Norton Community Hospital: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization: Norton Community Hospital (EIN 54-0566029)
Tax period: 2015-07-01 to 2016-06-30
Filed: 2017-05-12
IRS object ID: 201731329349300423
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	2017-05-12T07:58:53-04:00	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	540566029	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	NORTON COMMUNITY HOSPITAL INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	NORT	BusinessNameControlTxt
Phone	2766799600	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	100 15TH STREET NW	AddressLine1Txt
City	NORTON	CityNm
State Abbreviation	VA	StateAbbreviationCd
ZIP	24273	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	KEVIN MORRISON	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	2766799600	PhoneNum
Signature	2017-05-10	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	MARK LEONARD	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	100 15TH STREET NW	AddressLine1Txt
City	NORTON	CityNm
State Abbreviation	VA	StateAbbreviationCd
ZIP	24273	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$66,156,290	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.MOUNTAINSTATESHEALTH.COM/NCH	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1949	FormationYr
Legal Domicile State	VA	LegalDomicileStateCd
Activity Or Mission	NORTON COMMUNITY HOSPITAL (NCH) 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	13	VotingMembersGoverningBodyCnt
Voting Members Independent	4	VotingMembersIndependentCnt
Total Employee	554	TotalEmployeeCnt
Total Volunteers	55	TotalVolunteersCnt
Total Gross UBI	$52,417	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$39,649	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$149,982	PYContributionsGrantsAmt
CY Contributions Grants	$123,976	CYContributionsGrantsAmt
PY Program Service Revenue	$65,110,726	PYProgramServiceRevenueAmt
CY Program Service Revenue	$64,684,469	CYProgramServiceRevenueAmt
PY Investment Income	$995,576	PYInvestmentIncomeAmt
CY Investment Income	$879,993	CYInvestmentIncomeAmt
PY Other Revenue	$378,428	PYOtherRevenueAmt
CY Other Revenue	$433,267	CYOtherRevenueAmt
PY Total Revenue	$66,634,712	PYTotalRevenueAmt
CY Total Revenue	$66,121,705	CYTotalRevenueAmt
PY Grants And Similar Paid	$25,350	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$32,811	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$34,341,990	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$35,997,567	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$27,166,307	PYOtherExpensesAmt
CY Other Expenses	$26,098,553	CYOtherExpensesAmt
PY Total Expenses	$61,533,647	PYTotalExpensesAmt
CY Total Expenses	$62,128,931	CYTotalExpensesAmt
PY Revenues Less Expenses	$5,101,065	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$3,992,774	CYRevenuesLessExpensesAmt
Total Assets BOY	$96,638,270	TotalAssetsBOYAmt
Total Assets EOY	$95,001,591	TotalAssetsEOYAmt
Total Liabilities BOY	$39,042,998	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$40,777,394	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$57,595,272	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$54,224,197	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	NORTON COMMUNITY HOSPITAL (NCH) 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	$53,297,395	ExpenseAmt
Grant	$32,811	GrantAmt
Revenue	$64,752,236	RevenueAmt
Desc	NORTON COMMUNITY HOSPITAL (NCH) IS LOCATED IN NORTON, VIRGINIA. OUR 129-BED ACUTE-CARE FACILITY HAS SERVED SOUTHWEST VIRGINIA AND SOUTHEASTERN KENTUCKY SINCE 1949. NCH IS THE SOLE OWNER OF DICKENSON COMMUNITY HOSPITAL, A CRITICAL ACCESS HOSPITAL LOCATED IN CLINTWOOD, VIRGINIA. NCH IS A SUBSIDIARY OF MOUNTAIN STATES HEALTH ALLIANCE. (CONT'D ON SCHEDULE O) (CONT'D) AS THE LARGEST HEALTHCARE FACILITY IN THE COALFIELD REGION, NCH PROVIDES A WIDE ARRAY OF SERVICES THROUGH HIGHLY TRAINED PHYSICIANS AND SUPPORT STAFF. NCH IS RECOGNIZED FOR ITS OUTSTANDING INPATIENT REHABILITATION SERVICES, AN OSTEOPATHIC INTERNAL MEDICINE RESIDENCY PROGRAM, BLACK LUNG TREATMENT SERVICES, HIGH-QUALITY IMAGING TECHNOLOGY, AND MANY OTHER SERVICE LINES. SOME SIGNIFICANT NEW SERVICES AND IMPROVEMENTS OCCURRED AT NCH DURING THE YEAR. A NEW HEALTHPLEX AND AN EXPANSION OF THE EMERGENCY DEPARTMENT WERE ALL COMPLETED REPRESENTING AN INVESTMENT OF ALMOST 13 MILLION IN OUR COMMUNITY'S HEALTH. THE NEW 39,000 SQUARE FOOT HEALTHPLEX, LOCATED IN FRONT OF THE HOSPITAL, OFFERS A VARIETY OF HEALTH AND WELLNESS SERVICES AND PROVIDERS, SUCH AS: A WELLNESS CENTER, A PHARMACY, AN OCCUPATIONAL MEDICINE CENTER, DURABLE MEDICAL EQUIPMENT, OUTPATIENT REHAB SERVICES, AND SEVERAL PHYSICIAN PRACTICES. THE ER EXPANSION INCLUDES SIX ADDITIONAL PATIENT ROOMS AND A MORE EFFICIENT FLOOR PLAN. DURING FY16, OUR ER EXPERIENCED 22,373 PATIENT VISITS. BASED ON COMMUNITY NEED, NCH INCURRED DIRECT EXPENSE OF 58,227 TO RECRUIT PHYSICIANS INTO OUR COMMUNITY. IN ADDITION TO THIS DIRECT COST, NCH WAS ALLOCATED A PORTION OF EXPENSE FROM MSHA FOR THE PHYSICIAN RECRUITMENT SERVICES CONDUCTED BY MSHA'S PHYSICIAN RECRUITMENT DEPARTMENT THAT RELATE TO RECRUITMENT EFFORTS TO BENEFIT NCH'S SERVICE AREA. PHYSICIANS ARE RECRUITED TO REPLACE PHYSICIANS THAT RETIRE OR LEAVE THE AREA. RECRUITMENT EXPENSE DURING FY16 INCLUDED RECRUITMENT FOR EMERGENCY MEDICINE, HOSPITALISTS, A PULMONOLOGIST, AND SURGERY. 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 AS A PHYSICIAN REMAINS IN OUR COMMUNITY AND CONTINUES PROVIDING MEDICAL SERVICES TO OUR RESIDENTS. NCH'S BLACK LUNG CLINIC OFFERS THE REGION'S ONLY PROGRAM APPROVED AND FEDERALLY CERTIFIED BY THE U.S. DEPARTMENT OF LABOR FOR THE FEDERAL BLACK LUNG PROGRAM. OUR BLACK LUNG CLINIC OFFERS DISEASE SCREENING/DIAGNOSTIC TESTING AND PULMONARY REHABILITATION SERVICES. BLACK LUNG DISEASE, OR COAL WORKER'S PNEUMOCONIOSIS, IS A LUNG DISEASE THAT RESULTS FROM BREATHING IN DUST FROM COAL GRAPHITE, OR MAN-MADE CARBON OVER A LONG PERIOD OF TIME. WE PROVIDED MORE THAN 10,000 BLACK LUNG PROCEDURES THIS YEAR. WE WERE ABLE TO PROVIDE TELE-NEUROLOGY SERVICES IN OUR EMERGENCY ROOM THIS YEAR AND WE WERE THE FIRST MSHA HOSPITAL TO IMPLEMENT TELE-PEDS SERVICES, BEGINNING IN APRIL, WHICH CONNECTS OUR EMERGENCY ROOM PHYSICIANS AND PATIENTS TO PEDIATRIC PHYSICIANS AT NISWONGER CHILDREN'S HOSPITAL. NCH OPERATES A PHYSICIAN CLINIC THAT IS LOCATED IN A RURAL, LOW-INCOME AREA. THE CLINIC IS STAFFED PRIMARILY WITH MEDICAL RESIDENTS. WITHOUT THE CLINIC, COMMUNITY MEMBERS WOULD NOT HAVE ACCESS TO PRIMARY CARE. NCH SUSTAINS A LOSS OPERATING THE CLINIC, WHICH EXCEEDED 500,000 DURING FY16. NCH TAKES GREAT PRIDE IN TRAINING YOUNG PHYSICIANS FOR OUR RURAL, PREDOMINANTLY LOW-INCOME AND MEDICALLY UNDERSERVED AREA. INTERNAL MEDICINE RESIDENTS ROTATE THROUGH ALL AREAS OF MEDICINE AT NCH, FROM HEALTH MAINTENANCE TO CRITICAL CARE. THE RESIDENTS ASSIST OUR PHYSICIANS IN PROVIDING QUALITY HANDS-ON PATIENT CARE THROUGH OBSERVATION, EDUCATION AND BY PARTICIPATING IN GRAND ROUNDS. IN ADDITION TO SERVICES WITHIN THE HOSPITAL SETTING; AND, AS NOTED IN THE PRECEDING PARAGRAPH, MEDICAL RESIDENTS ARE EXPOSED TO TREATING PATIENTS IN A PHYSICIAN OFFICE SETTING AT OUR COMMUNITY CLINIC (RESIDENT CONTINUITY CLINIC) LOCATED IN WISE, VIRGINIA. INTERNAL MEDICINE RESIDENTS SPENT MORE THAN 49,000 HOURS AT NCH DURING FY16. OUR UNREIMBURSED COST FOR THIS RESIDENCY PROGRAM THIS YEAR WAS 778,000 IN ADDITION TO INTERNAL MEDICINE RESIDENTS, NCH SERVES AS A CLINICAL TRAINING HOSPITAL FOR OTHER ALLIED HEALTH PROFESSION EDUCATION STUDENTS. WE HAVE DEDICATED STAFF THAT WORK WITH REGIONAL COLLEGES AND UNIVERSITIES TO COORDINATE THE PLACEMENT OF HEALTHCARE PROFESSIONAL STUDENTS AS PART OF STUDENTS' EDUCATIONAL CURRICULUM. IN ADDITION TO CLINICAL TRAINING, THE HEALTH CARE STUDENTS ENTERING OUR SYSTEM ARE REQUIRED TO HAVE ORIENTATION AND COMPUTER TRAINING. PARTICIPANTS RECEIVING CLINICAL EXPERIENCE AT NCH DURING FY16 INCLUDED 113 NURSING STUDENTS FROM VARIOUS COLLEGES, UNIVERSITIES AND PROGRAMS (AN INCREASE OF 43% OVER FY15). THIS NURSING CLINICAL EXPERIENCE REQUIRED EXTENSIVE NCH NURSING STAFF INVOLVEMENT. THE CLINICAL SETTING AND HANDS-ON INSTRUCTION COST NCH 300,119. NCH PROVIDED A CLINICAL SETTING FOR ANOTHER 104 STUDENTS TRAINING IN HEALTH-RELATED PROGRAMS SUCH AS PHARMACY, RESPIRATORY THERAPY, EMT/PARAMEDIC AND OTHER ALLIED-HEALTH DISCIPLINES (AN INCREASE OF 63% OVER PRIOR YEAR). THESE ADDITIONAL CLINICAL STUDENTS COST NCH 205,960. WHILE REIMBURSEMENT FOR HEALTHCARE SERVICES RENDERED IS CRITICAL TO THE OPERATION AND SUSTAINABILITY OF THE ORGANIZATION, NCH 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 NCH 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, NCH INCURRED A LOSS OF 888,695 ATTRIBUTABLE TO OUR FINANCIAL ASSISTANCE PROGRAM. NCH PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS FOR LOW INCOME PEOPLE, SUCH AS MEDICAID. THE HOSPITAL INCURRED A LOSS OF 5,285,000 PROVIDING CARE TO THIS POPULATION OF PATIENTS DURING THE YEAR. WE ASSISTED SOME PATIENTS WHO COULD NOT PAY FOR THEIR PRESCRIPTIONS UPON DISCHARGE FROM THE HOSPITAL. OUR UNREIMBURSED COST FOR THESE PRESCRIPTIONS WAS 1,986. NCH PARTNERED WITH THE COMPANY ADVANCED PATIENT ADVOCACY TO WORK WITH SELF-PAYING PATIENTS WHO HAVE LIMITED FINANCIAL RESOURCES. DURING FY16, REPRESENTATIVES WERE AVAILABLE AT NCH TO ASSIST PATIENTS BY DETERMINING GOVERNMENTAL MEDICAL ASSISTANCE (MEDICAID OR TENNCARE) ELIGIBILITY, AND BY HELPING WITH THE APPLICATION PROCESS AND FOLLOW-UP. 760 PATIENTS WERE APPROVED FOR COVERAGE IN FY16. ONCE A PERSON IS APPROVED FOR MEDICAID OR TENNCARE THROUGH THE PROGRAM OFFERED THROUGH NCH, THEY RETAIN COVERAGE FOR FUTURE MEDICAL CARE. ADVANCED PATIENT ADVOCACY WAS COMPENSATED FOR THIS PATIENT ASSISTANCE BY NCH. OUR COST FOR THIS PROGRAM WAS 51,480. WE MADE CASH AND IN-KIND DONATIONS TO LOCAL NON-PROFIT ORGANIZATIONS. DRUGS AND SUPPLIES WITH A COST OF 5,611 WERE DONATED TO AREA EMERGENCY RESCUE SQUADS AND A COUNTY AMBULANCE SERVICE. 27,000 WAS DONATED TO THE UNIVERSITY OF VIRGINIA COLLEGE AT WISE FOUNDATION FOR NURSING SCHOLARSHIPS AND ATHLETIC PROGRAMS. THE HOSPITAL HAS LONG BEEN A SUPPORTER OF REMOTE AREA MEDICAL (RAM). RAM IS A NON-PROFIT ORGANIZATION THAT PROVIDES FREE DENTAL, VISION, AND MEDICAL CARE TO ISOLATED, IMPOVERISHED, OR UNDERSERVED COMMUNITIES. WE DONATED 8,000 IN MEDICATIONS TO RAM THIS YEAR. THE FOOD BANK OF WISE COUNTY, LOCATED IN NORTON, VIRGINIA LOST ITS BUILDING IN FEBRUARY 2015 WHEN IT COLLAPSED AFTER BACK-TO-BACK WINTER STORMS. BUILDING INSPECTORS DEEMED THE PROPERTY UNSAFE TO ENTER AND EVERYTHING INSIDE THE STRUCTURE WAS A TOTAL LOSS, INCLUDING 30,000 IN FOOD. THE FOOD BANK SERVES MORE THAN 1,700 PEOPLE. UNTIL THE FOOD BANK LOCATES A NEW PERMANENT LOCATION, NORTON COMMUNITY HOSPITAL IS PROVIDING ALMOST 3,300 SQUARE FEET OF SPACE, WITH A FAIR MARKET VALUE RENTAL RATE OF 23,064, FOR AN ANNUAL PAYMENT OF ONLY 1. NCH HAS DISCOUNTED THE ANNUAL RENT TO JUST 1 TO SUPPORT THE FOOD BANK'S MISSION OF SERVING THE NEEDY BY DISTRIBUTING FOOD AND TANGIBLE GOODS IN THE COMMUNITY SERVED BY NCH. THE FOOD BANK IS A 501(C)(3) NOT-FOR-PROFIT ORGANIZATION. FOR 10 CONSECUTIVE YEARS, NCH'S INPATIENT REHABILITATION UNIT HAS RANKED IN THE TOP 10% OF INPATIENT REHABILITATION FACILITIES BY UNIFORM DATA SYSTEM FOR MEDICAL REHABILITATION. UNIFORM DATA SYSTEM IS THE INDUSTRY'S LARGEST DATABASE OF PATIENT RECORDS WITH MORE THAN 70% OF ALL INPATIENT REHABILITATION FACILITIES USED TO EVALUATE AND BENCHMARK OBJECTIVELY. HEALTHGRADES RECOGNIZED NCH IN BOTH 2015 AND 2016 WITH THE PULMONARY CARE EXCELLENCE AWARD, WHICH RECOGNIZES HOSPITALS FOR SUPERIOR OUTCOMES IN TREATING CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) AND PNEUMONIA. PATIENTS WHO RECEIVE COPD OR PNEUMONIA TREATMENT AT HOSPITALS RECEIVING THIS CLINICAL QUALITY AWARD HAVE A LOWER RISK OF DYING. HEALTHGRADES EVALUATES HOSPITAL QUALITY FOR CONDITIONS AND PROCEDURES BASED SOLELY ON CLINICAL OUTCOMES. THEIR ANALYSIS IS BASED ON MORE THAN 45 MILLION MEDICARE MED	Desc
Total Program Service Expenses	$53,297,395	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	Yes (true)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	Yes (true)	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	130	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	554	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	13	GoverningBodyVotingMembersCnt
Independent Voting Member	4	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	KEVIN MORRISON	PersonNm
Phone	2764391011	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	100 15TH STREET NW	AddressLine1Txt
City	NORTON	CityNm
State Abbreviation	VA	StateAbbreviationCd
ZIP	24273	ZIPCd

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	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
MARVIN EICHORN MSHA EVPCOO
DIRECTOR	0.50	54.50	Yes (X)	$0	$747,271	$39,264
SHANE HILTON VPCFO MKT OPER
DIRECTOR	2.00	43.00	Yes (X)	$0	$406,667	$55,701
MONTY MCLAURIN VPCEO NW MKT
VICE-CHAIR	9.00	36.00	Yes (X)	$0	$357,781	$52,277	Yes (X)
MATTHEW CUSANO MD
PHYSICIAN &	41.00		Yes (X)	$320,086	$0	$29,106
TOM TULL MSHA VP
DIRECTOR	0.60	44.40	Yes (X)	$0	$176,832	$28,494
ROBERT LEONARD
SECRETARY/TR	0.60	0.30	Yes (X)	$21,190	$0	$0	Yes (X)
CHARLES WARD
CHAIR	1.00		Yes (X)	$21,025	$0	$0	Yes (X)
JAMES MANICURE
DIRECTOR	0.60	0.30	Yes (X)	$14,299	$0	$0
BUFORD STURGILL
DIRECTOR	0.60	0.20	Yes (X)	$13,825	$0	$0
WILLIE PRICE-HARRIS
DIRECTOR(PAR	0.20		Yes (X)	$9,398	$0	$0
BILL WAMPLER
DIRECTOR	0.60		Yes (X)	$6,068	$0	$0
CHARLES SLEMP
DIRECTOR	0.40		Yes (X)	$840	$0	$0
ERNIE WARD
DIRECTOR	0.60		Yes (X)	$840	$0	$0
VALERIE LAWSON
DIRECTOR	0.40		Yes (X)	$0	$0	$0
MARK LEONARD
CEO	39.00	6.00		$0	$335,259	$42,872	Yes (X)
KEVIN MORRISON
CFO	39.00	6.00		$0	$129,326	$10,409	Yes (X)
KENT VANBUECKEN MD
PHYSICIAN	40.00			$703,618	$0	$32,060		Yes (X)
MICHAEL GREEN MD
PHYSICIAN	40.00			$344,435	$0	$0		Yes (X)
RUBYE WASHINGTON-MOORE MD
PHYSICIAN	40.00			$306,418	$0	$30,229		Yes (X)
ROSEANN FRUENDEL
PHYSICIAN	40.00			$290,373	$0	$15,826		Yes (X)
MATHEW LENHARD
PHYSICIAN	40.00			$284,130	$0	$29,478		Yes (X)
JOHN WRIGHT
FORMER DIREC				$13,816	$0	$0			Yes (X)
STEPHEN SAWYER CFO NW MKT
FORMER NCH C	0.00	45.00		$0	$211,868	$24,930			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,350,361	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$2,365,004	TotReportableCompRltdOrgAmt
Total Other Compensation	$390,646	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	31	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
WEATHERBY LOCUMS INC
PO BOX 972633	DALLAS	TX	753972633	PHYSICIAN FEES	$1,246,771
BALL CONSTRUCTION CO INC
1675 PARK AVENUE SW	NORTON	VA	242731607	CONSTRUCTION	$1,181,633
ARAMARK HEALTHCARE
PO BOX 510467	NEW BERLIN	WI	53151	DIETARY SERV	$899,188
VIRGINIA HIGHLANDS ANESTHESIA
PO BOX 1476	ABINGDON	VA	24212	ANESTHESIA SERV	$888,740
DIAGNOSTIC IMAGING INC
P O BOX 12666	ROANOKE	VA	240272666	TELERADIOLOGY	$347,002

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	10	CntrctRcvdGreaterThan100KCnt
Related Organizations	$54,302	RelatedOrganizationsAmt
Government Grants	$62,224	GovernmentGrantsAmt
All Other Contributions	$7,450	AllOtherContributionsAmt
Total Contributions	$123,976	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT REVENUE	622110	$63,588,228	$63,588,228
WELLNESS PROGRAMS	622110	$1,082,892	$1,082,892
LABORATORY REVENUE	621511	$13,349		$13,349

Field	Value	IRS element (for citing)
Total Program Service Revenue	$64,684,469	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$613,094	TotalRevenueColumnAmt
Exclusion	$613,094	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$12,197	TotalRevenueColumnAmt
Exclusion	$12,197	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$166,244	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$34,585	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$131,659	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$131,659	TotalRevenueColumnAmt
Unrelated Business Revenue	$39,068	UnrelatedBusinessRevenueAmt
Exclusion	$92,591	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$239,228	SecuritiesAmt
Other	$15,474	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$239,228	SecuritiesAmt
Other	$15,474	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$254,702	TotalRevenueColumnAmt
Related Or Exempt Func Income	$15,474	RelatedOrExemptFuncIncomeAmt
Exclusion	$239,228	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
CAFETERIA & VENDING	722514	$171,724	$171,724
REVENUE FROM PARENT	900099	$52,293		$52,293
VENDOR SETTLEMENT	900099	$21,600	$21,600

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$55,991	TotalRevenueColumnAmt
Exclusion	$55,991	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$301,608	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$66,121,705	TotalRevenueColumnAmt
Related Or Exempt Func Income	$64,738,887	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$52,417	UnrelatedBusinessRevenueAmt
Exclusion	$1,206,425	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	$32,811	TotalAmt
Program Services	$32,811	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$1,053,789	TotalAmt
Program Services	$401,152	ProgramServicesAmt
Management And General	$652,637	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$27,391,555	TotalAmt
Program Services	$25,286,975	ProgramServicesAmt
Management And General	$2,104,580	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$873,913	TotalAmt
Program Services	$817,530	ProgramServicesAmt
Management And General	$56,383	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$4,909,127	TotalAmt
Program Services	$4,387,970	ProgramServicesAmt
Management And General	$521,157	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$1,769,183	TotalAmt
Program Services	$1,718,890	ProgramServicesAmt
Management And General	$50,293	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$268,856	TotalAmt
Program Services	$257,679	ProgramServicesAmt
Management And General	$11,177	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$165,057	TotalAmt
Management And General	$165,057	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$19,438	TotalAmt
Management And General	$19,438	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$77,686	TotalAmt
Management And General	$77,686	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$7,606,808	TotalAmt
Program Services	$5,904,356	ProgramServicesAmt
Management And General	$1,702,452	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$273,459	TotalAmt
Program Services	$29,679	ProgramServicesAmt
Management And General	$243,780	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$709,556	TotalAmt
Program Services	$611,050	ProgramServicesAmt
Management And General	$98,506	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$1,461,940	TotalAmt
Program Services	$1,437,260	ProgramServicesAmt
Management And General	$24,680	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,087,840	TotalAmt
Program Services	$950,939	ProgramServicesAmt
Management And General	$136,901	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$348,660	TotalAmt
Program Services	$337,060	ProgramServicesAmt
Management And General	$11,600	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$240,681	TotalAmt
Management And General	$240,681	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$4,272,065	TotalAmt
Program Services	$2,783,449	ProgramServicesAmt
Management And General	$1,488,616	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$124,990	TotalAmt
Program Services	$99,359	ProgramServicesAmt
Management And General	$25,631	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$5,926,609	$5,926,609
MANAGEMENT FEES TO PARENT	$1,556,979	$637,206	$919,773
REPAIRS & MAINTENANCE	$1,310,187	$1,258,670	$51,517
UBI TAXES	$6,388		$6,388

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$641,354	TotalAmt
Program Services	$418,751	ProgramServicesAmt
Management And General	$222,603	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$62,128,931	TotalAmt
Program Services	$53,297,395	ProgramServicesAmt
Management And General	$8,831,536	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	$5,007,854	BOYAmt
EOY	$7,369,839	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$9,823,180	BOYAmt
EOY	$9,496,254	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$949,125	BOYAmt
EOY	$62,692	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$1,492,034	BOYAmt
EOY	$1,436,665	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$602,351	BOYAmt
EOY	$485,218	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$102,330,054	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$52,468,094	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$48,312,497	BOYAmt
EOY	$49,861,960	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$25,232,132	BOYAmt
EOY	$26,107,697	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$5,219,097	BOYAmt
EOY	$181,266	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$96,638,270	BOYAmt
EOY	$95,001,591	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$9,452,573	BOYAmt
EOY	$7,118,549	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$21,095,386	BOYAmt
EOY	$20,985,500	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$8,495,039	BOYAmt
EOY	$12,673,345	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$39,042,998	BOYAmt
EOY	$40,777,394	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$57,473,603	BOYAmt
EOY	$54,096,792	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$121,669	BOYAmt
EOY	$127,405	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$57,595,272	BOYAmt
EOY	$54,224,197	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$96,638,270	BOYAmt
EOY	$95,001,591	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$3,992,774	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$724,739	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$6,639,110	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	$2,194	GrantsOtherOrganizationsAmt
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	false	OtherActivitiesInd
Total Lobbying Expenditures	$2,194	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE C, PART II-B, LINE 1	FormAndLineReferenceDesc
Explanation	NCH HAD LOBBYING EXPENSES OF 2,194 WHICH REPRESENTS THE PORTION OF DUES PAID TO VIRGINIA HOSPITAL AND HEALTHCARE ASSOCIATION AND TO NATIONAL RURAL HEALTH ASSOCIATION ATTRIBUTABLE TO DIRECT LOBBYING.	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,111,034	OtherCostOrOtherBasisAmt
Book Value	$2,111,034	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$51,903,935	OtherCostOrOtherBasisAmt
Depreciation	$20,247,876	DepreciationAmt
Book Value	$31,656,059	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$282,116	OtherCostOrOtherBasisAmt
Depreciation	$201,222	DepreciationAmt
Book Value	$80,894	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$46,842,180	OtherCostOrOtherBasisAmt
Depreciation	$31,626,635	DepreciationAmt
Book Value	$15,215,545	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,190,789	OtherCostOrOtherBasisAmt
Depreciation	$392,361	DepreciationAmt
Book Value	$798,428	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$49,861,960	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDesc	AmtAmt
PENSION BENEFITS	$11,465,823
DUE TO AFFILIATES	$685,950
RESERVE-PROF. LIABILITY SELF-INSUR	$521,572

Field	Value	IRS element (for citing)
Total Liability	$12,673,345	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	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
Annual Community Bnft Report	false	AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$888,695	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$888,695	NetCommunityBenefitExpnsAmt
Total Expense	0.01430	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$14,218,910	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$8,933,607	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,285,303	NetCommunityBenefitExpnsAmt
Total Expense	0.08510	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$15,107,605	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$8,933,607	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,173,998	NetCommunityBenefitExpnsAmt
Total Expense	0.09940	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$120,261	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$120,261	NetCommunityBenefitExpnsAmt
Total Expense	0.00190	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,815,403	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,531,556	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,283,847	NetCommunityBenefitExpnsAmt
Total Expense	0.02070	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,441,251	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,210,550	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,230,701	NetCommunityBenefitExpnsAmt
Total Expense	0.01980	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$7,611	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$7,611	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,384,526	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,742,106	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,642,420	NetCommunityBenefitExpnsAmt
Total Expense	0.04250	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$20,492,131	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$11,675,713	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$8,816,418	NetCommunityBenefitExpnsAmt
Total Expense	0.14190	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$9,472,122	BadDebtExpenseAmt
Bad Debt Expense Attributable	$6,709,349	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$16,894,365	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$16,292,321	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$602,044	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	NORTON COMMUNITY HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	100 15TH STREET NW	AddressLine1Txt
City	NORTON	CityNm
State Abbreviation	VA	StateAbbreviationCd
ZIP	24273	ZIPCd

Field	Value	IRS element (for citing)
Website Address	MOUNTAINSTATESHEALTH.COM/NCH	WebsiteAddressTxt
State License	H 1879	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Teaching Hospital	Yes (X)	TeachingHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	NORTON 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	MOUNTAINSTATESHEALTH.COM/NCH	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	MOUNTAINSTATESHEALTHCOM	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	MOUNTAINSTATESHEALTHCOM	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	MOUNTAINSTATESHEALTHCOM	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, NORTON COMMUNITY HOSPITAL - PART V, LINE 5	MSHA MET WITH TEN FOCUS GROUPS, EACH REPRESENTING ONE OF THE THIRTEEN HOSPITAL FACILITIES, INCLUDING NCH. EACH GROUP CONSISTED OF PUBLIC HEALTH LEADERS, NURSES, NON-PROFIT DIRECTORS, COMMUNITY DEVELOPERS, FAITH BASED LEADERS, PUBLIC OFFICIALS AND SCHOOL REPRESENTATIVES. 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 NCH'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, NORTON COMMUNITY HOSPITAL - PART V, LINE 6A	EACH HOSPITAL WITHIN THE MSHA SYSTEM COMPLETED A CHNA. NCH'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, SMYTH COUNTY COMMUNITY HOSPITAL, JOHNSTON MEMORIAL HOSPITAL AND DICKENSON COMMUNITY HOSPITAL.
FACILITY 1, NORTON 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, NCH WORKS WITH LOCAL PHYSICIANS TO PROVIDE A SUPPORT PROGRAM FOR PREGNANT WOMEN WITH SUBSTANCE ABUSE ISSUES. DCH HAS IMPLEMENTED SURVIVAL KITS WITH EDUCATION FOR NEWLY DIAGNOSED DIABETES PATIENTS PROVIDED IN LOCAL CLINICS AND PHYSICIAN PRACTICES. RCMC SUPPORTS THE RUSSELL COUNTY SCHOOL BACKPACK PROGRAM WHICH PROVIDES HEALTHY FOOD FOR KIDS IN NEED TO HELP ADDRESS CHILDHOOD OBESITY. IPMC HAS BEEN SUPPORTING SUGAR FREE INITIATIVES AT THE LOCAL BOYS AND GIRLS CLUB TO HELP REDUCE OBESITY IN CHILDREN. 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. SSH WORKS WITH RED LEGACY RECOVERY COUNSELING TO PROVIDE SUPPORT FOR YOUNG WOMEN AND MOTHERS RECOVERING FROM SUBSTANCE ABUSE. JCCH MEETS WITH THE 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.

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 NCH.
PART I, LINE 6A - RELATED ORGANIZATION INFORMATION	MSHA'S COMMUNITY BENEFIT REPORT COMPLETED IN FY15 INCLUDED NCH. 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 PHYSICIAN CLINICS BECAUSE THEIR DATA ARE NOT AVAILABLE IN OUR COST ACCOUNTING SOFTWARE. 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 STUDENT INTERNSHIPS (NURSING, PHARMACY, EMT, AND THERAPY STUDENTS) WITH 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 THE STUDENTS. NCH PARTICIPATES IN A MEDICARE-APPROVED INTERNAL MEDICINE RESIDENT PROGRAM. COSTS AND REIMBURSEMENT FOR THE MEDICAL RESIDENT PROGRAM ARE TAKEN FROM THE HOSPITAL'S FILED MEDICARE COST REPORT. FOR LINE 7G SUBSIDIZED HEALTH SERVICES, WE USE OUR COST ACCOUNTING SYSTEM. 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 THAT ARE READILY AVAILABLE FROM OTHER PROVIDERS. FOR THE SERVICE LINES WE DO REPORT(SUCH AS NEONATOLOGY, REHABILITATION AND WOUND CARE), WE USED OUR COST ACCOUNTING SYSTEM SINCE THESE SERVICES HAVE ESTABLISHED, STANDARD FINANCIAL REPORTS. LINE 7G INCLUDES A 510,585 SUBSIDY OF A PHYSICIAN CLINIC OWNED AND OPERATED BY NCH. THE CLINIC IS LOCATED IN A RURAL, LOW-INCOME AREA.
PART II - COMMUNITY BUILDING ACTIVITIES	NCH 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. NCH, 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.
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, NCH 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	NCH'S PATIENT FINANCIAL SERVICES MANAGEMENT ESTIMATE THAT 71% 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 DEBT 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 NCH'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 HAVE 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. OUR TEAM MEMBERS VOLUNTEER TO ASSIST PATIENTS WITH COMPLETION OF THE APPLICATION. MSHA WOULD PREFER FOR PATIENTS TO SUBMIT COMPLETED FINANCIAL ASSISTANCE APPLICATIONS GIVEN HISTORICAL DATA THAT MANY WOULD QUALIFY FOR THIS PROGRAM. WITHOUT A COMPLETED APPLICATION, MSHA MUST REPORT AN UNPAID ACCOUNT AS BAD DEBT INSTEAD OF CHARITY.
BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS	THE TEXT TO NCH'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 NCH'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, NCH 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 FINANCIALLY INJURIOUS. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION: NCH 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. NCH RECOGNIZES ITS OBLIGATION TO PROVIDE QUALITY HEALTHCARE TO THOSE WHO ARE UNABLE TO PAY. OUR 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 RANKED 44TH. HOWEVER, IT SHOULD BE NOTED THAT SOUTHWEST VIRGINIA (WHERE NCH 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, NONPROFIT 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 NON-PROFITS 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). NCH WAS GIVEN A HEALTH STATUS RANKING OF 3.6. 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 33% OF OUR COUNTY'S ADULTS ARE CONSIDERED OBESE AND 37% ARE PHYSICALLY INACTIVE. WISE COUNTY'S HEALTH RANKING IS 124 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	NCH IS LOCATED IN NORTON, WISE COUNTY, WHICH IS IN RURAL SOUTHWEST VIRGINIA. SOUTHWEST VIRGINIA (SWVA) IS LOCATED WITHIN THE APPALACHIAN MOUNTAINS, SPECIFICALLY THE BLUE RIDGE MOUNTAIN REGION. SWVA IS CONSIDERED RURAL AND MUCH DIFFERENT THAN THE REST OF THE STATE. SWVA HAS BEEN AND REMAINS A MAJOR COAL MINING REGION AND HAS A HIGH RATE OF UNINSURED ADULTS. ACCORDING TO U.S. CENSUS BUREAU ESTIMATES, NORTON HAS A POPULATION OF APPROXIMATELY 3,958, WHILE WISE COUNTY'S POPULATION IS 41,452. THE LATEST CENSUS BUREAU DATA ESTIMATES THE MEDIAN AGE OF RESIDENTS OF WISE COUNTY IS 39.8 WHICH IS OLDER THAN THE MEDIAN AGE OF 37.6 IN VIRGINIA. THE BUREAU ESTIMATES WISE COUNTY MEDIAN HOUSEHOLD INCOME AT 37,407 COMPARED TO 65,015 FOR THE STATE OF VIRGINIA. 29% OF WISE COUNTY'S CHILDREN LIVE IN POVERTY COMPARED TO 16% STATEWIDE. WISE COUNTY'S HEALTH OUTCOMES RANK 124 OUT OF 134 IN THE STATE.
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH	NCH 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 NCH'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA AND ARE NOT EMPLOYED BY NCH. MANY OF OUR BOARD MEMBERS ARE NOT CONSIDERED INDEPENDENT, PER IRS FORM 990 INSTRUCTIONS. FOUR WERE EMPLOYED BY NCH'S MAJORITY OWNER, MSHA. FIVE MEMBERS ARE NOT CONSIDERED INDEPENDENT BECAUSE THEY HAD 1099 REPORTABLE COMPENSATION EXCEEDING 10,000 FOR HEALTH INSURANCE PAID BY NCH OR BECAUSE THEY HAD A FAMILY MEMBER EMPLOYED BY NCH (IN NON-MANAGERIAL POSITIONS). ANOTHER BOARD MEMBER IS NOT INDEPENDENT BECAUSE HE IS EMPLOYED BY AND RECEIVED COMPENSATION FROM NCH AS A PHYSICIAN. PHYSICIANS THAT REQUEST PRIVILEGES WHO ARE QUALIFIED AND CREDENTIALED ARE EXTENDED PRIVILEGES BY NCH.
PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM	NCH IS A 129-BED, ACUTE-CARE FACILITY OPERATED UNDER THE DIRECTION OF A 13-MEMBER BOARD OF DIRECTORS PRIMARILY COMPRISED OF LOCAL COMMUNITY RESIDENTS. NCH 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. NCH SERVES AS ITS COUNTY'S PRIMARY HEALTH SERVICE PROVIDER. PATIENTS BENEFIT FROM NCH'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 NEED BE, 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, JOHNSTON MEMORIAL HOSPITAL (JMH) LOCATED IN ABINGDON, VIRGINIA ASSISTED NCH 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 NCH TIME, MONEY, AND MISTAKES. PRIOR TO NCH'S DIABETES CENTER, MANY PATIENTS IN OUR AREA HAD TO TRAVEL ONE TO TWO HOURS FOR THIS TYPE OF CARE. THERE ARE MANY OTHER EXAMPLES OF SHARED EXPERTISE AND SERVICES BETWEEN MSHA FACILITIES - LABORATORY, CARDIAC SERVICES, ADMINISTRATIVE, ETC.
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	UNIVERSITY OF VIRGINIA AT WISE	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1 COLLEGE AVE	AddressLine1Txt
City	WISE	CityNm
State Abbreviation	VA	StateAbbreviationCd
ZIP	24293	ZIPCd

Field	Value	IRS element (for citing)
Recipient EIN	541638774	RecipientEIN
IRC Section	501C3	IRCSectionDesc
Cash Grant	$27,000	CashGrantAmt
Purpose Of Grant	NRSG. & ATHL. PROGMS	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	NCH 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 NCH'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 NCH, 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 (13 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	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt
MARVIN EICHORN MSHA EVPCOO
DIRECTOR	$571,412	$134,090	$41,769	$18,550	$24,504	$786,535
SHANE HILTON VPCFO MKT OPER
DIRECTOR	$330,385	$65,889	$10,393	$34,851	$24,494	$462,368
MONTY MCLAURIN VPCEO NW MKT
VICE-CHAIR	$299,200	$41,814	$16,767	$31,753	$24,057	$410,058
MATTHEW CUSANO MD
PHYSICIAN & DIRECTOR							$314,573	$5,000	$513	$7,870	$22,468	$349,192
TOM TULL MSHA VP
DIRECTOR	$146,506	$22,755	$7,571	$12,400	$16,852	$205,326
MARK LEONARD
CEO	$254,332	$60,873	$20,054	$25,320	$20,833	$378,131
KENT VANBUECKEN MD
PHYSICIAN							$657,023	$40,000	$6,595	$9,053	$24,447	$735,678
MICHAEL GREEN MD
PHYSICIAN							$336,218		$8,217		$1,183	$344,435
RUBYE WASHINGTON-MOORE MD
PHYSICIAN							$284,440		$21,978	$8,290	$23,233	$336,647
ROSEANN FRUENDEL
PHYSICIAN							$252,272		$38,101	$8,757	$8,325	$306,199
MATHEW LENHARD
PHYSICIAN							$263,588		$20,542	$8,206	$22,545	$313,608
JOHN WRIGHT
FORMER DIRECTOR									$13,816			$13,816
STEPHEN SAWYER CFO NW MKT
FORMER NCH CFO	$175,344	$18,495	$18,029	$8,934	$17,995	$236,798

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

SCHEDULE J, PAGE 1, PART I, LINE 4

SHANE HILTON, VP/CFO MKT OPER. 0 16,331 0 MONTY MCLAURIN, VP/CEO NW MKT 0 14,905 0 MARK LEONARD 0 12,513 0

SCHEDULE J, PART III

PART I, LINE 4B SHANE HILTON, MONTY MCLAURIN, AND MARK LEONARD 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 (2 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
JAMIE FLEMING
FAMILY MEMBER	$36,016	FAMILY MBR OF BD MBR	false
DEBBIE WARD
FAMILY MEMBER	$70,858	FAMILY MBR OF BD MBR	false

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE L, PART V	FormAndLineReferenceDesc
Explanation	BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: 1(A) NAME OF PERSON: JAMIE FLEMING 1(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF JAMES MANICURE, NORTON COMMUNITY HOSPITAL (NCH)BOARD MEMBER 1(D) DESCRIPTION OF TRANSACTION: JAMES MANICURE, BOARD MEMBER OF NCH, IS A FAMILY MEMBER OF JAMIE FLEMING, AN EMPLOYEE OF NCH. 2(A) NAME OF PERSON: DEBBIE WARD 2(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF ERNIE WARD, NORTON COMMUNITY HOSPITAL (NCH)BOARD MEMBER 2(D) DESCRIPTION OF TRANSACTION: ERNIE WARD, BOARD MEMBER OF NCH, IS A FAMILY MEMBER OF DEBBIE WARD, AN EMPLOYEE OF NCH.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990 - ORGANIZATION'S MISSION	NORTON COMMUNITY HOSPITAL (NCH) 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	(CONT'D) AS THE LARGEST HEALTHCARE FACILITY IN THE COALFIELD REGION, NCH PROVIDES A WIDE ARRAY OF SERVICES THROUGH HIGHLY TRAINED PHYSICIANS AND SUPPORT STAFF. NCH IS RECOGNIZED FOR ITS OUTSTANDING INPATIENT REHABILITATION SERVICES, AN OSTEOPATHIC INTERNAL MEDICINE RESIDENCY PROGRAM, BLACK LUNG TREATMENT SERVICES, HIGH-QUALITY IMAGING TECHNOLOGY, AND MANY OTHER SERVICE LINES. SOME SIGNIFICANT NEW SERVICES AND IMPROVEMENTS OCCURRED AT NCH DURING THE YEAR. A NEW HEALTHPLEX AND AN EXPANSION OF THE EMERGENCY DEPARTMENT WERE ALL COMPLETED REPRESENTING AN INVESTMENT OF ALMOST 13 MILLION IN OUR COMMUNITY'S HEALTH. THE NEW 39,000 SQUARE FOOT HEALTHPLEX, LOCATED IN FRONT OF THE HOSPITAL, OFFERS A VARIETY OF HEALTH AND WELLNESS SERVICES AND PROVIDERS, SUCH AS: A WELLNESS CENTER, A PHARMACY, AN OCCUPATIONAL MEDICINE CENTER, DURABLE MEDICAL EQUIPMENT, OUTPATIENT REHAB SERVICES, AND SEVERAL PHYSICIAN PRACTICES. THE ER EXPANSION INCLUDES SIX ADDITIONAL PATIENT ROOMS AND A MORE EFFICIENT FLOOR PLAN. DURING FY16, OUR ER EXPERIENCED 22,373 PATIENT VISITS. BASED ON COMMUNITY NEED, NCH INCURRED DIRECT EXPENSE OF 58,227 TO RECRUIT PHYSICIANS INTO OUR COMMUNITY. IN ADDITION TO THIS DIRECT COST, NCH WAS ALLOCATED A PORTION OF EXPENSE FROM MSHA FOR THE PHYSICIAN RECRUITMENT SERVICES CONDUCTED BY MSHA'S PHYSICIAN RECRUITMENT DEPARTMENT THAT RELATE TO RECRUITMENT EFFORTS TO BENEFIT NCH'S SERVICE AREA. PHYSICIANS ARE RECRUITED TO REPLACE PHYSICIANS THAT RETIRE OR LEAVE THE AREA. RECRUITMENT EXPENSE DURING FY16 INCLUDED RECRUITMENT FOR EMERGENCY MEDICINE, HOSPITALISTS, A PULMONOLOGIST, AND SURGERY. 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 AS A PHYSICIAN REMAINS IN OUR COMMUNITY AND CONTINUES PROVIDING MEDICAL SERVICES TO OUR RESIDENTS. NCH'S BLACK LUNG CLINIC OFFERS THE REGION'S ONLY PROGRAM APPROVED AND FEDERALLY CERTIFIED BY THE U.S. DEPARTMENT OF LABOR FOR THE FEDERAL BLACK LUNG PROGRAM. OUR BLACK LUNG CLINIC OFFERS DISEASE SCREENING/DIAGNOSTIC TESTING AND PULMONARY REHABILITATION SERVICES. BLACK LUNG DISEASE, OR COAL WORKER'S PNEUMOCONIOSIS, IS A LUNG DISEASE THAT RESULTS FROM BREATHING IN DUST FROM COAL GRAPHITE, OR MAN-MADE CARBON OVER A LONG PERIOD OF TIME. WE PROVIDED MORE THAN 10,000 BLACK LUNG PROCEDURES THIS YEAR. WE WERE ABLE TO PROVIDE TELE-NEUROLOGY SERVICES IN OUR EMERGENCY ROOM THIS YEAR AND WE WERE THE FIRST MSHA HOSPITAL TO IMPLEMENT TELE-PEDS SERVICES, BEGINNING IN APRIL, WHICH CONNECTS OUR EMERGENCY ROOM PHYSICIANS AND PATIENTS TO PEDIATRIC PHYSICIANS AT NISWONGER CHILDREN'S HOSPITAL. NCH OPERATES A PHYSICIAN CLINIC THAT IS LOCATED IN A RURAL, LOW-INCOME AREA. THE CLINIC IS STAFFED PRIMARILY WITH MEDICAL RESIDENTS. WITHOUT THE CLINIC, COMMUNITY MEMBERS WOULD NOT HAVE ACCESS TO PRIMARY CARE. NCH SUSTAINS A LOSS OPERATING THE CLINIC, WHICH EXCEEDED 500,000 DURING FY16. NCH TAKES GREAT PRIDE IN TRAINING YOUNG PHYSICIANS FOR OUR RURAL, PREDOMINANTLY LOW-INCOME AND MEDICALLY UNDERSERVED AREA. INTERNAL MEDICINE RESIDENTS ROTATE THROUGH ALL AREAS OF MEDICINE AT NCH, FROM HEALTH MAINTENANCE TO CRITICAL CARE. THE RESIDENTS ASSIST OUR PHYSICIANS IN PROVIDING QUALITY HANDS-ON PATIENT CARE THROUGH OBSERVATION, EDUCATION AND BY PARTICIPATING IN GRAND ROUNDS. IN ADDITION TO SERVICES WITHIN THE HOSPITAL SETTING; AND, AS NOTED IN THE PRECEDING PARAGRAPH, MEDICAL RESIDENTS ARE EXPOSED TO TREATING PATIENTS IN A PHYSICIAN OFFICE SETTING AT OUR COMMUNITY CLINIC (RESIDENT CONTINUITY CLINIC) LOCATED IN WISE, VIRGINIA. INTERNAL MEDICINE RESIDENTS SPENT MORE THAN 49,000 HOURS AT NCH DURING FY16. OUR UNREIMBURSED COST FOR THIS RESIDENCY PROGRAM THIS YEAR WAS 778,000 IN ADDITION TO INTERNAL MEDICINE RESIDENTS, NCH SERVES AS A CLINICAL TRAINING HOSPITAL FOR OTHER ALLIED HEALTH PROFESSION EDUCATION STUDENTS. WE HAVE DEDICATED STAFF THAT WORK WITH REGIONAL COLLEGES AND UNIVERSITIES TO COORDINATE THE PLACEMENT OF HEALTHCARE PROFESSIONAL STUDENTS AS PART OF STUDENTS' EDUCATIONAL CURRICULUM. IN ADDITION TO CLINICAL TRAINING, THE HEALTH CARE STUDENTS ENTERING OUR SYSTEM ARE REQUIRED TO HAVE ORIENTATION AND COMPUTER TRAINING. PARTICIPANTS RECEIVING CLINICAL EXPERIENCE AT NCH DURING FY16 INCLUDED 113 NURSING STUDENTS FROM VARIOUS COLLEGES, UNIVERSITIES AND PROGRAMS (AN INCREASE OF 43% OVER FY15). THIS NURSING CLINICAL EXPERIENCE REQUIRED EXTENSIVE NCH NURSING STAFF INVOLVEMENT. THE CLINICAL SETTING AND HANDS-ON INSTRUCTION COST NCH 300,119. NCH PROVIDED A CLINICAL SETTING FOR ANOTHER 104 STUDENTS TRAINING IN HEALTH-RELATED PROGRAMS SUCH AS PHARMACY, RESPIRATORY THERAPY, EMT/PARAMEDIC AND OTHER ALLIED-HEALTH DISCIPLINES (AN INCREASE OF 63% OVER PRIOR YEAR). THESE ADDITIONAL CLINICAL STUDENTS COST NCH 205,960. WHILE REIMBURSEMENT FOR HEALTHCARE SERVICES RENDERED IS CRITICAL TO THE OPERATION AND SUSTAINABILITY OF THE ORGANIZATION, NCH 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 NCH 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, NCH INCURRED A LOSS OF 888,695 ATTRIBUTABLE TO OUR FINANCIAL ASSISTANCE PROGRAM. NCH PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS FOR LOW INCOME PEOPLE, SUCH AS MEDICAID. THE HOSPITAL INCURRED A LOSS OF 5,285,000 PROVIDING CARE TO THIS POPULATION OF PATIENTS DURING THE YEAR. WE ASSISTED SOME PATIENTS WHO COULD NOT PAY FOR THEIR PRESCRIPTIONS UPON DISCHARGE FROM THE HOSPITAL. OUR UNREIMBURSED COST FOR THESE PRESCRIPTIONS WAS 1,986. NCH PARTNERED WITH THE COMPANY ADVANCED PATIENT ADVOCACY TO WORK WITH SELF-PAYING PATIENTS WHO HAVE LIMITED FINANCIAL RESOURCES. DURING FY16, REPRESENTATIVES WERE AVAILABLE AT NCH TO ASSIST PATIENTS BY DETERMINING GOVERNMENTAL MEDICAL ASSISTANCE (MEDICAID OR TENNCARE) ELIGIBILITY, AND BY HELPING WITH THE APPLICATION PROCESS AND FOLLOW-UP. 760 PATIENTS WERE APPROVED FOR COVERAGE IN FY16. ONCE A PERSON IS APPROVED FOR MEDICAID OR TENNCARE THROUGH THE PROGRAM OFFERED THROUGH NCH, THEY RETAIN COVERAGE FOR FUTURE MEDICAL CARE. ADVANCED PATIENT ADVOCACY WAS COMPENSATED FOR THIS PATIENT ASSISTANCE BY NCH. OUR COST FOR THIS PROGRAM WAS 51,480. WE MADE CASH AND IN-KIND DONATIONS TO LOCAL NON-PROFIT ORGANIZATIONS. DRUGS AND SUPPLIES WITH A COST OF 5,611 WERE DONATED TO AREA EMERGENCY RESCUE SQUADS AND A COUNTY AMBULANCE SERVICE. 27,000 WAS DONATED TO THE UNIVERSITY OF VIRGINIA COLLEGE AT WISE FOUNDATION FOR NURSING SCHOLARSHIPS AND ATHLETIC PROGRAMS. THE HOSPITAL HAS LONG BEEN A SUPPORTER OF REMOTE AREA MEDICAL (RAM). RAM IS A NON-PROFIT ORGANIZATION THAT PROVIDES FREE DENTAL, VISION, AND MEDICAL CARE TO ISOLATED, IMPOVERISHED, OR UNDERSERVED COMMUNITIES. WE DONATED 8,000 IN MEDICATIONS TO RAM THIS YEAR. THE FOOD BANK OF WISE COUNTY, LOCATED IN NORTON, VIRGINIA LOST ITS BUILDING IN FEBRUARY 2015 WHEN IT COLLAPSED AFTER BACK-TO-BACK WINTER STORMS. BUILDING INSPECTORS DEEMED THE PROPERTY UNSAFE TO ENTER AND EVERYTHING INSIDE THE STRUCTURE WAS A TOTAL LOSS, INCLUDING 30,000 IN FOOD. THE FOOD BANK SERVES MORE THAN 1,700 PEOPLE. UNTIL THE FOOD BANK LOCATES A NEW PERMANENT LOCATION, NORTON COMMUNITY HOSPITAL IS PROVIDING ALMOST 3,300 SQUARE FEET OF SPACE, WITH A FAIR MARKET VALUE RENTAL RATE OF 23,064, FOR AN ANNUAL PAYMENT OF ONLY 1. NCH HAS DISCOUNTED THE ANNUAL RENT TO JUST 1 TO SUPPORT THE FOOD BANK'S MISSION OF SERVING THE NEEDY BY DISTRIBUTING FOOD AND TANGIBLE GOODS IN THE COMMUNITY SERVED BY NCH. THE FOOD BANK IS A 501(C)(3) NOT-FOR-PROFIT ORGANIZATION. FOR 10 CONSECUTIVE YEARS, NCH'S INPATIENT REHABILITATION UNIT HAS RANKED IN THE TOP 10% OF INPATIENT REHABILITATION FACILITIES BY UNIFORM DATA SYSTEM FOR MEDICAL REHABILITATION. UNIFORM DATA SYSTEM IS THE INDUSTRY'S LARGEST DATABASE OF PATIENT RECORDS WITH MORE THAN 70% OF ALL INPATIENT REHABILITATION FACILITIES USED TO EVALUATE AND BENCHMARK OBJECTIVELY. HEALTHGRADES RECOGNIZED NCH IN BOTH 2015 AND 2016 WITH THE PULMONARY CARE EXCELLENCE AWARD, WHICH RECOGNIZES HOSPITALS FOR SUPERIOR OUTCOMES IN TREATING CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) AND PNEUMONIA. PATIENTS WHO RECEIVE COPD OR PNEUMONIA TREATMENT AT HOSPITALS RECEIVING THIS CLINICAL QUALITY AWARD HAVE A LOWER RISK OF DYING. HEALTHGRADES EVALUATES HOSPITAL QUALITY FOR CONDITIONS AND PROCEDURES BASED SOLELY ON CLINICAL OUTCOMES. THEIR ANALYSIS IS BASED ON MORE THAN 45 MILLION MEDICARE MEDICAL CLAIMS RECORDS FOR THE MOST RECENT THREE-YEAR TIME PERIOD AVAILABLE FROM NEARLY 4,500 HOSPITALS NATIONWIDE.
FORM 990, PAGE 6, PART VI, LINE 6	THE CORPORATION IS ORGANIZED AS A VIRGINIA, NON-STOCK, NONPROFIT CORPORATION. MOUNTAIN STATES HEALTH ALLIANCE IS THE 50.1% MEMBER OF NORTON COMMUNITY HOSPITAL,INC. COMMUNITY HEALTHCARE FOUNDATION, INC. IS THE 49.9% MEMBER OF NORTON COMMUNITY HOSPITAL, INC.
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 NORTON COMMUNITY HOSPITAL CLASS IS ELECTED BY THE COMMUNITY HEALTHCARE 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 THE RETURN WITH THE IRS. 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 NCH. 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 NCH'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 NCH'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 CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE UPON REQUEST TO APPROPRIATE PARTIES REQUESTING THEM. FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST TO APPROPRIATE PARTIES REQUESTING THEM, AND THEY ARE MADE AVAILABLE TO THOSE PARTIES WHO OWN INDEBTEDNESS OF THE COMPANY ON A QUARTERLY BASIS. FORM 990, PART VII - RELATED ORGANIZATIONS DIRECTOR COMPENSATION: NORTON COMMUNITY HOSPITAL'S BOARD OF DIRECTOR, MATHEW CUSANO, M.D. HAS 990 REPORTABLE COMPENSATION DERIVED FROM MEDICAL SERVICES PROVIDED TO NCH. HE DOES NOT RECEIVE COMPENSATION FOR SERVICES AS A NCH BOARD MEMBER. MARVIN EICHORN, SHANE HILTON, MONTY MCLAURIN, AND TOM TULL RECEIVE COMPENSATION FOR SERVICES PROVIDED TO RELATED ORGANIZATIONS AND DO NOT RECEIVE COMPENSATION FOR SERVICES AS A NCH BOARD MEMBER.
FORM 990, PART IX, LINE 11G	HOSPITAL SUPPORTED CLINICS 1,190,045 0 0 HOSPITAL BASED PROVIDERS 1,708,907 0 0 PHYSICIAN FEES 1,641,592 0 0 LINEN & ENVIRONMENTAL SERV. 532,342 0 0 NUTRITIONAL SERVICES 241,506 0 0 LABORTORY 218,712 0 0 PHARMACY SERVICES 101,985 0 0 CONTRACT LABOR 90,367 183,146 0 COLLECTION FEES 0 426,224 0 CONSULTING FEES 0 186,705 0 EMERGENCY SERVICES 78,220 0 0 TRANSCRIPTION 0 74,491 0 ENGINEERING SERVICES 0 157,463 0 VARIOUS EXPENSES 100,680 674,423 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, NCH'S MAJORITY OWNER, ON BEHALF OF NCH FOR CAPITAL NEEDS. NCH PAYS ALL COSTS RELATED TO THIS PORTION OF THE BOND ISSUE.
FORM 990, PART XI, LINE 9	CHANGE IN TEMP. RESTRICTED GRANTS 5,736 ELIMINATION OF INTERCOMPANY REC/PAY -3,294,338 PENSION PLAN ADJUSTMENT -3,350,508 TOTAL -6,639,110

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

Field	Value	IRS element (for citing)
Business Name Line1	NORTON COMMUNITY PHYSICIAN SVCS LLC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	96 15TH ST NW	AddressLine1Txt
City	NORTON	CityNm
State Abbreviation	VA	StateAbbreviationCd
ZIP	24273	ZIPCd

Field	Value	IRS element (for citing)
EIN	260868690	EIN
Primary Activities	MED. SERV.	PrimaryActivitiesTxt
Legal Domicile State	VA	LegalDomicileStateCd
Total Income	$6,309,207	TotalIncomeAmt
End Of Year Assets	$3,572,369	EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

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

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
MOUNTAIN STATES HEALTH ALLIANCE
400 N STATE OF FRANKLIN RD	JOHNSON CITY	TN	37604	620476282	HOSP. SYS.	TN	501C3	3	NA	false
DICKENSON COMMUNITY HOSPITAL
ONE HOSPITAL DRIVE	CLINTWOOD	VA	24228	770599553	HOSPITAL	VA	501C3	3	NCH	false
JOHNSTON MEMORIAL HOSPITAL
16000 JOHNSTON MEMORIAL DRIVE	ABINGDON	VA	24211	540544705	HOSPITAL	VA	501C3	3	NA	false
ABINGDON PHYSICIAN PARTNERS
16000 JOHNSTON MEMORIAL DRIVE	ABINGDON	VA	24211	205485346	MED. SERV.	VA	501C3	11A	JMH	false
SMYTH COUNTY COMMUNITY HOSPITAL
245 MEDICAL PARK DRIVE	MARION	VA	24354	540794913	HOSPITAL	VA	501C3	3	MSHA	false
COMMUNITY HEALTHCARE FOUNDATION
100 15TH STREET NW	NORTON	VA	24273	542002314	SUPPORT	VA	501C3	11A	NA	false
MOUNTAIN STATES FOUNDATION
2335 KNOB CREEK ROAD SUITE 101	JOHNSON CITY	TN	37604	581418862	FUNDRAISER	TN	501C3	11A	MSHA	false
MOUNTAIN STATES HEALTH ALLIANCE AUX
400 N STATE OF FRANKLIN RD	JOHNSON CITY	TN	37604	581418345	SUPP. ORG.	TN	501C3	11A	MSHA	false
APPALACHIAN EMERGENCY PHYSICIANS
1021 W OAKLAND AVENUE STE 207	JOHNSON CITY	TN	37604	800592504	MED. SERV	TN	501C3	11A	NA	false
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 INC
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 CTR
701 MED TECH PARKWAY	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	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd
COMMUNITY HOME CARE INC
1460 PARK AVENUE	NORTON	VA	24273	541453810	DME	VA	NA	C CORP	$546,510	$865,426	1.00000	false
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 PHYSICIAN GROUP
1021 W OAKLAND AVENUE SUITE 207	JOHNSON CITY	TN	37604	621700412	HEALTHCARE	TN	NA	C CORP				false
WILSON PHARMACY INC
P O BOX 5289	JOHNSON CITY	TN	37602	620329587	PHARMACY	TN	NA	C CORP				false
CRESTPOINT HEALTH INSURANCE COMPANY
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	Yes (true)	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (true)	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	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (true)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	Yes (true)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (4 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt
COMMUNITY HOME CARE INC
A	$41,444
DICKENSON COMMUNITY HOSPITAL
B	$3,294,338
DICKENSON COMMUNITY HOSPITAL
O	$1,082,186
DICKENSON COMMUNITY HOSPITAL
Q	$1,088,134