SMYTH COUNTY COMMUNITY HOSPITAL: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization: SMYTH COUNTY COMMUNITY HOSPITAL (EIN 54-0794913)
Tax period: 2015-07-01 to 2016-06-30
Filed: 2017-05-04
IRS object ID: 201731249349300203
Schema version: 2015v3.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2017-05-04T07:26:10-04:00	ReturnTs
Tax Period End	2016-06-30	TaxPeriodEndDt
Return Type	990	ReturnTypeCd
Tax Period Begin	2015-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	540794913	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SMYTH COUNTY COMMUNITY HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	SMYT	BusinessNameControlTxt
Phone	2763781202	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 880	AddressLine1Txt
City	MARION	CityNm
State Abbreviation	VA	StateAbbreviationCd
ZIP	24354	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	JAMES TYLER	PersonNm
Person Title	SCCH CEO	PersonTitleTxt
Phone	2763781000	PhoneNum
Signature	2017-05-01	SignatureDt

Field	Value	IRS element (for citing)
Tax	2015	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	JAMES TYLER	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 880	AddressLine1Txt
City	MARION	CityNm
State Abbreviation	VA	StateAbbreviationCd
ZIP	24354	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$48,101,748	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.MOUNTAINSTATESHEALTH.COM	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1961	FormationYr
Legal Domicile State	VA	LegalDomicileStateCd
Activity Or Mission	PART I, LINE I - ORGANIZATION'S MISSION: SMYTH COUNTY COMMUNITY HOSPITAL (SCCH) IS COMMITTED TO BRINGING LOVING CARE TO HEALTH CARE. WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTH CARE NEEDS OF INDIVIDUALS AND COMMUNITIES IN OUR REGION AND TO ASSIST THEM IN ATTAINING THEIR HIGHEST POSSIBLE LEVEL OF HEALTH.	ActivityOrMissionDesc
Voting Members Governing Body	12	VotingMembersGoverningBodyCnt
Voting Members Independent	8	VotingMembersIndependentCnt
Total Employee	1	TotalEmployeeCnt
Total Volunteers	54	TotalVolunteersCnt
Total Gross UBI	$74,922	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$21,692	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$15,712	PYContributionsGrantsAmt
CY Contributions Grants	$287,543	CYContributionsGrantsAmt
PY Program Service Revenue	$43,201,932	PYProgramServiceRevenueAmt
CY Program Service Revenue	$45,469,679	CYProgramServiceRevenueAmt
PY Investment Income	$1,487,190	PYInvestmentIncomeAmt
CY Investment Income	$1,051,909	CYInvestmentIncomeAmt
PY Other Revenue	$830,811	PYOtherRevenueAmt
CY Other Revenue	$756,185	CYOtherRevenueAmt
PY Total Revenue	$45,535,645	PYTotalRevenueAmt
CY Total Revenue	$47,565,316	CYTotalRevenueAmt
PY Grants And Similar Paid	$9,151	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$17,655	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$21,911,072	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$22,370,567	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$24,262,807	PYOtherExpensesAmt
CY Other Expenses	$26,393,409	CYOtherExpensesAmt
PY Total Expenses	$46,183,030	PYTotalExpensesAmt
CY Total Expenses	$48,781,631	CYTotalExpensesAmt
PY Revenues Less Expenses	-$647,385	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$1,216,315	CYRevenuesLessExpensesAmt
Total Assets BOY	$104,500,332	TotalAssetsBOYAmt
Total Assets EOY	$101,207,946	TotalAssetsEOYAmt
Total Liabilities BOY	$22,377,677	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$21,294,182	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$82,122,655	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$79,913,764	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	PART I, LINE I - ORGANIZATION'S MISSION: SMYTH COUNTY COMMUNITY HOSPITAL (SCCH) IS COMMITTED TO BRINGING LOVING CARE TO HEALTH CARE. WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTH CARE NEEDS OF INDIVIDUALS AND COMMUNITIES IN OUR REGION AND TO ASSIST THEM IN ATTAINING THEIR HIGHEST POSSIBLE LEVEL OF HEALTH.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$33,445,957	ExpenseAmt
Grant	$17,655	GrantAmt
Revenue	$38,955,151	RevenueAmt
Desc	SMYTH COUNTY COMMUNITY HOSPITAL (SCCH) HAS A 55-PLUS YEAR HISTORY OF PROVIDING HEALTHCARE SERVICES WITHIN THE COMMUNITY OF MARION, VIRGINIA. SCCH IS A 44-BED COMMUNITY-BASED HOSPITAL THAT OFFERS BOTH ACUTE CARE AND INPATIENT REHABILITATION CARE. THE HOSPITAL PROVIDES COMPREHENSIVE OUTPATIENT SERVICES AND A VARIETY OF OUTREACH PROGRAMS SUCH AS HOMECARE. ADDITIONALLY, SCCH HAS A 109-BED NURSING CARE FACILITY, FRANCIS MARION MANOR HEALTH AND REHABILITATION (FMM). (CONTINUED ON SCHEDULE O) (CONTINUED)FOR THE YEAR ENDING JUNE 30, 2016, SCCH RECORDED 1,560 INPATIENT HOSPITAL ADMISSIONS AND 287 NURSING HOME ADMISSIONS. THERE WERE 81,023 OUTPATIENT VISITS, 17,545 EMERGENCY VISITS AND 13,625 HOME HEALTH VISITS. SCCH IS ON THE FRONT LINES IN THE BATTLE AGAINST PRESCRIPTION DRUG ABUSE. THE HOSPITAL HAS PARTNERED WITH EAST TENNESSEE STATE UNIVERSITY'S BILL GATTON COLLEGE OF PHARMACY TO CREATE A PHARMACY TASK FORCE. THE GROUP INCLUDES SCCH MEDICAL STAFF, MSHA PHARMACISTS, AND PHARMACISTS FROM THE COMMUNITY. DRUG ABUSE IN SMYTH COUNTY IS A SIGNIFICANT PROBLEM SO GETTING TOGETHER THE PHYSICIANS WHO WRITE PRESCRIPTIONS WITH THE PHARMACISTS WHO FILL THE PRESCRIPTIONS, THE PROBLEM CAN BE ADDRESSED WITH MUTUAL DIALOGUE. THE PHARMACY TAX FORCE IS FOCUSED ON PRESCRIPTION DRUG ABUSE IN THE HOSPITAL'S PRIMARY SERVICE AREA. THE HOSPITAL SUBSIDIZES TWO PHYSICIAN PRACTICES LOCATED IN RURAL, MEDICALLY UNDERSERVED AREAS. THESE CLINICS ALLOW RESIDENTS TO RECEIVE QUALITY CARE WITHOUT HAVING TO TRAVEL OUTSIDE OF THEIR HOME AREA. THIS IS ESPECIALLY IMPORTANT FOR ELDERLY RESIDENTS AND OTHERS THAT REQUIRE FAMILY OR FRIENDS TO PROVIDE TRANSPORTATION TO PHYSICIAN APPOINTMENTS. OUR COST DURING THE YEAR TO SUBSIDIZE THE TWO CLINICS WAS JUST UNDER 247,000. THE HOSPITAL CONTINUES THE VALUE OPTIMIZATION SYSTEM (VOS), A PRACTICE THAT USES THE "LEAN" PHILOSOPHY THAT LOOKS AT WORKDAY PROCESSES AND LOCATES WASTEFUL ACTIVITY. AFTER IDENTIFYING WASTE, WAYS ARE IDENTIFIED TO ELIMINATE THE WASTE. THE END RESULT FOR A HOSPITAL IS TO FREE UP MORE TIME TO SPEND WITH PATIENTS RATHER THAN DOING UNNECESSARY THINGS. DURING THE YEAR, SCCH CONDUCTED NINE VOS EVENTS. SEVERAL OF THE PROJECTS RESULTED IN BETTER PATIENT CARE AND IMPROVED PATIENT SATISFACTION, AS MEASURED BY PATIENT SURVEYS CONDUCTED BY AN OUTSIDE, INDEPENDENT FIRM. SOME OF THE MEASUREABLE IMPROVEMENTS INCLUDED: NURSE-PATIENT COMMUNICATION, PHYSICIAN- PATIENT COMMUNICATION, AND INFORMATION PROVIDED TO PATIENTS AT DISCHARGE. AT FRANCIS MARION MANOR (FMM), OUR NURSING HOME, VOS TEAMS WERE ABLE TO ACHIEVE A NUMBER OF SUCCESSES, SUCH AS: REDUCING THE NUMBER OF PATIENT FALLS, URINARY TRACT INFECTIONS, THE USE OF HYPNOTIC MEDICATIONS, AND EXCESSIVE WEIGHT LOSS. ANOTHER FMM IMPROVEMENT DURING THE YEAR WAS A SHARP DECLINE (70%) IN THE NUMBER OF TEAM MEMBER CALL-INS (ABSENTEEISM OR LATE FOR WORK). SCCH SERVES AS A CLINICAL TRAINING FACILITY FOR HEALTH PROFESSIONAL EDUCATION STUDENTS. WE HAVE DEDICATED STAFF TO WORK WITH REGIONAL COLLEGES AND UNIVERSITIES TO COORDINATE THE PLACEMENT OF HEALTHCARE PROFESSIONAL STUDENTS AS PART OF THEIR EDUCATIONAL CURRICULUM. IN ADDITION TO CLINICAL TRAINING, THE HEALTH CARE STUDENTS ENTERING OUR SYSTEM ARE REQUIRED TO HAVE ORIENTATION AND COMPUTER TRAINING. INCLUDED IN THE NUMBER OF PARTICIPANTS RECEIVING CLINICAL EXPERIENCE AT SCCH WERE 74 NURSING STUDENTS FROM VARIOUS COLLEGES, UNIVERSITIES AND PROGRAMS, A 23% INCREASE OVER PRIOR YEAR. IN ADDITION TO THE INCREASED NUMBER OF STUDENTS RECEIVING TRAINING IN OUR HOSPITALS, THE HOURS DEVOTED TO EACH STUDENT ALSO INCREASED. THIS NURSING CLINICAL EXPERIENCE REQUIRED EXTENSIVE SCCH NURSING STAFF INVOLVEMENT. THE CLINICAL SETTING AND HANDS-ON INSTRUCTION COST SCCH 196,538. SCCH PROVIDED A CLINICAL SETTING FOR ANOTHER 72 STUDENTS TRAINING IN HEALTH-RELATED PROGRAMS SUCH AS PHARMACY, SOCIAL WORK, OT/PT, EMT/PARAMEDIC AND OTHER ALLIED-HEALTH DISCIPLINES, A MORE THAN FOURFOLD INCREASE OVER PRIOR YEAR. NOT ONLY DID THE NUMBER OF STUDENTS INCREASE, BUT THE NUMBER OF HOURS DEVOTED TO EACH STUDENT INCREASED. THE INCREASED HOURS PER STUDENT WAS PREDOMINANTLY RELATED TO MORE STUDENTS IN PROGRAMS THAT REQUIRE MUCH LONGER HOSPITAL EXPERIENCE/TRAINING. THESE ADDITIONAL CLINICAL STUDENTS COST SCCH 315,009. SCCH'S NURSING CARE FACILITY, FRANCIS MARION MANOR, CONTINUES TO OFFER A SUCCESSFUL PROGRAM TO TRAIN CERTIFIED NURSE ASSISTANTS. THIS YEAR, OUR CERTIFIED NURSE ASSISTANT (CNA) PROGRAM WAS APPROVED BY MEDICARE AS AN ALLIED HEALTH EDUCATION PROGRAM. IN ORDER TO QUALIFY AS A MEDICARE-APPROVED PROGRAM, A PROVIDER MUST INCUR THE COSTS ASSOCIATED WITH BOTH THE CLINICAL AND THE CLASSROOM INSTRUCTION PORTIONS OF THE PROGRAM, MUST CONTROL THE PROGRAM CURRICULUM AND ADMINISTRATIVE DUTIES, MUST EMPLOY THE FACULTY, AND MUST CONTROL THE CLASSROOM INSTRUCTION AND CLINICAL TRAINING. IN ADDITION, THE PROGRAM MUST BE RECOGNIZED BY A NATIONAL APPROVING BODY OR STATE LICENSING ORGANIZATION. WE OFFER THE CNA PROGRAM FREE OF CHARGE AND PARTICIPANTS ARE UNDER NO OBLIGATION TO WORK FOR SCCH OR ANOTHER MSHA FACILITY UPON COMPLETION OF THE PROGRAM. BASED ON COMMUNITY NEED, SCCH INCURRED DIRECT EXPENSE OF 265,895 TO RECRUIT PHYSICIANS INTO OUR COMMUNITY. IN ADDITION, MSHA CORPORATE ALLOCATES A PORTION OF ITS PHYSICIAN RECRUITMENT DEPARTMENTAL EXPENSES TO ITS HOSPITALS, INCLUDING SCCH, SINCE THE CORPORATE DEPARTMENT SERVICES ALL MSHA DIVISIONS. PHYSICIANS ARE RECRUITED TO REPLACE PHYSICIANS THAT RETIRE OR LEAVE THE AREA. RECRUITMENT EXPENSE DURING FY16 INCLUDED RECRUITMENT FOR EMERGENCY MEDICINE, PRIMARY CARE, GENERAL SURGERY, AND A HOSPITALIST. ALL PHYSICIAN RECRUITMENT ACTIVITIES ARE BASED ON DOCUMENTED COMMUNITY NEED. A PORTION OF OUR RECRUITMENT IS PHYSICIAN DEBT FORGIVEN BY THE HOSPITAL OVER A PERIOD OF YEARS SO LONG AS THE PHYSICIAN REMAINS IN OUR COMMUNITY AND CONTINUES PROVIDING MEDICAL SERVICES TO OUR RESIDENTS. WITH A DONATION FROM SMYTH COUNTY HOSPITAL HEALTHTRUST, RENOVATION OF THE REGIONAL CANCER CENTER AT SCCH MADE TREATMENT EASIER AND MORE EFFICIENT FOR CANCER PATIENTS. THE RENOVATION INVESTMENT ENABLED THE HOSPITAL TO PROVIDE ESSENTIAL CANCER TREATMENT THAT PATIENTS PREVIOUSLY HAD TO LEAVE THE AREA TO RECEIVE. THE PROJECT ALLOWED DIFFERENT ELEMENTS OF CARE TO BE CONSOLIDATED SO PATIENTS ARE ABLE TO CHECK IN, SEE THEIR PROVIDER AND RECEIVE INFUSION OR CHEMOTHERAPY SERVICES WITHIN THE SAME AREA. THE RENOVATED SPACE INCLUDES A SUITE WITH EXAM ROOMS AND NURSING AREA, A WORK SPACE FOR THE CENTER'S PHYSICIAN AND NURSE PRACTITIONER, CANCER NAVIGATORS, SOCIAL WORKER AND DIETICIAN. THE NEW SPACE IS MORE CONVENIENT AND COMFORTABLE FOR OUR PATIENTS, WHO ARE OFTEN WEAK AND TIRED, TO BE SEEN IN ONE LOCATION. CHARITY AND OTHER UNREIMBURSED COSTS: WHILE REIMBURSEMENT FOR HEALTHCARE SERVICES RENDERED IS CRITICAL TO THE OPERATION AND SUSTAINABILITY OF THE ORGANIZATION, SCCH RECOGNIZES ITS OBLIGATION TO PROVIDE FREE OR DISCOUNTED CARE TO INDIVIDUALS WHO CANNOT AFFORD ESSENTIAL MEDICAL SERVICES, INCLUDING EMERGENCY CARE. A PATIENT IS DEEMED ELIGIBLE FOR FINANCIAL ASSISTANCE WHEN THEY MEET THE ESTABLISHED POLICIES OF SCCH AND GUIDELINES OUTLINED BY THE FEDERAL GOVERNMENT. IT IS NOT UNTIL AFTER VERIFICATION OF INCOME AND ASSETS THAT A DECISION REGARDING THE AMOUNT OF WRITE-OFF CAN BE MADE. IN FISCAL YEAR 2016, SCCH INCURRED A LOSS OF 448,039 ATTRIBUTABLE TO THE COSTS OF PROVIDING CARE TO PATIENTS APPROVED FOR FINANCIAL ASSISTANCE. SCCH PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS, SUCH AS MEDICAID, FOR LOW INCOME PEOPLE. SCCH INCURRED A LOSS OF 2.163,774 PROVIDING CARE TO THIS POPULATION OF PATIENTS DURING THE YEAR. SCCH PARTNERED WITH THE COMPANY ADVANCED PATIENT ADVOCACY TO WORK WITH SELF-PAYING PATIENTS WHO HAVE LIMITED FINANCIAL RESOURCES. REPRESENTATIVES WERE AVAILABLE FOR OUR PATIENTS TO DETERMINE POSSIBLE GOVERNMENTAL MEDICAL ASSISTANCE ELIGIBILITY AND TO HELP WITH THE APPLICATION PROCESS AND FOLLOW-UP. 451 PATIENTS WERE APPROVED DURING FY16 FOR COVERAGE AND ONCE A PERSON IS APPROVED FOR MEDICAID THROUGH THIS PROGRAM OFFERED THROUGH SCCH, THEY RETAIN COVERAGE FOR FUTURE MEDICAL CARE. SCCH BEARS THE EXPENSE FOR THIS SERVICE, WHICH TOTALED 19,781 IN FY16. COMMUNITY DONATIONS: FOR MANY YEARS, SCCH HAS PROVIDED ASSISTANCE TO LOCAL NON-PROFIT LIFESAVING ORGANIZATIONS SUCH AS AMBULANCE SERVICES, FIRE DEPARTMENTS AND RESCUE SQUADS. SCCH DONATES FREE MEDICATIONS AND PHARMACEUTICAL SUPPLIES TO THESE ORGANIZATIONS. THE COST OF DONATED MEDICATIONS TO RESCUE ORGANIZATIONS DURING FY16 WAS MORE THAN 7,000. SCCH CONTRIBUTED TO LOCAL CHAPTERS OF NATIONAL NON-PROFIT ORGANIZATIONS WHOSE RESEARCH FOCUSES ON THOSE DISEASES AND CONDITIONS MOST PREVALENT IN THE REGION, INCLUDING AMERICAN HEART ASSOCIATION AND AMERICAN CANCER SOCIETY. WE ALSO SUPPORTED REMOTE AREA MEDICAL CLINICS THAT PROVIDE FREE DENTAL, VISION, AND MEDICAL CARE TO ISOLATED, IMPOVERISHED, OR UNDERSERVED COMMUNITIES; A LOCAL BLOOD DONATION ORGANIZATION; A LOCAL HEALTH WEEK EVENT; AND, A LITTLE LEAGUE FOR CHILDREN WITH DISABILITIES. CONS	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$6,714,138	ExpenseAmt
Revenue	$6,733,776	RevenueAmt
Desc	FRANCIS MARION MANOR HEALTH AND REHABILITATION (FMM), PROVIDES BOTH SKILLED-LEVEL AND NURSING FACILITY-LEVEL HEALTH CARE SERVICES. THERE WERE 287 ADMISSIONS AND 34,828 PATIENT DAYS DURING FY16. WE RECEIVED THE "2015 BEST OF SMYTH COUNTY AWARD" FOR BEING THE BEST NURSING HOME/ASSISTED LIVING FACILITY, AS VOTED BY READERS OF THE SMYTH COUNTY NEWS AND MESSENGER.	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$40,160,095	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
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	Yes (true)	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
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	81	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	1	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	12	GoverningBodyVotingMembersCnt
Independent Voting Member	8	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	VA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	JOHN JETER	PersonNm
Phone	2762582830	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 880	AddressLine1Txt
City	MARION	CityNm
State Abbreviation	VA	StateAbbreviationCd
ZIP	24354	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 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	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
TONY KECK MSHA SVP
DIRECTOR	0.50	54.50	Yes (X)	$0	$451,023	$47,064
ERIC SACKNOFF MD MSMG PHYSICIAN
DIRECTOR	0.00	40.00	Yes (X)	$0	$442,373	$32,446
SEAN MCMURRAY JMH CEO
DIRECTOR	5.00	40.00	Yes (X)	$0	$385,990	$51,190
JOHN JETER JMHSCCH CFO
SECRETARY	9.00	36.00	Yes (X)	$0	$217,684	$26,523	Yes (X)
ANTHONY CLARYMDMSMG PHYSICIAN
DIRECTOR	0.50		Yes (X)	$0	$175,684	$24,982
ALLEN ABEL
DIRECTOR	1.25		Yes (X)	$0	$0	$0
JIM BEAR JR
VICE-CHAIR	0.75		Yes (X)	$0	$0	$0	Yes (X)
ANDY BLEVINS
DIRECTOR	0.50		Yes (X)	$0	$0	$0
RUTH COX
DIRECTOR	0.75		Yes (X)	$0	$0	$0
JOANNE GROSECLOSE
CHAIR	0.75		Yes (X)	$0	$0	$0	Yes (X)
JIM MCDOWELL MD
DIRECTOR	0.50		Yes (X)	$0	$0	$0
ROBERT SHULTS
TREASURER	1.00		Yes (X)	$0	$0	$0	Yes (X)
AMANDA CURRIN
DIRECTOR	0.50		Yes (X)	$0	$0	$0
GARY PEACOCK
DIRECTOR	0.50	11.00	Yes (X)	$0	$0	$0
JAMES TYLER
SCCH CEO	45.00			$0	$246,044	$16,458	Yes (X)
CATHY MAINE
ASSOC. ADMIN	45.00			$0	$173,767	$10,777		Yes (X)
BELDON FLEMING
PHARMACY MAN	40.00			$0	$143,998	$31,596			Yes (X)
BRUCE BRIGGS
PHARMACIST	40.00			$0	$125,397	$29,405			Yes (X)
ROBERT O'DONNELL
REHAB. THER.	40.00			$0	$119,716	$26,130			Yes (X)
BETTY SCHWARTZ
PHYSICAL THE	40.00			$0	$108,078	$30,141			Yes (X)
PATRICIA DEBUSK
PHYSICAL THE	40.00			$0	$101,354	$27,618			Yes (X)
RAMZI K HUMSI MD
MSMG PHYSICI				$0	$250,511	$22,385				Yes (X)
LINDA WHITE CEO FWCHWR
FORMER SCCH				$0	$325,783	$46,302				Yes (X)

Field	Value	IRS element (for citing)
Tot Reportable Comp Rltd Org	$3,267,402	TotReportableCompRltdOrgAmt
Total Other Compensation	$423,017	TotalOtherCompensationAmt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
VEP MSHA ED INC
1990 N CALIFORNIA BLVD STE 400	WALNUT CREEK	CA	94596	EMERGENCY SERV.	$728,333
VIRGINIA HIGHLANDS ANESTHESIA
PO BOX 1476	ABINGDON	VA	24212	ANESTHESIA SVCS	$600,791
HANCOCK DANIEL JOHNSON & NAGLE
PO BOX 72050	RICHMOND	VA	232552050	ATTORNEY SVCS	$366,131
CROTHALL LAUNDRY SERVICES EAST TN
13028 COLLECTIONS CENTER DRIVE	CHICAGO	IL	60693	LINEN SERVICES	$197,588
UMS UROLOGY SERVICES OF SMYTH COUNTY
700 WEST PARK DRIVE SUITE 410	WESTBOROUGH	MA	01581	LITHOTRIPSY SVC	$121,959

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	5	CntrctRcvdGreaterThan100KCnt
Related Organizations	$273,031	RelatedOrganizationsAmt
Government Grants	$7,686	GovernmentGrantsAmt
All Other Contributions	$6,826	AllOtherContributionsAmt
Noncash Contributions	$1,263	NoncashContributionsAmt
Total Contributions	$287,543	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT SERVICES	622110	$44,426,980	$44,426,980
WELLNESS PROGRAMS	622110	$967,777	$967,777
LABORATORY	621511	$74,922		$74,922

Field	Value	IRS element (for citing)
Total Program Service Revenue	$45,469,679	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$977,773	TotalRevenueColumnAmt
Related Or Exempt Func Income	$431,444	RelatedOrExemptFuncIncomeAmt
Exclusion	$546,329	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$307,161	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$206,943	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$100,218	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$100,218	TotalRevenueColumnAmt
Exclusion	$100,218	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$328,137	SecuritiesAmt
Other	$75,488	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$329,489	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$328,137	SecuritiesAmt
Other	-$254,001	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$74,136	TotalRevenueColumnAmt
Related Or Exempt Func Income	-$254,001	RelatedOrExemptFuncIncomeAmt
Exclusion	$328,137	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
CAFETERIA SALES	722514	$317,227	$317,227
VENDOR SETTLEMENT	900099	$257,651	$257,651
REVENUE FROM PARENT	900099	$41,805		$41,805

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$39,284	TotalRevenueColumnAmt
Exclusion	$39,284	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$655,967	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$47,565,316	TotalRevenueColumnAmt
Related Or Exempt Func Income	$45,614,005	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$74,922	UnrelatedBusinessRevenueAmt
Exclusion	$1,588,846	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	$17,655	TotalAmt
Program Services	$17,655	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$530,936	TotalAmt
Program Services	$190,324	ProgramServicesAmt
Management And General	$340,612	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$17,408,974	TotalAmt
Program Services	$15,589,077	ProgramServicesAmt
Management And General	$1,819,897	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$582,650	TotalAmt
Program Services	$514,329	ProgramServicesAmt
Management And General	$68,321	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$2,660,198	TotalAmt
Program Services	$2,199,676	ProgramServicesAmt
Management And General	$460,522	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$1,187,809	TotalAmt
Program Services	$1,129,916	ProgramServicesAmt
Management And General	$57,893	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$9,753	TotalAmt
Management And General	$9,753	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$143,304	TotalAmt
Management And General	$143,304	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$15,750	TotalAmt
Management And General	$15,750	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$59,571	TotalAmt
Management And General	$59,571	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$9,536,802	TotalAmt
Program Services	$8,905,045	ProgramServicesAmt
Management And General	$631,757	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$126,768	TotalAmt
Program Services	$3,826	ProgramServicesAmt
Management And General	$122,942	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$352,114	TotalAmt
Program Services	$281,192	ProgramServicesAmt
Management And General	$70,922	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$1,104,366	TotalAmt
Program Services	$1,056,126	ProgramServicesAmt
Management And General	$48,240	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$990,072	TotalAmt
Program Services	$927,787	ProgramServicesAmt
Management And General	$62,285	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$155,441	TotalAmt
Program Services	$134,047	ProgramServicesAmt
Management And General	$21,394	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$168,014	TotalAmt
Management And General	$168,014	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$4,218,775	TotalAmt
Program Services	$2,083,994	ProgramServicesAmt
Management And General	$2,134,781	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$1,292,756	TotalAmt
Program Services	$342	ProgramServicesAmt
Management And General	$1,292,414	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES & DRUGS	$5,487,880	$5,487,880
REPAIRS & MAINTENANCE	$1,201,257	$1,165,468	$35,789
MANAGEMENT FEES	$886,984	$57,926	$829,058
UBIT	$7,374		$7,374

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$636,428	TotalAmt
Program Services	$415,485	ProgramServicesAmt
Management And General	$220,943	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$48,781,631	TotalAmt
Program Services	$40,160,095	ProgramServicesAmt
Management And General	$8,621,536	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part X	Yes (X)	InfoInScheduleOPartXInd

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$2,939,379	BOYAmt
EOY	$3,103,122	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$6,294,996	BOYAmt
EOY	$6,560,667	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
EOY	$137,203	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$948,864	BOYAmt
EOY	$859,623	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$269,817	BOYAmt
EOY	$348,084	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$119,827,858	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$55,795,012	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$67,549,835	BOYAmt
EOY	$64,032,846	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$24,807,217	BOYAmt
EOY	$25,042,606	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$741,011	BOYAmt
EOY	$729,011	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$949,213	BOYAmt
EOY	$394,784	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$104,500,332	BOYAmt
EOY	$101,207,946	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$4,451,185	BOYAmt
EOY	$4,264,014	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$1,142,696	BOYAmt
EOY	$799,176	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$15,965,896	BOYAmt
EOY	$15,832,228	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$817,900	BOYAmt
EOY	$398,764	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$22,377,677	BOYAmt
EOY	$21,294,182	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$82,113,596	BOYAmt
EOY	$79,904,854	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$9,059	BOYAmt
EOY	$8,910	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$82,122,655	BOYAmt
EOY	$79,913,764	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$104,500,332	BOYAmt
EOY	$101,207,946	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$1,216,315	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$882,309	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$110,267	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	Yes (true)	GrantsOtherOrganizationsInd
Grants Other Organizations	$1,492	GrantsOtherOrganizationsAmt
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	false	OtherActivitiesInd
Total Lobbying Expenditures	$1,492	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE C, PART IV	FormAndLineReferenceDesc
Explanation	SCCH HAD LOBBYING EXPENSES OF 1,492 WHICH REPRESENTS THE PORTION OF DUES PAID TO VIRGINIA HOSPITAL AND HEALTHCARE ASSOCIATION ATTRIBUTABLE TO DIRECT LOBBYING.	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,123,969	OtherCostOrOtherBasisAmt
Book Value	$2,123,969	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$57,302,945	OtherCostOrOtherBasisAmt
Depreciation	$9,407,223	DepreciationAmt
Book Value	$47,895,722	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$72,169	OtherCostOrOtherBasisAmt
Depreciation	$67,909	DepreciationAmt
Book Value	$4,260	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$59,545,343	OtherCostOrOtherBasisAmt
Depreciation	$45,678,996	DepreciationAmt
Book Value	$13,866,347	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$783,432	OtherCostOrOtherBasisAmt
Depreciation	$640,884	DepreciationAmt
Book Value	$142,548	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$64,032,846	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
RESERVE FOR PROF. LIABILITIES	$379,740
OTHER LONG-TERM LIABILITIES	$19,024

Field	Value	IRS element (for citing)
Total Liability	$398,764	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE D, PAGE 3, PART X	FormAndLineReferenceDesc
Explanation	"THE ALLIANCE IS CLASSIFIED AS AN ORGANIZATION EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3)OF THE INTERNAL REVENUE CODE. AS SUCH, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS FOR THE ALLIANCE AND ITS TAX-EXEMPT SUBSIDIARIES. THE ALLIANCE'S TAXABLE SUBSIDIARIES ARE DISCUSSED IN NOTE L. THE ALLIANCE HAS NO SIGNIFICANT UNCERTAIN TAX POSITIONS AT JUNE 30, 2016 AND 2015. AT JUNE 30, 2016, TAX RETURNS FOR 2013 THROUGH 2015 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
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	false	AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$447,823	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$447,823	NetCommunityBenefitExpnsAmt
Total Expense	0.00920	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,844,777	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,681,003	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,163,774	NetCommunityBenefitExpnsAmt
Total Expense	0.04440	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,292,600	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,681,003	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,611,597	NetCommunityBenefitExpnsAmt
Total Expense	0.05350	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$293,607	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$293,607	NetCommunityBenefitExpnsAmt
Total Expense	0.00600	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$573,441	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,717	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$568,724	NetCommunityBenefitExpnsAmt
Total Expense	0.01170	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,927,204	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,956,679	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,970,525	NetCommunityBenefitExpnsAmt
Total Expense	0.04040	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,554	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$10,554	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,804,806	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,961,396	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,843,410	NetCommunityBenefitExpnsAmt
Total Expense	0.05830	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$12,097,406	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$6,642,399	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,455,007	NetCommunityBenefitExpnsAmt
Total Expense	0.11180	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$5,294,035	BadDebtExpenseAmt
Bad Debt Expense Attributable	$3,326,075	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$13,216,018	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$13,837,312	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$621,294	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	SMYTH COUNTY COMMUNITY HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 880	AddressLine1Txt
City	MARION	CityNm
State Abbreviation	VA	StateAbbreviationCd
ZIP	24354	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.MOUNTAINSTATESHEALTH.COM	WebsiteAddressTxt
State License	H 1902	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	SMYTH COUNTY 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
CHNA Conducted	15	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.MOUNTAINSTATESHEALTH.COM	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	16	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	200.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.000000000000	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
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
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	WWWMOUNTAINSTATESHEALTHCOM	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	WWWMOUNTAINSTATESHEALTHCOM	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	WWWMOUNTAINSTATESHEALTHCOM	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
FAP Notice Displayed	Yes (X)	FAPNoticeDisplayedInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	Yes (true)	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
FAP Notified Before Discharge	Yes (X)	FAPNotifiedBeforeDischargeInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Lowest Negotiated Rates	Yes (X)	LowestNegotiatedRatesInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FACILITY 1, SMYTH COUNTY COMMUNITY HOSPITAL - PART V, LINE 5	MSHA MET WITH TEN FOCUS GROUPS, EACH REPRESENTING ONE OF THE THIRTEEN HOSPITAL FACILITIES, INCLUDING SCCH. EACH GROUP CONSISTED OF PUBLIC HEALTH LEADERS, NURSES, NON-PROFIT DIRECTORS, COMMUNITY DEVELOPERS, FAITH BASED LEADERS, PUBLIC OFFICIALS AND SCHOOL REPRESENTATIVES. SPECIFIC TO SCCH, THE GROUP CONSISTED OF REPRESENTATIVES FROM THE SMYTH COUNTY SCHOOL BOARD, MOUNT ROGERS HEALTH DEPARTMENT, SMYTH COUNTY PUBLIC SCHOOLS, SMYTH COUNTY COMMUNITY HOSPITAL, AND THE TOWN OF CHILHOWIE. EACH GROUP RANGED IN ATTENDANCE FROM 5 TO 18 INDIVIDUALS. PARTICIPANTS WERE GIVEN SURVEYS TO DETERMINE A COUNTY'S PERCEIVED HEALTH STATUS RATING, AVAILABLE RESOURCES, TOP HEALTH PRIORITIES (DISEASE CONDITIONS, HEALTH BEHAVIORS, AND SOCIOECONOMIC FACTORS), AND SUGGESTIONS FOR IMPROVEMENT. OPEN DISCUSSION FOLLOWED. THE COLLECTED INFORMATION WAS THEN PAIRED WITH STATISTICAL DATA IN ORDER TO PRIORITIZE HEALTH NEEDS. THE FACILITY COMMUNITY BOARDS (SUCH AS SCCH'S BOARD) WERE PRESENTED THIS INFORMATION AND SHARED THEIR THOUGHTS AS WELL ON THE HEALTH NEEDS TO PRIORITIZE. THE SPECIFIC NEEDS FOR EACH COUNTY WERE THEN ADDRESSED IN THE RESPECTIVE FACILITY IMPLEMENTATION PLAN WHICH WAS ADOPTED SEVERAL MONTHS LATER.
FACILITY 1, SMYTH COUNTY COMMUNITY HOSPITAL - PART V, LINE 6A	EACH HOSPITAL WITHIN THE MSHA SYSTEM COMPLETED A CHNA. SCCH'S 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 MEDICAL CENTER, SYCAMORE SHOALS HOSPITAL, JOHNSON COUNTY COMMUNITY HOSPITAL, UNICOI COUNTY MEMORIAL HOSPITAL, RUSSELL COUNTY MEDICAL CENTER, JOHNSTON MEMORIAL HOSPITAL, NORTON COMMUNITY HOSPITAL AND DICKENSON COMMUNITY HOSPITAL.
FACILITY 1, SMYTH COUNTY COMMUNITY HOSPITAL - PART V, LINE 11	MSHA PUBLISHED ITS COMMUNITY HEALTH NEEDS ASSESSMENT ON JUNE 29, 2015. THE DATA INCLUDED WAS COLLECTED OVER THE COURSE OF 2014 AND 2015. DUE TO LIMITED RESOURCES, EACH FACILITY PRIORITIZED FOUR TO FIVE HEALTH PRIORITIES ON WHICH TO FOCUS AND DEVELOP IMPLEMENTATION PLANS TO IMPACT. THERE WERE SEVEN COMMON HEALTH PRIORITIES SELECTED BY THE VARIOUS 11 FACILITIES, BUT NOT ALL FACILITIES SELECTED THE SAME AREAS. THE SEVEN ARE OBESITY, SUBSTANCE/PRESCRIPTION DRUG ABUSE, DIABETES, CANCER, HEART DISEASE, SMOKING AND MENTAL HEALTH. ALL OF THESE ARE SIGNIFICANT ISSUES FOR ALL 11 FACILITIES, BUT EACH CHOSE TO PRIORITIZE ON A DIFFERENT SET SO THEY COULD TARGET THEIR EFFORTS AND BE MORE EFFECTIVE WITH LIMITED RESOURCES. FOR EXAMPLE, WHILE NEARLY ALL THE FACILITIES IDENTIFIED OBESITY (11 OF 11) AND SUBSTANCE/ PRESCRIPTION DRUG ABUSE (10 OF 11), ONLY CERTAIN FACILITIES ELECTED TO FOCUS ON SOME NUMBER OF THE OTHER FIVE COMMON HEALTH PRIORITIES. WHILE MENTAL HEALTH IS CLEARLY A SIGNIFICANT ISSUE FOR ALL 11 FACILITIES, ONLY THREE ARE FOCUSED ON IT DUE TO LIMITED RESOURCES. THE SAME IS TRUE WITH SMOKING WHERE ONLY 5 OF THE 11 FACILITIES ARE FOCUSED ON IT, BUT IT IS AN ISSUE FOR ALL FACILITIES. SIX OF THE 11 FACILITIES SELECTED CANCER; 6 OF THE 11 SELECTED HEART DISEASE; AND 9 OF THE 11 CHOSE DIABETES. ANOTHER WAY TO STATE THIS IS BY FACILITY. FOR EXAMPLE, WHILE CANCER AND MENTAL HEALTH ARE PREVALENT CHALLENGES FOR JCMC'S PRIMARY SERVICE AREA, THE HOSPITAL ELECTED NOT TO FOCUS ON THOSE DUE TO LIMITED TIME, FUNDING, PERSONNEL AND OTHER RESOURCES NEEDED TO EFFECTUATE CHANGE. UCMH FELT IT WAS UNABLE TO ADDRESS HEART DISEASE, SMOKING, AND MENTAL HEALTH ISSUES IN ITS PRIMARY SERVICE AREA. SOME FACILITIES IDENTIFIED ISSUES SUCH AS TRANSPORTATION AND EDUCATION AS BARRIERS TO GOOD HEALTH, BUT WERE ALSO UNABLE TO SET ASIDE SUFFICIENT RESOURCES TO MEANINGFULLY IMPACT THOSE CHALLENGES. AFTER THE FACILITIES SELECTED A REASONABLE NUMBER OF HEALTH PRIORITIES THEY FELT THEY COULD ADEQUATELY IMPACT, AN IMPLEMENTATION PLAN WAS CREATED FOR EACH HOSPITAL, AND EACH HOSPITAL'S BOARD APPROVED THE IMPLEMENTATION PLAN DURING THE MONTHS OF NOVEMBER AND DECEMBER 2015. MSHA ANNUALLY TRACKS PROGRESS OF IMPLEMENTATION STRATEGIES FOR EACH HOSPITAL. THE FACILITIES HAVE BEEN CONDUCTING ACTIVITIES CONSISTENT WITH THEIR RESPECTIVE IMPLEMENTATION PLANS. FOR EXAMPLE, SCCH SPONSORS THE LOCAL COMMUNITY ACTION NETWORK AND PROVIDES NUTRITIONAL AND WELLNESS INFORMATION TARGETING OBESITY. RCMC SUPPORTS THE RUSSELL COUNTY SCHOOL BACKPACK PROGRAM WHICH PROVIDES HEALTHY FOOD FOR KIDS IN NEED TO HELP ADDRESS CHILDHOOD OBESITY. JMH SUPPORTS THE LOCAL MORNING MILE PROGRAM WHICH IS A SCHOOL BASED PROGRAM IN WHICH KIDS ARRIVE AT SCHOOL EARLY AND PARTICIPATE IN A SUPERVISED WALK OR RUN FOR A MILE. FWCH PROVIDES COOKING AND PHYSICAL ACTIVITY CLASSES TO THE COMMUNITY TO ADDRESS OBESITY AND DIABETES. UCMH PARTNERS WITH THE LOCAL YMCA TO PROVIDE DIABETES EDUCATION CLASSES AND SUPPORT FOR THE COMMUNITY. IPMC HAS BEEN SUPPORTING SUGAR FREE INITIATIVES AT THE LOCAL BOYS AND GIRLS CLUB TO HELP REDUCE OBESITY IN CHILDREN. JCCH MEETS WITH LOCAL SCHOOLS TO PROVIDE EDUCATION ON THE DANGERS OF SMOKING. THESE ARE JUST A FEW EXAMPLES OF THE EFFORTS MADE BY MSHA HOSPITALS TO SUPPORT THEIR IMPLEMENTATION PLANS.

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	FRANCIS MARION MANOR HEALTH &	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	REHABILITATION	AddressLine1Txt
Address Line2	100 FRANCIS MARION LANE	AddressLine2Txt
City	MARION	CityNm
State Abbreviation	VA	StateAbbreviationCd
ZIP	24354	ZIPCd

Field	Value	IRS element (for citing)
Facility	NURSING HOME	FacilityTxt

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3C - OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARE	FINANCIAL ASSISTANCE APPROVAL CAN APPLY TO AN ASSORTMENT OF PATIENTS SUCH AS THOSE WHO HAVE EXHAUSTED THEIR MEDICAID BENEFITS, THOSE WHO QUALIFIED FOR MEDICAID AFTER THE DATE OF SERVICE, DECEASED PATIENTS WITH NO ESTATE OR ASSETS, UNINSURED PATIENTS, AND UNDERINSURED PATIENTS. MSHA CHARITY QUALIFICATION IS BASED ON FEDERAL POVERTY GUIDELINES BUT ALSO USES ASSET VALUES TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY. CHARITY APPROVAL COVERS ALL DATES OF SERVICE FOR THE PATIENT WHEN THEY ARE APPROVED AND THERE IS NO LIMITATION OR CAP ON THE AMOUNT OF CHARITY THAT THEY CAN RECEIVE. MSHA ALWAYS ATTEMPTS TO FULFILL ITS OBLIGATION TO PROVIDE FINANCIAL ASSISTANCE TO THOSE PATIENTS WITHOUT THE ABILITY TO PAY. THE MAJORITY OF MSHA HOSPITALS ARE LOCATED IN TENNESSEE AND PURSUANT TO TENNESSEE LAW ALL PATIENTS WITHOUT THIRD-PARTY PAYER COVERAGE RECEIVE A DISCOUNT OF 67%, WITH THE EXCEPTION OF CRITICAL ACCESS HOSPITALS THAT RECEIVE 58%. THIS IS A CALCULATED DISCOUNT THAT IS UPDATED ON AN ANNUAL BASIS. ALTHOUGH VIRGINIA DOES NOT HAVE A LAW THAT REQUIRES HOSPITALS TO PROVIDE DISCOUNTS TO UNINSURED PATIENTS, MSHA EXTENDS THESE UNINSURED DISCOUNTS TO ITS VIRGINIA HOSPITALS AS WELL, INCLUDING SCCH.
PART I, LINE 6A - RELATED ORGANIZATION INFORMATION	MSHA'S COMMUNITY BENEFIT REPORT COMPLETED IN FY15 INCLUDED SCCH. OUR NEXT COMMUNITY BENEFIT REPORT WILL BE ISSUED DURING FY17.
PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION	THE COST TO CHARGE RATIO (WORKSHEET 2 "RATIO OF PATIENT CARE COST TO CHARGES") WAS USED TO CALCULATE LINE 7A FINANCIAL ASSISTANCE COST. OUR COST ACCOUNTING SYSTEM PROVIDED MEDICAID/TENNCARE LOSSES REPORTED ON LINE 7B, WITH THE EXCEPTION OF HOME HEALTH AND OUR PHYSICIAN CLINICS. WE USED COST TO CHARGE RATIOS FOR HOME HEALTH AND OUR SMALL PHYSICIAN CLINICS BECAUSE THEIR DATA ARE NOT AVAILABLE IN OUR COST ACCOUNTING SOFTWARE. THE PHYSICIAN CLINICS' MEDICAID LOSS WAS 14,776. LINE 7E COMMUNITY HEALTH IMPROVEMENT INCLUDES COSTS THAT ARE TAKEN DIRECTLY FROM DEPARTMENTAL OPERATING REPORTS, WITH NO ADDITIONAL OVERHEAD INCLUDED IN THE COST. LINE 7F HEALTH PROFESSIONS EDUCATION IS COMPRISED OF INTERNSHIPS (NURSING, THERAPY, EMT, PHARMACY, AND SOCIAL WORK STUDENTS) FROM AREA SCHOOLS AND UNIVERSITIES, ALLOWING THEIR HEALTH PROFESSION STUDENTS TO GET HANDS-ON TRAINING AT A HOSPITAL AS PART OF THEIR EDUCATION AND TRAINING. OUR ORGANIZATIONAL DEVELOPMENT DEPARTMENT KEEPS DETAILED RECORDS OF HOURS SPENT ON THESE STUDENT ACTIVITIES, THE NUMBER OF STUDENTS THAT ROTATE THROUGH OUR HOSPITAL, ETC. INFORMATION IS MAINTAINED FOR EACH HOSPITAL UNIT THAT PARTICIPATES. WE ONLY INCLUDE LABOR COSTS AND WE ONLY ASSUME A PERCENTAGE OF OUR INVOLVED TEAM MEMBERS' TIME IS DEVOTED TO THESE STUDENTS. NEW IN FY16 IS A MEDICARE-APPROVED CERTIFIED NURSE ASSISTANT PROGRAM. FOR LINE 7G SUBSIDIZED HEALTH SERVICES, WE USE OUR COST ACCOUNTING SYSTEM, EXCEPT FOR OUR RURAL PHYSICIAN CLINICS. WE ARE CAREFUL TO ENSURE NO DOUBLE COUNTING OF COST (FOR EXAMPLE, WE DO NOT INCLUDE CHARITY AND MEDICAID/TENNCARE ALREADY REPORTED ON LINES 7A AND 7B). AND, PURSUANT TO IRS INSTRUCTIONS, WE DO NOT INCLUDE BAD DEBT LOSSES. ALTHOUGH WE HAVE MANY SERVICE LINES WITHIN OUR HOSPITAL THAT LOSE MONEY, WE DO NOT REPORT SERVICES THAT HOSPITALS ARE REQUIRED BY STATE LICENSURE TO PROVIDE OR SERVICES READILY AVAILABLE IN OUR AREA. FOR THE SERVICE LINES WE DO REPORT, SUCH AS OUTPATIENT REHABILITATION, WE USED OUR COST ACCOUNTING SYSTEM SINCE THESE PARTICULAR SERVICES HAVE ESTABLISHED, STANDARD FINANCIAL REPORTS. THE HOSPITAL SUBSIDIZED TWO CLINICS OWNED AND OPERATED BY SCCH. THE CLINICS ARE LOCATED IN RURAL, MEDICALLY UNDERSERVED AREAS. WE INCLUDED THE HOSPITAL'S 246,920 SUBSIDY IN LINE 7G. LINE 7I CASH AND IN-KIND CONTRIBUTIONS INCLUDE IN-KIND DONATIONS OF MEDICATIONS AND SUPPLIES TO LOCAL NONPROFIT RESCUE SQUADS. IN-KIND DONATIONS OF MEDICATIONS ARE BASED ON OUR ACTUAL COST FOR THESE ITEMS.
PART II - COMMUNITY BUILDING ACTIVITIES	SCCH 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 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. SCCH, 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 III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY	SELF-PAY BALANCES INCLUDE ACCOUNTS AFTER PAYMENTS AND CONTRACTUAL ADJUSTMENTS (DISCOUNTS) HAVE BEEN POSTED FROM ALL THIRD-PARTY PAYERS- 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. AFTER THE NORMAL COLLECTION PROCESS HAS INDICATED AN ACCOUNT IS UNCOLLECTIBLE, SCCH WRITES THE ACCOUNT OFF TO BAD DEBT. THE HOSPITAL'S OVERALL SELF-PAY ACCOUNTS RECEIVABLE BALANCE IS EVALUATED ON AN ONGOING BASIS TO GATHER HISTORICAL INFORMATION TO APPLY TO THE CURRENT BALANCE. IN OTHER WORDS, THE HOSPITAL EVALUATES PAST COLLECTION HISTORY ON ACCOUNTS WRITTEN OFF TO BAD DEBT AND APPLIES THE HISTORICAL UNPAID RATE TO THE CURRENT SELF-PAY ACCOUNTS RECEIVABLE BALANCE.
PART III, LINE 3 BAD DEBT EXPENSE, PATIENTS ELIGIBLE FOR ASSISTANCE	SCCH'S PATIENT FINANCIAL SERVICES MANAGEMENT ESTIMATE THAT 63% OF BAD DEBT EXPENSE IS ASSUMED ATTRIBUTABLE TO PATIENTS LIKELY ELIGIBLE FOR FINANCIAL ASSISTANCE. WE BASE THIS PERCENTAGE ON THE COMPOSITION OF BAD DEBTS ATTRIBUTABLE TO PEOPLE WITH NO FORM OF INSURANCE OR OTHER THIRD-PARTY COVERAGE, WHICH REPRESENTS THE MAJORITY OF BAD BEBT ACCOUNTS. WE ALSO ESTIMATE A MUCH SMALLER PERCENTAGE OF LIKELY CHARITY-ELIGIBLE ACCOUNTS TO PEOPLE WITH BALANCES AFTER INSURANCE/THIRD-PARTY COVERAGE HAS PAID (E.G. DEDUCTIBLES AND CO-PAYMENT BALANCES). IT IS IMPLAUSIBLE TO DETERMINE WITH EXACTITUDE THE AMOUNT OF SCCH'S BAD DEBT ASSOCIATED WITH THOSE PATIENTS WHO MAY HAVE MET THE CRITERIA SET FORTH IN OUR FINANCIAL ASSISTANCE POLICY WITHOUT HAVING A COMPLETED FINANCIAL ASSESSMENT. WE ARE UNABLE TO DETERMINE OUR PATIENTS' FINANCIAL CIRCUMSTANCES UNLESS A COMPLETED FINANCIAL ASSISTANCE FORM IS VOLUNTARILY PROVIDED TO US. WE CAN ASSERT THAT 95% OF OUR PATIENTS WHO COMPLETED OUR FINANCIAL ASSISTANCE APPLICATION WERE APPROVED FOR AT LEAST PARTIAL FINANCIAL ASSISTANCE. IN FACT 83% OF COMPLETED APPLICATIONS RECEIVED A COMPLETE WRITE-OFF OF ALL CHARGES (FREE CARE). ANOTHER 12% RECEIVED A PARTIAL DISCOUNT. DURING FY16, ONLY 5% OF COMPLETED FINANCIAL ASSISTANCE APPLICATIONS WERE DENIED. UNFORTUNATELY, 33% OF SUBMITTED APPLICATIONS ARE INCOMPLETE. WE RETURN INCOMPLETE APPLICATIONS TO PATIENTS ALONG WITH A NOTICE OF MISSING INFORMATION. THE NOTICE ALSO PROVIDES A CONTACT PHONE NUMBER PATIENTS MAY CALL. WE HAVE MANY INSTANCES OF PATIENTS WITH LARGE ACCOUNT BALANCES AND NO HEALTH INSURANCE COVERAGE THAT WE ARE SURE WOULD QUALIFY FOR CHARITY CARE. ALTHOUGH HOSPITAL TEAM MEMBERS ENCOURAGE THESE INDIVIDUALS TO COMPLETE OUR FINANCIAL ASSISTANCE APPLICATION, MANY WILL NOT DO SO. EVEN WHEN THESE INDIVIDUALS ARE TOLD WE FEEL SURE THEY DO QUALIFY FOR FULL OR PARTIAL ASSISTANCE, THEY STILL FAIL TO COMPLETE OUR FINANCIAL ASSISTANCE APPLICATION.
BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS	THE TEXT OF MSHA'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE APPEARS ON PAGE 13 IN OUR MOST RECENT AUDITED FINANCIAL STATEMENTS (ATTACHED).
PART III, LINE 8 - MEDICARE EXPLANATION	MEDICARE ALLOWABLE COSTS ARE REPORTED USING SCCH'S FILED MEDICARE COST REPORT (C/R). THE C/R USES A COST TO CHARGE RATIO BASED ON A STEP-DOWN ALLOCATION METHODOLOGY. IN CARING FOR THE PATIENT, THERE ARE SEVERAL SERVICES THAT ARE CONSIDERED NON-ALLOWABLE SUCH AS TRANSPORTATION OF A PATIENT AND COMFORT ITEMS TO INCLUDE A TELEVISION AND A TELEPHONE. THE RECRUITMENT OF PHYSICIANS AND PHYSICIAN GUARANTEES ARE NON-ALLOWED COSTS BY THE MEDICARE PROGRAM EVEN THOUGH PHYSICIANS ARE RECRUITED BASED ON DOCUMENTED COMMUNITY NEED. ALSO, A PORTION OF THE BAD DEBT ASSOCIATED WITH THE CARE OF THE PATIENT IS NOT AN ALLOWED COST BY MEDICARE. MEDICARE LOSSES, INCLUDING SOME NON-ALLOWABLE COSTS SUCH AS THOSE NOTED ABOVE, SHOULD BE COUNTED AS A COMMUNITY BENEFIT AS THIS IS THE COST OF CARE FOR SERVING THE AGING POPULATION. WHILE WE AGREE THAT COSTS SUCH AS MARKETING TO ATTRACT PATIENTS AND LOBBYING ARE REASONABLE TO EXCLUDE, IT DOES NOT SEEM REASONABLE TO EXCLUDE RECRUITMENT OF PHYSICIANS AND BASIC ITEMS SUCH AS TELEVISIONS IN PATIENT ROOMS. AS A NONPROFIT ORGANIZATION, WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTH CARE NEEDS OF THE COMMUNITY AND THE INDIVIDUAL WHILE MAINTAINING A HIGH LEVEL OF HEALTH CARE SERVICES WITHOUT LOSSES. SINCE LOSSES DO OCCUR THROUGH THE CMS SYSTEM OF REIMBURSEMENT, THESE LOSSES ARE A COST OF DOING BUSINESS FOR OUR COMMUNITY AND SHOULD BE CONSIDERED A COMMUNITY BENEFIT. AS A PARTICIPATING PROVIDER IN THE MEDICARE PROGRAM, SCCH IS REQUIRED TO PROVIDE THE FULL REGIMEN OF CARE FOR OUR MEDICARE POPULATION. THERE ARE A NUMBER OF CARE REGIMENS THAT ARE COMPENSATED BY THE MEDICARE PROGRAM AT LEVELS BELOW OUR 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 SUSTAIN IMPORTANT CARE DELIVERY MODELS FOR OUR AGING POPULATION IN SPITE OF THE FACT IT IS SOMETIMES ECONOMICALLY INJURIOUS. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION SCCH HAS ESTABLISHED A STRONG COMMITMENT TO MEET THE MEDICAL NEEDS OF THE COMMUNITIES WE SERVE. ALL REQUESTS FOR FINANCIAL ASSISTANCE ARE EVALUATED USING ESTABLISHED GENERAL GUIDELINES, WHILE ALLOWING FOR UNIQUE FINANCIAL CIRCUMSTANCES. SMYTH COUNTY COMMUNITY HOSPITAL RECOGNIZES ITS OBLIGATION TO PROVIDE QUALITY HEALTH CARE TO THOSE WHO ARE UNABLE TO PAY. SCCH CHARITY GUIDELINES ARE BASED ON THE NATIONAL POVERTY GUIDELINES. HOWEVER, FINANCIAL ASSISTANCE IS NOT BASED SOLELY ON INCOME. UNIQUE FINANCIAL CIRCUMSTANCES ARE CONSIDERED, WHICH CAN CHANGE THE CATEGORY OF ELIGIBILITY. IN ADDITION, CHARITY DETERMINATION MAY BE RETROACTIVE FOR ALL DATES OF SERVICE. WHEN A PATIENT REQUESTS FINANCIAL ASSISTANCE OR WHEN AN APPLICATION HAS BEEN RECEIVED, THE PATIENT ACCOUNT IS PLACED IN A HOLD STATUS TO PREVENT FURTHER COLLECTION ACTIVITIES UNTIL FINANCIAL ASSISTANCE ELIGIBILITY IS DETERMINED.
PART VI, LINE 2 - NEEDS ASSESSMENT	MSHA INCLUDED AMERICA'S HEALTH RANKINGS (AHR) IN ITS ASSESSMENT IN ORDER TO BETTER DEFINE THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES. IN 2016, VIRGINIA'S OVERALL HEALTH RANKING MOVED UP TO 19TH, WHILE TENNESSEE IS RANKED 44TH. HOWEVER, IT SHOULD BE NOTED THAT SOUTHWEST VIRGINIA (WHERE SCCH IS LOCATED) CLOSELY RESEMBLES THE HEALTH RANKINGS FOR TENNESSEE. AMERICA'S HEALTH RANKINGS ARE BASED ON A SERIES OF MEASURES INCLUDING SEVERAL HEALTH OUTCOMES AND HEALTH FACTORS. A SURVEY WAS GIVEN TO 106 INDIVIDUALS REPRESENTING THE TEN COUNTIES IN WHICH MSHA OWNS A FACILITY. THESE INDIVIDUALS INCLUDED PHYSICIANS, PUBLIC HEALTH LEADERS, NON-PROFIT DIRECTORS, SCHOOL NURSES AND OFFICIALS, AND BUSINESS LEADERS. A SURVEY WAS GIVEN TO EACH INDIVIDUAL SEEKING FEEDBACK REGARDING AVAILABLE RESOURCES IN EACH AREA, THE PERCEIVED HEALTH STATUS, HEALTH PRIORITIES (DISEASE CONDITIONS, HEALTH BEHAVIORS AND SOCIOECONOMIC FACTORS), AND SUGGESTIONS FOR IMPROVEMENT. THE MAJORITY OF RESPONSES SUGGESTED FOCUSING ON EDUCATION IN ORDER TO PROMOTE HEALTHY HABITS AND INCREASED ACCESS TO RESOURCES. OTHER RESPONSES INCLUDED: MAKE PHYSICAL EDUCATION A REQUIREMENT AS PART OF SCHOOL CURRICULUM, IMPROVE NATURAL TRAILS AND WALKWAYS, INCREASE COMMUNITY SUPPORT FOR SMOKE-FREE AREAS, PARTNER WITH LOCAL FARMER'S MARKETS, SHARE HEALTH INFORMATION BETWEEN PHARMACIES, NETWORK WITH SMALL BUSINESSES AND NONPROFITS IN ORDER TO AVOID DUPLICATING RESOURCES, AND PROVIDE EARLY SCREENINGS FOR THE UNINSURED OR UNDERINSURED. OVERALL, THE COMMUNITY MEMBERS GAVE MSHA'S CORE SERVICE AREA A HEALTH STATUS RANKING OF 4.55 OUT OF 10 (1 BEING THE LOWEST, 10 BEING THE HIGHEST). SCCH WAS GIVEN A HEALTH STATUS RANKING OF 5.0. AMONG THE 106 PARTICIPANTS, THE AREAS OF OBESITY, CANCER, HEART DISEASE, SMOKING, SUBSTANCE/PRESCRIPTION DRUG ABUSE, AND DIABETES WERE THE TOP HEALTH PRIORITIES IN OUR REGION. ACCORDING TO THE MOST RECENT AHR REPORTS, VIRGINIA AND TENNESSEE BOTH SAW AN INCREASE IN DIABETES AND OBESITY WITHIN THE PAST TEN YEARS. VIRGINIA RANKS 25TH FOR CARDIOVASCULAR DEATHS, 23RD FOR CANCER DEATHS AND 28TH FOR DIABETES. THE ROBERT WOOD JOHNSON FOUNDATION REPORTS 27% OF OUR COUNTY'S ADULTS ARE CONSIDERED OBESE AND PHYSICALLY INACTIVE. SMYTH COUNTY'S HEALTH RANKING IS 100 OUT OF 134 STATEWIDE (1 BEING THE BEST AND 134 BEING THE WORST).
PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	MOUNTAIN STATES HEALTH ALLIANCE COMMUNICATES WITH AND EDUCATES OUR PATIENTS THROUGH VARIOUS AVENUES FOR GOVERNMENTAL ASSISTANCE PROGRAMS AND HOSPITAL FINANCIAL ASSISTANCE. EDUCATION IS PROVIDED TO PATIENTS THROUGH SIGNAGE AND FINANCIAL ASSISTANCE BROCHURES AT ALL HOSPITAL AND AMBULATORY ADMISSION LOCATIONS. FINANCIAL ASSISTANCE APPLICATIONS AND PLAIN LANGUAGE SUMMARIES ARE PROVIDED TO PATIENTS SHOULD THEY REQUEST ONE DURING THEIR PRE- REGISTRATION, REGISTRATION OR FINANCIAL COUNSELING PROCESS. OUR GOVERNMENTAL PROGRAM ELIGIBILITY REPRESENTATIVES ASSIST PATIENTS IN SECURING ELIGIBILITY FOR MEDICAID, FEDERAL DISABILITY AND OTHER GOVERNMENTAL ASSISTANCE PROGRAMS. ADDITIONALLY, IF A PATIENT OR COMMUNITY RESIDENT EXPRESSES AN INTEREST IN THE ACA-HEALTHCARE EXCHANGE, OUR REPRESENTATIVES HAVE THE QUALIFICATIONS AND EXPERIENCE TO ASSIST THEM THROUGH THE ENTIRE PROCESS. FINANCIAL COUNSELORS OFFER FINANCIAL ASSISTANCE APPLICATIONS TO PATIENTS WHO DO NOT QUALIFY FOR GOVERNMENTAL ASSISTANCE PROGRAMS AND ARE UNABLE TO PAY FOR THE COST OF THEIR HEALTHCARE. FINANCIAL ASSISTANCE APPLICATIONS ARE AVAILABLE ON OUR WEBSITE TO INCLUDE THE FINANCIAL ASSISTANCE APPLICATION, POLICY AND PLAIN LANGUAGE SUMMARY IN BOTH ENGLISH AND SPANISH. ALL PATIENT STATEMENTS HAVE VERBIAGE DISCUSSING FINANCIAL ASSISTANCE ALONG WITH THE CONTACT INFORMATION. OUR LAST LETTER TO THE PATIENT DISPLAYS THE PLAIN LANGUAGE SUMMARY. IN ALL ORAL CORRESPONDENCES WITH THE PATIENT, IF IT IS IDENTIFIED THEY CANNOT MEET THE PAYMENT REQUIREMENTS ON THEIR ACCOUNT, FINANCIAL ASSISTANCE IS DISCUSSED AS AN OPTION.
PART VI, LINE 4 - COMMUNITY INFORMATION	SCCH IS LOCATED IN THE TOWN OF MARION, SMYTH 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 INDIVIDUALS WHO ARE UNINSURED. ACCORDING TO U.S. CENSUS BUREAU ESTIMATES, THE TOWN OF MARION HAS A POPULATION OF APPROXIMATELY 5,970, WHILE SMYTH COUNTY'S POPULATION IS JUST OVER 32,000. THE LATEST CENSUS BUREAU DATA ESTIMATES THE MEDIAN AGE OF RESIDENTS OF SMYTH COUNTY IS 44.3 WHICH IS OLDER THAN THE MEDIAN AGE OF 37.6 IN VIRGINIA. THE BUREAU ESTIMATES SMYTH COUNTY MEDIAN HOUSEHOLD INCOME AT 37,983 COMPARED TO 65,015 FOR THE STATE OF VIRGINIA. 27% OF SMYTH COUNTY'S CHILDREN LIVE IN POVERTY COMPARED TO 16% STATEWIDE. SMYTH COUNTY'S HEALTH OUTCOMES RANK 100 OUT OF 134 IN THE STATE.
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH	SCCH IS DEDICATED TO OPERATING EFFICIENTLY SO THAT WASTE IS MINIMIZED. OPERATING SURPLUSES ARE INVESTED INTO IMPROVING TREATMENT OPTIONS FOR OUR PATIENTS THROUGH NEW TECHNOLOGIES, RECRUITING PHYSICIANS AND OTHER HEALTH PROFESSIONALS IN SHORTAGE AREAS, AND IMPROVING OUR FACILITIES AND EQUIPMENT. VARIOUS CHECKS AND BALANCES ARE ESTABLISHED TO ENSURE THAT EXPENDITURES FOR OPERATING EXPENSES AND CAPITAL COSTS ARE REASONABLE AND NECESSARY. THE MAJORITY OF SCCH'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREAS. THERE ARE FOUR DIRECTORS DEEMED NON-INDEPENDENT, PER IRS INSTRUCTIONS. ONE IS SCCH'S CFO, RESPONSIBLE FOR BOTH SCCH AND JOHNSTON MEMORIAL HOSPITAL (JMH), A RELATED ORGANIZATION. ONE MEMBER IS AN EMPLOYEE OF MSHA, A RELATED ORGANIZATION. A THIRD IS A PHYSICIAN EMPLOYED BY MSMG, A RELATED ORGANIZATION. THE FOURTH DIRECTOR IS A PHYSICIAN EMPLOYED BY MSMG, A RELATED ORGANIZATION, AND HE ALSO HAS INTEREST IN A COMPANY THAT PROVIDES SERVICES TO SCCH, WITH ALL TRANSACTIONS CONDUCTED AT ARMS LENGTH. PHYSICIANS THAT REQUEST PRIVILEGES WHO ARE QUALIFIED AND CREDENTIALED ARE EXTENDED PRIVILEGES BY SCCH.
PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM	SCCH IS A 44-BED, ACUTE-CARE FACILITY OPERATED UNDER THE DIRECTION OF A 12-MEMBER BOARD OF DIRECTORS PRIMARILY COMPRISED OF LOCAL COMMUNITY RESIDENTS. SCCH IS MAJORITY OWNED BY MOUNTAIN STATES HEALTH ALLIANCE (MSHA) BASED IN JOHNSON CITY, TENNESSEE, THE LARGEST REGIONAL HEALTHCARE SYSTEM WITH 13 HOSPITALS. MSHA PROVIDES CARE TO PEOPLE IN 29 COUNTIES IN TENNESSEE, VIRGINIA, KENTUCKY, AND NORTH CAROLINA. SCCH SERVES AS ITS COUNTY'S PRIMARY HEALTH SERVICE PROVIDER. PATIENTS BENEFIT FROM SCCH'S AFFILIATION WITH A HEALTHCARE SYSTEM WHERE THEY CAN BE EFFICIENTLY MOVED ALONG AN INTEGRATED, COMPREHENSIVE CONTINUUM OF CARE AS THEIR HEALTH STATUS DICTATES. IF NEEDED, PATIENTS CAN BE MOVED TO THE SYSTEM'S FLAGSHIP FACILITY, JOHNSON CITY MEDICAL CENTER, WHICH IS A TERTIARY CARE FACILITY PROVIDING ADVANCED TREATMENT OPTIONS. MSHA HOSPITALS WORK CLOSELY WITH ONE ANOTHER TO SHARE EXPERTISE AND RESOURCES. FOR EXAMPLE, JMH ASSISTED SCCH ESTABLISH A DIABETES CENTER. JMH'S CENTER HAS BEEN OPERATIONAL FOR MANY YEARS SO THE EXPERIENCED CLINICAL TEAM AT JMH PROVIDED VALUABLE INSIGHT THAT SAVED SCCH TIME, MONEY, AND MISTAKES. THERE ARE MANY OTHER EXAMPLES OF SHARED EXPERTISE AND SERVICES BETWEEN MSHA FACILITIES - LABORATORY, CARDIAC SERVICES, ADMINISTRATIVE, ETC. AND, AS NOTED EARLIER, TWO OF SCCH'S BOARD MEMBERS HAVE SHARED RESPONSIBILITIES BETWEEN SCCH AND JMH.
PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT	VIRGINIA

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	LINCOLN THEATRE	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	117 E MAIN STREET	AddressLine1Txt
City	MARION	CityNm
State Abbreviation	VA	StateAbbreviationCd
ZIP	24354	ZIPCd

Field	Value	IRS element (for citing)
Recipient EIN	541477479	RecipientEIN
IRC Section	501C3	IRCSectionDesc
Cash Grant	$5,500	CashGrantAmt
Purpose Of Grant	SPONSORSHIP	PurposeOfGrantTxt

Field	Value	IRS element (for citing)
Total501c3 Org	1	Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE I, PAGE 1, PART I, LINE 2	FormAndLineReferenceDesc
Explanation	SCCH CHARITABLE DONATIONS REQUIRE FINAL APPROVAL BY THE CEO. DURING PART OF THE YEAR, WE ENCOURAGED DONATION REQUESTS TO BE COMPLETED USING OUR ONLINE DONATION APPLICATION FORM, BUT WE ACCEPTED DONATION REQUESTS IN THE FORM OF LETTERS WHEN AN ADEQUATE EXPLANATION FOR THE REQUEST WAS PROVIDED IN THE LETTER. IN ORDER TO IMPROVE THE OVERALL EFFICIENCY OF CONTRIBUTION REQUEST EVALUATION, WE CHANGED OUR PROCESS SO THAT ALL REQUESTS ARE NOW REQUIRED TO BE COMPLETED USING THE ONLINE APPLICATION FORM. THE ONLINE FORM PROVIDES CONSISTENCY AMONG APPLICANTS AND GIVES US THE INFORMATION WE NEED IN ORDER TO MAKE A FULLY VETTED FUNDING DECISION. SOME OF THE INFORMATION WE REQUIRE FROM APPLICANTS INCLUDES: IF THE APPLICANT IS REQUESTING FUNDING FOR A SPECIFIC EVENT OR PROGRAM, THE DATE, LOCATION, AND TIME ARE REQUIRED DESCRIPTION OF THE EVENT/PROGRAM APPLICANTS OTHER SOURCES OF INCOME EVENT/PROGRAM BUDGET HOW THE EVENT/PROGRAM SUPPORTS SCCH'S MISSION WHO WILL BENEFIT FROM OUR CONTRIBUTION WHAT WILL THE EVENT/PROGRAM ACCOMPLISH APPLICANT ORGANIZATION'S MISSION STATEMENT YEAR THE APPLICANT ORGANIZATION WAS FOUNDED NUMBER OF PEOPLE SERVED ANNUALLY BY THE APPLICANT APPLICANT'S WEBSITE TAX STATUS OF THE APPLICANT AND FEDERAL TAXPAYER ID NUMBER WITH FEW EXCEPTIONS, DONATIONS TO NATIONAL ORGANIZATIONS ARE HANDLED AT MSHA'S CORPORATE LEVEL, WHICH PREVENTS MULTIPLE CONTRIBUTIONS BEING MADE TO THE SAME NATIONAL ORGANIZATION AND ALLOWS ADDITIONAL CONTRIBUTION DOLLARS TO BE USED FOR REGION-SPECIFIC REQUESTS. DONATIONS FROM MSHA HOSPITALS, INCLUDING SCCH, ARE ALMOST ENTIRELY DIRECTED TO LOCAL NONPROFIT ORGANIZATIONS. MSHA'S SOCIAL RESPONSIBILITY COMMITTEE, WHICH PROVIDES SYSTEM-WIDE GUIDANCE, IS COMPRISED OF COMMUNITY LEADERS INCLUDING THE DEAN OF A LOCAL UNIVERSITY, THE PRESIDENT OF A LOCAL COLLEGE, UNITED WAY OF WASHINGTON COUNTY'S PRESIDENT, COMMUNITY VOLUNTEERS, BUSINESS LEADERS, MOUNTAIN STATES FOUNDATION'S PRESIDENT, MSHA'S PRESIDENT AND CEO, AND OTHERS. COMMITTEE MEMBERS WERE SELECTED SO THAT MEMBERSHIP EXPERTISE INCLUDES PUBLIC HEALTH, HEALTH PROFESSIONS EDUCATION, KNOWLEDGE OF OTHER RESOURCES AVAILABLE TO CHARITABLE ORGANIZATIONS, AND INDIVIDUALS WITH HANDS-ON COMMUNITY VOLUNTEER EXPERIENCE. SOME OF THE ROUTINE ACTIVITIES OF THE COMMITTEE DURING QUARTERLY MEETINGS INCLUDE: QUARTERLY REVIEW OF THE SOCIAL RESPONSIBILITY SCORECARD; A MEASUREMENT OF ACTUAL ACCOMPLISHMENTS IN THE YEAR COMPARED TO TARGETS SET AT THE BEGINNING OF THE YEAR REVIEW OF CHARITABLE CONTRIBUTION GIVING FOR THE PREVIOUS QUARTER THIS YEAR, THE COMMITTEE BEGAN WORK TO DEVELOP A SOCIAL RESPONSIBILITY BUSINESS PLAN OPPORTUNITY FOR LOCAL TAX EXEMPT ORGANIZATIONS TO PRESENT TO THE COMMITTEE PROGRAMS THEY OFFER, ACHIEVEMENTS, AND FUNDING NEEDS THE COMMITTEE MAY OR MAY NOT RECOMMEND MSHA CORPORATE/HOSPITAL FUNDING OF PROGRAMS SOMETIMES, MSHA DEPARTMENTS WILL BRING PROPOSALS FOR NEW PROGRAMS TO BENEFIT A SPECIFIC POPULATION, SUCH AS CHILDREN	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Independent Consultant	Yes (X)	IndependentConsultantInd
Compensation Survey	Yes (X)	CompensationSurveyInd
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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)

TitleTitleTxt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt
TONY KECK MSHA SVP
DIRECTOR	$361,624	$84,485	$4,914	$34,596	$14,884	$498,087
ERIC SACKNOFF MD MSMG PHYSICIAN
DIRECTOR	$426,356		$16,017	$12,773	$20,283	$474,819
SEAN MCMURRAY JMH CEO
DIRECTOR	$302,663	$71,472	$11,855	$31,719	$23,005	$437,180
JOHN JETER JMHSCCH CFO
SECRETARY	$176,353	$37,433	$3,898	$8,555	$18,399	$244,207
ANTHONY CLARYMDMSMG PHYSICIAN
DIRECTOR	$174,061		$1,623	$5,452	$19,960	$200,666
JAMES TYLER
SCCH CEO	$187,683	$51,134	$7,227		$18,305	$262,502
CATHY MAINE
ASSOC. ADMIN. & CNO	$144,405	$27,253	$2,109	$5,895	$5,110	$184,544
BELDON FLEMING
PHARMACY MANAGER	$142,376	$1,544	$78	$8,910	$22,906	$175,594
BRUCE BRIGGS
PHARMACIST	$124,769	$613	$15	$7,851	$21,624	$154,802
RAMZI K HUMSI MD
MSMG PHYSICIAN	$234,316	$5,233	$10,962	$7,319	$15,262	$272,896
LINDA WHITE CEO FWCHWR
FORMER SCCH CEO	$261,240	$54,065	$10,478	$28,850	$20,812	$372,085

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

SCHEDULE J, PAGE 1, PART I, LINE 4

TONY KECK, MSHA SVP 0 34,596 0 SEAN MCMURRAY, JMH CEO 0 14,925 0 LINDA WHITE, CEO FWCH/WR 0 12,840 0

SCHEDULE J, PART III

PART I, LINE 4B SEAN MCMURRAY, TONY KECK, AND LINDA WHITE PARTICIPATED IN A 457(F) RETIREMENT PLAN PROVIDED BY MOUNTAIN STATES HEALTH ALLIANCE (MSHA). THE 457(F)PLAN IS A NONQUALIFIED TAX-DEFERRED COMPENSATION PLAN AVAILABLE TO A SELECT GROUP OF KEY EXECUTIVES FOR THE INTENT OF SUPPORTING RETENTION AND TO OFFER A COMPETITIVE TOTAL RETIREMENT PROGRAM. ACCOUNT BALANCES HAVE A "SUBSTANTIAL RISK OF FORFEITURE". IN ADDITION TO CREDITOR RISK, SUBSTANTIAL RISK OF FORFEITURE IS CREATED THROUGH DEFAULT RISK IF THE PARTICIPANT'S EMPLOYMENT WITH MSHA IS TERMINATED PRIOR TO AGE 65. HOWEVER, THE 457(F) PLAN CONTAINS A NON-COMPETE PROVISION THAT PROVIDES THE ACCOUNT BALANCE TO BE PAID IN A LUMP SUM AFTER THE EXECUTIVE SATISFIES THE TWO-YEAR NON- COMPETE PERIOD. THIS PROVISION APPLIES TO EMPLOYER CONTRIBUTIONS IF THE EXECUTIVE HAS PROVIDED ELIGIBLE SERVICE FOR SIX OR MORE YEARS. (ELIGIBLE SERVICE IS OFFICER SERVICE THAT PERMITTED THE EXECUTIVE TO PARTICIPATE IN THE PLAN.) THE EXECUTIVE WILL RECEIVE THE ENTIRE ACCOUNT BALANCE IF HE/SHE BECOMES DISABLED, DIES OR IF THE EXECUTIVE TERMINATES FOR "GOOD REASON- OR IS INVOLUNTARILY TERMINATED WITHOUT "GOOD CAUSE" WITHIN A 24-MONTH PERIOD AFTER A CHANGE-OF-CONTROL OCCURS. DISTRIBUTIONS FROM THIS PLAN ARE SUBJECT TO FEDERAL, STATE, AND LOCAL TAXES ON THE ENTIRE ACCOUNT BALANCE UPON DISTRIBUTION.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	UMS UROLOGY SERVICES OF SMYTH CO	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Relationship Description	VENDOR	RelationshipDescriptionTxt
Transaction	$107,703	TransactionAmt
Transaction	SEE PART V	TransactionDesc
Sharing Of Revenues	false	SharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE L, PART V	FormAndLineReferenceDesc
Explanation	ERIC SACKNOFF, M.D., BOARD MEMBER OF SCCH, HAS PARTNERSHIP INTEREST IN UMS UROLOGY SERVICES OF SMYTH COUNTY (UMS). UMS PROVIDES UROLOGY SERVICES TO SCCH. TRANSACTIONS ARE CONDUCTED AT ARMS-LENGTH.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990 - ORGANIZATION'S MISSION	PART I, LINE I - ORGANIZATION'S MISSION: SMYTH COUNTY COMMUNITY HOSPITAL (SCCH) IS COMMITTED TO BRINGING LOVING CARE TO HEALTH CARE. WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTH CARE NEEDS OF INDIVIDUALS AND COMMUNITIES IN OUR REGION AND TO ASSIST THEM IN ATTAINING THEIR HIGHEST POSSIBLE LEVEL OF HEALTH.
FORM 990, PAGE 2, PART III, LINE 4A	(CONTINUED)FOR THE YEAR ENDING JUNE 30, 2016, SCCH RECORDED 1,560 INPATIENT HOSPITAL ADMISSIONS AND 287 NURSING HOME ADMISSIONS. THERE WERE 81,023 OUTPATIENT VISITS, 17,545 EMERGENCY VISITS AND 13,625 HOME HEALTH VISITS. SCCH IS ON THE FRONT LINES IN THE BATTLE AGAINST PRESCRIPTION DRUG ABUSE. THE HOSPITAL HAS PARTNERED WITH EAST TENNESSEE STATE UNIVERSITY'S BILL GATTON COLLEGE OF PHARMACY TO CREATE A PHARMACY TASK FORCE. THE GROUP INCLUDES SCCH MEDICAL STAFF, MSHA PHARMACISTS, AND PHARMACISTS FROM THE COMMUNITY. DRUG ABUSE IN SMYTH COUNTY IS A SIGNIFICANT PROBLEM SO GETTING TOGETHER THE PHYSICIANS WHO WRITE PRESCRIPTIONS WITH THE PHARMACISTS WHO FILL THE PRESCRIPTIONS, THE PROBLEM CAN BE ADDRESSED WITH MUTUAL DIALOGUE. THE PHARMACY TAX FORCE IS FOCUSED ON PRESCRIPTION DRUG ABUSE IN THE HOSPITAL'S PRIMARY SERVICE AREA. THE HOSPITAL SUBSIDIZES TWO PHYSICIAN PRACTICES LOCATED IN RURAL, MEDICALLY UNDERSERVED AREAS. THESE CLINICS ALLOW RESIDENTS TO RECEIVE QUALITY CARE WITHOUT HAVING TO TRAVEL OUTSIDE OF THEIR HOME AREA. THIS IS ESPECIALLY IMPORTANT FOR ELDERLY RESIDENTS AND OTHERS THAT REQUIRE FAMILY OR FRIENDS TO PROVIDE TRANSPORTATION TO PHYSICIAN APPOINTMENTS. OUR COST DURING THE YEAR TO SUBSIDIZE THE TWO CLINICS WAS JUST UNDER 247,000. THE HOSPITAL CONTINUES THE VALUE OPTIMIZATION SYSTEM (VOS), A PRACTICE THAT USES THE "LEAN" PHILOSOPHY THAT LOOKS AT WORKDAY PROCESSES AND LOCATES WASTEFUL ACTIVITY. AFTER IDENTIFYING WASTE, WAYS ARE IDENTIFIED TO ELIMINATE THE WASTE. THE END RESULT FOR A HOSPITAL IS TO FREE UP MORE TIME TO SPEND WITH PATIENTS RATHER THAN DOING UNNECESSARY THINGS. DURING THE YEAR, SCCH CONDUCTED NINE VOS EVENTS. SEVERAL OF THE PROJECTS RESULTED IN BETTER PATIENT CARE AND IMPROVED PATIENT SATISFACTION, AS MEASURED BY PATIENT SURVEYS CONDUCTED BY AN OUTSIDE, INDEPENDENT FIRM. SOME OF THE MEASUREABLE IMPROVEMENTS INCLUDED: NURSE-PATIENT COMMUNICATION, PHYSICIAN- PATIENT COMMUNICATION, AND INFORMATION PROVIDED TO PATIENTS AT DISCHARGE. AT FRANCIS MARION MANOR (FMM), OUR NURSING HOME, VOS TEAMS WERE ABLE TO ACHIEVE A NUMBER OF SUCCESSES, SUCH AS: REDUCING THE NUMBER OF PATIENT FALLS, URINARY TRACT INFECTIONS, THE USE OF HYPNOTIC MEDICATIONS, AND EXCESSIVE WEIGHT LOSS. ANOTHER FMM IMPROVEMENT DURING THE YEAR WAS A SHARP DECLINE (70%) IN THE NUMBER OF TEAM MEMBER CALL-INS (ABSENTEEISM OR LATE FOR WORK). SCCH SERVES AS A CLINICAL TRAINING FACILITY FOR HEALTH PROFESSIONAL EDUCATION STUDENTS. WE HAVE DEDICATED STAFF TO WORK WITH REGIONAL COLLEGES AND UNIVERSITIES TO COORDINATE THE PLACEMENT OF HEALTHCARE PROFESSIONAL STUDENTS AS PART OF THEIR EDUCATIONAL CURRICULUM. IN ADDITION TO CLINICAL TRAINING, THE HEALTH CARE STUDENTS ENTERING OUR SYSTEM ARE REQUIRED TO HAVE ORIENTATION AND COMPUTER TRAINING. INCLUDED IN THE NUMBER OF PARTICIPANTS RECEIVING CLINICAL EXPERIENCE AT SCCH WERE 74 NURSING STUDENTS FROM VARIOUS COLLEGES, UNIVERSITIES AND PROGRAMS, A 23% INCREASE OVER PRIOR YEAR. IN ADDITION TO THE INCREASED NUMBER OF STUDENTS RECEIVING TRAINING IN OUR HOSPITALS, THE HOURS DEVOTED TO EACH STUDENT ALSO INCREASED. THIS NURSING CLINICAL EXPERIENCE REQUIRED EXTENSIVE SCCH NURSING STAFF INVOLVEMENT. THE CLINICAL SETTING AND HANDS-ON INSTRUCTION COST SCCH 196,538. SCCH PROVIDED A CLINICAL SETTING FOR ANOTHER 72 STUDENTS TRAINING IN HEALTH-RELATED PROGRAMS SUCH AS PHARMACY, SOCIAL WORK, OT/PT, EMT/PARAMEDIC AND OTHER ALLIED-HEALTH DISCIPLINES, A MORE THAN FOURFOLD INCREASE OVER PRIOR YEAR. NOT ONLY DID THE NUMBER OF STUDENTS INCREASE, BUT THE NUMBER OF HOURS DEVOTED TO EACH STUDENT INCREASED. THE INCREASED HOURS PER STUDENT WAS PREDOMINANTLY RELATED TO MORE STUDENTS IN PROGRAMS THAT REQUIRE MUCH LONGER HOSPITAL EXPERIENCE/TRAINING. THESE ADDITIONAL CLINICAL STUDENTS COST SCCH 315,009. SCCH'S NURSING CARE FACILITY, FRANCIS MARION MANOR, CONTINUES TO OFFER A SUCCESSFUL PROGRAM TO TRAIN CERTIFIED NURSE ASSISTANTS. THIS YEAR, OUR CERTIFIED NURSE ASSISTANT (CNA) PROGRAM WAS APPROVED BY MEDICARE AS AN ALLIED HEALTH EDUCATION PROGRAM. IN ORDER TO QUALIFY AS A MEDICARE-APPROVED PROGRAM, A PROVIDER MUST INCUR THE COSTS ASSOCIATED WITH BOTH THE CLINICAL AND THE CLASSROOM INSTRUCTION PORTIONS OF THE PROGRAM, MUST CONTROL THE PROGRAM CURRICULUM AND ADMINISTRATIVE DUTIES, MUST EMPLOY THE FACULTY, AND MUST CONTROL THE CLASSROOM INSTRUCTION AND CLINICAL TRAINING. IN ADDITION, THE PROGRAM MUST BE RECOGNIZED BY A NATIONAL APPROVING BODY OR STATE LICENSING ORGANIZATION. WE OFFER THE CNA PROGRAM FREE OF CHARGE AND PARTICIPANTS ARE UNDER NO OBLIGATION TO WORK FOR SCCH OR ANOTHER MSHA FACILITY UPON COMPLETION OF THE PROGRAM. BASED ON COMMUNITY NEED, SCCH INCURRED DIRECT EXPENSE OF 265,895 TO RECRUIT PHYSICIANS INTO OUR COMMUNITY. IN ADDITION, MSHA CORPORATE ALLOCATES A PORTION OF ITS PHYSICIAN RECRUITMENT DEPARTMENTAL EXPENSES TO ITS HOSPITALS, INCLUDING SCCH, SINCE THE CORPORATE DEPARTMENT SERVICES ALL MSHA DIVISIONS. PHYSICIANS ARE RECRUITED TO REPLACE PHYSICIANS THAT RETIRE OR LEAVE THE AREA. RECRUITMENT EXPENSE DURING FY16 INCLUDED RECRUITMENT FOR EMERGENCY MEDICINE, PRIMARY CARE, GENERAL SURGERY, AND A HOSPITALIST. ALL PHYSICIAN RECRUITMENT ACTIVITIES ARE BASED ON DOCUMENTED COMMUNITY NEED. A PORTION OF OUR RECRUITMENT IS PHYSICIAN DEBT FORGIVEN BY THE HOSPITAL OVER A PERIOD OF YEARS SO LONG AS THE PHYSICIAN REMAINS IN OUR COMMUNITY AND CONTINUES PROVIDING MEDICAL SERVICES TO OUR RESIDENTS. WITH A DONATION FROM SMYTH COUNTY HOSPITAL HEALTHTRUST, RENOVATION OF THE REGIONAL CANCER CENTER AT SCCH MADE TREATMENT EASIER AND MORE EFFICIENT FOR CANCER PATIENTS. THE RENOVATION INVESTMENT ENABLED THE HOSPITAL TO PROVIDE ESSENTIAL CANCER TREATMENT THAT PATIENTS PREVIOUSLY HAD TO LEAVE THE AREA TO RECEIVE. THE PROJECT ALLOWED DIFFERENT ELEMENTS OF CARE TO BE CONSOLIDATED SO PATIENTS ARE ABLE TO CHECK IN, SEE THEIR PROVIDER AND RECEIVE INFUSION OR CHEMOTHERAPY SERVICES WITHIN THE SAME AREA. THE RENOVATED SPACE INCLUDES A SUITE WITH EXAM ROOMS AND NURSING AREA, A WORK SPACE FOR THE CENTER'S PHYSICIAN AND NURSE PRACTITIONER, CANCER NAVIGATORS, SOCIAL WORKER AND DIETICIAN. THE NEW SPACE IS MORE CONVENIENT AND COMFORTABLE FOR OUR PATIENTS, WHO ARE OFTEN WEAK AND TIRED, TO BE SEEN IN ONE LOCATION. CHARITY AND OTHER UNREIMBURSED COSTS: WHILE REIMBURSEMENT FOR HEALTHCARE SERVICES RENDERED IS CRITICAL TO THE OPERATION AND SUSTAINABILITY OF THE ORGANIZATION, SCCH RECOGNIZES ITS OBLIGATION TO PROVIDE FREE OR DISCOUNTED CARE TO INDIVIDUALS WHO CANNOT AFFORD ESSENTIAL MEDICAL SERVICES, INCLUDING EMERGENCY CARE. A PATIENT IS DEEMED ELIGIBLE FOR FINANCIAL ASSISTANCE WHEN THEY MEET THE ESTABLISHED POLICIES OF SCCH AND GUIDELINES OUTLINED BY THE FEDERAL GOVERNMENT. IT IS NOT UNTIL AFTER VERIFICATION OF INCOME AND ASSETS THAT A DECISION REGARDING THE AMOUNT OF WRITE-OFF CAN BE MADE. IN FISCAL YEAR 2016, SCCH INCURRED A LOSS OF 448,039 ATTRIBUTABLE TO THE COSTS OF PROVIDING CARE TO PATIENTS APPROVED FOR FINANCIAL ASSISTANCE. SCCH PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS, SUCH AS MEDICAID, FOR LOW INCOME PEOPLE. SCCH INCURRED A LOSS OF 2.163,774 PROVIDING CARE TO THIS POPULATION OF PATIENTS DURING THE YEAR. SCCH PARTNERED WITH THE COMPANY ADVANCED PATIENT ADVOCACY TO WORK WITH SELF-PAYING PATIENTS WHO HAVE LIMITED FINANCIAL RESOURCES. REPRESENTATIVES WERE AVAILABLE FOR OUR PATIENTS TO DETERMINE POSSIBLE GOVERNMENTAL MEDICAL ASSISTANCE ELIGIBILITY AND TO HELP WITH THE APPLICATION PROCESS AND FOLLOW-UP. 451 PATIENTS WERE APPROVED DURING FY16 FOR COVERAGE AND ONCE A PERSON IS APPROVED FOR MEDICAID THROUGH THIS PROGRAM OFFERED THROUGH SCCH, THEY RETAIN COVERAGE FOR FUTURE MEDICAL CARE. SCCH BEARS THE EXPENSE FOR THIS SERVICE, WHICH TOTALED 19,781 IN FY16. COMMUNITY DONATIONS: FOR MANY YEARS, SCCH HAS PROVIDED ASSISTANCE TO LOCAL NON-PROFIT LIFESAVING ORGANIZATIONS SUCH AS AMBULANCE SERVICES, FIRE DEPARTMENTS AND RESCUE SQUADS. SCCH DONATES FREE MEDICATIONS AND PHARMACEUTICAL SUPPLIES TO THESE ORGANIZATIONS. THE COST OF DONATED MEDICATIONS TO RESCUE ORGANIZATIONS DURING FY16 WAS MORE THAN 7,000. SCCH CONTRIBUTED TO LOCAL CHAPTERS OF NATIONAL NON-PROFIT ORGANIZATIONS WHOSE RESEARCH FOCUSES ON THOSE DISEASES AND CONDITIONS MOST PREVALENT IN THE REGION, INCLUDING AMERICAN HEART ASSOCIATION AND AMERICAN CANCER SOCIETY. WE ALSO SUPPORTED REMOTE AREA MEDICAL CLINICS THAT PROVIDE FREE DENTAL, VISION, AND MEDICAL CARE TO ISOLATED, IMPOVERISHED, OR UNDERSERVED COMMUNITIES; A LOCAL BLOOD DONATION ORGANIZATION; A LOCAL HEALTH WEEK EVENT; AND, A LITTLE LEAGUE FOR CHILDREN WITH DISABILITIES. CONSISTENT WITH PRIOR YEARS, WE WROTE OFF LAB CHARGES OF MORE THAN 24,000 RELATED TO LAB TESTS PERFORMED FOR A LOCAL FREE CLINIC. THE HOSPITAL SUPPORTED LOCAL PROGRAMS THAT ENHANCE THE QUALITY OF LIFE TO RESIDENTS, WHICH IS ALSO IMPORTANT IN THE RECRUITMENT EFFORTS OF BUSINESSES IN THE REGION TO ATTRACT AND RETAIN THE BEST TALENT. DONATIONS WERE MADE TO LINCOLN THEATRE AND MARION DOWNTOWN REVITALIZATION ASSOCIATION. SEVERAL SCCH TEAM MEMBERS SERVED AT THE REMOTE AREA MEDICAL (RAM) CLINIC HE
FORM 990, PART V	PART V, LINE 2A MSHA, SCCH'S MAJORITY OWNER, PROCESSES PAYROLL FOR SCCH. SCCH REIMBURSES MSHA FOR ALL SALARY AND BENEFITS RELATED TO OUR TEAM MEMBERS AND THE EXPENSE IS RECORDED ON SCCH'S BOOKS. SCCH OPERATES A RURAL HEALTH CLINIC. UNDER CURRENT CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) REGULATIONS GOVERNING STAFFING AT A RURAL HEALTH CLINIC, AT LEAST ONE MIDLEVEL PROVIDER (NURSE PRACTITIONER, PHYSICIAN ASSISTANT, ETC.) MUST BE A W-2 EMPLOYEE OF THE CLINIC. THEREFORE, SCCH PAYS ONE MIDLEVEL PROVIDER DIRECTLY (RATHER THAN MSHA PAYING THIS TEAM MEMBER'S SALARY WITH SCCH REIMBURSING MSHA).
FORM 990, PAGE 6, PART VI, LINE 6	MOUNTAIN STATES HEALTH ALLIANCE IS THE 80% MEMBER OF SMYTH COUNTY COMMUNITY HOSPITAL. SMYTH COUNTY COMMUNITY HOSPITAL FOUNDATION IS THE 20% MEMBER OF SMYTH COUNTY COMMUNITY HOSPITAL.
FORM 990, PAGE 6, PART VI, LINE 7A	THERE ARE TWO CLASSES OF MEMBERS, AND EACH CLASS IS ENTITLED TO ELECT A SPECIFIED NUMBER OF DIRECTORS TO THE BOARD. THE MOUNTAIN STATES HEALTH ALLIANCE (MSHA) CLASS IS ELECTED BY THE MSHA BOARD OF DIRECTORS AND THE SMYTH COUNTY COMMUNITY HOSPITAL CLASS IS ELECTED BY THE SMYTH COUNTY COMMUNITY HOSPITAL FOUNDATION BOARD OF DIRECTORS. NEITHER SIDE CAN VETO AN APPOINTMENT.
FORM 990, PAGE 6, PART VI, LINE 7B	CERTAIN DECISIONS OF THE BOARD ARE, PURSUANT TO CHARTER AND VIRGINIA STATUTE, 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, PAGE 6, PART VI, LINE 11B	THE CFO REVIEWED THE FORM 990 WITH THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS AND THE RETURN WAS MADE AVAILABLE TO EACH BOARD MEMBER IN AN ELECTRONIC FORMAT PRIOR TO THE REVIEW.
FORM 990, PAGE 6, PART VI, LINE 12C	ANNUALLY, THE CORPORATE AUDIT AND COMPLIANCE DEPARTMENT OF MSHA FORWARDS THE CONFLICT OF INTEREST POLICY AND DISCLOSURE FORM TO ALL MSHA MANAGEMENT TEAM MEMBERS AND BOARD MEMBERS INCLUDING THOSE AT SCCH. EMPLOYEES AND BOARD MEMBERS MUST NOTE ANY CONFLICTS OR ATTEST THEY HAVE "NONE", AND RETURN THE FORM TO THE AUDIT AND COMPLIANCE DEPARTMENT. ANY NOTED DISCLOSURES ARE FORWARDED TO THE APPROPRIATE MANAGEMENT OR BOARD PERSONNEL TO EVALUATE AND UTILIZE WHEN A TRANSACTION INVOLVING A CONFLICTED PERSON ARISES. ADDITIONALLY, PERSONNEL WHO HAVE A CONFLICT ARISE BETWEEN THE ANNUAL DISTRIBUTION OF THE POLICY AND FORMS ARE REQUIRED TO DISCLOSE THE CONFLICT AND WOULD BE DISCIPLINED IN ANY INSTANCE WHERE THEY HAVE NOT DISCLOSED AND ENGAGED IN A CONFLICTED TRANSACTION.
FORM 990, PAGE 6, PART VI, LINE 15A	MSHA'S HUMAN RESOURCE (H/R) DEPARTMENT EVALUATES SALARY AND BENEFITS FOR SCCH'S CEO ON AN ANNUAL OR NEAR-ANNUAL BASIS. 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 THAT REVIEW, H/R MAKES A RECOMMENDATION TO MSHA'S PRESIDENT & CEO, WHO HAS FINAL APPROVAL FOR THE COMPENSATION OF SCCH'S CEO. IN ADDITION, MSHA 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. THESE SAME METRICS ARE USED FOR ALL EMPLOYEES WITHIN MSHA, WITH A SMALL NUMBER OF EXCEPTIONS FOR OUR COMPANIES THAT DO NOT PROVIDE DIRECT PATIENT CARE.
FORM 990, PAGE 6, PART VI, LINE 15B	SIMILAR TO THE CEO'S COMPENSATION, THE CFO RECEIVES COMPENSATION AND BENEFITS THAT COMPLY WITH MSHA'S SALARY POLICY. HIS PAY IS SET AT A MARKET PERCENTILE SPECIFIC TO HIS POSITION.
FORM 990, PAGE 6, PART VI, LINE 19	GOVERNING DOCUMENTS AND OUR CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE UPON REQUEST TO APPROPRIATE PARTIES REQUESTING THEM. FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THOSE PARTIES WHO OWN INDEBTEDNESS OF THE COMPANY ON A QUARTERLY BASIS. FORM 990, PART VII - RELATED ORGANIZATIONS DIRECTOR COMPENSATION: HOSPITAL BOARD OF DIRECTORS MEMBERS JOHN JETER, SEAN MCMURRAY, AND ANTHONY CLARY, M.D. HAVE FORM 990 REPORTABLE COMPENSATION DERIVED FROM SERVICES THEY PROVIDE TO RELATED ORGANIZATIONS AND TO SCCH. TONY KECK HAS FORM 990 REPORTABLE COMPENSATION FOR SERVICES PROVIDED TO MSHA, A RELATED ORGANIZATION. ERIC SACKNOFF, M.D., HAS FORM 990 REPORTABLE COMPENSATION FOR SERVICES PROVIDED TO MSMG, A RELATED ORGANIZATION. NONE OF THEIR COMPENSATION IS RELATED TO THEIR BOARD SERVICE.
FORM 990, PART IX, LINE 11G	HOSPITAL SUPPORTED CLINICS 4,169,277 0 0 PHYSICIAN FEES 1,799,065 0 0 DIETARY FEES 1,497,399 0 0 LAUNDRY SERVICES 210,783 0 0 ENVIRONMENTAL SERVICES 0 134,277 0 LABORATORY SERVICES 68,421 0 0 OTHER 953,885 13,807 0 LITHOTRIPSY SERVICES 142,871 0 0 TRANSCRIPTION SERVICES 63,344 0 0 COLLECTION SERVICES 0 314,459 0 CONSULTING FEES 0 169,214 0
FORM 990, PART X	PART IV, LINE 24A AND PART X, LINE 20 - TAX EXEMPT BOND LIABILITY THE TAX EXEMPT BOND LIABILITY REFLECTS THE PORTION OF BONDS ISSUED BY MOUNTAIN STATES HEALTH ALLIANCE, SCCH'S MAJORITY OWNER, ON BEHALF OF SCCH FOR CAPITAL NEEDS. SCCH PAYS ALL COSTS RELATED TO THIS PORTION OF THE BOND ISSUE.
FORM 990, PART XI, LINE 9	CAPITAL CONTRIBUTION TO RELATED ORGANIZATION -110,118 TEMPORARILY RESTRICTED GRANTS -149 TOTAL -110,267

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 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	Direct Controlling NADirectControllingNACd
MOUNTAIN STATES HEALTH ALLIANCE
400 N STATE OF FRANKLIN ROAD	JOHNSON CITY	TN	37604	620476282	HOSPITAL	TN	501C3	3	NA	false
SMYTH COUNTY COMM FOUNDATION
1 HEALTH WAY	MARION	VA	24354	311650055	SUPPORT	VA	501C3	11A	NA	false
NORTON COMMUNITY HOSPITAL
100 15TH STREET NORTHWEST	NORTON	VA	24273	540566029	HOSPITAL	VA	501C3	3	NA	false
DICKENSON COMMUNITY HOSPITAL
ONE HOSPITAL DRIVE	CLINTWOOD	VA	24238	770599553	HOSPITAL	VA	501C3	3	NCH	false
JOHNSTON MEMORIAL HOSPITAL
16000 JOHNSTON MEMORIAL DRIVE	ABINGDON	VA	24211	540544705	HOSPITAL	VA	501C3	3	NA	false
ABINGDON PHYSICIAN PARTNERS
16000 JOHNSTON MEMORIAL DRIVE	ABINGDON	VA	24211	205485346	MED. SERV.	VA	501C3	11A	JMH	false
MOUNTAIN STATES FOUNDATION
2335 KNOB CREEK ROAD STE 101	JOHNSON CITY	TN	37604	581418862	FUNDRAISER	TN	501C3	11A	MSHA	false
MSHA AUXILIARY
400 N STATE OF FRANKLIN ROAD	JOHNSON CITY	TN	37604	581418345	SUPPORT	TN	501C3	11A	MSHA	false
APPALACHIAN EMERGENCY PHYSICIANS
1021 W OAKLAND AVENUE STE 207	JOHNSON CITY	TN	37604	800592504	MED. SERV	VA	501C3	11A		false	N/A
NEWCO INC
211 COMMERCE ST STE 800	NASHVILLE	TN	372011817	611771290	SUPP. ORG	TN	501C3	11B	NA	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
INTEGRATED SOLUTIONS HLTH NTWK LLC
509 MED TECH PARKWAY SUITE 100	JOHNSON CITY	TN	37604	621711997	INVESTMENT	TN	NA	false	false
EMMAUS COMMUNITY HEALTHCARE PLLC
6070 HWY 11E	PINEY FLATS	TN	37686	200577483	MED. SERV.	TN	NA	false	false
MEDICAL SPECIALISTS OF J C LLC
2528 WESLEY STREET SUITE 2	JOHNSON CITY	TN	37604	272199037	MED. SERV.	TN	NA	false	false
EAST TN AMBULATORY SURGERY CNTR
701 MED TECH PARKWAY SUITE 100	JOHNSON CITY	TN	37604	621787537	MED. SERV.	TN	NA	false	false

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 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
BLUE RIDGE MEDICAL MANAGEMENT CORP
1021 W OAKLAND AVENUE SUITE 207	JOHNSON CITY	TN	37604	621490616	MED. SERV.	TN	NA	C CORP	false
MEDISERVE MED EQUIP OF KINGSPORT
1021 W OAKLAND AVENUE SUITE 207	JOHNSON CITY	TN	37604	621212286	DME	TN	NA	C CORP	false
MOUNTAIN STATES PROPERTIES
1021 W OAKLAND AVENUE SUITE 207	JOHNSON CITY	TN	37604	621845895	PROP MGMT	TN	NA	C CORP	false
MOUNTAIN STATES PHYSICIANS GRP INC
1021 W OAKLAND AVENUE SUITE 207	JOHNSON CITY	TN	37604	621700412	HEALTHCARE	TN	NA	C CORP	false
COMMUNITY HOME CARE INC
1460 PARK AVENUE	NORTON	VA	24273	541453810	MED. EQUIP	TN	NA	C CORP	false
WILSON PHARMACY INC
PO BOX 5289	JOHNSON CITY	TN	37602	620329587	PHARMACY	TN	NA	C CORP	false
CRESTPOINT HEALTH INSURANCE CO INC
509 MED TECH PARKWAY SUITE 100	JOHNSON CITY	TN	37604	620381170	INSURANCE	TN	NA	C CORP	false

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	false	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	Yes (true)	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	Yes (true)	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	false	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	Yes (true)	TransferFromOtherOrgInd