospital. As a result, pre-admission testing length-of-stay at HVMC decreased by 8.9% and day-of-surgery cancellation rates dropped by 13.9%.IPCH created a standard scheduling document for physician offices to ensure required documentation, necessary to schedule a patient procedure, was received at time of scheduling. This resulted in a decrease of incorrect and/or missing patient procedure information and scheduling errors decreased by 51%. IPCH eliminated lengthy patient discharge wait times by implementing several visual/electronic notifications of milestones needed for discharge completion. Durable medical equipment needs are identified earlier, and notifications are sent resulting in equipment delivery to the patient prior to discharge order completion. Surgical pathways and documents providing a tentative daily guide for medical care expectations are provided for nursing staff. These documents are provided to patients to foster transparency and proactively plan the discharge. The time the patient spends in recovery, prior to going to the floor, has decreased by 9.4%. These process improvements have expedited patient discharges.IPCH created a standard process for daily charge reconciliation that ensured that information needed for charge creation and processing is communicated timely and effectively. The new process continues to decrease the number of unbilled claims. |
| Part III, Program Service Accomplishments | Ballad Health (Ballad) is a tax-exempt entity and the parent corporation of both Mountain States Health Alliance (MSHA) and Wellmont Health System (WHS). The two healthcare systems came together on February 1, 2018 as a result of a merger approved by both Tennessee and Virginia Departments of Health. Ballad operates under a Certificate of Public Advantage (COPA) in Tennessee and a Cooperative Agreement (CA) in Virginia. Pursuant to the COPA and CA, MSHA and WHS are required to fulfill the obligations, commitments and covenants set forth in the COPA. Such obligations include that Ballad Health shall meet, over the ten-year period beginning July 1, 2018, established minimum spending criteria on initiatives for expanded access to healthcare services, health research and graduate medical education, population health improvement, and a region-wide health information exchange. The full text of the COPA can be found on the Tennessee Department of Health's website, while the CA can be found on the Virginia Department of Health's website.Ballad Health is a healthcare delivery system serving 1.2 million residents from 29 counties in Northeast Tennessee, Southwest Virginia, Northwest North Carolina, and Southeastern Kentucky. Ballad operates 3,162 licensed beds in 21 hospitals, including a dedicated children's hospital, community hospitals, three critical access hospitals, a behavioral health hospital, an addiction treatment facility, long-term care facilities, home care and hospice services, retail pharmacies, outpatient services and a comprehensive medical management corporation. Form 990 for MSHA includes seven wholly-owned hospitals including a childrens hospital and a behavioral health hospital; four others, majority owned by MSHA, each file a separate return. Laughlin Memorial Hospital, wholly-owned by MSHA, also files a separate return. MSHA is sole shareholder of Blue Ridge Medical Management Corporation (BRMMC), a for-profit entity that owns and manages physician practices and real estate and provides other health care services to patients in Tennessee and Virginia. MSHA is the sole member of Integrated Solutions Health Network, LLC (ISHN). ISHN, also included in this Form 990, is a regional health solutions company headquartered in Johnson City, Tennessee. ISHN is an expansive network of providers serving residents of Northeast Tennessee and Southwest Virginia and consists of provider groups, primary care physicians, specialists, and allied health providers. Specific to the hospitals included in this Form 990, services were provided to: 43,164 inpatients 739,743 outpatient visits 162,833 emergency visits 116,942 home health visits 3,309 deliveries |
| Part VI, Line 15a Compensation Process for Top Official | The executive committee serves as the compensation committee of Ballad Health's Board of Directors. The compensation plan for Alan Levine, Ballad Health's President and CEO, was reviewed and approved by the executive committee. An outside and independent compensation consultant was used to determine his compensation and benefits. Studies and surveys were used to ensure his pay is comparable to like positions at similarly situated organizations. |
| Part VI, Line 15b - Compensation Process for Officers | The executive committee reviewed and approved compensation for all Ballad Health executives at the vice-president level and above during FY19 using the same methodology used to determine the CEO's compensation. |
| PROGRAMS FOR SPECIAL POPULATIONS | One of the Ballad Health Foundations fundraising activities is for the benefit of the Circle of Hope program. The Circle of Hope is a program specifically designed to provide financial assistance to oncology patients in active treatment at one of the Mountain States cancer centers (Johnson City Medical Center, Indian Path Community Hospital, Russell County Hospital, Johnston Memorial Hospital, and Smyth County Community Hospital). The program assists patients with transportation to and from appointments by providing gas cards or transportation vouchers. Other assistance may include mediation assistance, housing, meal vouchers and accommodation stays. The Circle of Hope has assisted head, neck, and throat cancer patients in need of immediate dental care prior to the start of radiation treatment. Thousands of patients have been helped since program inception. MSHA assisted some patients not able to pay for prescriptions at discharge. The unreimbursed cost for these prescriptions was $40,626.MSHA partnered with Bolder Outreach Solutions to assist patients without insurance. Representatives were available for these patients at all MSHA facilities in order to determine sources of possible governmental medical assistance (TennCare or Medicaid) and to assist in the application process and follow-up. 7,442 patients were approved for coverage during FY19. MSHA incurred expense of $879,208 during FY19 to provide this service. |
| PROGRAMS TO IMPROVE CHILDHOOD LITERACY | Since 2014, Niswonger Childrens Hospital has reached outside the hospital walls and into the community to improve child literacy through the B.E.A.R. Buddies reading program, which pairs volunteer mentors with elementary school students who need a boost in their reading skills. When five new schools recently requested to join the program, Ballad Health Chairman and CEO Alan Levine issued a call to Ballad Health team members to help fill the gap. To date, 100 volunteers for the 2020 school year have signed up.Ballad Health is participating in a new initiative called STRONG Kids, which stands for Striving Toward Resiliency and Opportunities for the Next Generation, that brings together and assists regional organizations that support children. The program will enable Ballad Health, Niswonger Childrens Hospital and the Bristol chapter of Speedway Childrens Charities to share ideas and best practices that will help children in the region reach their potential through expanded opportunities in health, education and economic vitality. The partnership is designed to bring a new level of support to these organizations that are on the front lines serving children. |
| Russell County Hospital | Russell County Hospital, located in rural Southwest Virginia, held their seventh annual health fair on the hospital campus. Local physicians and hospital staff were on hand to offer screenings at a reduced cost of $15 to the community. Screenings included complete blood count, chemistry profile (including glucose), lipid profile (including cholesterol) and thyroid test. For an additional $10 a prostate cancer screening (PSA blood work) was provided.Other outreach programs provided by Russell County Hospital include:-Continued to provide medications and supplies to area rescue squads -Provided flu vaccinations to local emergency medical service volunteers and local police departments-Provided free health screenings for Southwest Virginia veterans and health care provider talks on a variety of topics including post-traumatic stress-Partnering with the Ballad Health foundation to provide a Trunk or Treat giving children a safe and fun alternative to traditional door-to-door trick or treating-Supported and encouraged team members to participate in the Relay for Life fundraiser for the American Cancer Society-Participated in October National Breast Cancer Awareness Month events |
| RUSSELL COUNTY, VA: RUSSELL COUNTY HOSPITAL (RCH) | 78-bed acute care hospital located in Southwest Virginia Offers a full array of primary care services and some specialty services such as Clearview Psychiatric Center, hospice care, center for sleep disorders, direct lab testing, and a cancer center |
| SULLIVAN COUNTY, TN: INDIAN PATH COMMUNITY HOSPITAL (IPCH) | 239-bed acute care hospital Provides advanced services including lung nodule clinic, an accredited joint replacement program and a dedicated spine centerCampus offers a regional cancer center, a sleep center for both adults and children, a full range of surgical services, a family birth center and many other service lines Primary stroke center received advanced certification from the Joint Commission Chest pain center is also certified by the Joint Commission |
| Unicoi County Hospital | The new Unicoi County Hospital opened in October 2018. With many rural hospital closures or reductions in services throughout the nation recently, Ballad Health implemented its vision for a new kind of rural health access. The new rural hospital in Unicoi County replaced an aging facility originally constructed in 1953. While the hospital is not financially feasible as a stand-alone entity, Ballad Health committed to keep the communitys hospital open and is introducing new services to the community in a new state-of-the-art facility that houses some of the most advanced technology within the health system. The new hospital features limited, low-acuity inpatient acute care services, a 24-hour emergency department, physician office space, a chest pain center and standard and advanced diagnostics. Among the outpatient diagnostic offerings is CT Scanning, ED mammography and a virtual theater MRI featuring a built-in movie screen and music to create a relaxing virtual experience for patients undergoing scans. The advanced technology encourages patients to remain still longer and results in more efficient, high-quality images and patient satisfaction. The virtual theater MRI is the first of its kind in the Ballad Health system.In addition to these services, the new hospital introduced nuclear medicine services, allowing patients to receive cardiac stress tests close to home. The hospital also offers inpatient cardiology coverage seven days a week.The hospital has a unique partnership with the International Storytelling Center (ISC) to embed a storytelling culture for staff, patients, visitors and the community. The storytelling culture improves patient and staff satisfaction and wellbeing, patient education, and provides more meaningful community engagement. The hospital is working toward an ISC Site of Excellence designation, an honor earned by organizations that incorporate storytelling into their core missions, planning, training programs, programming and community outreach. The designation certifies that Unicoi County Hospital has created a sustainable storytelling culture, one that can be perpetuated through multiple generations. |
| UNICOI COUNTY, TN: UNICOI COUNTY HOSPITAL (UCH) | 10-bed acute care hospital opened in October 2018 Services include 24/7 emergency care, cardiology services, radiology and diagnostic imaging, laboratory, respiratory, sleep lab, and rehabilitation |
| WASHINGTON COUNTY, TN: FRANKLIN WOODS COMMUNITY HOSPITAL (FWCH) | 80-bed acute care hospital First Leadership in Energy and Environmental Design (LEED) certified hospital in Tennessee, setting the precedent for environmentally friendly designs, and named one of Soliant Healths 2016 Most Beautiful HospitalsFirst hospital in Tennessee to earn Perinatal Care Certification from the Joint Commission Achieved the Pathway to Excellence designation by the American Nurses Credentialing Center (ANCC), designating the hospital as one of the best places to work for nursesCertified with The Joint Commission for their Minimally Invasive Colorectal Program - only hospital in Tennessee and one of five hospitals in the nation to have this disease-specific certification |
| WASHINGTON COUNTY, TN: JOHNSON CITY MEDICAL CENTER (JCMC) | 585-bed regional tertiary referral center 432 acute care beds, a 69-bed dedicated childrens hospital and an 84-bed behavioral health hospitalTeaching hospital affiliated with James H. & Cecile C. Quillen College of Medicine at East Tennessee State University (ETSU)Second hospital built in TennesseeLevel I trauma center one of only six in Tennessee Regional Cancer CenterRanked by U.S. News and World Report as one of the top 10 hospitals in Tennessee Niswonger Childrens Hospital (NsCH) is a 69-bed childrens hospital within a hospital located on the campus of Johnson City Medical Center serving more than 200,000 children in the four-state, 29-county region. Regions only dedicated hospital for children providing comprehensive services with access to more than 20 pediatric subspecialties One of only eight clinics in the nation affiliated with St. Jude Childrens Research Hospital located on the campus. Staffed by pediatric hematology-oncology physicians and other clinic support team members, the Tri-Cities affiliate is a partnership among the St. Jude Childrens Research Hospital, East Tennessee State University and NsCH. The outpatient clinic, established in 1999, is part of the St. Jude mission to extend the protocol-structured treatment and research at St. Jude through clinical, research and academic partnerships with pediatric programs. More than 300 children with malignancies are followed each year and more than 3,000 outpatient visits occur annually, including treatment of many children with congenital bleeding disorders and a variety of other hematological problems. The First Regional Hemophilia Program, a state sponsored program for congenital bleeding disorders, is housed in the St. Jude Tri-Cities Affiliate and provides programs for both children and adults with hemophilia. Only childrens hospital in the region affiliated with the Childrens Hospital Association Neonatal intensive care unit, with Level III designation, is one of only five state-designated perinatal centers in Tennessee and is the regional referral center for neonatal patients Regions only pediatric emergency department serving patients from birth to 18 years of age 24 hours a day from specially trained personnel partners with med flight provider to provide a specialty crew for neonates requiring isolette transports The Northeast Tennessee Regional Perinatal Center located at JCMC is one of five state-designated tertiary centers for high-risk maternal fetal care. State designation is based on guidelines for the service provisions and designations of levels of care governed and reviewed by a state appointed committee through Tennessee Department of Health. Woodridge Hospital, a service of JCMC, is an 84-bed inpatient behavioral health hospital serving a wide region in Northeast Tennessee and Southwest Virginia. Woodridge is the only dedicated inpatient behavioral health hospital in the region providing mental health and chemical dependency services for adults, adolescents, and children ages 6 and older. The hospital provides a 24/7 intervention helpline. For three consecutive years, Woodridge has received the Guardian of Excellence Award from Press Ganey Associates, Inc., given to organizations achieving the 95th percentile or higher in designated survey results. |
| Woodridge Hospital | At Woodridge Hospital team members participate in a training program to reduce the use of restraints. The use of restraints can cause injury to patients and staff, psychological harm and loss of dignity. While sometimes restraints are necessary to ensure patient safety, the goal is to use them only when they are absolutely necessary. The focus of the de-escalation program is the early recognition of tension, identifying triggers, de-escalating aggression and implementing safe, effective restraint techniques. With the training, the team is given confidence to handle difficult situations resulting in a dramatic reduction in restraint rates. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Integrated Solutions Health Network | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 509 Med Tech Parkway Suite 100 | AddressLine1Txt |
| City | Johnson City | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37604 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 621711997 | EIN |
| Primary Activities | Hlth Netwk | PrimaryActivitiesTxt |
| Legal Domicile State | TN | LegalDomicileStateCd |
| Total Income | $3,058,391 | TotalIncomeAmt |
| End Of Year Assets | $184,595 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MSHA | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (20 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| MSHA Auxiliary | ||||||||||
| 400 N State of Franklin Road | Johnson City | TN | 37604 | 581418345 | Supp. Org. | TN | 501C3 | 12a | MSHA | Yes (true) |
| Smyth County Community Hospital | ||||||||||
| 245 Medical Park Drive | Marion | VA | 24354 | 540794913 | Hospital | VA | 501C3 | 3 | MSHA | Yes (true) |
| Norton Community Hospital | ||||||||||
| 100 15th Street NW | Norton | VA | 24273 | 540566029 | Hospital | VA | 501C3 | 3 | NA | false |
| Dickenson Community Hospital | ||||||||||
| 312 Hospital Drive | Clintwood | VA | 24228 | 770599553 | Hospital | VA | 501C3 | 3 | NCH | false |
| Johnston Memorial Hospital | ||||||||||
| 16000 Johnston Memorial Drive | Abingdon | VA | 24211 | 540544705 | Hospital | VA | 501C3 | 3 | NA | false |
| Abingdon Physician Partners | ||||||||||
| 16000 Johnston Memorial Drive | Abingdon | VA | 24211 | 205485346 | Med. Serv. | VA | 501C3 | 12a | JMH | false |
| Ballad Health | ||||||||||
| 303 Med Tech Parkway Suite 220 | Johnson City | TN | 37604 | 611771290 | Supp. Org. | TN | 501C3 | 12b | NA | false |
| East TN Healthcare Holdings Inc | ||||||||||
| 203 Gray Commons Circle | Gray | TN | 37615 | 815475903 | Opioid Trt | TN | 501C3 | 3 | MSHA | Yes (true) |
| Wellmont Health System | ||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621636465 | Hosp. Sys. | TN | 501C3 | 3 | BALLAD | false |
| Wellmont Hawkins Co Memorial Hosp | ||||||||||
| 851 Locust Street | Rogersville | TN | 37857 | 621816368 | Hospital | TN | 501C3 | 3 | WHS | false |
| Takoma Regional Hospital Inc DBA GCH | ||||||||||
| 1420 Tusculum Boulevard | Greeneville | TN | 37745 | 510603966 | Hospital | TN | 501C3 | 3 | WHS | false |
| Wellmont Cardiology Services | ||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 263557623 | Med. Serv. | TN | 501C3 | 10 | WHS | false |
| Wellmont Medical Associates | ||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 270898372 | Med. Serv. | TN | 501C3 | 7 | WHS | false |
| Ballad Health Foundation | ||||||||||
| 1019 West Oakland Ave Suite 2 | Johnson City | TN | 37604 | 581594191 | Fundraiser | TN | 501C3 | 7 | BALLAD | false |
| Wellmont Madison House | ||||||||||
| 2000 Greenway Street | Kingsport | TN | 37660 | 621308216 | Asst. Liv. | TN | 501C3 | 10 | WHS | false |
| Wellmont Wexford House | ||||||||||
| 2421 N John B Dennis Hwy | Kingsport | TN | 37660 | 581859039 | Nsg. Home | TN | 501C3 | 10 | WHS | false |
| Wellmont Imaging Services Inc | ||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 861103148 | Healthcare | TN | 501C3 | 12a | WHS | false |
| Wellmont Sleep Services | ||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 273777167 | Med. Serv. | TN | 501C3 | 3 | WHS | false |
| Laughlin Memorial Hospital Inc | ||||||||||
| 1420 Tusculum Boulevard | Greeneville | TN | 37745 | 620701119 | Hospital | TN | 501C3 | 3 | MSHA | Yes (true) |
| Laughlin Healthcare Foundation | ||||||||||
| 1420 Tusculum Boulevard | Greeneville | TN | 37745 | 582105493 | Fundraiser | TN | 501C3 | 12a | MSHA | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Emmaus Community Healthcare PLLC | |||||||||||||
| 6070 Hwy 11E | Piney Flats | TN | 37686 | 200577483 | Med. Serv. | TN | NA | N/A | false | false | |||
| Medical Specialists of JC LLC | |||||||||||||
| 2528 Wesley Street Suite 2 | Johnson City | TN | 37601 | 272199037 | Med. Serv. | TN | MSHA | excluded | false | false | -$304,442 | $290,188 | 0.51000 |
| East TN Ambulatory Surgery Cntr | |||||||||||||
| 701 Med Tech Parkway Suite 100 | Johnson City | TN | 37604 | 621787537 | Med. Serv. | TN | NA | N/A | false | false | |||
| Greeneville Physician Services LLC | |||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 455070419 | Med. Serv. | TN | NA | Related | false | false | -$14 | $81,260 | 0.25000 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (15 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Blue Ridge Medical Management Corp | ||||||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621490616 | Med. Serv. | TN | MSHA | C | $150,465,309 | $228,009,590 | 1.00000 | false | ||||||
| Mediserve Medical Equipment | ||||||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621212286 | DME | TN | BRMMC | C | $379,349 | $4,924,892 | 1.00000 | false | ||||||
| Mountain States Properties | ||||||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621845895 | Prop. Mgmt. | TN | BRMMC | C | $17,456,548 | $147,692,320 | 1.00000 | false | ||||||
| Mountain States Physician Grp | ||||||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621700412 | Med. Serv. | TN | BRMMC | C | $74,592,246 | $7,348,809 | 1.00000 | false | ||||||
| Community Home Care Inc | ||||||||||||||||||
| 1490 Park Avenue NW Suite B | Norton | VA | 24273 | 541453810 | DME | VA | NCH | C | $178,353 | $461,624 | 0.50100 | false | ||||||
| Wilson Pharmacy Inc | ||||||||||||||||||
| PO Box 5289 | Johnson City | TN | 37604 | 620329587 | Pharmacy | TN | BRMMC | C | $6,269,865 | $6,591,077 | 1.00000 | false | ||||||
| Crestpoint Health Insurance Company | ||||||||||||||||||
| 509 Med Tech Parkway Suite 100 | Johnson City | TN | 37604 | 620381170 | Insurance | TN | ISHN | C | $180,945 | $1,464,726 | 1.00000 | false | ||||||
| Wellmont Inc | ||||||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621320035 | Med. Serv. | TN | NA | C | false | |||||||||
| Wellmont Collections Inc | ||||||||||||||||||
| 2004 American Way Suite 101 | Kingsport | TN | 37660 | 621325938 | Bus. Serv. | TN | NA | C | false | |||||||||
| Medical Mall Pharmacy Inc | ||||||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621565006 | Med. Serv. | TN | NA | C | false | |||||||||
| Wellmont Physician Services | ||||||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621567353 | Med. Serv. | TN | NA | C | false | |||||||||
| WPS Providers Inc | ||||||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 205564642 | Med. Serv. | TN | NA | C | false | |||||||||
| Wellmont Health Services Inc | ||||||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621254373 | Med. Serv. | TN | NA | C | false | |||||||||
| Nolichuckey Mgmt Svcs Inc | ||||||||||||||||||
| 1420 Tusculum Blvd | Greeneville | TN | 37745 | 621776681 | Med. Serv. | TN | LMH | C | 1.00000 | false | ||||||||
| Wellmont Insurance Co SPC LTD | ||||||||||||||||||
| 981195624 | Insurance | C | false | PO Box 30600 | Grand Cayman | CJ | KY1-1203 | CJ | N/A | |||||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (true) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | Yes (true) | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | Yes (true) | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (22 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Smyth County Community Hospital | ||
| q | $183,894 | Cost |
| Norton Community Hospital | ||
| o | $230,587 | Cost |
| Norton Community Hospital | ||
| q | $233,193 | Cost |
| Dickenson Community Hospital | ||
| o | $75,480 | Cost |
| Johnston Memorial Hospital | ||
| h | $164,683 | FMV |
| Johnston Memorial Hospital | ||
| p | $112,252 | Cost |
| Ballad Health Foundation | ||
| c | $318,925 | Cash |
| Blue Ridge Medical Management Corp | ||
| a | $399,340 | FMV |
| Blue Ridge Medical Management Corp | ||
| g | $1,195,000 | FMV |
| Blue Ridge Medical Management Corp | ||
| l | $423,797 | FMV |
| Blue Ridge Medical Management Corp | ||
| m | $44,150,883 | FMV |
| Blue Ridge Medical Management Corp | ||
| o | $284,987 | Cost |
| Blue Ridge Medical Management Corp | ||
| q | $1,129,730 | Cost |
| Blue Ridge Medical Management Corp | ||
| r | $233,944 | Cash |
| Blue Ridge Medical Management Corp | ||
| s | $274,681 | Cash |
| Mediserve Medical Equipment | ||
| k | $158,025 | FMV |
| Mediserve Medical Equipment | ||
| o | $53,433 | Cost |
| Mountain States Properties | ||
| k | $1,273,336 | FMV |
| Mountain States Properties | ||
| m | $151,685 | FMV |
| Mountain States Properties | ||
| o | $390,687 | Cost |
| Wilson Pharmacy Inc | ||
| o | $317,619 | Cost |
| Wilson Pharmacy Inc | ||
| q | $694,248 | Cost |