DICKENSON COMMUNITY HOSPITAL INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- DICKENSON COMMUNITY HOSPITAL INC (EIN 77-0599553)
- Tax period
- 2018-07-01 to 2019-06-30
- Filed
- 2020-07-09
- IRS object ID
- 202021919349301412
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-07-09T07:48:01-07:00 | 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 | 770599553 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Dickenson Community Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | DICK | BusinessNameControlTxt |
| Phone | 2769260319 | 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 | Stephen Sawyer | PersonNm |
| Person Title | CFO NW Region | PersonTitleTxt |
| Signature | 2020-07-08 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-09-23 17:36:50Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Mark Leonard | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 15th Street NW | AddressLine1Txt |
| City | Norton | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 24273 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $8,384,820 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| All Affiliates Included | false | AllAffiliatesIncludedInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.balladhealth.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2003 | FormationYr |
| Legal Domicile State | VA | 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 | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $51,758 | PYContributionsGrantsAmt |
| CY Contributions Grants | $8,785 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $9,351,031 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $8,338,451 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,622 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,044 | CYInvestmentIncomeAmt |
| PY Other Revenue | $11,724 | PYOtherRevenueAmt |
| CY Other Revenue | $35,361 | CYOtherRevenueAmt |
| PY Total Revenue | $9,416,135 | PYTotalRevenueAmt |
| CY Total Revenue | $8,383,641 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $3,114 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $5,564,824 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,499,189 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,291,996 | PYOtherExpensesAmt |
| CY Other Expenses | $4,154,822 | CYOtherExpensesAmt |
| PY Total Expenses | $9,856,820 | PYTotalExpensesAmt |
| CY Total Expenses | $9,657,125 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$440,685 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,273,484 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,916,837 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,761,236 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $914,618 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $852,504 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,002,219 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,908,732 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Our mission is to honor those we serve by delivering the best possible care. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $3,932,442 | ExpenseAmt |
| Revenue | $3,909,446 | RevenueAmt |
| Desc | Emergency Services: Our fully staffed 24-hour emergency department is available for patients in a life threatening situation. We can provide air medical transportation to a larger regional hospital for any patient needing a higher level of care. There were 7,153 ED visits during FY19. Almost half of DCH's ER visitis are Medicaid/Self Pay. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,963,567 | ExpenseAmt |
| Revenue | $1,964,892 | RevenueAmt |
| Desc | Behavioral Health: Our 10-bed inpatient behavioral health unit (Green Oak Behavioral Health) focuses on senior citizens and is the only inpatient behavioral health unit in Southwest Virginia specifically for older adults. We also continue to offer our outpatient behavioral health program, Senior Life Solutions. There were 235 inpatient admissions and 2,239 outpatient visits during FY19. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $733,033 | ExpenseAmt |
| Revenue | $954,376 | RevenueAmt |
| Desc | Laboratory: Our experienced staff offers complete and comprehensive services including: outpatient services, stat testing, comprehensive chemistry studies, occupational drug testing, high sensitive coumadin monitoring, transfusion services, and more. We provide lab services 24 hours a day, 7 days a week. During FY19, 68,754 lab tests were processed. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $42,330 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $1,522,277 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $7,671,372 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | 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 | Yes (true) | 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 | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | 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 | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 24 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Employment Tax Returns Filed | false | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | false | 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 | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| Monty McLaurin CEO NW MKT | |||||||||
| Director | 0.50 | 44.50 | Yes (X) | $0 | $558,099 | $42,029 | |||
| Shane Hilton SVP Market Oper | |||||||||
| Director | 0.50 | 49.50 | Yes (X) | $0 | $530,280 | $73,798 | |||
| Donald Baker Chair | |||||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Robert Leonard SecTreasurer | |||||||||
| Director | 1.00 | 2.00 | Yes (X) | $0 | $11,711 | $0 | Yes (X) | ||
| James Manicure Vice-Chair | |||||||||
| Director | 1.00 | 2.00 | Yes (X) | $0 | $5,946 | $0 | Yes (X) | ||
| Paul Buchanan | |||||||||
| Director | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Teddy Bailey | |||||||||
| Director | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Susan Wood | |||||||||
| Director | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Ernie Ward | |||||||||
| Director | 0.50 | 1.50 | Yes (X) | $0 | $1,260 | $0 | |||
| Michael Strouth | |||||||||
| Director | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Mark Leonard | |||||||||
| DCH/NCH CEO | 22.00 | 23.00 | $0 | $302,476 | $51,631 | Yes (X) | |||
| Stephen Sawyer | |||||||||
| CFO NW Region | 2.00 | 43.00 | $0 | $244,949 | $32,397 | Yes (X) | |||
| Mark Vanover | |||||||||
| AVP Operations | 45.00 | 0.00 | $0 | $135,181 | $7,045 | Yes (X) | |||
| Roy Deal DO | |||||||||
| Physician | 40.00 | 0.00 | $0 | $274,377 | $20,970 | Yes (X) | |||
| Heather Blair NP | |||||||||
| Nurse Practioner | 40.00 | 0.00 | $0 | $138,489 | $3,411 | Yes (X) | |||
| Justin Ivory | |||||||||
| Former DCH/NCH CFO | 0.00 | 40.00 | $0 | $120,052 | $13,425 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Reportable Comp Rltd Org | $2,322,820 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $244,706 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Western VA Regional Emergency Physicians LLC | |||||
| 200 Corporate Blvd | Lafayette | LA | 70508 | ED Physician Svcs | $2,005,772 |
| Psychiatric Medical Care LLC | |||||
| PO Box 305172 Dept 141 | Nashville | TN | 372305172 | Mgmt/Director Fees | $545,681 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $8,785 | RelatedOrganizationsAmt |
| Total Contributions | $8,785 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| 340B Program | 900099 | $42,264 | $42,264 | |
| Patient Services | 900099 | $8,249,800 | $8,249,800 | |
| Peformance & MSSP Payment | 900099 | $35,442 | $35,442 | |
| Rental Inc T/E Affiliate | 900099 | $10,945 | $10,945 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $8,338,451 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,223 | TotalRevenueColumnAmt |
| Exclusion | $2,223 | 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 |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,179 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$1,179 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,179 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$1,179 | 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 | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| Hosp. Improvement Network | 900099 | $9,644 | $9,644 | |
| Revenue from Parent | 900099 | $20,592 | $20,592 | |
| Unclaimed Prop. Recovery | 900099 | $4,072 | $4,072 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,053 | TotalRevenueColumnAmt |
| Exclusion | $1,053 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $35,361 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,383,641 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,350,991 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $23,865 | 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 | $3,114 | TotalAmt |
| Program Services | $3,114 | 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 | $72,403 | TotalAmt |
| Management And General | $72,403 | 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 | $4,365,768 | TotalAmt |
| Program Services | $3,473,104 | ProgramServicesAmt |
| Management And General | $892,664 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,441 | TotalAmt |
| Program Services | $95,440 | ProgramServicesAmt |
| Management And General | $24,001 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $667,365 | TotalAmt |
| Program Services | $441,344 | ProgramServicesAmt |
| Management And General | $226,021 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $274,212 | TotalAmt |
| Program Services | $249,073 | ProgramServicesAmt |
| Management And General | $25,139 | 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 | $3,500 | TotalAmt |
| Management And General | $3,500 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
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 | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,155,251 | TotalAmt |
| Program Services | $2,045,344 | ProgramServicesAmt |
| Management And General | $109,907 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,314 | TotalAmt |
| Program Services | $4,317 | ProgramServicesAmt |
| Management And General | $8,997 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $117,527 | TotalAmt |
| Program Services | $98,629 | ProgramServicesAmt |
| Management And General | $18,898 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $161,210 | TotalAmt |
| Program Services | $117,323 | ProgramServicesAmt |
| Management And General | $43,887 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,853 | TotalAmt |
| Program Services | $24,075 | ProgramServicesAmt |
| Management And General | $5,778 | 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 | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $324,906 | TotalAmt |
| Program Services | $276,155 | ProgramServicesAmt |
| Management And General | $48,751 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,138 | TotalAmt |
| Program Services | $9,277 | ProgramServicesAmt |
| Management And General | $861 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Management Fees to Parent | $481,303 | $17,233 | $464,070 |
| Medical Supplies and Drugs | $442,538 | $442,538 | |
| Repairs and Maintenance | $366,220 | $349,737 | $16,483 |
| Dues & Subscriptions | $18,388 | $5,878 | $12,510 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,674 | TotalAmt |
| Program Services | $18,791 | ProgramServicesAmt |
| Management And General | $11,883 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,657,125 | TotalAmt |
| Program Services | $7,671,372 | ProgramServicesAmt |
| Management And General | $1,985,753 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,331,408 | BOYAmt |
| EOY | $841,180 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,484,291 | BOYAmt |
| EOY | $1,463,901 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $170,590 | BOYAmt |
| EOY | $207,815 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $65,725 | BOYAmt |
| EOY | $11,174 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $5,319,749 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,966,474 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,451,285 | BOYAmt |
| EOY | $1,353,275 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,413,538 | BOYAmt |
| EOY | $883,891 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,916,837 | BOYAmt |
| EOY | $4,761,236 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $413,239 | BOYAmt |
| EOY | $471,293 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $501,379 | BOYAmt |
| EOY | $381,211 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $914,618 | BOYAmt |
| EOY | $852,504 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,995,034 | BOYAmt |
| EOY | $3,896,547 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,185 | BOYAmt |
| EOY | $12,185 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,002,219 | BOYAmt |
| EOY | $3,908,732 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,916,837 | BOYAmt |
| EOY | $4,761,236 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,273,484 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $179,997 | 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 D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $959,371 | OtherCostOrOtherBasisAmt |
| Depreciation | $430,360 | DepreciationAmt |
| Book Value | $529,011 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $557,291 | OtherCostOrOtherBasisAmt |
| Depreciation | $525,739 | DepreciationAmt |
| Book Value | $31,552 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,803,087 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,010,375 | DepreciationAmt |
| Book Value | $792,712 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,353,275 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Due from Affiliates | $873,323 |
| Other Receivables | $10,568 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $883,891 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| Due to Third-Party Payors | $133,946 |
| Reserve for Professional Liabiliities | $41,140 |
| Retiree Health Care Benefits | $157,265 |
| Retiree Pension Payable | $48,860 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $381,211 | 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 | Dickenson Community Hospital 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 | $30,974 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $30,974 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00320 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,093,031 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,096,352 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $996,679 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10320 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,124,005 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,096,352 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,027,653 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10640 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $32,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,177 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $29,823 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00310 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $30,033 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $30,033 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00310 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,987,816 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,809,403 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,178,413 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12200 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $221 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $221 | NetCommunityBenefitExpnsAmt |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,115 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,115 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,053,185 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,811,580 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,241,605 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12850 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,177,190 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,907,932 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,269,258 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.23490 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,214,685 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $449,433 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $1,422,775 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $1,381,141 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $41,634 | 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 |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Dickenson Community Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1440 | AddressLine1Txt |
| City | Clintwood | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 24228 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | balladhealth.org/locations | WebsiteAddressTxt |
| State License | H 1918 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | Mental Health | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Dickenson Community Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | 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 | www.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 | www.balladhealth.org | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | www.balladhealth.org | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | www.blladhealth.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: Dickenson Community Hospital - Part V, Section B, Line 3j | During FY19, DCH was operating under the CHNA approved by its board of directors at the end of FY18. Priorities established for their CHNA were determined by the most significant health needs of the community. MSHA hospitals, including DCH, conducted their fourth CHNA this tax reporting period with board approval and publication occurring during FY19. For the FY18 CHNA, Ballad Health 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 CHNA 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, our health system's parent, when completing their individual FY19 CHNA's.To understand each community's individual needs, Ballad Health conducted a community health needs assessment (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 Dickenson County CHNA community members evaluated measures that make up DCH's population health index and a few additional measures related to access to health screenings. The Dickenson County group's members completed a survey relative to what health priorities should be a focus for their specific community over the next three years. After all the details and data collection was complete and interviews with various focus groups were complete, the Dickenson County representatives identified three top focus areas:-Smoking-Physical Activity/Obesity-Substance Abuse |
| Facility: Dickenson Community Hospital - Part V, Section B, Line 5 | As part of the FY18 CHNA process, MSHA hospitals 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 DCH's community were selected for participation by the hospital's CEO. The DCH focus group members were represented by Virginia Department of Health, Health Wagon of Southwestern Virginia, Mountain States Health Alliance Government Relations, Dickenson County Department of Social Services, Lenowisco Health District, Dickenson Medical Associates, Dickenson County Behavioral Health Services, Dickenson County Public Schools, Dickenson Community Board and Dickenson Community Foundation Board. Low income, minority and medically underserved populations were represented by Virginia Department of Health, Lenowisco Health District and Health Wagon of Southwestern Virginia. Also, between the foundation board and the community board, there are a number of individuals that sit on these boards that represent low income, minority populations, and medically underserved.Activities associated with the June 2018 assessment took place from fall of 2017 through the spring of 2018. Community members from Dickenson County met with Ballad Health and DCH representatives to discuss health priorities and identify potential solutions. Community members were made aware of the 25 measures that make up Ballad Health's population health index plus 3 additional measures related to access to health screening. Participants then completed a survey to indicate their opinion on what health priorities should be a focus for their community. |
| Facility: Dickenson Community Hospital - Part V, Section B, Line 6a | Each hospital within Mountain States Health Alliance completed a CHNA. DCHs CHNA was conducted with all MSHA hospitals to include: 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 Medical Center, Smyth County Community Hospital, Sycamore Shoals Hospital, and Unicoi County Hospital. |
| Facility: Dickenson Community Hospital - Part V, Section B, Line 11 | During the year, DCH continued to focus on its CHNA priorities as identified in its FY18 CHNA report. DCHs primary areas of focus included: diabetes, obesity, mental health and substance abuse. Many additional community needs exist in our region. 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. DCH also lends support to other nonprofit organizations by serving on their boards, committees, and assisting with fundraising efforts. DCH reached out to the Dickenson County School System in partnership for education on diabetes. DCH became a member of the school systems Wellness Committee.DCH coordinated with Clintwood Elementary School for implementation of The Morning Mile, and worked to engage the other county elementary schools in the same program. The Morning Mile program is focused on encouraging elementary and middle school students to get 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. DCH presented education materials to physicians, community groups, nursing homes and assisted living facilities regarding need and benefits of treatment of psychiatric issues in the community. DCH worked with the Dickenson Countys Sheriffs Department for pill round-up program for out-of-date medications and to assist with proper needle disposal. DCH became a pilot site for the Virginia Rural Health Association High Risk Patient Education Program (HRPEP) for substance abuse. The HRPEP targets rural communities in Virginia for preventative intervention regarding prescription opioids through a training and education program. The HRPEP training provided to entities such as DCH includes curriculum training to identify high-risk patients, provide training to high-risk patients and their families, provide medication assistance, refer patients to pain management clinics when appropriate, and provide public education about risks and how to respond to opioid overdose. DCH will select staff members to receive the HRPEP training.DCH provided medications and supplies to area rescue squads this year. |
| Facility: Dickenson Community Hospital - Part V, Section B, Line 13h | Ballad Healths 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 Healths financial assistance policy. |
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 Medicaid/TennCare benefits, those who qualified for Medicaid/TennCare 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 (including DCH) that provide 62%. 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. |
| 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 Medicaid/TennCare reported on line 7b, with the exception of our physician clinic. We used the cost to charge ratio for our physician clinic because its data is not available in our cost accounting system. Line 7e community health improvement includes costs associated with payments to an unrelated, outside organization that assisted DCH patients obtain Medicaid coverage.Line 7f health professions education is comprised of nursing and other allied health students from schools and universities, allowing their health profession students to receive hands-on training in a hospital setting. For line 7g subsidized health services, we use our cost accounting system, except for the $196,425 subsidy of our owned and operated clinic located in a rural, low income area. For our physician clinic, the departmental operating report is used to determine the subsidy. We are careful to ensure no double counting of cost. |
| 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, Medicaid, 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, DCH 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 DCHs 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. 97% of completed financial assistance applications processed during FY19 received a full discount (complete write-off). An additional 3% received a partial discount, resulting in an overall approval rate of 100% for completed applications. Therefore, no 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 DCH pays to process charity care applications for uninsured patients and to offer patients enrollment assistance in Medicaid (VA) or TennCare (TN). 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. DCH 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 included a footnote on page 13 that describes bad debt. DCH 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 DCH'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 hospitals' collection program includes communicating expected financial responsibility prior to service. Our hospital 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 Medicaid or TennCare.After insurance benefit verification, the hospital bills 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 hospital provides 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 hospital accepts 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 so 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 hospitals 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 last year. 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 Healths 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, DCH 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 DCH 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 Department 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 Medicaid or TennCare, 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 | DCH is located in Clintwood, Dickenson County, which is in rural southwest Virginia. Southwest Virginia (SWVA) is located within the Appalachian Mountains, specifically the Blue Ridge mountain region. SWVA is considered rural and much different than the rest of the state. SWVA has been and remains a major coal mining region and has a high rate of uninsured adults. According to U.S. Census Bureau estimates, the Town of Clintwood has a population of 1,434, while Dickenson Countys population is 14,782. The latest census bureau data estimates the median age of residents of Dickenson County is 44.3 which is older than the median age of 38.3 in Virginia. 21.3% of Dickenson Countys residents are 65 or older compared to almost 15.5% for the state. While the overall population of Dickenson County is projected to remain relatively flat over the next five years the 65+ age group is expected to grow significantly over the same five-year period. The aging population of the county presents opportunities for earlier identification and better management of health conditions that oftentimes affect elderly populations in rural areas.The bureau estimates Dickenson County median household income at $33,400 compared to $72,577 for the state of Virginia. 31% of Dickenson County's children live in poverty compared to 14% statewide. Dickenson County is 100% rural compared with the statewide rural rate of 24.5%. This factor is a significant contributing factor in influencing health outcomes in a population. Many rural residents must travel a greater distance to access different points of the health care delivery system; however, 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. More than 50% of vehicle crash-related fatalities occur in rural areas, even though less than one-third of miles traveled in a vehicle occur there and there is an additional 22% risk of injury-related deaths in rural communities. Within our own county, injury deaths are more than double the statewide rate. And, while our area has generally unfavorable health statistics, there are far fewer primary care physicians per resident in our county than the states average. Our countys ratio of population to primary care physicians is 3,740:1 compared to the states average of 1,310:1. In other words, we have 185% more residents per physician than the overall state rate. Because of the severe primary care physician shortage in our area, DCH continues to operate a physician clinic despite financial loss.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 education, 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.A number of factors contribute to a unique and challenging environment that influence overall health standing in our county. According to the Robert Wood Johnson foundations county health rankings, 36% of the adults in DCHs home county are obese. 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. Dickenson Countys adult smoking rate is 33% higher than that of Virginias 0average. According to the 2019 County Health Rankings, Dickenson County is ranked 117th out of 133 counties in Virginia for health outcomes and 116th (down from 112th in 2018) in health behaviors. As for social and economic factors, Dickenson County ranks 130th primarily due to high rates of children in poverty and above average unemployment rates. |
| Part VI, Line 4 - Community Building Activities | DCH 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 DCH 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.DCH, 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 | DCH is dedicated to operating efficiently so that waste is minimized. In most years, DCH does not enjoy net operating surpluses and relies on subsidization from Norton Community Hospital. Various checks and balances are established to ensure that expenditures for operating expenses and capital costs are reasonable and necessary.The majority of DCH's governing body is comprised of persons who reside in the organization's primary service area. Only two directors; Shane Hilton, and Monty McLaurin, employees of Ballad Health, live outside of the area. Physicians that request privileges who are qualified and credentialed are extended privileges by DCH. |
| Part VI, Line 6 - Affilated Health Care System | DCH is a federally designated critical access hospital operated under the direction of a 9-member board of directors primarily comprised of local community residents. The hospital operates 1 acute bed and a 10-bed behavioral health unit. DCH is owned by Norton Community hospital (NCH). DCH has a loan agreement with NCH that provides for NCH to assist in subsidizing DCHs operating expenses. DCH is one of the hospitals within the Ballad Health system. Ballad Health operates a family of 21 hospitals, including three tertiary care facilities, a dedicated childrens 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. DCH serves as the county's primary health service provider. Patients benefit from DCHs affiliation with a healthcare system where they can be efficiently moved along an integrated, comprehensive continuum of care as their health status dictates. If need be, patients can be moved to one of Ballad Healths tertiary care facilities providing advanced treatment options.DCH operates a 24-hour emergency department to treat patients in life threatening situations. For any patient who needs a higher level of care than DCH can provide, air medical transportation is available through Med-Trans (Wings Air Rescue), based in Jenkins, Kentucky, or Ballad Health One Air Ambulance, based in Tennessee, and can quickly respond and have any patient transported to Norton Community hospital (7 minutes), Johnson City Medical Center (20 minutes) and other regional hospitals when minutes count. 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 | VA TN |
| Part VI - Additional Information | Ballad Health is required to report community benefit estimates on a quarterly basis with the states of Virginia and Tennessee. The reporting includes all of Ballad Health hospital organizations and is reported using IRS Form 990, Schedule H instructions for reporting community benefit. Ballad Health operates under a Cooperative Agreement (CA) in Virginia and a Certificate of Public Advantage (COPA) in Tennessee as obligated by agreements between Ballad and the two states to allow Mountain States Health Alliance and Wellmont Health System to merge. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | 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 (6 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|
| Justin Ivory | |||||||
| Former DCH/NCH CFO | $106,743 | $13,309 | $1,823 | $11,602 | $133,477 | ||
| Mark Leonard | |||||||
| DCH/NCH CEO | $269,210 | $18,266 | $30,434 | $21,197 | $354,107 | $15,000 | |
| Monty McLaurin CEO NW MKT | |||||||
| Director | $357,053 | $43,422 | $18,299 | $23,730 | $600,128 | $157,624 | $16,160 |
| Roy Deal DO | |||||||
| Physician | $199,744 | $20,854 | $3,970 | $17,000 | $295,347 | $53,779 | |
| Shane Hilton SVP Market Oper | |||||||
| Director | $356,020 | $3,500 | $50,554 | $23,244 | $604,078 | $170,760 | |
| Stephen Sawyer | |||||||
| CFO NW Region | $182,298 | $15,364 | $10,709 | $21,688 | $277,346 | $47,287 | |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, Line 4d: Other Program Services Description | OTHER PROGRAM SERVICES 4: Dickenson Community Hospital (DCH) is a federally designated critical access hospital. Federal critical access hospital designation requires that a hospital be small and located in a rural area and located more than a 35-mile drive from another hospital or more than a 15-mile drive from another hospital in an area with mountainous terrain or only secondary roads, and be state-designated as a necessary provider of health care services to residents in the area. DCH is the only hospital located in Dickenson County, with the next nearest hospitals located a 45-minute drive away. DCH is a wholly-owned subsidiary of Norton Community Hospital (NCH). NCH has two members: Mountain States Health Alliance (50.1%) and Community Healthcare Foundation (49.9%). In February 2018, Mountain States Health Alliance (MSHA) and Wellmont Health System (WHS) merged to form Ballad Health, a tax-exempt entity and parent company of MSHA and WHS. Ballad operates 3,162 licensed beds in 21 hospitals, an outpatient addiction treatment facility, long-term care facilities, home care and hospice services, retail pharmacies, outpatient services and a comprehensive medical management corporation.During FY19, we experienced 7, 153 visits to our ER, 26,032 outpatient visits an increase of 11% over FY18, and 261 inpatient admissions.PROMOTE COMMUNITY HEALTHDickenson Community Hospital continues to subsidize a rural physician clinic to provide some relief of the physician shortage in our area. Our FY19 subsidy was just over $196,000. The primary care physician ratio in our county (number of residents to 1 primary care physician) is 185% higher than the overall state ratio. Recruiting physicians to a rural county such as ours 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 Association of American Medical Colleges (AAMC) issued a press release dated April 11, 2018 stating that the United States could see a shortage of up to 120,000 physicians by 2030. The U.S. population is estimated to grow by nearly 11%, with those over age 65 increasing 50% by 2030. Much of the increased demand comes from a growing, aging population. The aging population will also affect physician supply since one-third of all currently active doctors will be older than 65 in the next decade and likely to retire. The AAMC points out that data conducted in 2017 indicated that an additional 31,600 physicians would have been needed if underserved populations utilized the same health care services as insured individuals. The data looked at people in non-metropolitan areas and people without insurance compared to people living in metropolitan areas. Furthermore, the study indicated nearly half of the shortage was in the South. DCH spent $3,723 during FY19 to recruit and retain physicians. DCH recruitment efforts are based on documented community need. DCH is located in a MUA (medically underserved area), as designated by the U.S. Health Resources & Services Administration (HRSA). MUA designation indicates an area as: having too few primary care providers, having a high infant mortality, a high poverty rate or a high elderly population.As the sixth leading cause of death in the United States, Alzheimer's disease is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks. According to the National Institute on Aging, the number of people diagnosed is increasing each year. Alzheimer's is one of the many conditions treated at our Green Oak behavioral health unit, which focuses on senior citizens and the elderly. Green Oak is the only inpatient behavioral health unit in Southwest Virginia specifically for older adults. The unit, in conjunction with our outpatient Senior Life Solutions program, treats patients over the age of 55, and some over the age of 45 (on a case-by-case basis), keeping families that would normally have to travel for these services close to home. Green Oak is a 10-bed inpatient unit. During FY19, there were 235 admissions. The population in our region is aging and with the next closest inpatient behavioral facility about two hours away, Green Oak provides care close to home for patients from Southwest Virginia and Southeastern Kentucky.Senior Life Solutions, our outpatient behavioral health program, allows seniors access to behavioral health services without having to travel outside of the area. 21% of our residents are 65 years of age or older and with mountainous terrain especially dangerous in winter months, residents needing behavioral health services previously had to leave the area or do without needed care. Similar to our Green Oak inpatient unit, the benefit of this outpatient program extends benefit to patients families and friends since they often provide transportation for seniors to medical care appointments. Despite incurring a significant operating loss to provide our Senior Life Solutions program, DCH and NCH recognizes the need in our service area for these valuable services.Another essential service we provide despite financial loss is our wound care program. Wound care patients often have multiple health issues and many times travel is very difficult for them. These hardships often caused patients the inability to access necessary care. Patients served at DCH include those with diabetic ulcers, venous stasis ulcers, arterial ulcers, non-healing traumatic and surgical wounds and other chronic wound conditions. 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. OTHER PROGRAM SERVICES 5: Ballad Health embarked on a campaign near the end of fiscal year 2018 to reduce hospital-acquired C. diff by 30% in 90 days. This was a bold undertaking by Ballad Healths new Clinical Council and our Infection Prevention Department. C. diff is a significant threat to hospital patients everywhere. It is our duty as caregivers to protect our patients from harm all of the time, so preventing C. diff i |
| Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder | The corporation is organized as a Virginia non-stock, nonprofit corporation. Dickenson Community Hospital IS A 100% owned subsidiary of Norton Community Hospital, Inc. |
| Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body | The board of directors of Norton Community Hospital annually elect members to the board of directors for Dickenson Community Hospital. A requirement of at least (1) member is to be from Dickenson County Industrial Development Authority. Norton community hospital is the sole member of Dickenson Community Hospital. |
| Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders | Certain decisions of the board are, pursuant to charter and Virginia stature, subject to approval of the members. These decisions include: dissolution of the corporation; merger of the corporation; non-ordinary course of business sale of assets, etc. No ordinary day-to-day decisions are subject to member approval. |
| Form 990, Part VI, Line 11b: Form 990 Review Process | The CFO reviewed the Form 990 with the board of directors prior to filing the return 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 Increases | Change in Temp. Restricted Net Assets = $5000 |
| Other Changes In Net Assets Or Fund Balances - Other Increases | Elimination of Intercompany Receivables/Payables = $164441 |
| Other Changes In Net Assets Or Fund Balances - Other Increases | Pension Liability Adjustment = $10556 |
| Part V, Line 2A: W-2 Employees | Dickenson Community Hospital (DCH) team members are paid by Norton Community Hospital, DCH's sole member, except for the CEO and CFO who are paid by Ballad Health. The CEO and CFO salary and benefit costs are allocated between NCH and DCH. Norton Community Hospital bills DCH for its share of salary and benefits and the expense is recorded on DCHS books. There were three DCH team members that received reportable compensation in excess of $100,000. |
| Part VI, Line 15A - Compensation Process for Top Official | On an annual basis, Ballad Health's Human Resource (H/R) Department evaluates compensation for all executives at a position level of Assistant Vice President and above. The review includes DCH/NCH's CEO. H/R's evaluation is based on market data obtained from independent third-party consultants for positions with similar responsibilities at similarly situated organizations. Based on this comparable data, the President & CEO of Ballad Health evaluates the data and submits his recommendations to the Board of Directors for Ballad Health for their final review and approval. In addition, Ballad Health offers an incentive plan to executives based on targeted achievement metrics set in advance of the pay year. Established metrics include: communication with patients, patient evidence-based care scores and patient safety, value-based purchasing, etc. |
| Part VI, Line 15B - Compensation Process for Officers or Key Employees | Similar to DCH/NCH's CEO, DCH's CFO receives compensation that complies with salary policy of Ballad Health. His pay is set at a market percentile specific to his position as CFO of DCH and NCH. |
| Part Vll - Related Organizations | Director compensation: Dickenson Community Hospitals board members, Shane Hilton and Monty McLaurin, receive compensation for services provided to related organizations and do not receive compensation for services as a DCH board member. |
Schedule R IRS990ScheduleR
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 |
|---|---|---|---|---|---|---|---|---|---|---|
| Mountain States Health Alliance | ||||||||||
| 303 Med Tech Parkway Suite 220 | Johnson City | TN | 37604 | 620476282 | Hospital System | TN | 501C3 | 3 | BALLAD | false |
| MSHA Auxiliary | ||||||||||
| 400 N State of Franklin Road | Johnson City | TN | 37604 | 581418345 | Supporting Organization | TN | 501C3 | 12a | MSHA | false |
| Smyth County Community Hospital | ||||||||||
| 245 Medical Park Drive | Marion | VA | 24354 | 540794913 | Hospital | VA | 501C3 | 3 | MSHA | false |
| Norton Community Hospital | ||||||||||
| 100 15th Street NW | Norton | VA | 24273 | 540566029 | Hospital | VA | 501C3 | 3 | NA | 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 | Medical Services | VA | 501C3 | 12a | JMH | false |
| Ballad Health | ||||||||||
| 303 Med Tech Parkway Suite 220 | Johnson City | TN | 37604 | 611771290 | Supporting Organization | TN | 501C3 | 12b | NA | false |
| East TN Healthcare Holdings Inc | ||||||||||
| 203 Gray Commons Circle | Gray | TN | 37615 | 815475903 | Opioid Treatment | TN | 501C3 | 3 | MSHA | false |
| Wellmont Health System | ||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621636465 | Hospital System | 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 | Medical Services | TN | 501C3 | 10 | WHS | false |
| Wellmont Medical Associates | ||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 270898372 | Medical Services | 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 | Assisted Living | TN | 501C3 | 10 | WHS | false |
| Wellmont Wexford House | ||||||||||
| 2421 N John B Dennis Hwy | Kingsport | TN | 37660 | 581859039 | Nursing 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 | Medical Services | TN | 501C3 | 3 | WHS | false |
| Laughlin Memorial Hospital Inc | ||||||||||
| 1420 Tusculum Boulevard | Greeneville | TN | 37745 | 620701119 | Hospital | TN | 501C3 | 3 | MSHA | false |
| Laughlin Healthcare Foundation | ||||||||||
| 1420 Tusculum Boulevard | Greeneville | TN | 37745 | 582105493 | Fundraiser | TN | 501C3 | 12a | MSHA | false |
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 | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| Emmaus Comm Hlth PLLC | |||||||||
| 6070 HWY 11E | Piney Flats | TN | 37686 | 200577483 | Medical Services | TN | NA | false | false |
| Medl Spec of JC LLC | |||||||||
| 2528 Wesley Street Suite 2 | Johnson City | TN | 37601 | 272199037 | Medical Services | TN | NA | false | false |
| ETn AmbSrg Cntr | |||||||||
| 701 Med Tech Parkway Suite 100 | Johnson City | TN | 37604 | 621787537 | Medical Services | TN | NA | false | false |
| GreenevillePhySvc LLC | |||||||||
| 1905 American Way | Kingsport | TN | 37660 | 455070419 | Medical Services | TN | NA | false | false |
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 | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Blue Ridge Medical Management Corp | ||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621490616 | Medical Services | TN | MSHA | C | false | |||||
| Mediserve Medical Equipment | ||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621212286 | Durable Medical Equipment | TN | BRMMC | C | false | |||||
| Mountain States Properties | ||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621845895 | Property Management | TN | BRMMC | C | false | |||||
| Mountain States Physician Grp | ||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621700412 | Medical Services | TN | BRMMC | C | false | |||||
| Community Home Care Inc | ||||||||||||||
| 1490 Park Avenue NW Suite B | Norton | VA | 24273 | 541453810 | Durable Medical Equipment | VA | NCH | C | false | |||||
| Wilson Pharmacy Inc | ||||||||||||||
| PO Box 5289 | Johnson City | TN | 37604 | 620329587 | Pharmacy | TN | BRMMC | C | false | |||||
| Crestpoint Health Insurance Company | ||||||||||||||
| 509 Med Tech Parkway Suite 100 | Johnson City | TN | 37604 | 620381170 | Insurance | TN | ISHN | C | false | |||||
| Wellmont Inc | ||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621320035 | Medical Services | TN | NA | C | false | |||||
| Wellmont Collections Inc | ||||||||||||||
| 2004 American Way Suite 101 | Kingsport | TN | 37660 | 621325938 | Business Services | TN | NA | C | false | |||||
| Medical Mall Pharmacy Inc | ||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621565006 | Medical Services | TN | NA | C | false | |||||
| Wellmont Physician Services | ||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621567353 | Medical Services | TN | NA | C | false | |||||
| WPS Providers Inc | ||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 205564642 | Medical Services | TN | NA | C | false | |||||
| Wellmont Health Services Inc | ||||||||||||||
| 1905 American Way | Kingsport | TN | 37660 | 621254373 | Medical Services | TN | NA | C | false | |||||
| Nolichuckey Management Svcs Inc | ||||||||||||||
| 1420 Tusculum Boulevard | Greeneville | TN | 37745 | 621776681 | Medical Services | TN | NA | C | false | |||||
| Wellmont Insurance Co SPC LTD | ||||||||||||||
| 981195624 | Insurance | NA | C | false | P O Box 30600 | Grand Cayman | CJ | KY1-1203 | CJ | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | 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 | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | 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 | false | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |