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Norton Community Hospital: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
Norton Community Hospital (EIN 54-0566029)
Tax period
2014-07-01 to 2015-06-30
Filed
2016-04-26
IRS object ID
201631179349300738
Schema version
2014v6.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2016-04-26T12:50:22-05:00ReturnTs
Tax Period End2015-06-30TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2014-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN540566029EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NORTON COMMUNITY HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlNORTBusinessNameControlTxt
Phone2766799600PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 15TH STREET NWAddressLine1Txt
CityNORTONCityNm
State AbbreviationVAStateAbbreviationCd
ZIP24273ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKEVIN MORRISONPersonNm
Person TitleCFOPersonTitleTxt
Phone2766799600PhoneNum
Signature2016-04-26SignatureDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-08-17 19:52:53ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMARK LEONARDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 15TH STREET NWAddressLine1Txt
CityNORTONCityNm
State AbbreviationVAStateAbbreviationCd
ZIP24273ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$66,755,805GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MOUNTAINSTATESHEALTH.COM/NCHWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1949FormationYr
Legal Domicile StateVALegalDomicileStateCd
Activity Or MissionNORTON 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 Body13VotingMembersGoverningBodyCnt
Voting Members Independent3VotingMembersIndependentCnt
Total Employee537TotalEmployeeCnt
Total Volunteers17TotalVolunteersCnt
Total Gross UBI$60,502TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$47,423NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$11,240PYContributionsGrantsAmt
CY Contributions Grants$149,982CYContributionsGrantsAmt
PY Program Service Revenue$64,087,799PYProgramServiceRevenueAmt
CY Program Service Revenue$65,110,726CYProgramServiceRevenueAmt
PY Investment Income$1,265,555PYInvestmentIncomeAmt
CY Investment Income$995,576CYInvestmentIncomeAmt
PY Other Revenue$26,834PYOtherRevenueAmt
CY Other Revenue$378,428CYOtherRevenueAmt
PY Total Revenue$65,391,428PYTotalRevenueAmt
CY Total Revenue$66,634,712CYTotalRevenueAmt
PY Grants And Similar Paid$86,652PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$25,350CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$34,144,220PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$34,341,990CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$29,251,782PYOtherExpensesAmt
CY Other Expenses$27,166,307CYOtherExpensesAmt
PY Total Expenses$63,482,654PYTotalExpensesAmt
CY Total Expenses$61,533,647CYTotalExpensesAmt
PY Revenues Less Expenses$1,908,774PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$5,101,065CYRevenuesLessExpensesAmt
Total Assets BOY$90,682,634TotalAssetsBOYAmt
Total Assets EOY$96,638,270TotalAssetsEOYAmt
Total Liabilities BOY$36,935,287TotalLiabilitiesBOYAmt
Total Liabilities EOY$39,042,998TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$53,747,347NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$57,595,272NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionNORTON 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 SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$53,481,413ExpenseAmt
Grant$25,350GrantAmt
Revenue$65,258,556RevenueAmt
DescNORTON COMMUNITY HOSPITAL (NCH) IN NORTON, VIRGINIA, IS A NOT-FOR-PROFIT, 129-BED ACUTE-CARE FACILITY SERVING SOUTHWEST VIRGINIA AND SOUTHEASTERN KENTUCKY SINCE 1949. NCH IS A SUBSIDIARY OF MOUNTAIN STATES HEALTH ALLIANCE. NCH IS THE SOLE OWNER OF DICKENSON COMMUNITY HOSPITAL, LOCATED IN CLINTWOOD, VIRGINIA. (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. FOR THE YEAR ENDING JUNE 30, 2015, NCH RECORDED 12,477 INPATIENT ADMISSIONS, AND PROVIDED FOR 133,724 OUTPATIENT VISITS. THERE WERE 22,953 EMERGENCY VISITS, AND 12,304 HOME HEALTH VISITS. OUR HOSPITAL SAW SIGNIFICANT VOLUME INCREASES IN A NUMBER OF SERVICE LINES DURING FY15. FOR EXAMPLE, INPATIENT REHABILITATION OCCUPANCY INCREASED MORE THAN 8%, WHILE OUR SKILLED NURSING PATIENT DAYS INCREASED BY 15%. ENDOSCOPIES ROSE ALMOST 5%, THE EMERGENCY DEPARTMENT SAW VISITS INCREASE BY NEARLY 7%, OUTPATIENT REHAB PROCEDURES ROSE 18%, AND WE PERFORMED 22% MORE SLEEP STUDIES. NCH IS A MEMBER OF VIRGINIA HOSPITAL AND HEALTHCARE ASSOCIATION AND IS ACCREDITED BY THE AMERICAN OSTEOPATHIC ASSOCIATION (AOA). OUR HOSPITAL WAS THE FIRST AOA ACCREDITED TEACHING FACILITY IN THE STATE OF VIRGINIA. NORTON COMMUNITY HOSPITAL OFFERS A FULL ARRAY OF PRIMARY CARE AND SPECIALTY SERVICES AS WELL AS SEVERAL AMENITIES THAT MAKE US THE HOSPITAL OF CHOICE FOR RESIDENTS IN OUR AREA. OUR TEAM APPROACH TO HEALTH CARE REFLECTS OUR COMMITMENT TO KEEPING OUR PATIENTS AT THE CENTER OF EVERYTHING WE DO. SEVERAL MAJOR PROJECTS WERE ANNOUNCED BY MOUNTAIN STATES HEALTH ALLIANCE LEADERSHIP THIS YEAR THAT WILL BROADEN AND ENHANCE KEY SERVICES AT NCH, INCLUDING A RENOVATED AND EXPANDED EMERGENCY ROOM AT THE HOSPITAL AND A NEW 39,000-SQUARE FOOT MEDICAL COMPLEX THAT WILL BE HOME TO KEY OUTPATIENT SERVICES LIKE REHABILITATION, OCCUPATIONAL MEDICINE, PHARMACY, SURGERY AND ORTHOPEDIC SERVICES, AS WELL AS A NEW WELLNESS CENTER. THESE PROJECTS ARE EXPECTED TO BE COMPLETED NEXT YEAR. RENOVATION AND EXPANSION OF THE EMERGENCY DEPARTMENT WILL INCLUDE SIX ADDITIONAL EXAM ROOMS AND A CENTRALIZED PROVIDER STATION THAT WILL IMPROVE COMMUNICATION, DEPARTMENT EFFICIENCY AND PATIENT FLOW. A NEW URGENT CARE OFFICE WILL WORK IN CONJUNCTION WITH THE ER BY PROVIDING A QUICK, CONVENIENT OPTION FOR PATIENTS WHOSE CONCERNS ARE NOT LIFE THREATENING. AMBULANCE BAYS WILL BE IMPROVED FOR BETTER ACCESS AND FASTER CARE. IN ADDITION, NCH WILL OFFER TELEMEDICINE SERVICES - CONNECTING PATIENTS AND PROVIDERS AT THE HOSPITAL WITH OTHER MSHA-AFFILIATED EXPERTS AT DIFFERENT FACILITIES, MOST NOTABLY NISWONGER CHILDREN'S HOSPITAL (NISWONGER). CHILDREN WHO VISIT THE ER AT NCH WILL HAVE DIRECT ACCESS TO THE PEDIATRIC EMERGENCY PHYSICIANS AT NISWONGER VIA TWO-WAY, LIVE VIDEO. THE NEW TELEMEDICINE SERVICE WILL OFFER A HIGHER LEVEL OF SPECIALTY CARE FOR PATIENTS WITHOUT THEM NEEDING TO TRAVEL OUTSIDE THE AREA. DURING THE YEAR, MSHA HOSPITALS, INCLUDING NCH, WENT THROUGH SURPRISE DRILLS TO TEST READINESS FOR POTENTIAL EBOLA PATIENTS, AND THE RESULTS WERE IMPRESSIVE. PARTNERS FROM THE VIRGINIA DEPARTMENT OF HEALTH SERVED AS EVALUATORS AT OUR VIRGINIA DRILLS. FOR SEVERAL MONTHS, OUR HOSPITALS PLACED AN INTENSE FOCUS ON TRAINING TO IDENTIFY AND ISOLATE A SUSPECTED EBOLA PATIENT. A PRIMARY GOAL WAS TO ENSURE THAT ASKING TRAVEL QUESTIONS AT THE POINT OF REGISTRATION WAS HARDWIRED INTO THE REGULAR REGISTRATION PROCESS. NCH RECEIVED NATIONAL RECOGNITION BY BECKER'S HOSPITAL REVIEW FOR HIGH QUALITY CARE OF PNEUMONIA PATIENTS AND BEING AMONG THE NATION'S 53 HOSPITALS WITH THE BEST OUTCOME FOR PNEUMONIA PATIENTS. USING DATA OBTAINED FROM THE CENTERS FOR MEDICARE AND MEDICAID SERVICES, BECKER'S IDENTIFIED 53 HOSPITALS IN THE U.S. WHOSE PNEUMONIA PATIENTS HAD A 30-DAY MORTALITY RATE AT OR BELOW 8.4, WHICH IS WELL BELOW THE NATIONAL AVERAGE OF 11.9. FOR THE SECOND YEAR IN A ROW, NCH PROVIDED 400 LUNCHES TO PATIENTS ATTENDING THE REMOTE AREA MEDICAL (RAM) EVENT IN LEE COUNTY. THE RAM EVENT TOOK PLACE OVER A TWO-DAY PERIOD OFFERING FREE DENTAL, VISION AND MEDICAL CARE TO THOSE IN NEED. NCH TEAM MEMBERS DISTRIBUTED THE FREE LUNCHES TO PATIENTS THE FIRST DAY OF THE RAM EVENT. NCH TAKES GREAT PRIDE IN TRAINING YOUNG PHYSICIANS FOR OUR RURAL, MEDICALLY UNDERSERVED AREA. THE RESIDENCY PROGRAM HAS RESULTED IN AN INCREASE IN QUALITY PRIMARY CARE FOR SOUTHWEST VIRGINIA AND THE SURROUNDING AREA AND THE GROWTH OF OUR HOSPITAL. NCH OFFERS THE BENEFITS OF RURAL LIVING WITH THE OPPORTUNITY TO TRAIN IN A MODERN AND PROGRESSIVE HOSPITAL. INTERNAL MEDICINE RESIDENTS ROTATE THROUGH ALL AREAS OF MEDICINE, 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 THESE SERVICES WITHIN THE HOSPITAL SETTING, THE RESIDENTS ARE ALSO EXPOSED TO TREATING PATIENTS IN AN OFFICE SETTING AT THE COMMUNITY CLINIC (RESIDENT CONTINUITY CLINIC) IN WISE, VIRGINIA. INTERNAL MEDICINE RESIDENTS SPENT MORE THAN 54,000 HOURS AT NCH DURING FY15. OUR UNREIMBURSED COST FOR THIS RESIDENCY PROGRAM EXCEEDED 700,000. 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 FY15 INCLUDED 80 NURSING STUDENTS FROM VARIOUS COLLEGES, UNIVERSITIES AND PROGRAMS. THIS NURSING CLINICAL EXPERIENCE REQUIRED EXTENSIVE NCH NURSING STAFF INVOLVEMENT. THE CLINICAL SETTING AND HANDS-ON INSTRUCTION COST NCH 159,250. NCH PROVIDED A CLINICAL SETTING FOR ANOTHER 64 STUDENTS TRAINING IN HEALTH-RELATED PROGRAMS SUCH AS RADIOLOGY, PHARMACY, PHYSICAL THERAPY, EMT/PARAMEDIC AND OTHER ALLIED-HEALTH DISCIPLINES. THESE ADDITIONAL CLINICAL STUDENTS COST NCH 54,211. NCH PARTNERED WITH THE COMPANIES, FIRSTSOURCE SOLUTIONS USA AND ADVANCED PATIENT ADVOCACY, TO WORK WITH SELF-PAYING PATIENTS WHO HAVE LIMITED FINANCIAL RESOURCES. DURING FY15, 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. 514 PATIENTS WERE APPROVED FOR COVERAGE IN FY15. ONCE A PERSON IS APPROVED FOR MEDICAID OR TENNCARE THROUGH THE PROGRAM OFFERED THROUGH NCH, THEY RETAIN COVERAGE FOR FUTURE MEDICAL CARE. FIRSTSOURCE SOLUTIONS AND ADVANCED PATIENT ADVOCACY ARE COMPENSATED BY NCH. OUR COST FOR THIS PROGRAM WAS 78,786. NCH CONTINUED THE VALUE OPTIMIZATION SYSTEM (VOS) PROGRAM DURING FY15. VOS ALLOWS A TRANSFORMATION OF CARE BY PROVIDING TRAINING AND TOOLS TO REDUCE WASTE, MEET PATIENTS' EXPECTATIONS OF HIGH QUALITY AND EFFICIENT CARE, WHILE ACHIEVING OUTSTANDING OUTCOMES. THE PROGRAM IS STRUCTURED FOR CONTINUOUS MONITORING AND IMPROVEMENT. IDENTIFIED PROJECTS ARE REFERRED TO AS "STREAMS". IN FY15, NCH REDUCED PATIENTS' ARRIVAL TIME TO DOCTOR TIME FROM 20 MINUTES TO 13 MINUTES, A 35% REDUCTION IN A PATIENT'S WAIT TIME. A VALUE STREAM THAT FOCUSED ON INPATIENT CARE LOOKED AT MEDICATION RECONCILIATIONS. THIS PROJECT INCLUDED NURSES, PHYSICIANS, INTERNAL MEDICINE RESIDENTS, AND PHARMACY STAFF WITH THE GOAL TO REDUCE MEDICATION LIST ERRORS. A MEDICATION LIST, IN THIS CONTEXT, REFERS TO MEDICATIONS AND DOSAGES A PATIENT TAKES AT HOME. IF A PATIENT BEGINS THEIR HOSPITAL VISIT IN THE ED, THE ED NURSE IS RESPONSIBLE FOR MAKING HIS/HER BEST FAITH EFFORT TO OBTAIN A COMPLETE LIST OF CURRENT MEDICATIONS USED BY THE PATIENT. THE INFORMATION INCLUDES DRUG NAME, DOSAGE AND FREQUENCY, LAST DOSE TAKEN, AND REASON FOR THE MEDICATION. WHEN THE PATIENT IS TRANSFERRED FROM THE ED TO A NURSING FLOOR, THE FLOOR NURSE IS RESPONSIBLE FOR REVIEWING THE LIST AND CHECKING FOR MISSING INFORMATION OR NOTES. PHYSICIAN AND RESIDENTS ARE THE THIRD CHECKPOINT IN THE MEDICATION RECONCILIATION PROCESS. PHARMACY REVIEWS MEDICATION INFORMATION FOR EACH PATIENT DAILY AND ERRORS ARE BROUGHT TO THE ATTENTION OF MANAGERS SO THAT ADDITIONAL TRAINING MAY BE PROVIDED WHERE GAPS OR ERRORS ARE IDENTIFIED. THIS VERY STRUCTURED PROCESS RESULTED IN REDUCING ERRORS ON THE MEDICATION LIST BY OVER 85%. TO IMPROVE ACCESS TO PRIMARY CARE, NORTON COMMUNITY HOSPITAL, OPERATES A RESIDENCY CLINIC IN A RURAL, LOW-INCOME AREA. BECAUSE REIMBURSEMENT DOES NOT COVER THE OPERATING EXPENSES OF THE CLINIC, THE HOSPITAL SUBSIDIZES IT. DURING FY15, THE SUBSIDY WAS MORE THANDesc
Total Program Service Expenses$53,481,413TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (true)BusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityYes (true)DisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document135IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee537EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member3IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldVAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonKEVIN MORRISONPersonNm
Phone2764391011PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 15TH STREET NWAddressLine1Txt
CityNORTONCityNm
State AbbreviationVAStateAbbreviationCd
ZIP24273ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
MARVIN EICHORN
MSHA EXEC. V1.0054.00Yes (X)$0$705,370$42,125
ANN FLEMING
DIRECTOR1.0044.00Yes (X)$0$549,839$22,858
MATTHEW CUSANO MD
DIRECTOR39.500.50Yes (X)$358,968$0$29,393
JOHN DOYLE
DIRECTOR1.0044.00Yes (X)$0$354,549$55,691
MONTY MCLAURIN
VICE-CHAIR1.0044.00Yes (X)$0$351,121$54,334
SHANE HILTON
MSHA WASH. C1.0044.00Yes (X)$0$348,154$55,626
TOM TULL
DIRECTOR1.0044.00Yes (X)$0$146,402$32,163
ROBERT LEONARD
SECRETARY/TR1.001.00Yes (X)$23,302$0$0
JAMES MANICURE
DIRECTOR1.001.00Yes (X)$17,943$0$0
BUFORD STURGILL
DIRECTOR1.001.00Yes (X)$17,512$0$0
CHARLES WARD
CHAIR1.000.50Yes (X)$15,844$0$0
BILL WAMPLER
DIRECTOR1.000.50Yes (X)$8,014$0$0
WILLIE PRICE-HARRIS
DIRECTOR1.000.50Yes (X)$7,742$0$0
CHARLES SLEMP
DIRECTOR1.000.50Yes (X)$0$0$0
ERNIE WARD
DIRECTOR1.000.50Yes (X)$0$0$0
MARK LEONARD
CEO40.204.80$0$316,295$47,380Yes (X)
KEVIN MORRISON
CFO40.204.80$0$83,936$7,626Yes (X)
KENT VANBUECKEN MD
PHYSICIAN40.00$383,830$0$22,668Yes (X)
JAMES WILSON MD
PHYSICIAN40.00$356,305$0$27,455Yes (X)
BERNIE SERGENT MD
PHYSICIAN40.00$324,575$0$29,171Yes (X)
LATISHA HILTON MD
PHYSICIAN40.00$306,475$0$8,366Yes (X)
RUBYE WASHINGTON-MOORE MD
PHYSICIAN40.00$304,402$0$27,243Yes (X)
JOHN WRIGHT
FORMER$17,775$0$0Yes (X)
STEPHEN SAWYER CFO
IPMC CFO/FMR45.00$0$165,484$24,048Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,142,687TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,021,150TotReportableCompRltdOrgAmt
Total Other Compensation$486,147TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K29IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
WEATHERBY LOCUMS INC
PO BOX 972633DALLASTX753972633PHYSICIAN FEES$2,126,733
VIRGINIA HIGHLANDS ANESTHESIA
PO BOX 1476ABINGDONVA24212ANESTHESIA SERV$922,972
ARAMARK HEALTHCARE
PO BOX 510467NEW BERLINWI53151DIETARY SERV.$760,400
THOMPSON & LITTON INC
103 EAST MAIN STREET PO BOX 1307WISEVA24293CONSULTING$508,044
CROTHALL SERVICES EAST TN
955 CHESTERBROOK BLVD STE 300WAYNEPA19087LINEN SERVICES$206,046
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K10CntrctRcvdGreaterThan100KCnt
Related Organizations$106,591RelatedOrganizationsAmt
Government Grants$26,812GovernmentGrantsAmt
All Other Contributions$16,579AllOtherContributionsAmt
Total Contributions$149,982TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT REVENUE622110$64,492,117$64,492,117
WELLNESS PROGRAMS622110$606,663$606,663
LABORATORY REVENUE621500$11,946$11,946
FieldValueIRS element (for citing)
Total Program Service Revenue$65,110,726TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$497,237TotalRevenueColumnAmt
Exclusion$497,237ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$677TotalRevenueColumnAmt
Exclusion$677ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$184,341RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$121,093RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$63,248RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$63,248TotalRevenueColumnAmt
Unrelated Business Revenue$48,556UnrelatedBusinessRevenueAmt
Exclusion$14,692ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$416,612SecuritiesAmt
Other$81,050OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$416,612SecuritiesAmt
Other$81,050OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$497,662TotalRevenueColumnAmt
Related Or Exempt Func Income$81,050RelatedOrExemptFuncIncomeAmt
Exclusion$416,612ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
CAFETERIA & VENDING722210$177,120$177,120
HQPAF ADMINISTRATION FEE561000$66,780$66,780
REVENUE FROM PARENT900099$52,353$52,353

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$18,927TotalRevenueColumnAmt
Exclusion$18,927ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$315,180OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$66,634,712TotalRevenueColumnAmt
Related Or Exempt Func Income$65,246,610RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$60,502UnrelatedBusinessRevenueAmt
Exclusion$1,177,618ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$25,350TotalAmt
Program Services$25,350ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$854,795TotalAmt
Program Services$370,479ProgramServicesAmt
Management And General$484,316ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$25,569,404TotalAmt
Program Services$23,539,582ProgramServicesAmt
Management And General$2,029,822ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$810,269TotalAmt
Program Services$761,292ProgramServicesAmt
Management And General$48,977ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$5,397,381TotalAmt
Program Services$4,829,275ProgramServicesAmt
Management And General$568,106ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,710,141TotalAmt
Program Services$1,643,624ProgramServicesAmt
Management And General$66,517ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$227,257TotalAmt
Program Services$219,045ProgramServicesAmt
Management And General$8,212ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$151,746TotalAmt
Management And General$151,746ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$9,510TotalAmt
Management And General$9,510ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$67,476TotalAmt
Management And General$67,476ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$6,937,510TotalAmt
Program Services$5,707,778ProgramServicesAmt
Management And General$1,229,732ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$154,701TotalAmt
Program Services$5,067ProgramServicesAmt
Management And General$149,634ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$794,892TotalAmt
Program Services$709,205ProgramServicesAmt
Management And General$85,687ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,631,057TotalAmt
Program Services$1,604,278ProgramServicesAmt
Management And General$26,779ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,041,972TotalAmt
Program Services$919,598ProgramServicesAmt
Management And General$122,374ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$264,761TotalAmt
Program Services$248,892ProgramServicesAmt
Management And General$15,869ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$91,784TotalAmt
Program Services$90,874ProgramServicesAmt
Management And General$910ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$218,449TotalAmt
Management And General$218,449ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,126,934TotalAmt
Program Services$2,863,193ProgramServicesAmt
Management And General$1,263,741ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$517,777TotalAmt
Program Services$131,489ProgramServicesAmt
Management And General$386,288ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$7,868,566$7,868,566
MANAGEMENT FEES TO PARENT$1,428,852$591,952$836,900
REPAIRS & MAINTENANCE$1,113,364$1,073,902$39,462
UBI TAXES$11,847$11,847

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$507,852TotalAmt
Program Services$277,972ProgramServicesAmt
Management And General$229,880ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$61,533,647TotalAmt
Program Services$53,481,413ProgramServicesAmt
Management And General$8,052,234ManagementAndGeneralAmt
Fundraising$0FundraisingAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XYes (X)InfoInScheduleOPartXInd

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$4,802,630BOYAmt
EOY$5,007,854EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$9,304,073BOYAmt
EOY$9,823,180EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$1,098,013BOYAmt
EOY$949,125EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,266,794BOYAmt
EOY$1,492,034EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$668,366BOYAmt
EOY$602,351EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$96,658,042LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$48,345,545LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$43,402,815BOYAmt
EOY$48,312,497EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$20,031,745BOYAmt
EOY$25,232,132EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$10,108,198BOYAmt
EOY$5,219,097EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$90,682,634BOYAmt
EOY$96,638,270EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$7,431,149BOYAmt
EOY$9,452,573EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$21,242,680BOYAmt
EOY$21,095,386EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,261,458BOYAmt
EOY$8,495,039EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$36,935,287BOYAmt
EOY$39,042,998EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$53,594,573BOYAmt
EOY$57,473,603EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$152,774BOYAmt
EOY$121,669EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$53,747,347BOYAmt
EOY$57,595,272EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$90,682,634BOYAmt
EOY$96,638,270EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$5,101,065ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$101,953NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$1,151,187OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsYes (true)GrantsOtherOrganizationsInd
Grants Other Organizations$3,382GrantsOtherOrganizationsAmt
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesfalseOtherActivitiesInd
Total Lobbying Expenditures$3,382TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE C, PART II-B, LINE 1FormAndLineReferenceDesc
ExplanationPORTION OF DUES PAID TO VIRGINIA HOSPITAL AND HEALTHCARE ASSOCIATION THAT ARE ATTRIBUTABLE TO DIRECT LOBBYING.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

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

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$48,513,880OtherCostOrOtherBasisAmt
Depreciation$18,790,774DepreciationAmt
Book Value$29,723,106BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$282,116OtherCostOrOtherBasisAmt
Depreciation$188,424DepreciationAmt
Book Value$93,692BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$44,560,223OtherCostOrOtherBasisAmt
Depreciation$29,026,313DepreciationAmt
Book Value$15,533,910BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,190,789OtherCostOrOtherBasisAmt
Depreciation$340,034DepreciationAmt
Book Value$850,755BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$48,312,497TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescUNDER BOND INDENTURE AGREEMENTSDesc
Book Value$5,219,097BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$5,219,097TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
RETIREE BENEFITS PAYABLE$7,840,925
RESERVE FOR PROF LIABILITIES$599,792
DUE TO AFFILIATES$54,322
FieldValueIRS element (for citing)
Total Liability$8,495,039TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE D, PAGE 3, PART XFormAndLineReferenceDesc
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, 2015 AND 2014. AT JUNE 30, 2015, TAX RETURNS FOR 2011 THROUGH 2014 ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE."ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$719,975TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$719,975NetCommunityBenefitExpnsAmt
Total Expense0.01170TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,946,627TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$8,032,167DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,914,460NetCommunityBenefitExpnsAmt
Total Expense0.07990TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$13,666,602TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$8,032,167DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,634,435NetCommunityBenefitExpnsAmt
Total Expense0.09160TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$146,513TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$146,513NetCommunityBenefitExpnsAmt
Total Expense0.00240TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,466,333TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,533,358DirectOffsettingRevenueAmt
Net Community Benefit Expns$932,975NetCommunityBenefitExpnsAmt
Total Expense0.01520TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,373,133TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,008,414DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,364,719NetCommunityBenefitExpnsAmt
Total Expense0.02220TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,028TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$8,028NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,994,007TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,541,772DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,452,235NetCommunityBenefitExpnsAmt
Total Expense0.03990TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$21,660,609TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$13,573,939DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,086,670NetCommunityBenefitExpnsAmt
Total Expense0.13140TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$7,028,655BadDebtExpenseAmt
Bad Debt Expense Attributable$5,341,777BadDebtExpenseAttributableAmt
Reimbursed By Medicare$14,973,650ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$14,944,188CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$29,462MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NORTON COMMUNITY HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 15TH STREET NWAddressLine1Txt
CityNORTONCityNm
State AbbreviationVAStateAbbreviationCd
ZIP24273ZIPCd
FieldValueIRS element (for citing)
Website AddressMOUNTAINSTATESHEALTH.COM/NCHWebsiteAddressTxt
State LicenseH 1879StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Teaching HospitalYes (X)TeachingHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1NORTON COMMUNITY HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLMOUNTAINSTATESHEALTH.COM/NCHOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt16ImplementationStrategyAdptYr
Strategy Posted WebsitefalseStrategyPostedWebsiteInd
Strategy AttachedYes (true)StrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLMOUNTAINSTATESHEALTHCOMFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLMOUNTAINSTATESHEALTHCOMFAPAppAvailableOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesYes (true)CollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FACILITY 1, NORTON COMMUNITY HOSPITAL - PART V, LINE 5MSHA 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 6AEACH 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 11MSHA PUBLISHED ITS COMMUNITY HEALTH NEEDS ASSESSMENT ON JUNE 29, 2015. THE DATA INCLUDED WAS COLLECTED OVER THE COURSE OF 2014 AND 2015. 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. DUE TO LACK OF RESOURCES, SOME OF MSHA FACILITIES WERE UNABLE TO ADDRESS ISSUES THAT WERE IDENTIFIED.
FACILITY 1, NORTON COMMUNITY HOSPITAL - PART V, LINE 22DUNINSURED PATIENTS RECEIVE A 66% DISCOUNT; AND, BASED ON OTHER FACTORS SUCH AS INCOME OR MEDICAL INDIGENCY, MAY QUALIFY FOR AN ADDITIONAL DISCOUNT. ALLOWABLE AMOUNTS FOR INSURED PATIENTS ARE BASED ON THE NEGOIATED RATE WITH COMMERCIAL INSURANCE OR MEDICARE.

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 6A - RELATED ORGANIZATION INFORMATIONMSHA'S COMMUNITY BENEFIT REPORT COMPLETED IN FY15 INCLUDES NCH. MSHA IS NCH'S MAJORITY OWNER.
PART I, LINE 7 - COSTING METHODOLOGY EXPLANATIONTHE 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 INTERNSHIPS (PRIMARILY INTERNAL MEDICINE RESIDENTS, NURSING, PHARMACY, 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. DETAILED RECORDS ARE MAINTAINED FOR HOURS SPENT ON THESE RESIDENTS/STUDENT ACTIVITIES, THE NUMBER OF RESIDENTS/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 TEAM MEMBERS' TIME IS DEVOTED TO THE STUDENTS. MEDICARE ALLOWABLE INDIRECT COSTS ARE INCLUDED FOR MEDICAL RESIDENTS AND MEDICARE REIMBURSEMENT RELATED TO RESIDENT TRAINING IS REPORTED AS AN OFFSET TO RESIDENT COSTS ON LINE 7F. 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/TNCARE 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. 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 473,988 SUBSIDY OF A PHYSICIAN CLINIC OWNED AND OPERATED BY NCH. THE CLINIC IS LOCATED IN A RURAL, LOW-INCOME AREA.
PART II - COMMUNITY BUILDING ACTIVITIESNCH LEADERS SUPPORT AND ENCOURAGE ALL TEAM MEMBERS TO VOLUNTEER THEIR 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 MANAGING BOARDS OF LOCAL SERVICE AND NON-PROFIT ORGANIZATIONS. SOME ALSO SERVE AS MEMBERS AND CONSULTANTS ON PROFESSIONAL COMMITTEES AND TASK FORCES THAT AFFECT REGIONAL DEVELOPMENT IN HEALTHCARE AND EDUCATION. 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. MOST OF THESE ORGANIZATIONS WORK TO IMPROVE THE LIVES OF COMMUNITY MEMBERS THAT HAVE LIMITED, OR NO, FINANCIAL RESOURCES.
PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGYSELF-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. ALL PATIENTS WITH NO FORM OF THIRD-PARTY PAYER COVERAGE RECEIVE A 66% CALCULATED DISCOUNT, AS REQUIRED BY TENNESSEE LAW. MSHA APPLIES TENNESSEE LAW TO OUR VIRGINIA HOSPITALS' PATIENT ACCOUNTS. 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 ASSISTANCENCH'S PATIENT FINANCIAL SERVICES MANAGEMENT ESTIMATE THAT 76% 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 MORE THAN 97% OF OUR PATIENTS WHO HAVE PROVIDED COMPLETED FINANCIAL ASSISTANCE FORMS HAVE BEEN APPROVED FOR AT LEAST PARTIAL FINANCIAL ASSISTANCE. WE HAVE MANY INSTANCES OF PATIENTS WITH LARGE ACCOUNT BALANCES AND NO HEALTH INSURANCE COVERAGE THAT WE ARE SURE WOULD QUALIFY FOR CHARITY CARE. ALTHOUGH HOSPITAL TEAM MEMBERS ENCOURAGE THESE INDIVIDUALS TO COMPLETE OUR FINANCIAL ASSISTANCE APPLICATION, MANY WILL NOT DO SO. EVEN WHEN THESE INDIVIDUALS ARE TOLD WE FEEL SURE THEY DO QUALIFY FOR FULL OR PARTIAL ASSISTANCE, THEY STILL REFUSE TO COMPLETE OUR FINANCIAL ASSISTANCE APPLICATION.
BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTSTHE 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 EXPLANATIONMEDICARE 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 NOT-FOR-PROFIT 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, NON-PROFIT 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. FINANCIAL ASSISTANCE ELIGIBILITY ENCOMPASSES A VARIETY OF PATIENTS, SUCH AS THOSE WITH MEDICAID ELIGIBILITY AFTER THE DATE OF SERVICE, PATIENTS THAT ARE DECEASED WITH NO ESTATE, MEDICAID ELIGIBLE ENCOUNTERS WHERE BENEFITS HAVE BEEN EXHAUSTED, ETC. 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 ASSESSMENTMSHA INCLUDED AMERICA'S HEALTH RANKINGS (AHR) IN ITS ASSESSMENT IN ORDER TO BETTER DEFINE THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES. VIRGINIA RANKED 21ST AND TENNESSEE RANKED 43RD. 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, NON-PROFIT DIRECTORS, SCHOOL NURSES AND OFFICIALS, AND BUSINESS LEADERS. A SURVEY WAS GIVEN TO EACH INDIVIDUAL SEEKING FEEDBACK REGARDING AVAILABLE RESOURCES IN EACH AREA, THE PERCEIVED HEALTH STATUS, HEALTH PRIORITIES (DISEASE CONDITIONS, HEALTH BEHAVIORS AND SOCIOECONOMIC FACTORS), AND SUGGESTIONS FOR IMPROVEMENT. THE MAJORITY OF RESPONSES SUGGESTED FOCUSING ON EDUCATION IN ORDER TO PROMOTE HEALTHY HABITS AND INCREASED ACCESS TO RESOURCES. OTHER RESPONSES INCLUDED: MAKE PHYSICAL EDUCATION A REQUIREMENT AS PART OF SCHOOL CURRICULUM, IMPROVE NATURAL TRAILS AND WALKWAYS, INCREASE COMMUNITY SUPPORT FOR SMOKE-FREE AREAS, PARTNER WITH LOCAL FARMER'S MARKETS, SHARE HEALTH INFORMATION BETWEEN PHARMACIES, NETWORK WITH SMALL BUSINESSES AND 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). 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. AHR REPORTS THAT 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 (31ST FOR SMOKING) AND 21ST FOR DIABETES. THE ROBERT WOOD JOHNSON FOUNDATION REPORTS 33% OF WISE COUNTY'S CITIZENS SMOKE COMPARED TO 18% IN THE STATE OF VIRGINIA. 32% OF OUR COUNTY'S ADULTS ARE CONSIDERED OBESE AND 38% ARE PHYSICALLY INACTIVE. WISE COUNTY'S HEALTH RANKING IS 129 OUT OF 133 STATEWIDE (1 BEING THE BEST AND 133 BEING THE WORST).
PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCENCH PROVIDES COMMUNICATION OF FINANCIAL ASSISTANCE ON OUR WEBSITE AND ON POSTERS LOCATED IN PROMINENT AREAS OF THE HOSPITALS SUCH AS ADMITTING AND THE EMERGENCY DEPARTMENT. PRINTED EDUCATIONAL MATERIALS INCLUDING FINANCIAL ASSISTANCE CONTACT INFORMATION ARE ALSO PROVIDED IN EACH PATIENT'S REGISTRATION PAPERWORK. POSTERS AND REFERENCE MATERIALS ARE WRITTEN IN BOTH ENGLISH AND SPANISH. ADMITTING STAFF ARE TRAINED TO EDUCATE PATIENTS ON OUR FINANCIAL ASSISTANCE POLICY THESE COUNSELORS HELP UNINSURED PATIENTS DETERMINE SOURCES OF PAYMENT FOR MEDICAL BILLS AND HELP PATIENTS DETERMINE ELIGIBILITY FOR PROGRAMS SUCH AS MEDICAID/TENNCARE. NCH PARTNERED WITH THE COMPANIES FIRSTSOURCE SOLUTIONS USA AND ADVANCED PATIENT ADVOCACY TO WORK WITH SELF-PAYING PATIENTS WHO HAVE LIMITED FINANCIAL RESOURCES. REPRESENTATIVES WERE AVAILABLE AT NCH TO ASSIST PATIENTS. THE REPRESENTATIVES WERE ABLE TO DETERMINE GOVERNMENTAL MEDICAL ASSISTANCE (MEDICAID OR TENNCARE) ELIGIBILITY, AND TO HELP WITH THE APPLICATION PROCESS AND FOLLOW-UP. ONCE A PERSON IS APPROVED FOR MEDICAID OR TENNCARE THROUGH THE PROGRAM OFFERED THROUGH NCH, THEY RETAIN COVERAGE FOR FUTURE MEDICAL CARE. 738 PATIENTS WERE APPROVED FOR GOVERNMENTAL ASSISTANCE DURING THE YEAR.FIRSTSOURCE AND ADVANCED PATIENT ADVOCACY ARE COMPENSATED BY NCH. DURING FY15, OUR COST FOR THIS PROGRAM WAS 78,786.
PART VI, LINE 4 - COMMUNITY INFORMATIONNCH 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 INDIVIDUALS WHO ARE UNINSURED. ACCORDING TO U.S. CENSUS BUREAU ESTIMATES, NORTON HAS A POPULATION OF APPROXIMATELY 4,031, WHILE WISE COUNTY'S POPULATION IS 39,935. THE LATEST CENSUS BUREAU DATA ESTIMATES THE MEDIAN AGE OF RESIDENTS OF WISE COUNTY IS 39.7 WHICH IS OLDER THAN THE MEDIAN AGE OF 37.6 IN VIRGINIA. THE BUREAU ESTIMATES WISE COUNTY MEDIAN HOUSEHOLD INCOME AT 37,357 COMPARED TO 62,792 FOR THE STATE OF VIRGINIA. 28% OF WISE COUNTY'S CHILDREN LIVE IN POVERTY COMPARED TO 16% STATEWIDE. WISE COUNTY'S HEALTH OUTCOMES RANK 129 OUT OF 133 IN THE STATE.
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTHNCH 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 TRAINED STAFF 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, AND WERE SERVING AS NCH BOARD MEMBERS ON THE LAST DAY OF THE FISCAL YEAR. 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 SYSTEMNCH 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. MSHA IS INTEGRATED BOTH VERTICALLY AND HORIZONTALLY AND IS 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 THE 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 REPORTVIRGINIA

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1UNIVERSITY OF VIRGINIA AT WISEBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 COLLEGE AVEAddressLine1Txt
CityWISECityNm
State AbbreviationVAStateAbbreviationCd
ZIP24293ZIPCd
FieldValueIRS element (for citing)
Recipient EIN541638774RecipientEIN
IRC Section501C3IRCSectionDesc
Cash Grant$25,000CashGrantAmt
Purpose Of GrantATHLETICS PROGRAMPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE I, PAGE 1, PART I, LINE 2FormAndLineReferenceDesc
ExplanationOUR DONATION TO THE UNIVERSITY OF VIRGINIA AT WISE WAS MADE TO SUPPORT ATHLETICS PROGRAMS AT THE SCHOOL. WHILE ATHLETIC PROGRAMS PROVIDE ENTERTAINMENT, THESE PROGRAMS ALSO ENCOURAGE HEALTHY LIFESTYLES AND DISCIPLINE THROUGH TRAINING AND REQUIRING OBEYING RULES OF CONDUCT. MOST DONATION REQUESTS ARE MADE THROUGH AN APPLICATION PROCESS WHERE THE APPLICANT DESCRIBES HOW THE MONEY WILL BE USED, HOW IT BENEFITS THE COMMUNITY, HOW OUR DONATION WILL CORRELATE WITH HEALTH NEEDS IDENTIFIED BY OUR COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), AND THE AGREEMENT THAT THE DONEE WILL PROVIDE FOLLOW-UP OF HOW OUR DONATION WAS USED (WHO BENEFITED, ETC.). NOT ALL OF OUR DONATIONS ARE RESTRICTED TO OUR CHNA, BUT MANY ARE. MSHA'S SOCIAL RESPONSIBILITY COMMITTEE REVIEWS MOST DONATION REQUESTS TO DETERMINE WHICH REQUESTS MSHA, INCLUDING NCH, WILL FUND. THERE ARE MANY FACTORS THAT ARE CONSIDERED DURING THE REVIEW PROCESS BY THE COMMITTEE, SUCH AS OUR BUDGET CONSTRAINTS, IF THE APPLICANT HAS ALREADY RECEIVED A DONATION FROM A MSHA FACILITY, HOW THE REQUESTING ORGANIZATION FITS WITH OUR CNHA, ETC.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 entries)

TitleTitleTxtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmtBase Compensation Filing OrgBaseCompensationFilingOrgAmtBonus Filing OrganizationBonusFilingOrganizationAmountOther Compensation Filing OrgOtherCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
MARVIN EICHORN
MSHA EXEC. VP/COO$513,864$140,426$51,080$18,788$23,337$747,495
ANN FLEMING
DIRECTOR$319,105$108,007$122,727$10,125$12,733$572,697$39,222
MATTHEW CUSANO MD
DIRECTOR$302,391$56,096$481$7,642$21,751$388,361
JOHN DOYLE
DIRECTOR$287,522$58,179$8,848$32,472$23,219$410,240
MONTY MCLAURIN
VICE-CHAIR$268,960$61,819$20,342$29,617$24,717$405,455
SHANE HILTON
MSHA WASH. CO. CFO$287,587$51,843$8,724$32,472$23,154$403,780
TOM TULL
DIRECTOR$128,194$6,550$11,658$10,968$21,195$178,565
MARK LEONARD
CEO$239,328$61,237$15,730$22,220$25,160$363,675
KENT VANBUECKEN MD
PHYSICIAN$360,940$20,000$2,890$10,782$11,886$406,498
JAMES WILSON MD
PHYSICIAN$202,200$153,762$343$10,781$16,674$383,760
BERNIE SERGENT MD
PHYSICIAN$217,405$86,777$20,393$7,923$21,248$353,746
LATISHA HILTON MD
PHYSICIAN$197,225$76,844$32,406$7,321$1,045$314,841
RUBYE WASHINGTON-MOORE MD
PHYSICIAN$282,998$21,404$9,267$17,976$331,645
JOHN WRIGHT
FORMER$17,775$17,775
STEPHEN SAWYER CFO
IPMC CFO/FMR NCH CFO$150,118$6,550$8,816$6,418$17,630$189,532

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PAGE 1, PART I, LINE 4JOHN DOYLE 0 14,760 0 MONTY MCLAURIN 0 13,992 0 SHANE HILTON 0 14,760 0 MARK LEONARD 0 12,451 0
SCHEDULE J, PART IIIPART I, LINE 4B MONTY MCLAURIN, SHANE HILTON, MARK LEONARD, AND JOHN DOYLE 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 DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
JAMIE FLEMING
FAMILY MEMBER$34,136FAMILY MBR OF BD MBRfalse
DEBBIE WARD
FAMILY MEMBER$67,756FAMILY MBR OF BD MBRfalse

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE L, PART VFormAndLineReferenceDesc
ExplanationBUSINESS 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 ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990 - ORGANIZATION'S MISSIONNORTON 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. FOR THE YEAR ENDING JUNE 30, 2015, NCH RECORDED 12,477 INPATIENT ADMISSIONS, AND PROVIDED FOR 133,724 OUTPATIENT VISITS. THERE WERE 22,953 EMERGENCY VISITS, AND 12,304 HOME HEALTH VISITS. OUR HOSPITAL SAW SIGNIFICANT VOLUME INCREASES IN A NUMBER OF SERVICE LINES DURING FY15. FOR EXAMPLE, INPATIENT REHABILITATION OCCUPANCY INCREASED MORE THAN 8%, WHILE OUR SKILLED NURSING PATIENT DAYS INCREASED BY 15%. ENDOSCOPIES ROSE ALMOST 5%, THE EMERGENCY DEPARTMENT SAW VISITS INCREASE BY NEARLY 7%, OUTPATIENT REHAB PROCEDURES ROSE 18%, AND WE PERFORMED 22% MORE SLEEP STUDIES. NCH IS A MEMBER OF VIRGINIA HOSPITAL AND HEALTHCARE ASSOCIATION AND IS ACCREDITED BY THE AMERICAN OSTEOPATHIC ASSOCIATION (AOA). OUR HOSPITAL WAS THE FIRST AOA ACCREDITED TEACHING FACILITY IN THE STATE OF VIRGINIA. NORTON COMMUNITY HOSPITAL OFFERS A FULL ARRAY OF PRIMARY CARE AND SPECIALTY SERVICES AS WELL AS SEVERAL AMENITIES THAT MAKE US THE HOSPITAL OF CHOICE FOR RESIDENTS IN OUR AREA. OUR TEAM APPROACH TO HEALTH CARE REFLECTS OUR COMMITMENT TO KEEPING OUR PATIENTS AT THE CENTER OF EVERYTHING WE DO. SEVERAL MAJOR PROJECTS WERE ANNOUNCED BY MOUNTAIN STATES HEALTH ALLIANCE LEADERSHIP THIS YEAR THAT WILL BROADEN AND ENHANCE KEY SERVICES AT NCH, INCLUDING A RENOVATED AND EXPANDED EMERGENCY ROOM AT THE HOSPITAL AND A NEW 39,000-SQUARE FOOT MEDICAL COMPLEX THAT WILL BE HOME TO KEY OUTPATIENT SERVICES LIKE REHABILITATION, OCCUPATIONAL MEDICINE, PHARMACY, SURGERY AND ORTHOPEDIC SERVICES, AS WELL AS A NEW WELLNESS CENTER. THESE PROJECTS ARE EXPECTED TO BE COMPLETED NEXT YEAR. RENOVATION AND EXPANSION OF THE EMERGENCY DEPARTMENT WILL INCLUDE SIX ADDITIONAL EXAM ROOMS AND A CENTRALIZED PROVIDER STATION THAT WILL IMPROVE COMMUNICATION, DEPARTMENT EFFICIENCY AND PATIENT FLOW. A NEW URGENT CARE OFFICE WILL WORK IN CONJUNCTION WITH THE ER BY PROVIDING A QUICK, CONVENIENT OPTION FOR PATIENTS WHOSE CONCERNS ARE NOT LIFE THREATENING. AMBULANCE BAYS WILL BE IMPROVED FOR BETTER ACCESS AND FASTER CARE. IN ADDITION, NCH WILL OFFER TELEMEDICINE SERVICES - CONNECTING PATIENTS AND PROVIDERS AT THE HOSPITAL WITH OTHER MSHA-AFFILIATED EXPERTS AT DIFFERENT FACILITIES, MOST NOTABLY NISWONGER CHILDREN'S HOSPITAL (NISWONGER). CHILDREN WHO VISIT THE ER AT NCH WILL HAVE DIRECT ACCESS TO THE PEDIATRIC EMERGENCY PHYSICIANS AT NISWONGER VIA TWO-WAY, LIVE VIDEO. THE NEW TELEMEDICINE SERVICE WILL OFFER A HIGHER LEVEL OF SPECIALTY CARE FOR PATIENTS WITHOUT THEM NEEDING TO TRAVEL OUTSIDE THE AREA. DURING THE YEAR, MSHA HOSPITALS, INCLUDING NCH, WENT THROUGH SURPRISE DRILLS TO TEST READINESS FOR POTENTIAL EBOLA PATIENTS, AND THE RESULTS WERE IMPRESSIVE. PARTNERS FROM THE VIRGINIA DEPARTMENT OF HEALTH SERVED AS EVALUATORS AT OUR VIRGINIA DRILLS. FOR SEVERAL MONTHS, OUR HOSPITALS PLACED AN INTENSE FOCUS ON TRAINING TO IDENTIFY AND ISOLATE A SUSPECTED EBOLA PATIENT. A PRIMARY GOAL WAS TO ENSURE THAT ASKING TRAVEL QUESTIONS AT THE POINT OF REGISTRATION WAS HARDWIRED INTO THE REGULAR REGISTRATION PROCESS. NCH RECEIVED NATIONAL RECOGNITION BY BECKER'S HOSPITAL REVIEW FOR HIGH QUALITY CARE OF PNEUMONIA PATIENTS AND BEING AMONG THE NATION'S 53 HOSPITALS WITH THE BEST OUTCOME FOR PNEUMONIA PATIENTS. USING DATA OBTAINED FROM THE CENTERS FOR MEDICARE AND MEDICAID SERVICES, BECKER'S IDENTIFIED 53 HOSPITALS IN THE U.S. WHOSE PNEUMONIA PATIENTS HAD A 30-DAY MORTALITY RATE AT OR BELOW 8.4, WHICH IS WELL BELOW THE NATIONAL AVERAGE OF 11.9. FOR THE SECOND YEAR IN A ROW, NCH PROVIDED 400 LUNCHES TO PATIENTS ATTENDING THE REMOTE AREA MEDICAL (RAM) EVENT IN LEE COUNTY. THE RAM EVENT TOOK PLACE OVER A TWO-DAY PERIOD OFFERING FREE DENTAL, VISION AND MEDICAL CARE TO THOSE IN NEED. NCH TEAM MEMBERS DISTRIBUTED THE FREE LUNCHES TO PATIENTS THE FIRST DAY OF THE RAM EVENT. NCH TAKES GREAT PRIDE IN TRAINING YOUNG PHYSICIANS FOR OUR RURAL, MEDICALLY UNDERSERVED AREA. THE RESIDENCY PROGRAM HAS RESULTED IN AN INCREASE IN QUALITY PRIMARY CARE FOR SOUTHWEST VIRGINIA AND THE SURROUNDING AREA AND THE GROWTH OF OUR HOSPITAL. NCH OFFERS THE BENEFITS OF RURAL LIVING WITH THE OPPORTUNITY TO TRAIN IN A MODERN AND PROGRESSIVE HOSPITAL. INTERNAL MEDICINE RESIDENTS ROTATE THROUGH ALL AREAS OF MEDICINE, 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 THESE SERVICES WITHIN THE HOSPITAL SETTING, THE RESIDENTS ARE ALSO EXPOSED TO TREATING PATIENTS IN AN OFFICE SETTING AT THE COMMUNITY CLINIC (RESIDENT CONTINUITY CLINIC) IN WISE, VIRGINIA. INTERNAL MEDICINE RESIDENTS SPENT MORE THAN 54,000 HOURS AT NCH DURING FY15. OUR UNREIMBURSED COST FOR THIS RESIDENCY PROGRAM EXCEEDED 700,000. 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 FY15 INCLUDED 80 NURSING STUDENTS FROM VARIOUS COLLEGES, UNIVERSITIES AND PROGRAMS. THIS NURSING CLINICAL EXPERIENCE REQUIRED EXTENSIVE NCH NURSING STAFF INVOLVEMENT. THE CLINICAL SETTING AND HANDS-ON INSTRUCTION COST NCH 159,250. NCH PROVIDED A CLINICAL SETTING FOR ANOTHER 64 STUDENTS TRAINING IN HEALTH-RELATED PROGRAMS SUCH AS RADIOLOGY, PHARMACY, PHYSICAL THERAPY, EMT/PARAMEDIC AND OTHER ALLIED-HEALTH DISCIPLINES. THESE ADDITIONAL CLINICAL STUDENTS COST NCH 54,211. NCH PARTNERED WITH THE COMPANIES, FIRSTSOURCE SOLUTIONS USA AND ADVANCED PATIENT ADVOCACY, TO WORK WITH SELF-PAYING PATIENTS WHO HAVE LIMITED FINANCIAL RESOURCES. DURING FY15, 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. 514 PATIENTS WERE APPROVED FOR COVERAGE IN FY15. ONCE A PERSON IS APPROVED FOR MEDICAID OR TENNCARE THROUGH THE PROGRAM OFFERED THROUGH NCH, THEY RETAIN COVERAGE FOR FUTURE MEDICAL CARE. FIRSTSOURCE SOLUTIONS AND ADVANCED PATIENT ADVOCACY ARE COMPENSATED BY NCH. OUR COST FOR THIS PROGRAM WAS 78,786. NCH CONTINUED THE VALUE OPTIMIZATION SYSTEM (VOS) PROGRAM DURING FY15. VOS ALLOWS A TRANSFORMATION OF CARE BY PROVIDING TRAINING AND TOOLS TO REDUCE WASTE, MEET PATIENTS' EXPECTATIONS OF HIGH QUALITY AND EFFICIENT CARE, WHILE ACHIEVING OUTSTANDING OUTCOMES. THE PROGRAM IS STRUCTURED FOR CONTINUOUS MONITORING AND IMPROVEMENT. IDENTIFIED PROJECTS ARE REFERRED TO AS "STREAMS". IN FY15, NCH REDUCED PATIENTS' ARRIVAL TIME TO DOCTOR TIME FROM 20 MINUTES TO 13 MINUTES, A 35% REDUCTION IN A PATIENT'S WAIT TIME. A VALUE STREAM THAT FOCUSED ON INPATIENT CARE LOOKED AT MEDICATION RECONCILIATIONS. THIS PROJECT INCLUDED NURSES, PHYSICIANS, INTERNAL MEDICINE RESIDENTS, AND PHARMACY STAFF WITH THE GOAL TO REDUCE MEDICATION LIST ERRORS. A MEDICATION LIST, IN THIS CONTEXT, REFERS TO MEDICATIONS AND DOSAGES A PATIENT TAKES AT HOME. IF A PATIENT BEGINS THEIR HOSPITAL VISIT IN THE ED, THE ED NURSE IS RESPONSIBLE FOR MAKING HIS/HER BEST FAITH EFFORT TO OBTAIN A COMPLETE LIST OF CURRENT MEDICATIONS USED BY THE PATIENT. THE INFORMATION INCLUDES DRUG NAME, DOSAGE AND FREQUENCY, LAST DOSE TAKEN, AND REASON FOR THE MEDICATION. WHEN THE PATIENT IS TRANSFERRED FROM THE ED TO A NURSING FLOOR, THE FLOOR NURSE IS RESPONSIBLE FOR REVIEWING THE LIST AND CHECKING FOR MISSING INFORMATION OR NOTES. PHYSICIAN AND RESIDENTS ARE THE THIRD CHECKPOINT IN THE MEDICATION RECONCILIATION PROCESS. PHARMACY REVIEWS MEDICATION INFORMATION FOR EACH PATIENT DAILY AND ERRORS ARE BROUGHT TO THE ATTENTION OF MANAGERS SO THAT ADDITIONAL TRAINING MAY BE PROVIDED WHERE GAPS OR ERRORS ARE IDENTIFIED. THIS VERY STRUCTURED PROCESS RESULTED IN REDUCING ERRORS ON THE MEDICATION LIST BY OVER 85%. TO IMPROVE ACCESS TO PRIMARY CARE, NORTON COMMUNITY HOSPITAL, OPERATES A RESIDENCY CLINIC IN A RURAL, LOW-INCOME AREA. BECAUSE REIMBURSEMENT DOES NOT COVER THE OPERATING EXPENSES OF THE CLINIC, THE HOSPITAL SUBSIDIZES IT. DURING FY15, THE SUBSIDY WAS MORE THAN 470,000. NCH DONATED MEDICATIONS TO THE REMOTE AREA MEDICAL (RAM) WITH A COST OF JUST OVER 8,000. RAM PROVIDES FREE DENTAL, VISION, AND MEDICAL CARE TO ISOLATED, IMPOVERISHED, OR UNDERSERVED COMMUNITIES. US NEWS & WORLD REPORT RANKS NCH AS "BETTER THAN EXPECTED" FOR CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) AND HEART FAILURE FO
FORM 990, PAGE 6, PART VI, LINE 6THE CORPORATION IS ORGANIZED AS A VIRGINIA, NON-STOCK, NON-PROFIT 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 7ATHERE 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 7BCERTAIN 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 11BTHE 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 12CANNUALLY, 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 15ATHE COMPENSATION OF NCH'S CEO IS INITIALLY DETERMINED BY MOUNTAIN STATES HEALTH ALLIANCE'S HUMAN RESOURCE DEPARTMENT BASED ON MARKET DATA OF COMPARABLE POSITIONS IN SIMILAR SETTINGS. EXECUTIVE SALARIES ARE EVALUATED ON AN ANNUAL OR NEAR-ANNUAL BASIS. 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 MSHA EMPLOYEES WITHIN MSHA, WITH A SMALL NUMBER OF EXCEPTIONS FOR COMPANIES THAT DO NOT PROVIDE DIRECT PATIENT CARE. MSHA USES AN OUTSIDE AND INDEPENDENT COMPENSATION CONSULTING FIRM TO ESTABLISH REASONABLE COMPENSATION.
FORM 990, PAGE 6, PART VI, LINE 15BCOMPENSATION FOR NCH'S CFO IS ESTABLISHED THE SAME WAY AS THE CEO'S, DESCRIBED ABOVE (LINE 15A).
FORM 990, PAGE 6, PART VI, LINE 19GOVERNING 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 IX, LINE 11GPHYSICIAN FEES 4,637,384 0 0 HYPERBARIC SERVICES 57,049 0 0 AMBULANCE FEES 45,671 0 0 LAB TESTS 190,226 0 0 LINEN & ENVIRONMENTAL SERV. 0 454,824 0 COLLECTION FEES 0 305,526 0 PATIENT RESOURCE MGMT. 0 80,419 0 TRANSCRIPTION 0 109,865 0 NUTRITIONAL SERVICES 310,027 0 0 ENGINEERING SERVICES 0 183,337 0 VARIOUS EXPENSES 467,421 95,761 0
FORM 990, PART XPART 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 9CHANGE IN TEMP. RESTRICTED GRANTS -31,105 ELIMINATION OF INTERCOMPANY REC/PAY 2,635 PENSION & POST LIABILITY ADJUSTMENT -1,122,717 TOTAL TO FORM 990, PART XI, LINE 9 -1,151,187

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1NORTON COMMUNITY PHYSICIAN SVCS LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line196 15TH ST NWAddressLine1Txt
CityNORTONCityNm
State AbbreviationVAStateAbbreviationCd
ZIP24273ZIPCd
FieldValueIRS element (for citing)
EIN260868690EIN
Primary ActivitiesMED. SERV.PrimaryActivitiesTxt
Legal Domicile StateVALegalDomicileStateCd
Total Income$8,889,913TotalIncomeAmt
End Of Year Assets$4,160,848EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NCHBusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
MOUNTAIN STATES HEALTH ALLIANCE
400 N STATE OF FRANKLIN RDJOHNSON CITYTN37604620476282HOSP. SYS.TN501C33NAfalse
DICKENSON COMMUNITY HOSPITAL
ONE HOSPITAL DRIVECLINTWOODVA24228770599553HOSPITALVA501C33NCHfalse
JOHNSTON MEMORIAL HOSPITAL
16000 JOHNSTON MEMORIAL DRIVEABINGDONVA24211540544705HOSPITALVA501C33NAfalse
ABINGDON PHYSICIAN PARTNERS
16000 JOHNSTON MEMORIAL DRIVEABINGDONVA24211205485346MED. SERV.VA501C311AJMHfalse
SMYTH COUNTY COMMUNITY HOSPITAL
245 MEDICAL PARK DRIVEMARIONVA24354540794913HOSPITALVA501C33MSHAfalse
COMMUNITY HEALTHCARE FOUNDATION
100 15TH STREET NWNORTONVA24273542002314SUPPORTVA501C311ANAfalse
MOUNTAIN STATES FOUNDATION
2335 KNOB CREEK ROAD SUITE 101JOHNSON CITYTN37604581418862FUNDRAISERTN501C311AMSHAfalse
MOUNTAIN STATES HEALTH ALLIANCE AUX
400 N STATE OF FRANKLIN RDJOHNSON CITYTN37604581418345SUPP. ORG.TN501C311AMSHAfalse
APPALACHIAN EMERGENCY PHYSICIANS
1021 W OAKLAND AVENUE STE 207JOHNSON CITYTN37604800592504MED. SERVTN501C311ANAfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerInd
INTEGRATED SOLUTIONS HLTH NTWK INC
509 MED TECH PARKWAY SUITE 100JOHNSON CITYTN37604621711997INVESTMENTTNNAfalsefalse
EMMAUS COMMUNITY HEALTHCARE PLLC
6070 HWY 11EPINEY FLATSTN37686200577483MED. SERV.TNNAfalsefalse
MEDICAL SPECIALISTS OF J C LLC
2528 WESLEY STREET SUITE 2JOHNSON CITYTN37604272199037MED. SERV.TNNAfalsefalse
EAST TN AMBULATORY SURGERY CTR
701 MED TECH PARKWAYJOHNSON CITYTN37604621787537MED. SERV.TNNAfalsefalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationInd
COMMUNITY HOME CARE INC
1460 PARK AVENUENORTONVA24273541453810DMEVANAC CORP$704,729$1,075,0071.00000false
SOUTHWEST COMMUNITY HEALTH SERVICES
P O BOX 880MARIONVA24354541460695MED. SERV.VANAC CORPfalse
BLUE RIDGE MEDICAL MANAGEMENT CORP
1021 W OAKLAND AVENUE SUITE 207JOHNSON CITYTN37604621490616MED. SERV.TNNAC CORPfalse
MEDISERVE MED EQUIP OF KINGSPORT
1021 W OAKLAND AVENUE SUITE 207JOHNSON CITYTN37604621212286DMETNNAC CORPfalse
MOUNTAIN STATES PROPERTIES
1021 W OAKLAND AVENUE SUITE 207JOHNSON CITYTN37604621845895PROP MGMTTNNAC CORPfalse
MOUNTAIN STATES PHYSICIAN GROUP
1021 W OAKLAND AVENUE SUITE 207JOHNSON CITYTN37604621700412HEALTHCARETNNAC CORPfalse
WILSON PHARMACY INC
P O BOX 5289JOHNSON CITYTN37602620329587PHARMACYTNNAC CORPfalse
CRESTPOINT HEALTH INSURANCE COMPANY
509 MED TECH PARKWAY SUITE 100JOHNSON CITYTN37604620381170INSURANCETNNAC CORPfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (true)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (true)LoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (7 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmt
COMMUNITY HOME CARE INC
A$51,859
COMMUNITY HOME CARE INC
O$59,226
COMMUNITY HOME CARE INC
Q$138,554
COMMUNITY HOME CARE INC
M$4,125
DICKENSON COMMUNITY HOSPITAL
B$2,635
DICKENSON COMMUNITY HOSPITAL
O$1,364,244
DICKENSON COMMUNITY HOSPITAL
Q$525,543