MOUNTAIN STATES HEALTH ALLIANCE: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization: MOUNTAIN STATES HEALTH ALLIANCE (EIN 62-0476282)
Tax period: 2014-07-01 to 2015-06-30
Filed: 2016-05-09
IRS object ID: 201631309349300908
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2016-05-09T09:09:56-05:00	ReturnTs
Tax Period End	2015-06-30	TaxPeriodEndDt
Return Type	990	ReturnTypeCd
Tax Period Begin	2014-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	620476282	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MOUNTAIN STATES HEALTH ALLIANCE	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	MOUN	BusinessNameControlTxt
Phone	4233023374	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	400 N STATE OF FRANKLIN ROAD	AddressLine1Txt
City	JOHNSON CITY	CityNm
State Abbreviation	TN	StateAbbreviationCd
ZIP	37604	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	LYNN KRUTAK	PersonNm
Person Title	SENIOR VP & CFO	PersonTitleTxt
Phone	4233023374	PhoneNum
Signature	2016-04-12	SignatureDt

Field	Value	IRS element (for citing)
Tax	2014	TaxYr
Build TS	2016-08-17 19:52:53Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	JOHNSON CITY MEDICAL CENTER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	ALAN LEVINE	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	303 MED TECH PARKWAY STE 300	AddressLine1Txt
City	JOHNSON CITY	CityNm
State Abbreviation	TN	StateAbbreviationCd
ZIP	37604	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$733,451,692	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.MOUNTAINSTATESHEALTH.COM	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1945	FormationYr
Legal Domicile State	TN	LegalDomicileStateCd
Activity Or Mission	MOUNTAIN STATES HEALTH ALLIANCE (MSHA) IS COMMITTED TO OUR MISSION OF BRINGING LOVING CARE TO HEALTH CARE. WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTHCARE NEEDS OF INDIVIDUALS AND COMMUNITIES IN THE 29-COUNTY AREA WE SERVE, HELPING THEM ATTAIN THEIR HIGHEST LEVEL OF HEALTH. MSHA DELIVERS THIS CARE THROUGH THE PHILOSOPHY OF PATIENT-CENTERED CARE, AND THE DEVELOPMENT OF COMPREHENSIVE STRATEGIC PLANNING AND IMPLEMENTATION. SEE ATTACHED NARRATIVE "PROGRAM SERVICE ACCOMPLISHMENTS".	ActivityOrMissionDesc
Voting Members Governing Body	13	VotingMembersGoverningBodyCnt
Voting Members Independent	8	VotingMembersIndependentCnt
Total Employee	8237	TotalEmployeeCnt
Total Volunteers	1589	TotalVolunteersCnt
Total Gross UBI	$881,265	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$248,254	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$4,260,554	PYContributionsGrantsAmt
CY Contributions Grants	$1,268,900	CYContributionsGrantsAmt
PY Program Service Revenue	$670,231,172	PYProgramServiceRevenueAmt
CY Program Service Revenue	$693,631,193	CYProgramServiceRevenueAmt
PY Investment Income	$28,617,401	PYInvestmentIncomeAmt
CY Investment Income	$22,153,666	CYInvestmentIncomeAmt
PY Other Revenue	$4,204,431	PYOtherRevenueAmt
CY Other Revenue	$9,431,964	CYOtherRevenueAmt
PY Total Revenue	$707,313,558	PYTotalRevenueAmt
CY Total Revenue	$726,485,723	CYTotalRevenueAmt
PY Grants And Similar Paid	$705,491	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$1,816,780	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$295,522,740	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$298,141,980	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$1,173,485	CYTotalFundraisingExpenseAmt
PY Other Expenses	$378,145,629	PYOtherExpensesAmt
CY Other Expenses	$393,805,378	CYOtherExpensesAmt
PY Total Expenses	$674,373,860	PYTotalExpensesAmt
CY Total Expenses	$693,764,138	CYTotalExpensesAmt
PY Revenues Less Expenses	$32,939,698	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$32,721,585	CYRevenuesLessExpensesAmt
Total Assets BOY	$1,603,260,990	TotalAssetsBOYAmt
Total Assets EOY	$1,615,714,180	TotalAssetsEOYAmt
Total Liabilities BOY	$1,166,845,910	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$1,141,215,270	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$436,415,080	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$474,498,910	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	MOUNTAIN STATES HEALTH ALLIANCE (MSHA) IS COMMITTED TO OUR MISSION OF BRINGING LOVING CARE TO HEALTH CARE. WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTHCARE NEEDS OF INDIVIDUALS AND COMMUNITIES IN THE 29-COUNTY AREA WE SERVE, HELPING THEM ATTAIN THEIR HIGHEST LEVEL OF HEALTH. MSHA DELIVERS THIS CARE THROUGH THE PHILOSOPHY OF PATIENT-CENTERED CARE, AND THE DEVELOPMENT OF COMPREHENSIVE STRATEGIC PLANNING AND IMPLEMENTATION. SEE ATTACHED NARRATIVE "PROGRAM SERVICE ACCOMPLISHMENTS".	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$579,838,341	ExpenseAmt
Grant	$1,816,780	GrantAmt
Revenue	$695,692,282	RevenueAmt
Desc	SEE ATTACHED DOCUMENT: MSHA - PROGRAM SERVICE ACCOMPLISHMENTS FOR GUIDESTAR READERS, OUR PROGRAM SERVICE ACCOMPLISHMENTS MAY BE FOUND AT THE END.	Desc
Total Program Service Expenses	$579,838,341	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	Yes (true)	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	Yes (true)	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	Yes (true)	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (true)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	Yes (true)	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	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	593	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	8237	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
Form8899 Filedind	false	Form8899Filedind
Form1098 C Filed	false	Form1098CFiledInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	13	GoverningBodyVotingMembersCnt
Independent Voting Member	8	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	false	MembersOrStockholdersInd
Election Of Board Members	false	ElectionOfBoardMembersInd
Decisions Subject To Approva	false	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	Yes (true)	LocalChaptersInd
Policies Reference Chapters	Yes (true)	PoliciesReferenceChaptersInd
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	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (true)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (true)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	VA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	LYNN KRUTAK	PersonNm
Phone	4233023374	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	303 MED TECH PARKWAY	AddressLine1Txt
City	JOHNSON CITY	CityNm
State Abbreviation	TN	StateAbbreviationCd
ZIP	37604	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (33 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
ALAN LEVINE
PRESIDENT &	55.00	Yes (X)	Yes (X)	$1,131,975	$0	$142,409
JEFF FARROW MD
DIRECTOR	4.00	Yes (X)		$42,800	$0	$0
CLEM WILKES JR
PAST CHAIR	7.00	Yes (X)		$0	$0	$0	0.50
GARY PEACOCK
DIRECTOR	6.00	Yes (X)		$0	$0	$0	2.00
SANDRA BROOKS MD
DIRECTOR	5.00	Yes (X)		$0	$0	$0	2.00
RICK STOREY
DIRECTOR	6.00	Yes (X)		$0	$0	$0
THOMAS FOWLKES
DIRECTOR	5.00	Yes (X)		$0	$0	$0
LINDA GARCEAU
DIRECTOR	6.00	Yes (X)		$0	$0	$0
JOANNE GILMER
SECRETARY	7.00	Yes (X)		$0	$0	$0	3.00
DAVID MAY MD
DIRECTOR	7.00	Yes (X)		$0	$0	$0
ROBERT FEATHERS
VICE CHAIR	7.00	Yes (X)		$0	$0	$0	0.50
MICHAEL CHRISTIAN
TREASURER	7.00	Yes (X)		$0	$0	$0
BARBARA ALLEN
CHAIR	9.00	Yes (X)		$0	$0	$0
MARVIN EICHORN
EVP/COO	47.00		Yes (X)	$705,370	$0	$42,125	8.00
LYNN KRUTAK
SVP/CFO	50.00		Yes (X)	$390,582	$0	$66,400
DENNIS VONDERFECHT
CEO (RETIRED	55.00		Yes (X)	$338,334	$0	$4,300
ANN FLEMING
SVP/CONSULTA	42.50			$549,839	$0	$22,858	2.50	Yes (X)
CANDACE JENNINGS
SR. VP TN OP	50.00			$351,819	$0	$22,496		Yes (X)
MONTY MCLAURIN
VP/CEO NW MK	43.00			$351,121	$0	$54,334	2.00	Yes (X)
SHANE HILTON
VP/TN CFO	43.50			$348,154	$0	$55,626	1.50	Yes (X)
TONY BENTON
VP/COO WASH.	45.00			$332,837	$0	$38,246		Yes (X)
LINDA WHITE
VP & CEO, FW	45.00			$267,119	$0	$43,807		Yes (X)
LEMMIE TAYLOR
VP/CEO SE MK	45.00			$234,615	$0	$46,487		Yes (X)
RHONDA MANN
JCMC CNO	45.00			$187,454	$0	$26,150		Yes (X)
DRU MALCOLM
VP & CNO JCM	45.00			$165,697	$0	$17,636		Yes (X)
STEVE SAWYER
AVP/CFO NW M	45.00			$165,484	$0	$24,048		Yes (X)
MORRIS SELIGMAN MD
EVP/CMO	55.00			$583,005	$0	$75,184			Yes (X)
FRANK LAURO MD
VP/MED. DIR.	45.00			$453,473	$0	$44,406			Yes (X)
STEVE KILGORE
PRES./CEO BR	48.00			$419,843	$0	$66,506	2.00		Yes (X)
MARK WILKINSON MD
VP/CMO	45.00			$419,545	$0	$35,297			Yes (X)
CLAY RUNNELS MD
VP/CMO WASH.	45.00			$414,248	$0	$35,258			Yes (X)
DALE CLAYTORE
VP RESOURCE	45.00			$238,752	$0	$13,581				Yes (X)
PAT NIDAY
FORMER CNO W	45.00			$205,648	$0	$26,134				Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$8,297,714	TotalReportableCompFromOrgAmt
Total Other Compensation	$903,288	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	21	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
SODEXO INC
PO BOX 905374	CHARLOTTE	NC	282905374	FOOD SERVICES	$4,424,319
ANESTHESIA PAIN CONSULTANTS
PO BOX 3727	JOHNSON CITY	TN	376023727	ANESTHESIA SVCS	$4,173,782
CROTHALL SERVICES EAST TN
13028 COLLECTIONS CENTER DRIVE	CHICAGO	IL	60693	LAUNDRY SVCS	$2,787,669
WEATHERBY LOCUMS INC
PO BOX 972633	DALLAS	TX	753972633	PHYSICIAN SVCS	$2,522,133
PREMIER ANESTHESIA SERVICES
PO BOX 4653	JOHNSON CITY	TN	376024653	ANESTHESIA SVCS	$2,427,608

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	76	CntrctRcvdGreaterThan100KCnt
Related Organizations	$432,538	RelatedOrganizationsAmt
Government Grants	$604,845	GovernmentGrantsAmt
All Other Contributions	$231,517	AllOtherContributionsAmt
Total Contributions	$1,268,900	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT REVENUE	622110	$688,861,116	$688,861,116
WELLNESS PROGRAMS	622110	$4,847,416	$4,847,416
LAB UBI REVENUE	621500	$128,293		$128,293
RENTAL TO EXEMPT AFFILIATE	531120	$13,220	$13,220
P/S INCOME ISHN-MSJC	900099	-$218,852	-$218,852

Field	Value	IRS element (for citing)
Total Program Service Revenue	$693,631,193	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$14,153,591	TotalRevenueColumnAmt
Exclusion	$14,153,591	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$49,673	TotalRevenueColumnAmt
Exclusion	$49,673	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$434,370	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$265,253	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$169,117	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$169,117	TotalRevenueColumnAmt
Unrelated Business Revenue	$49,954	UnrelatedBusinessRevenueAmt
Exclusion	$119,163	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$5,889,313	SecuritiesAmt
Other	$8,761,805	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$6,700,716	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$5,889,313	SecuritiesAmt
Other	$2,061,089	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$7,950,402	TotalRevenueColumnAmt
Related Or Exempt Func Income	$2,061,089	RelatedOrExemptFuncIncomeAmt
Exclusion	$5,889,313	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
CAFE' SALES	722210	$3,902,669	$3,902,669
PREMIER VENDOR INCENTIVE	900099	$3,011,683	$3,011,683
DAY CARE	624410	$1,037,639	$1,037,639

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,310,856	TotalRevenueColumnAmt
Unrelated Business Revenue	$703,018	UnrelatedBusinessRevenueAmt
Exclusion	$607,838	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$9,262,847	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$726,485,723	TotalRevenueColumnAmt
Related Or Exempt Func Income	$695,563,989	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$881,265	UnrelatedBusinessRevenueAmt
Exclusion	$28,771,569	ExclusionAmt

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

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$1,816,780	TotalAmt
Program Services	$1,816,780	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$5,695,686	TotalAmt
Program Services	$46,763	ProgramServicesAmt
Management And General	$5,648,923	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$228,406,921	TotalAmt
Program Services	$213,605,830	ProgramServicesAmt
Management And General	$13,956,457	ManagementAndGeneralAmt
Fundraising	$844,634	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$10,803,715	TotalAmt
Program Services	$10,232,783	ProgramServicesAmt
Management And General	$530,470	ManagementAndGeneralAmt
Fundraising	$40,462	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$35,998,683	TotalAmt
Program Services	$35,532,397	ProgramServicesAmt
Management And General	$458,288	ManagementAndGeneralAmt
Fundraising	$7,998	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$17,236,975	TotalAmt
Program Services	$15,573,416	ProgramServicesAmt
Management And General	$1,613,741	ManagementAndGeneralAmt
Fundraising	$49,818	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$4,827,725	TotalAmt
Program Services	$20,305	ProgramServicesAmt
Management And General	$4,807,420	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$387,756	TotalAmt
Program Services	$5,100	ProgramServicesAmt
Management And General	$366,711	ManagementAndGeneralAmt
Fundraising	$15,945	FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$150,136	TotalAmt
Program Services	$150,136	ProgramServicesAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$981,765	TotalAmt
Management And General	$981,765	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$105,617,378	TotalAmt
Program Services	$97,394,017	ProgramServicesAmt
Management And General	$8,218,284	ManagementAndGeneralAmt
Fundraising	$5,077	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$2,902,045	TotalAmt
Program Services	$97,330	ProgramServicesAmt
Management And General	$2,779,857	ManagementAndGeneralAmt
Fundraising	$24,858	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$8,621,509	TotalAmt
Program Services	$7,489,678	ProgramServicesAmt
Management And General	$1,111,896	ManagementAndGeneralAmt
Fundraising	$19,935	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$16,279,219	TotalAmt
Program Services	$14,557,137	ProgramServicesAmt
Management And General	$1,722,082	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$14,262,873	TotalAmt
Program Services	$11,053,980	ProgramServicesAmt
Management And General	$3,142,344	ManagementAndGeneralAmt
Fundraising	$66,549	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$1,681,314	TotalAmt
Program Services	$1,241,596	ProgramServicesAmt
Management And General	$437,814	ManagementAndGeneralAmt
Fundraising	$1,904	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$42,023,955	TotalAmt
Management And General	$42,023,955	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$42,026,540	TotalAmt
Program Services	$21,782,580	ProgramServicesAmt
Management And General	$20,239,745	ManagementAndGeneralAmt
Fundraising	$4,215	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$1,087,692	TotalAmt
Program Services	$2,134	ProgramServicesAmt
Management And General	$1,085,558	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
MEDICAL SUPPLIES & DRUGS	$129,100,590	$129,079,049	$21,541
REPAIRS & MAINTENANCE	$16,610,054	$15,813,605	$744,019	$52,430
DUES & SUBSCRIPTIONS	$3,847,285	$1,599,624	$2,244,315	$3,346
TAXES- UBIT	$82,655		$82,655

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$3,314,887	TotalAmt
Program Services	$2,744,101	ProgramServicesAmt
Management And General	$534,472	ManagementAndGeneralAmt
Fundraising	$36,314	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$693,764,138	TotalAmt
Program Services	$579,838,341	ProgramServicesAmt
Management And General	$112,752,312	ManagementAndGeneralAmt
Fundraising	$1,173,485	FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$78,251,832	BOYAmt
EOY	$62,262,670	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$99,629	BOYAmt
EOY	$212,728	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$111,736,791	BOYAmt
EOY	$111,027,708	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$8,988,974	BOYAmt
EOY	$10,680,656	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$29,866,592	BOYAmt
EOY	$24,321,103	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$15,723,351	BOYAmt
EOY	$16,971,892	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$4,344,835	BOYAmt
EOY	$5,197,148	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$1,048,448,069	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$548,979,568	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$526,552,014	BOYAmt
EOY	$499,468,501	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$261,766,810	BOYAmt
EOY	$312,855,173	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$324,481,069	BOYAmt
EOY	$335,649,496	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$144,707,541	BOYAmt
EOY	$145,025,185	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$96,741,552	BOYAmt
EOY	$92,041,920	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,603,260,990	BOYAmt
EOY	$1,615,714,180	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$63,659,832	BOYAmt
EOY	$68,353,826	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$1,273,627	BOYAmt
EOY	$11,354,761	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$981,126,646	BOYAmt
EOY	$966,918,770	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$25,846,994	BOYAmt
EOY	$16,314,872	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$94,938,811	BOYAmt
EOY	$78,273,041	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,166,845,910	BOYAmt
EOY	$1,141,215,270	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$436,180,033	BOYAmt
EOY	$474,227,931	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$235,047	BOYAmt
EOY	$270,979	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$436,415,080	BOYAmt
EOY	$474,498,910	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,603,260,990	BOYAmt
EOY	$1,615,714,180	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$32,721,585	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$2,815,368	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$8,177,613	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	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

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	Yes (true)	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	Yes (true)	GrantsOtherOrganizationsInd
Grants Other Organizations	$1,129	GrantsOtherOrganizationsAmt
Direct Contact Legislators	Yes (true)	DirectContactLegislatorsInd
Direct Contact Legislators	$253,186	DirectContactLegislatorsAmt
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	false	OtherActivitiesInd
Total Lobbying Expenditures	$254,315	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	THE COMMUNITY & GOVERNMENT RELATIONS VICE PRESIDENT AND/OR THE DEPARTMENT'S MANAGER OR DIRECTOR ATTENDED THE FOLLOWING LEGISLATIVE CONFERENCES: - PREMIER FEDERAL AFFAIRS NETWORK MEETING - AMERICAN HOSPITAL ASSOCIATION ANNUAL MEETING - TENNESSEE HOSPITAL ASSOCIATION LEGISLATIVE ADVOCACY DAY - HOSPITAL ALLIANCE OF TENNESSEE ANNUAL MEETING - TENNESSEE PUBLIC & TEACHING HOSPITALS ASSOCIATION ANNUAL MEETING - VIRGINIA HOSPITAL & HEALTHCARE ASSOCIATION LEGISLATIVE ISSUES CONFERENCE THE COMMUNITY & GOVERNMENT RELATIONS VICE PRESIDENT AND/OR DEPARTMENTAL STAFF ALSO CONTACTED CONGRESSIONAL OFFICES CONCERNING THE FOLLOWING ISSUES: - SUPPORTED PERMANENT DISPROPORTIONATE SHARE HOSPITAL FOR THE STATE OF TENNESSEE - SUPPORTED SUSTAINABLE GROWTH RATE REFORM - OPPOSED ADDITIONAL CUTS IN MEDICARE/MEDICAID - SUPPORTED REAUTHORIZATION AND FUNDING OF CHILDREN'S HOSPITALS GRADUATE MEDICAL EDUCATION - SUPPORTED FEDERAL FUNDING FOR TRAUMA CARE - SUPPORTED CONTINUATION OF GRADUATE MEDICAL EDUCATION FUNDING - SUPPORTED AREA WAGE INDEX REFORM - SUPPORTED STUDY OF CHRONIC CARE FOR MEDICARE RECIPIENTS - SUPPORTED CHANGES TO 2 MIDNIGHT RULE - SUPPORTED RECOVERY AUDIT CONTRACTOR REFORM - SUPPORTED MEDICARE DEPENDENT HOSPITAL AND LOW-VOLUME DESIGNATIONS THE COMMUNITY & GOVERNMENT RELATIONS VICE PRESIDENT AND/OR DEPARTMENTAL DIRECTOR RESPONDED VIA LETTER, PHONE, OR IN PERSON TO SUPPORT THE FOLLOWING TENNESSEE AND VIRGINIA LEGISLATIVE ISSUES: - MEDICAID EXPANSION - TENNESSSEE - CERTIFICATE OF PUBLIC ADVANTAGE - STRONG CERTIFICATE OF NEED PROGRAMS IN TENNESSEE AND VIRGINIA - CONTINUATION OF HOSPITAL ASSESSMENT FEE IN TENNESSEE - FUNDING FOR PERINATAL CENTERS IN TENNESSEE - MENTAL HEALTH FUNDING FOR INPATIENT PSYCHIATRIC CARE - TENNESSEE - STABLE MEDICAID RATES IN VIRGINIA - LESS BURDENSOME LICENSURE REQUIREMENTS FOR GRADUATES OF FOREIGN MEDICAL SCHOOLS - HELMET REQUIREMENT FOR MOTORCYCLISTS	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$48,225,494	OtherCostOrOtherBasisAmt
Book Value	$48,225,494	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$511,933,826	OtherCostOrOtherBasisAmt
Depreciation	$179,762,710	DepreciationAmt
Book Value	$332,171,116	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$950,676	OtherCostOrOtherBasisAmt
Depreciation	$562,176	DepreciationAmt
Book Value	$388,500	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$487,338,073	OtherCostOrOtherBasisAmt
Depreciation	$368,654,682	DepreciationAmt
Book Value	$118,683,391	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$499,468,501	TotalBookValueLandBuildingsAmt

Invst Program Related Org InvstProgramRelatedOrgGrp (9 entries)

DescDesc	Book ValueBookValueAmt	Method ValuationMethodValuationCd
INVESTMENT IN JMH	$132,000,000	C
INVESTMENT IN BRMMC	$100,310,432	C
INVESTMENT IN SCCH	$68,400,494	C
INVESTMENT IN ISHN	$35,854,787	C
INVESTMENT IN PREMIER	$425,000	C
INVESTMENT IN QRH OF JC, LLC	$1,305	C
INVESTMENT IN QRH OF JC, LLC	-$18,302	C
PREMIER RESERVE	-$260,000	C
INVESTMENT IN MSJC	-$1,064,220	C

Field	Value	IRS element (for citing)
Total Book Value Program Rltd	$335,649,496	TotalBookValueProgramRltdAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDesc	Book ValueBookValueAmt
AWUL-UNDER BOND INDENTURE AGREEMENT	$45,220,027
AWUL - CURRENT	$19,597,595
LONG TERM COMPENSATION INVESTMENT	$15,105,469
DEFERRED CHARGES AND OTHER	$12,118,829

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$92,041,920	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDesc	AmtAmt
ACCRUED SALARIES, ABSENCES & W/H	$43,146,334
ACCRUED INTEREST	$18,062,772
OTHER LONG-TERM LIABILITIES	$9,208,370
DUE TO THIRD-PARTY PAYERS	$5,314,883
EST. FAIR VALUE OF INT. RATE SWAP	$2,540,682

Field	Value	IRS element (for citing)
Total Liability	$78,273,041	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, 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

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$12,019,626	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$12,019,626	NetCommunityBenefitExpnsAmt
Total Expense	0.01730	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$110,038,412	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$80,207,944	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$29,830,468	NetCommunityBenefitExpnsAmt
Total Expense	0.04300	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$122,058,038	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$80,207,944	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$41,850,094	NetCommunityBenefitExpnsAmt
Total Expense	0.06030	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,952,128	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$838,561	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,113,567	NetCommunityBenefitExpnsAmt
Total Expense	0.00590	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$12,296,806	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,020,754	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$9,276,052	NetCommunityBenefitExpnsAmt
Total Expense	0.01340	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$20,740,601	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$12,558,813	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$8,181,788	NetCommunityBenefitExpnsAmt
Total Expense	0.01180	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$260,074	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$22,625	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$237,449	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,736,609	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,736,609	NetCommunityBenefitExpnsAmt
Total Expense	0.00250	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$39,986,218	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$16,440,753	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$23,545,465	NetCommunityBenefitExpnsAmt
Total Expense	0.03390	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$162,044,256	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$96,648,697	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$65,395,559	NetCommunityBenefitExpnsAmt
Total Expense	0.09430	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$84,032,514	BadDebtExpenseAmt
Bad Debt Expense Attributable	$63,864,711	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$170,145,174	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$165,836,466	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$4,308,708	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

Field	Value	IRS element (for citing)
Business Name Line1	MED'L SPEC OF JC LLC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Primary Activities	MEDICAL SERVICES	PrimaryActivitiesTxt
Org Profit Or Ownership	0.51000	OrgProfitOrOwnershipPct
Physicians Profit Or Ownership	0.49000	PhysiciansProfitOrOwnershipPct

Field	Value	IRS element (for citing)
Hospital Facilities	7	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (7 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	State LicenseStateLicenseNum	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Childrens HospitalChildrensHospitalInd	Teaching HospitalTeachingHospitalInd	Research FacilityResearchFacilityInd	Emergency Room24 HrsEmergencyRoom24HrsInd	OtherOtherDesc	Critical Access HospitalCriticalAccessHospitalInd
JOHNSON CITY MEDICAL CENTER
1	400 N STATE OF FRANKLIN ROAD	JOHNSON CITY	TN	37604	00000121	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	MENTAL HEALTH
INDIAN PATH MEDICAL CENTER
2	2000 BROOKSIDE DRIVE	KINGSPORT	TN	37660	00000134	Yes (X)	Yes (X)		Yes (X)		Yes (X)
FRANKLIN WOODS COMMUNITY HOSPITAL
3	300 MED TECH PARKWAY	JOHNSON CITY	TN	37604	00000123	Yes (X)	Yes (X)				Yes (X)
SYCAMORE SHOALS HOSPITAL
4	1501 W ELK AVENUE	ELIZABETHTON	TN	37643	00000012	Yes (X)	Yes (X)				Yes (X)
RUSSELL COUNTY MEDICAL CENTER
5	58 CARROLL STREET	LEBANON	VA	24266	H 1892	Yes (X)	Yes (X)				Yes (X)
JOHNSON COUNTY COMMUNITY HOSPITAL
6	16901 S SHADY STREET	MOUNTAIN CITY	TN	37683	00000039	Yes (X)					Yes (X)		Yes (X)
UNICOI COUNTY MEMORIAL HOSPITAL
7	100 GREENWAY CIRCLE	ERWIN	TN	37650	00000119	Yes (X)	Yes (X)				Yes (X)

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (7 entries)

FacilityFacilityNum	First Licensed CY Or PYFirstLicensedCYOrPYInd	Tax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYInd	CHNA ConductedCHNAConductedInd	Community DefinitionCommunityDefinitionInd	Community DemographicsCommunityDemographicsInd	Existing ResourcesExistingResourcesInd	How Data ObtainedHowDataObtainedInd	Community Health NeedsCommunityHealthNeedsInd	Other Health IssuesOtherHealthIssuesInd	Community Hlth Needs Id ProcessCommunityHlthNeedsIdProcessInd	Consulting ProcessConsultingProcessInd	CHNA ConductedCHNAConductedYr	Take Into Account Others InputTakeIntoAccountOthersInputInd	CHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsInd	CHNA Conducted With Non FcltsCHNAConductedWithNonFcltsInd	CHNA Report Widely AvailableCHNAReportWidelyAvailableInd	Rpt Available On Own WebsiteRptAvailableOnOwnWebsiteInd	Own Website URLOwnWebsiteURLTxt	Paper Copy Public InspectionPaperCopyPublicInspectionInd	Implementation Strategy AdoptImplementationStrategyAdoptInd	Implementation Strategy AdptImplementationStrategyAdptYr	Strategy Posted WebsiteStrategyPostedWebsiteInd	Strategy AttachedStrategyAttachedInd	Organization Incur Excise TaxOrganizationIncurExciseTaxInd	Elig Criteria ExplainedEligCriteriaExplainedInd	FPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntInd	FPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePct	FPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePct	Asset Level CriteriaAssetLevelCriteriaInd	Medical Indigency CriteriaMedicalIndigencyCriteriaInd	Underinsurance Stat CriteriaUnderinsuranceStatCriteriaInd	Explained BasisExplainedBasisInd	App Financial Asst ExplnAppFinancialAsstExplnInd	Described InfoDescribedInfoInd	Described Suprt DocDescribedSuprtDocInd	Provided Hospital ContactProvidedHospitalContactInd	Includes Publicity MeasuresIncludesPublicityMeasuresInd	FAP Available On WebsiteFAPAvailableOnWebsiteInd	FAP Available On Website URLFAPAvailableOnWebsiteURLTxt	FAP App Available On WebsiteFAPAppAvailableOnWebsiteInd	FAP App Available On Website URLFAPAppAvailableOnWebsiteURLTxt	FAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeInd	FAP App Avlbl On Request No ChrgFAPAppAvlblOnRequestNoChrgInd	FAP Notice DisplayedFAPNoticeDisplayedInd	Communtity Notified FAPCommuntityNotifiedFAPInd	FAP Actions On NonpaymentFAPActionsOnNonpaymentInd	Permit No ActionsPermitNoActionsInd	Collection ActivitiesCollectionActivitiesInd	FAP Notified Upon AdmissionFAPNotifiedUponAdmissionInd	FAP Notified Before DischargeFAPNotifiedBeforeDischargeInd	FAP Notified All PatientsFAPNotifiedAllPatientsInd	Documented Elig DeterminationDocumentedEligDeterminationInd	Nondis Emergency Care PolicyNondisEmergencyCarePolicyInd	Other Method UsedOtherMethodUsedInd	Amounts Generally BilledAmountsGenerallyBilledInd	Gross ChargesGrossChargesInd
JOHNSON CITY MEDICAL CENTER
1	false	false	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	15	Yes (true)	Yes (true)	false	Yes (true)	Yes (X)	WWW.MOUNTAINSTATESHEALTH.COM	Yes (X)	Yes (true)	16	false	Yes (true)	false	Yes (true)	Yes (X)	200.000000000000	400.000000000000	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	WWWMOUNTAINSTATESHEALTHCOM	Yes (X)	WWWMOUNTAINSTATESHEALTHCOM	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	false	false
INDIAN PATH MEDICAL CENTER
2	false	false	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	15	Yes (true)	Yes (true)	false	Yes (true)	Yes (X)	WWW.MOUNTAINSTATESHEALTH.COM	Yes (X)	Yes (true)	16	false	Yes (true)	false	Yes (true)	Yes (X)	200.000000000000	400.000000000000	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	WWWMOUNTAINSTATESHEALTHCOM	Yes (X)	WWWMOUNTAINSTATESHEALTHCOM	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	false	false
FRANKLIN WOODS COMMUNITY HOSPITAL
3	false	false	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	15	Yes (true)	Yes (true)	false	Yes (true)	Yes (X)	WWW.MOUNTAINSTATESHEALTH.COM	Yes (X)	Yes (true)	16	false	Yes (true)	false	Yes (true)	Yes (X)	200.000000000000	400.000000000000	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	WWWMOUNTAINSTATESHEALTHCOM	Yes (X)	WWWMOUNTAINSTATESHEALTHCOM	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	false	false
SYCAMORE SHOALS HOSPITAL
4	false	false	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	15	Yes (true)	Yes (true)	false	Yes (true)	Yes (X)	WWW.MOUNTAINSTATESHEALTH.COM	Yes (X)	Yes (true)	16	false	Yes (true)	false	Yes (true)	Yes (X)	200.000000000000	400.000000000000	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	WWWMOUNTAINSTATESHEALTHCOM	Yes (X)	WWWMOUNTAINSTATESHEALTHCOM	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	false	false
RUSSELL COUNTY MEDICAL CENTER
5	false	false	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	15	Yes (true)	Yes (true)	false	Yes (true)	Yes (X)	WWW.MOUNTAINSTATESHEALTH.COM	Yes (X)	Yes (true)	16	false	Yes (true)	false	Yes (true)	Yes (X)	200.000000000000	400.000000000000	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	WWWMOUNTAINSTATESHEALTHCOM	Yes (X)	WWWMOUNTAINSTATESHEALTHCOM	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	false	false
JOHNSON COUNTY COMMUNITY HOSPITAL
6	false	false	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	15	Yes (true)	Yes (true)	false	Yes (true)	Yes (X)	WWW.MOUNTAINSTATESHEALTH.COM	Yes (X)	Yes (true)	16	false	Yes (true)	false	Yes (true)	Yes (X)	200.000000000000	400.000000000000	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	WWWMOUNTAINSTATESHEALTHCOM	Yes (X)	WWWMOUNTAINSTATESHEALTHCOM	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	false	false
UNICOI COUNTY MEMORIAL HOSPITAL
7	false	false	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	15	Yes (true)	Yes (true)	false	Yes (true)	Yes (X)	WWW.MOUNTAINSTATESHEALTH.COM	Yes (X)	Yes (true)	16	false	Yes (true)	false	Yes (true)	Yes (X)	200.000000000000	400.000000000000	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	WWWMOUNTAINSTATESHEALTHCOM	Yes (X)	WWWMOUNTAINSTATESHEALTHCOM	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	false	false

Supplemental Information SupplementalInformationGrp (28 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FACILITY 1, JOHNSON CITY MEDICAL CENTER - PART V, LINE 5	MSHA MET WITH TEN FOCUS GROUPS, EACH REPRESENTING ONE OF THE THIRTEEN HOSPITAL FACILITIES (INCLUDING ALL OF THE HOSPITALS INCLUDED IN THIS 990) LOCATED WITHIN THE CORE COUNTIES OF MSHA FACILITIES (16 COUNTIES). EACH GROUP CONSISTED OF PUBLIC HEALTH LEADERS, NURSES, NON-PROFIT DIRECTORS, COMMUNITY DEVELOPERS, FAITH BASED LEADERS, PUBLIC OFFICIALS AND SCHOOL REPRESENTATIVES. SPECIFIC TO JCMC, THE GROUP CONSISTED OF REPRESENTATIVES FROM THE WASHINGTON COUNTY HEALTH DEPARTMENT, FRONTIER HEALTH, ETSU COLLEGE OF NURSING, ETSU JOHNSON CITY COMMUNITY HEALTH CENTER, ETSU COLLEGE OF PUBLIC HEALTH, WASHINGTON COUNTY COMMISSION, NORTHEAST TENNESSEE REGIONAL HEALTH DEPARTMENT, WASHINGTON COUNTY/JOHNSON CITY EMERGENCY MEDICAL SERVICES, UNITED WAY, PROJECT ACCESS, CHAMBER OF COMMERCE, FAMILIES FREE, CITY OF JOHNSON CITY, AND CENTER ON AGING AND HEALTH. 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 THE WASHINGTON COUNTY COMMUNITY 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, JOHNSON CITY MEDICAL CENTER - PART V, LINE 6A	EACH HOSPITAL WITHIN THE MSHA SYSTEM COMPLETED A CHNA. FOR THOSE HOSPITALS THAT ARE LOCATED IN THE SAME COUNTY, ONLY ONE COMMUNITY GROUP WAS SURVEYED. FOR INSTANCE, JOHNSON CITY MEDICAL CENTER (INCLUDES NISWONGER CHILDREN'S HOSPITAL AND WOODRIDGE HOSPITAL) AND FRANKLIN WOODS COMMUNITY HOSPITAL ARE ALL LOCATED IN WASHINGTON COUNTY, TENNESSEE. JCMC'S CHNA WAS CONDUCTED WITH ALL MSHA HOSPITALS TO INCLUDE: 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, NORTON COMMUNITY HOSPITAL AND DICKENSON COMMUNITY HOSPITAL.
FACILITY 1, JOHNSON CITY MEDICAL CENTER - 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. AN IMPLEMENTATION PLAN WAS CREATED FOR EACH HOSPITAL, AND EACH HOSPITAL'S COMMUNITY 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'S FACILITIES WERE UNABLE TO ADDRESS ISSUES THAT WERE IDENTIFIED.
FACILITY 1, JOHNSON CITY MEDICAL CENTER - PART V, LINE 22D	UNINSURED 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 NEGOTIATED RATE WITH COMMERCIAL INSURANCE OR MEDICARE.
FACILITY 2, INDIAN PATH MEDICAL CENTER - PART V, LINE 5	MSHA MET WITH TEN FOCUS GROUPS, EACH REPRESENTING ONE OF THE THIRTEEN HOSPITAL FACILITIES (INCLUDING ALL OF THE HOSPITALS INCLUDED IN THIS 990) LOCATED WITHIN THE CORE COUNTIES OF MSHA FACILITIES (16 COUNTIES). EACH GROUP CONSISTED OF PUBLIC HEALTH LEADERS, NURSES, NON-PROFIT DIRECTORS, COMMUNITY DEVELOPERS, FAITH BASED LEADERS, PUBLIC OFFICIALS AND SCHOOL REPRESENTATIVES. SPECIFIC TO IPMC, THE GROUP CONSISTED OF REPRESENTATIVES FROM HEALTHY KINGSPORT, KINGSPORT CITY SCHOOLS, UNITED WAY OF GREATER KINGSPORT, SULLIVAN COUNTY HEALTH DEPARTMENT, IPMC HEALTH RESOURCE CENTER, SULLIVAN COUNTY DEPARTMENT OF EDUCATION, KINGSPORT CHAMBER OF COMMERCE, AND KINGSPORT BOARD OF MAYOR AND ALDERMAN. 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 IPMC'S SULLIVAN COUNTY COMMUNITY 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 2, INDIAN PATH MEDICAL CENTER - PART V, LINE 6A	EACH HOSPITAL WITHIN THE MSHA SYSTEM COMPLETED A CHNA. FOR THOSE HOSPITALS THAT ARE LOCATED IN THE SAME COUNTY, ONLY ONE COMMUNITY GROUP WAS SURVEYED. FOR INSTANCE, JOHNSON CITY MEDICAL CENTER (INCLUDES NISWONGER CHILDREN'S HOSPITAL AND WOODRIDGE HOSPITAL) AND FRANKLIN WOODS COMMUNITY HOSPITAL ARE ALL LOCATED IN WASHINGTON COUNTY, TENNESSEE. IPMC'S CHNA WAS CONDUCTED WITH ALL MSHA HOSPITALS TO INCLUDE: FRANKLIN WOODS COMMUNITY HOSPITAL, JOHNSON CITY MEDICAL CENTER, SYCAMORE SHOALS HOSPITAL, JOHNSON COUNTY COMMUNITY HOSPITAL, UNICOI COUNTY MEMORIAL HOSPITAL, RUSSELL COUNTY MEDICAL CENTER, SMYTH COUNTY COMMUNITY HOSPITAL, JOHNSTON MEMORIAL HOSPITAL, NORTON COMMUNITY HOSPITAL AND DICKENSON COMMUNITY HOSPITAL.
FACILITY 2, INDIAN PATH MEDICAL CENTER - 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. AN IMPLEMENTATION PLAN WAS CREATED FOR EACH HOSPITAL, AND EACH HOSPITAL'S COMMUNITY 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'S FACILITIES WERE UNABLE TO ADDRESS ISSUES THAT WERE IDENTIFIED.
FACILITY 2, INDIAN PATH MEDICAL CENTER - PART V, LINE 22D	UNINSURED 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 NEGOTIATED RATE WITH COMMERCIAL INSURANCE OR MEDICARE.
FACILITY 3, FRANKLIN WOODS COMMUNITY HOSPITAL - PART V, LINE 5	MSHA MET WITH TEN FOCUS GROUPS, EACH REPRESENTING ONE OF THE THIRTEEN HOSPITAL FACILITIES (INCLUDING ALL OF THE HOSPITALS INCLUDED IN THIS 990) LOCATED WITHIN THE CORE COUNTIES OF MSHA FACILITIES (16 COUNTIES). EACH GROUP CONSISTED OF PUBLIC HEALTH LEADERS, NURSES, NON-PROFIT DIRECTORS, COMMUNITY DEVELOPERS, FAITH BASED LEADERS, PUBLIC OFFICIALS AND SCHOOL REPRESENTATIVES. SPECIFIC TO FWCH, THE GROUP CONSISTED OF REPRESENTATIVES FROM THE WASHINGTON COUNTY HEALTH DEPARTMENT, FRONTIER HEALTH, ETSU COLLEGE OF NURSING, ETSU JOHNSON CITY COMMUNITY HEALTH CENTER, ETSU COLLEGE OF PUBLIC HEALTH, WASHINGTON COUNTY COMMISSION, NORTHEAST TENNESSEE REGIONAL HEALTH DEPARTMENT, WASHINGTON COUNTY/JOHNSON CITY EMERGENCY MEDICAL SERVICES, UNITED WAY, PROJECT ACCESS, CHAMBER OF COMMERCE, FAMILIES FREE, CITY OF JOHNSON CITY, AND CENTER ON AGING AND HEALTH. 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 THE WASHINGTON COUNTY COMMUNITY 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 3, FRANKLIN WOODS COMMUNITY HOSPITAL - PART V, LINE 6A	EACH HOSPITAL WITHIN THE MSHA SYSTEM COMPLETED A CHNA. FOR THOSE HOSPITALS THAT ARE LOCATED IN THE SAME COUNTY, ONLY ONE COMMUNITY GROUP WAS SURVEYED. FOR INSTANCE, JOHNSON CITY MEDICAL CENTER (INCLUDES NISWONGER CHILDREN'S HOSPITAL AND WOODRIDGE HOSPITAL) AND FRANKLIN WOODS COMMUNITY HOSPITAL ARE ALL LOCATED IN WASHINGTON COUNTY, TENNESSEE. FWCH'S CHNA WAS CONDUCTED WITH ALL MSHA HOSPITALS TO INCLUDE: JOHNSON CITY MEDICAL CENTER, 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, NORTON COMMUNITY HOSPITAL AND DICKENSON COMMUNITY HOSPITAL.
FACILITY 3, FRANKLIN WOODS 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. AN IMPLEMENTATION PLAN WAS CREATED FOR EACH HOSPITAL, AND EACH HOSPITAL'S COMMUNITY 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'S FACILITIES WERE UNABLE TO ADDRESS ISSUES THAT WERE IDENTIFIED.
FACILITY 3, FRANKLIN WOODS COMMUNITY HOSPITAL - PART V, LINE 22D	UNINSURED 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 NEGOTIATED RATE WITH COMMERCIAL INSURANCE OR MEDICARE.
FACILITY 4, SYCAMORE SHOALS HOSPITAL - PART V, LINE 5	MSHA MET WITH TEN FOCUS GROUPS, EACH REPRESENTING ONE OF THE THIRTEEN HOSPITAL FACILITIES (INCLUDING ALL OF THE HOSPITALS INCLUDED IN THIS 990) LOCATED WITHIN THE CORE COUNTIES OF MSHA FACILITIES (16 COUNTIES). EACH GROUP CONSISTED OF PUBLIC HEALTH LEADERS, NURSES, NON-PROFIT DIRECTORS, COMMUNITY DEVELOPERS, FAITH BASED LEADERS, PUBLIC OFFICIALS AND SCHOOL REPRESENTATIVES. SPECIFIC TO SSH, THE GROUP CONSISTED OF REPRESENTATIVES FROM ELIZABETHTON CITY SCHOOLS, CARTER COUNTY SCHOOLS, UNITED HEALTHCARE, UT-CARTER COUNTY EXTENSION, CENTER ON AGING AND HEALTH, CARTER COUNTY GOVERNOR'S OFFICE, COORDINATED SCHOOL HEALTH, BABE BREASTFEEDING COALITION, PROJECT ACCESS AND CARTER COUNTY HEALTH DEPARTMENT. 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 SSH'S CARTER COUNTY COMMUNITY 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 4, SYCAMORE SHOALS HOSPITAL - PART V, LINE 6A	EACH HOSPITAL WITHIN THE MSHA SYSTEM COMPLETED A CHNA. FOR THOSE HOSPITALS THAT ARE LOCATED IN THE SAME COUNTY, ONLY ONE COMMUNITY GROUP WAS SURVEYED. FOR INSTANCE, JOHNSON CITY MEDICAL CENTER (INCLUDES NISWONGER CHILDREN'S HOSPITAL AND WOODRIDGE HOSPITAL) AND FRANKLIN WOODS COMMUNITY HOSPITAL ARE ALL LOCATED IN WASHINGTON COUNTY, TENNESSEE. SSH'S CHNA WAS CONDUCTED WITH ALL MSHA HOSPITALS TO INCLUDE: FRANKLIN WOODS COMMUNITY HOSPITAL, INDIAN PATH MEDICAL CENTER, JOHNSON CITY MEDICAL CENTER, JOHNSON COUNTY COMMUNITY HOSPITAL, UNICOI COUNTY MEMORIAL HOSPITAL, RUSSELL COUNTY MEDICAL CENTER, SMYTH COUNTY COMMUNITY HOSPITAL, JOHNSTON MEMORIAL HOSPITAL, NORTON COMMUNITY HOSPITAL AND DICKENSON COMMUNITY HOSPITAL.
FACILITY 4, SYCAMORE SHOALS 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. AN IMPLEMENTATION PLAN WAS CREATED FOR EACH HOSPITAL, AND EACH HOSPITAL'S COMMUNITY 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'S FACILITIES WERE UNABLE TO ADDRESS ISSUES THAT WERE IDENTIFIED.
FACILITY 4, SYCAMORE SHOALS HOSPITAL - PART V, LINE 22D	UNINSURED 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 NEGOTIATED RATE WITH COMMERCIAL INSURANCE OR MEDICARE.
FACILITY 5, RUSSELL COUNTY MEDICAL CENTER - PART V, LINE 5	MSHA MET WITH TEN FOCUS GROUPS, EACH REPRESENTING ONE OF THE THIRTEEN HOSPITAL FACILITIES (INCLUDING ALL OF THE HOSPITALS INCLUDED IN THIS 990) LOCATED WITHIN THE CORE COUNTIES OF MSHA FACILITIES (16 COUNTIES). EACH GROUP CONSISTED OF PUBLIC HEALTH LEADERS, NURSES, NON-PROFIT DIRECTORS, COMMUNITY DEVELOPERS, FAITH BASED LEADERS, PUBLIC OFFICIALS AND SCHOOL REPRESENTATIVES. SPECIFIC TO RCMC, THE GROUP CONSISTED OF REPRESENTATIVES FROM THE CUMBERLAND PLATEAU HEALTH DISTRICT, VIRGINIA DEPARTMENT OF HEALTH, DANTE EMERGENCY MEDICAL SERVICES, TOWN OF LEBANON, RUSSELL COUNTY DEPARTMENT OF SOCIAL SERVICES, AND RUSSELL COUNTY YMCA. 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 RUSSELL COUNTY MEDICAL CENTER'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 5, RUSSELL COUNTY MEDICAL CENTER - PART V, LINE 6A	EACH HOSPITAL WITHIN THE MSHA SYSTEM COMPLETED A CHNA. FOR THOSE HOSPITALS THAT ARE LOCATED IN THE SAME COUNTY, ONLY ONE COMMUNITY GROUP WAS SURVEYED. FOR INSTANCE, JOHNSON CITY MEDICAL CENTER (INCLUDES NISWONGER CHILDREN'S HOSPITAL AND WOODRIDGE HOSPITAL) AND FRANKLIN WOODS COMMUNITY HOSPITAL ARE ALL LOCATED IN WASHINGTON COUNTY, TENNESSEE. RCMC'S CHNA WAS CONDUCTED WITH ALL MSHA HOSPITALS TO INCLUDE: FRANKLIN WOODS COMMUNITY HOSPITAL, INDIAN PATH MEDICAL CENTER, SYCAMORE SHOALS HOSPITAL, JOHNSON COUNTY COMMUNITY HOSPITAL, UNICOI COUNTY MEMORIAL HOSPITAL, JOHNSON CITY MEDICAL CENTER, SMYTH COUNTY COMMUNITY HOSPITAL, JOHNSTON MEMORIAL HOSPITAL, NORTON COMMUNITY HOSPITAL AND DICKENSON COMMUNITY HOSPITAL.
FACILITY 5, RUSSELL COUNTY MEDICAL CENTER - 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. AN IMPLEMENTATION PLAN WAS CREATED FOR EACH HOSPITAL, AND EACH HOSPITAL'S COMMUNITY 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'S FACILITIES WERE UNABLE TO ADDRESS ISSUES THAT WERE IDENTIFIED
FACILITY 5, RUSSELL COUNTY MEDICAL CENTER - PART V, LINE 22D	UNINSURED 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 NEGOTIATED RATE WITH COMMERCIAL INSURANCE OR MEDICARE.
FACILITY 6, JOHNSON COUNTY COMMUNITY HOSPITAL - PART V, LINE 5	MSHA MET WITH TEN FOCUS GROUPS, EACH REPRESENTING ONE OF THE THIRTEEN HOSPITAL FACILITIES (INCLUDING ALL OF THE HOSPITALS INCLUDED IN THIS 990) LOCATED WITHIN THE CORE COUNTIES OF MSHA FACILITIES (16 COUNTIES). EACH GROUP CONSISTED OF PUBLIC HEALTH LEADERS, NURSES, NON-PROFIT DIRECTORS, COMMUNITY DEVELOPERS, FAITH BASED LEADERS, PUBLIC OFFICIALS AND SCHOOL REPRESENTATIVES. SPECIFIC TO JCCH, THE GROUP CONSISTED OF REPRESENTATIVES FROM JOHNSON COUNTY COMMUNITY HOSPITAL, JOHNSON COUNTY HEALTH DEPARTMENT, JOHNSON COUNTY RESCUE AND EMERGENCY MEDICAL SERVICES, ETSU COLLEGE OF NURSING AT MOUNTAIN CITY EXTENDED HOURS, AND JOHNSON COUNTY SCHOOLS. 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 JOHNSON COUNTY COMMUNITY HOSPITAL'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 6, JOHNSON COUNTY COMMUNITY HOSPITAL - PART V, LINE 6A	EACH HOSPITAL WITHIN THE MSHA SYSTEM COMPLETED A CHNA. FOR THOSE HOSPITALS THAT ARE LOCATED IN THE SAME COUNTY, ONLY ONE COMMUNITY GROUP WAS SURVEYED. FOR INSTANCE, JOHNSON CITY MEDICAL CENTER (INCLUDES NISWONGER CHILDREN'S HOSPITAL AND WOODRIDGE HOSPITAL) AND FRANKLIN WOODS COMMUNITY HOSPITAL ARE ALL LOCATED IN WASHINGTON COUNTY, TENNESSEE. JCCH'S CHNA WAS CONDUCTED WITH ALL MSHA HOSPITALS TO INCLUDE: FRANKLIN WOODS COMMUNITY HOSPITAL, INDIAN PATH MEDICAL CENTER, SYCAMORE SHOALS HOSPITAL, JOHNSON CITY MEDICAL CENTER, UNICOI COUNTY MEMORIAL HOSPITAL, RUSSELL COUNTY MEDICAL CENTER, SMYTH COUNTY COMMUNITY HOSPITAL, JOHNSTON MEMORIAL HOSPITAL, NORTON COMMUNITY HOSPITAL AND DICKENSON COMMUNITY HOSPITAL.
FACILITY 6, JOHNSON COUNTY COMMUNITY HOSPITAL - PART V, LINE 11	MSHA PUBLISHED ITS COMMUNITY HEALTH NEEDS ASSESSMENT ON JUNE 29, 2015. THE DATA INCLUDED WAS COLLECTED OVER THE COURSE OF 2014 AND 2015. AN IMPLEMENTATION PLAN WAS CREATED FOR EACH HOSPITAL, AND EACH HOSPITAL'S COMMUNITY 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'S FACILITIES WERE UNABLE TO ADDRESS ISSUES THAT WERE IDENTIFIED.
FACILITY 6, JOHNSON COUNTY COMMUNITY HOSPITAL - PART V, LINE 22D	UNINSURED PATIENTS RECEIVE A 50% 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 NEGOTIATED RATE WITH COMMERCIAL INSURANCE OR MEDICARE.
FACILITY 7, UNICOI COUNTY MEMORIAL HOSPITAL - PART V, LINE 5	MSHA MET WITH TEN FOCUS GROUPS, EACH REPRESENTING ONE OF THE THIRTEEN HOSPITAL FACILITIES (INCLUDING ALL OF THE HOSPITALS INCLUDED IN THIS 990) LOCATED WITHIN THE CORE COUNTIES OF MSHA FACILITIES (16 COUNTIES). EACH GROUP CONSISTED OF PUBLIC HEALTH LEADERS, NURSES, NON-PROFIT DIRECTORS, COMMUNITY DEVELOPERS, FAITH BASED LEADERS, PUBLIC OFFICIALS AND SCHOOL REPRESENTATIVES. SPECIFIC TO UCMH, THE GROUP CONSISTED OF REPRESENTATIVES FROM THE UNICOI COUNTY CHAMBER OF COMMERCE, BANK OF TENNESSEE, UNICOI COUNTY FAMILY YMCA, KEESECKER/STEEL RAILS, CENTER ON AGING AND HEALTH, UETHDA HEAD START, TELEMON HEAD START, AND UNICOI COUNTY HEALTH DEPARTMENT. 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 THE UNICOI COUNTY COMMUNITY 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 7, UNICOI COUNTY MEMORIAL HOSPITAL - PART V, LINE 6A	EACH HOSPITAL WITHIN THE MSHA SYSTEM COMPLETED A CHNA. FOR THOSE HOSPITALS THAT ARE LOCATED IN THE SAME COUNTY, ONLY ONE COMMUNITY GROUP WAS SURVEYED. FOR INSTANCE, JOHNSON CITY MEDICAL CENTER (INCLUDES NISWONGER CHILDREN'S HOSPITAL AND WOODRIDGE HOSPITAL) AND FRANKLIN WOODS COMMUNITY HOSPITAL ARE ALL LOCATED IN WASHINGTON COUNTY, TENNESSEE. UCMH'S CHNA WAS CONDUCTED WITH ALL MSHA HOSPITALS TO INCLUDE: FRANKLIN WOODS COMMUNITY HOSPITAL, INDIAN PATH MEDICAL CENTER, SYCAMORE SHOALS HOSPITAL, JOHNSON COUNTY COMMUNITY HOSPITAL, JOHNSON CITY MEDICAL CENTER, RUSSELL COUNTY MEDICAL CENTER, SMYTH COUNTY COMMUNITY HOSPITAL, JOHNSTON MEMORIAL HOSPITAL, NORTON COMMUNITY HOSPITAL AND DICKENSON COMMUNITY HOSPITAL.
FACILITY 7, UNICOI COUNTY MEMORIAL 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. AN IMPLEMENTATION PLAN WAS CREATED FOR EACH HOSPITAL, AND EACH HOSPITAL'S COMMUNITY 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'S FACILITIES WERE UNABLE TO ADDRESS ISSUES THAT WERE IDENTIFIED.
FACILITY 7, UNICOI COUNTY MEMORIAL HOSPITAL - PART V, LINE 22D	UNINSURED 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 NEGOTIATED RATE WITH COMMERCIAL INSURANCE OR MEDICARE.

Field	Value	IRS element (for citing)
Facility	10	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (10 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
JCMC AMBULATORY SURGERY CENTER
400 N STATE OF FRANKLIN ROAD	JOHNSON CITY	TN	37604	LICENSED AMBULATORY SURGERY CENTER
MOUNTAIN STATES IMAGING CENTER
301 MED TECH PARKWAY SUITE 100	JOHNSON CITY	TN	37604	LICENSED OUTPATIENT DIAGNOSTIC CENTER
INDIAN PATH TRANSITIONAL CARE
2000 BROOKSIDE DRIVE	KINGSPORT	TN	37660	LICENSED SKILLED NURSING FACILITY
MEDICAL CNTR HOME CARE-JOHNSON CITY
101 MED TECH PARKWAY SUITE 100	JOHNSON CITY	TN	37604	LICENSED HOME HEALTH AGENCY
MEDICAL CNTR HOME CARE-KINGSPORT
2020 BROOKSIDE DRIVE 28	KINGSPORT	TN	37660	LICENSED HOME HEALTH AGENCY
RUSSELL CO MEDICAL CNTR HOME HLTH
116 FLANNAGAN AVENUE	LEBANON	VA	24266	LICENSED HOME HEALTH AGENCY
MEDICAL CENTER HOSPICE
101 MED TECH PARKWAY SUITE 100	JOHNSON CITY	TN	37604	LICENSED HOSPICE AGENCY
JOHNSON COUNTY HOME HEALTH
1987 SOUTH SHADY STREET	MOUNTAIN CITY	TN	37683	LICENSED HOME HEALTH AGENCY
RUSSELL COUNTY MEDICAL CNTR HOSPICE
116 FLANNAGAN AVENUE	LABANON	VA	24266	LICENSED HOSPICE AGENCY
UNICOI COUNTY LONG TERM CARE
100 GREENWAY CIRCLE	UNICOI	TN	37650	LICENSED LONG TERM CARE FACILITY

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 6A - RELATED ORGANIZATION INFORMATION	MSHA'S COMMUNITY BENEFIT REPORT WAS COMPLETED IN FY15.
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 (CHARITY CARE) COST. OUR COST ACCOUNTING SYSTEM WAS USED TO DETERMINE LOSSES FROM MEDICAID AND TENNCARE REPORTED ON LINE 7B, WITH THE EXCEPTION OF HOME HEALTH, A SMALL PHYSICIAN CLINIC AND UCMH - WE USED THE COST TO CHARGE RATIO FOR THEIR DATA BECAUSE THESE ARE SMALLER DIVISIONS NOT AVAILABLE IN OUR COST ACCOUNTING SOFTWARE. LINE 7E COMMUNITY HEALTH IMPROVEMENT INCLUDES COSTS THAT ARE TAKEN DIRECTLY FROM DEPARTMENTAL OPERATING REPORTS, 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. MEDICAL RESIDENT COSTS ARE TAKEN FROM JCMC AND IPMC MEDICARE COST REPORTS (NET OF ASSOCIATED REIMBURSEMENT). OUR ORGANIZATIONAL DEVELOPMENT DEPARTMENT KEEPS DETAILED RECORDS ON HOURS SPENT ON THE OTHER TYPES OF STUDENTS' ACTIVITIES, THE NUMBER OF STUDENTS THAT ROTATE THROUGH OUR HOSPITALS, 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 DEVOTED TO THESE STUDENTS. FOR LINE 7G SUBSIDIZED HEALTH CARE SERVICES, WE USE OUR COST ACCOUNTING SYSTEM BECAUSE WE HAVE ESTABLISHED, STANDARD COSTING REPORTS FOR THESE SERVICES. WE ARE CAREFUL TO ENSURE NO DOUBLE COUNTING OF COST (FOR EXAMPLE, WE DO NOT INCLUDE CHARITY AND TENNCARE/MEDICAID 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 HOSPITALS THAT LOSE MONEY, WE DO NOT REPORT SERVICES THAT HOSPITALS ARE REQUIRED BY STATE LICENSURE TO PROVIDE. WE ALSO INCLUDE A PHYSICIAN SPECIALTY CLINIC OPERATED BY JCCH, A FEDERALLY DESIGNATED CRITICAL ACCESS HOSPITAL. THIS CONTINUES TO BA A VALUABLE RESOURCE TO THE RESIDENTS OF THE AREA BY AIDING WITH TRANSPORTATION ISSUES (OTHER PHYSICIAN OFFICES ARE MORE THAN AN HOUR AWAY), RESOLVING ACCESS LIMITATIONS FOR SPECIALTY SERVICES, AND PROVIDING RELIEF TO THE SPECIAL HEALTH PROBLEMS OF A LARGELY ELDERLY POPULATION. THE CLINIC INCURRED A LOSS OF 54,215 DURING FY15. LINE 7H RESEARCH IS REPORTED USING THE RESEARCH DEPARTMENT'S ACTUAL EXPENSES AND NO OVERHEAD PROVISION IS ADDED. LINE 7I CASH AND IN-KIND CONTRIBUTIONS INCLUDES CASH DISBURSEMENTS AND IN-KIND DONATIONS OF MEDICATIONS TO LOCAL NON-PROFIT RESCUE SQUADS AND FIRE DEPARTMENTS. IN-KIND DONATIONS OF MEDICATIONS ARE BASED ON OUR ACTUAL COST FOR THESE ITEMS.
PART II - COMMUNITY BUILDING ACTIVITIES	MSHA LEADERS SUPPORT AND ENCOURAGE ALL TEAM MEMBERS TO VOLUNTEER TIME, MONEY AND SKILLS TO COMMUNITY SERVICE PROJECTS AND CHARITABLE ORGANIZATIONS. SENIOR LEADERS AND BOARD MEMBERS SET A POSITIVE EXAMPLE FOR MSHA TEAM MEMBERS, SERVING VOLUNTARILY ON COMMITTEES AND 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. MSHA, IN COLLABORATION WITH AREA HEALTH AGENCIES AND PROVIDERS, MAY OFFER ASSISTANCE WITH COORDINATION, ADVOCACY; PROVIDE SPACE; OR CONTRIBUTE SUPPLIES TO SUPPORT GROUPS FOR THEIR PROGRAM ACTIVITIES THAT SERVE TO ASSIST SPECIAL POPULATIONS WITHIN OUR AREA. MSHA INCURRED EXPENSES OF ALMOST 1.6 MILLION ON PHYSICIAN RECRUITMENT TO REPLACE PHYSICIANS RETIRING OR LEAVING OUR SERVICE AREAS, INCLUDING RECRUITMENT TO GOVERNMENT DESIGNATED UNDERSERVED COMMUNITIES. WITHOUT MSHA'S DEDICATION TO RURAL HEALTH, THERE WOULD NOT BE AN ADEQUATE NUMBER OF PHYSICIANS TO SERVE THIS PATIENT POPULATION. MSHA PROVIDED NUMEROUS CONTRIBUTIONS TO CHARITABLE ORGANIZATIONS 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. SOME OF THESE INCLUDE FEEDING THE POOR, HEALTH AND DENTAL CARE, HOMES FOR CHILDREN, IMPROVING ACCESS TO HEALTH CARE, AND ACTIVITIES FOR AT-RISK CHILDREN. WE MADE MANY DONATIONS SPECIFIC TO CHILDREN, SUCH AS AFTER SCHOOL ACTIVITIES, HEALTH IMPROVEMENT SERVICES AND MENTORING PROGRAMS. OTHER DONATIONS ARE MADE TO BROADER-BASED ORGANIZATIONS SUCH AS AMERICAN CANCER SOCIETY AND AMERICAN HEART ASSOCIATION. MSHA PROVIDES FUNDING TO AREA UNIVERSITIES AND COLLEGES IN SUPPORT OF HEALTH PROFESSIONAL EDUCATION.
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. ALL PATIENTS WITH NO FORM OF THIRD-PARTY PAYER COVERAGE RECEIVE A 66% CALCULATED DISCOUNT, AS REQUIRED BY TENNESSEE LAW. THE EXCEPTION IS OUR CRITICAL ACCESS HOSPITAL, JOHNSON COUNTY COMMUNITY HOSPITAL, WHICH PROVIDES THE UNINSURED WITH A 50% CALCULATED DISCOUNT. JCCH'S CALCULATED DISCOUNT, AS DETERMINED BY TENNESSEE LAW, IS LOWER DUE TO THE SMALL HOSPITAL'S LOWER COST STRUCTURE. MSHA APPLIES TENNESSEE LAW TO OUR VIRGINIA HOSPITALS' PATIENT ACCOUNTS AS WELL. AFTER THE NORMAL COLLECTION PROCESS HAS INDICATED AN ACCOUNT IS UNCOLLECTIBLE, MSHA WRITES THE ACCOUNT OFF TO BAD DEBT. THE HOSPITAL'S OVERALL SELF-PAY ACCOUNTS RECEIVABLE BALANCE IS EVALUATED ON AN ONGOING BASIS TO 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	MSHA'S PATIENT FINANCIAL SERVICES MANAGEMENT ESTIMATES 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 PATIENT ACCOUNTS WITH NO FORM OF INSURANCE OR THIRD-PARTY COVERAGE, WHICH REPRESENTS THE MAJORITY OF BAD BEBT ACCOUNTS. WE ALSO ESTIMATE A MUCH SMALLER PERCENTAGE OF LIKELY CHARITY-ELIGIBLE ACCOUNTS TO ACCOUNTS WITH BALANCES AFTER INSURANCE/THIRD-PARTY COVERAGE HAS PAID (E.G. REMAINING DEDUCTIBLE AND CO-PAYMENT BALANCES). IT IS IMPLAUSIBLE TO DETERMINE WITH EXACTITUDE THE AMOUNT OF MSHA'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 WE TELL PATIENTS THAT WE FEEL CONFIDENT THEY WILL QUALIFY FOR FINANCIAL ASSISTANCE, MANY STILL REFUSE TO COMPLETE OUR FINANCIAL ASSISTANCE APPLICATION. OUR TEAM MEMBERS VOLUNTEER TO ASSIST PATIENTS WITH COMPLETION OF THE APPLICATION SO IT IS FRUSTRATING TO WRITE OFF AN ACCOUNT TO BAD DEBT MERELY BECAUSE THE PATIENT WILL NOT PROVIDE THE REQUIRED INFORMATION TO CONFIRM ELIGIBILITY.
BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS	THE TEXT OF MSHA'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE APPEARS ON PAGE 13 IN OUR MOST RECENT AUDITED FINANCIAL STATEMENTS (ATTACHED).
PART III, LINE 8 - MEDICARE EXPLANATION	MEDICARE ALLOWABLE COSTS ARE REPORTED USING MSHA'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 ARE NON-ALLOWED COSTS BY THE MEDICARE PROGRAM EVEN THOUGH PHYSICIANS ARE RECRUITED BASED ON DOCUMENTED COMMUNITY NEED. 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, HOSPITALS ARE REQUIRED TO PROVIDE THE FULL REGIMEN OF CARE FOR THE MEDICARE POPULATION. THERE ARE A NUMBER OF CARE REGIMENS THAT ARE COMPENSATED BY THE MEDICARE PROGRAM AT LEVELS BELOW COST. THEREFORE, IT IS ONLY LOGICAL TO ALLOW HOSPITALS TO REPORT THESE UNCOMPENSATED SERVICES AS A COMMUNITY BENEFIT. BY MAKING THIS CHANGE, NON-PROFIT PROVIDERS WILL BE ENCOURAGED TO SUSTAIN IMPORTANT CARE DELIVERY MODELS FOR OUR AGING POPULATION IN SPITE OF THE FACT IT IS SOMETIMES ECONOMICALLY INJURIOUS. PART III, LINE 9B COLLECTION PRACTICES EXPLANATION MSHA 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. MSHA RECOGNIZES ITS OBLIGATION TO PROVIDE QUALITY HEALTH CARE 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. MSHA 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. TENNESSEE RANKED 43RD AND VIRGINIA RANKED 21ST. HOWEVER, IT SHOULD BE NOTED THAT SOUTHWEST VIRGINIA (WHERE SOME OF MSHA FACILITIES ARE 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). RANKINGS BY FACILITY: -JCMC AND FWCH WERE GIVEN A HEALTH STATUS RANKING OF 5.3 -IPMC WAS GIVEN A HEALTH STATUS RANKING OF 3.6 -SSH WAS GIVEN A HEALTH STATUS RANKING OF 4.7 -JCCH WAS GIVEN A HEALTH STATUS RANKING OF 5.14 -UCMH WAS GIVEN A HEALTH STATUS RANKING OF 4.9 -RCMC WAS GIVEN A HEALTH STATUS RANKING OF 5.0 AMONG THE 106 PARTICIPANTS, THE AREAS OF OBESITY, CANCER, HEART DISEASE, SMOKING, SUBSTANCE/PRESCRIPTION DRUG ABUSE, AND DIABETES WERE THE TOP HEALTH PRIORITIES IN OUR REGION. AHR REPORTS THAT VIRGINIA AND TENNESSEE BOTH SAW AN INCREASE IN DIABETES AND OBESITY WITHIN THE PAST TEN YEARS. TENNESSEE RANKS 44TH FOR BOTH CARDIOVASCULAR DEATHS AND CANCER DEATHS (47TH FOR SMOKING) AND 48TH FOR DIABETES. VIRGINIA RANKS 25TH FOR CARDIOVASCULAR DEATHS, 23RD FOR CANCER DEATHS (31ST FOR SMOKING) AND 21ST FOR DIABETES. COUNTY HEALTH RANKINGS FOR COUNTIES INCLUDED IN THE MSHA SERVICE AREA: THE PERCENTAGE OF CHILDREN LIVING IN POVERTY: JOHNSON COUNTY 38%, CARTER COUNTY 34%, UNICOI COUNTY 29%, AND RUSSELL COUNTY 26% PERCENTAGE OF PHYSICAL INACTIVITY: UNICOI COUNTY 37%, RUSSELL COUNTY 36%, JOHNSON COUNTY 34%, AND CARTER COUNTY 32% PERCENTAGE OF ADULT OBESITY: RUSSELL COUNTY 35%, JOHNSON COUNTY 31%, UNICOI COUNTY 30%, AND CARTER COUNTY 29% PERCENTAGE OF ADULT SMOKING: CARTER COUNTY 31%, JOHNSON COUNTY 28%, RUSSELL COUNTY 25%, AND UNICOI COUNTY 23%
PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	MSHA PROVIDES COMMUNICATION OF FINANCIAL ASSISTANCE ON ITS WEBSITE AND ON POSTERS LOCATED IN PROMINENT AREAS OF OUR HOSPITALS SUCH AS ADMITTING AND EMERGENCY DEPARTMENTS. 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. MSHA ALSO HAS FINANCIAL COUNSELORS TO PROVIDE FURTHER INFORMATION AND ASSISTANCE TO PATIENTS REGARDING 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 TENNNCARE/MEDICAID. MSHA 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 MSHA TO ASSIST PATIENTS. THE REPRESENTATIVES WERE ABLE TO DETERMINE GOVERNMENTAL MEDICAL ASSISTANCE (TENNCARE OR MEDICAID) ELIGIBILITY, AND TO HELP WITH THE APPLICATION PROCESS AND FOLLOW-UP. ONCE A PERSON IS APPROVED FOR TENNCARE OR MEDICAID THROUGH THE PROGRAM OFFERED THROUGH MSHA, THEY RETAIN COVERAGE FOR FUTURE MEDICAL CARE. 7,851 PATIENTS WERE APPROVED FOR GOVERNMENTAL ASSISTANCE DURING THE YEAR. FIRSTSOURCE AND ADVANCED PATIENT ADVOCACY ARE COMPENSATED BY MSHA. DURING FY15, OUR COST FOR THIS PROGRAM WAS 701,226.
PART VI, LINE 4 - COMMUNITY INFORMATION	MSHA SERVES THE HEALTHCARE NEEDS OF 29 APPALACHIAN COUNTIES IN TENNESSEE, SOUTHWEST VIRGINIA, KENTUCKY AND NORTH CAROLINA. SOME OF THE COUNTIES MSHA SERVES ARE FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREAS. MSHA OPERATES 2 CRITICAL ACCESS HOSPITALS: DICKENSON COMMUNITY HOSPITAL IN VIRGINIA, AND JOHNSON COUNTY COMMUNITY HOSPITAL IN TENNESSEE. THE HEALTH STATUS OF THE POPULATION IN MSHA'S SERVICE AREA IS GENERALLY POOR. THE SERVICE AREA EXTENDS TO SOME OF THE POOREST RURAL COUNTIES IN THE REGION WITH A POVERTY RATE OF ALMOST 30%. SOME OF THE MOST WELL-OFF COUNTIES IN MSHA'S SERVICE AREA STILL HAVE A MEDIAN HOUSEHOLD INCOME LOWER THAN STATE AND NATIONAL AVERAGES. RURAL SERVICE AREA COUNTIES SHARE COMMON CHALLENGES OF: 1. HIGH RATES OF UNINSURED 2. HIGH PREVALENCE OF OBESITY 3. HIGH PREVALENCE OF DIABETES 4. HIGH PREVALENCE OF CANCER 5. HIGH PREVALENCE OF POOR CARDIAC HEALTH
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH	MSHA IS DEDICATED TO OPERATING EFFICIENTLY SO THAT WASTE IS MINIMIZED. MSHA'S LEADERSHIP REMAINS MINDFUL OF MANAGING THE ALLIANCE'S LIMITED RESOURCES SO THAT ADEQUATE FACILITIES AND EQUIPMENT ARE AVAILABLE FOR THE CARE OF OUR PATIENTS. VARIOUS CHECKS AND BALANCES ARE ESTABLISHED TO ENSURE THAT EXPENDITURES FOR OPERATING EXPENSES AND CAPITAL COSTS ARE REASONABLE AND NECESSARY. SURPLUS FUNDS ARE INVESTED INTO IMPROVING TREATMENT OPTIONS FOR OUR PATIENTS THROUGH NEW TECHNOLOGIES, RECRUITING PHYSICIANS AND TRAINED STAFF IN SHORTAGE AREAS, AND IMPROVING OUR FACILITIES. THE MAJORITY OF MSHA'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA. PHYSICIANS THAT REQUEST PRIVILEGES WHO ARE QUALIFIED AND CREDENTIALED ARE EXTENDED PRIVILEGES BY MSHA.
PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM	MSHA PROVIDES CARE TO PEOPLE IN 29 COUNTIES IN TENNESSEE, VIRGINIA, KENTUCKY AND NORTH CAROLINA. EACH HOSPITAL IS FULLY ACCREDITED BY THE JOINT COMMISSION, WITH THE EXCEPTION OF JCCH. JCCH RECEIVES CERTIFICATION THROUGH THE STATE OF TENNESSEE SINCE IT IS A CRITICAL ACCESS HOSPITAL. MSHA, BASED IN JOHNSON CITY, TENNESSEE IS INTEGRATED BOTH VERTICALLY AND HORIZONTALLY AND IS THE LARGEST REGIONAL HEALTHCARE SYSTEM WITH 13 HOSPITALS. NINE FACILITIES ARE WHOLLY-OWNED FACILITIES: 8 FACILITIES IN TENNESSEE AND 1 IN VIRGINIA. IN ADDITION TO THE WHOLLY-OWNED HOSPITALS REPORTED WITHIN THIS FORM 990, MSHA ALSO HAS MAJORITY OWNERSHIP IN 4 HOSPITALS IN SOUTHWEST VIRGINIA. IN ADDITION TO OUR ACUTE CARE HOSPITALS, OUR SYSTEM INCLUDES SUCH SERVICES AS: PRIMARY/SPECIALTY PHYSICIAN PRACTICES, URGENT CARE CENTERS, EMERGENCY DEPARTMENTS, OCCUPATIONAL MEDICINE, REHABILITATION, OUTREACH LABORATORY, MENTAL HEALTH, NEONATAL INTENSIVE CARE, A NACHRI-AFFILIATED CHILDREN'S HOSPITAL, RENAL DIALYSIS, ST. JUDE'S ONCOLOGY, INPATIENT/OUTPATIENT SURGERY, SKILLED NURSING, LONG-TERM CARE, HOME HEALTH, AIR AMBULANCE TRANSPORT AND MORE. WITH THESE ADDITIONAL FACILITIES AND SERVICES, MSHA EXTENDS A HIGHLY EFFECTIVE HEALTH CARE DELIVERY SYSTEM. SINCE OUR SYSTEM IS BOTH HORIZONTALLY AND VERTICALLY INTEGRATED, PATIENTS CAN BE EFFICIENTLY MOVED ALONG AN INTEGRATED, COMPREHENSIVE CONTINUUM OF CARE AS THEIR HEALTH STATUS DICTATES. OUR FLAGSHIP FACILITY, JOHNSON CITY MEDICAL CENTER IS AT THE CORE OF OUR SYSTEM OFFERING FULL-SERVICE TERTIARY CARE. IN ADDITION TO OUR HOSPITALS, MSHA IS THE SOLE MEMBER OF BLUE RIDGE MEDICAL MANAGEMENT CORPORATION (BRMMC). MSHA EXTENDS AN INTEGRATED HEALTHCARE DELIVERY SYSTEM THROUGH BRMMC TO INCLUDE MULTIPLE PRIMARY AND SPECIALTY CARE PATIENT ACCESS CENTERS AND NUMEROUS OUTPATIENT CARE SITES, INCLUDING URGENT CARE CENTERS, OCCUPATIONAL MEDICINE SERVICES, SAME DAY SURGERY CENTERS AND REHABILITATION. MSHA COUNTY-SPECIFIC OPERATIONS ARE GOVERNED BY A COMMUNITY BOARD OF DIRECTORS. COUNTY BOARDS REPORT TO A SYSTEM LEVEL BOARD OF DIRECTORS. ALL BOARDS ARE PRIMARILY COMPOSED OF LOCAL COMMUNITY RESIDENTS.
PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT	TENNESSEE, VIRGINIA

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (19 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt	Non Cash AssistanceNonCashAssistanceAmt	Non Cash AssistanceNonCashAssistanceDesc
AMERICAN CANCER SOCIETY
250 WILLIAMS STREET NW SUITE 400	ATLANTA	GA	30303	131788491	501C3	$26,000	PROGRAM SUPPORT
AMERICAN HEART ASSOCIATION
208 SUNSET DRIVE	JOHNSON CITY	TN	37604	135613797	501C3	$41,250	MULTI-EVENT SPONSOR
APPALACHIAN MOUNTAIN PROJECT ACCESS
809 SOUTH ROAN STREET SUITE 4	JOHNSON CITY	TN	37601	262102040	501C3	$336,846	HEALTH ACCESS
BARTER THEATRE
PO BOX 867	ABINGDON	VA	24212	546000120	501C3	$18,800	CONTRIBUTION
CASA OF NE TENNESSEE
PO BOX 1021	JOHNSON CITY	TN	37605	450515257	501C3	$12,500	PROGRAM SUPPORT
CITY OF JOHNSON CITY
601 E MAIN ST	JOHNSON CITY	TN	37601	626000320	501C3	$26,250	NATURE TRAIL, ETC.
CROSSROADS MEDICAL MISSION
PO BOX 16852	BRISTOL	VA	24209	542038877	501C3	$10,000	PROGRAM SUPPORT
CRUMLEY HOUSE BRAIN INJURY REHAB
300 URBANA ROAD	LIMESTONE	TN	37681	581988511	501C3	$5,000	PROGRAM SUPPORT	$83	PRINTING
EAST TENN STATE UNIV FNDTN
PO BOX 70721	JOHNSON CITY	TN	37614	237092731	501C3	$14,600	CLINIC & MED SCHOOL
EAST TENNESSEE STATE UNIVERSITY
PO BOX 70732	JOHNSON CITY	TN	37614	626021046	501C3	$721,547	NURSING & PHARMACY
FRIENDS IN NEED HEALTH CENTER
1105 W STONE DRIVE	KINGSPORT	TN	37660	621541637	501C3	$15,000	DENTAL CARE
GOV'S FNDTN FOR HEALTH & WELLNESS
PO BOX 198198	NASHVILLE	TN	37219	453635908	501C3	$25,000	HEALTH INITIATIVE
HANDS ON REGIONAL MUSEUM
315 EAST MAIN STREET	JOHNSON CITY	TN	37601	621282542	501C3	$7,500	HEALTH EXHIBIT
KINGSPORT CHAMBER FOUNDATION
151 EAST MAIN STREET	KINGSPORT	TN	37660	581453565	501C3	$20,000	HEALTHY KPT PRGRM
LEBANON LIFESAVING CREW INC
P O BOX 516 60 S CHURCH ST	LEBANON	VA	24266	541382140	501C3		DRUG REFILLS	$7,129	MED SUPPLIES
MARCH OF DIMES
PO BOX 799 2700 S ROAN ST 430	JOHNSON CITY	TN	37605	131846366	501C3	$10,000	MARCH FOR BABIES
MILLIGAN COLLEGE
PO BOX 189	MILLIGAN COLLEGE	TN	37682	620535755	501C3	$432,948	HEALTH PROF. PROGRAM
SUSAN KOMEN BREAST CANCER FOUND
PO BOX 5835	KINGSPORT	TN	37663	841689067	501C3	$10,000	PROGRAM SUPPORT
WOUNDED WARRIORS PROJECT INC
4899 BELFORT RD 300	JACKSONVILLE	FL	32256	202370934	501C3	$10,000	CONTRIBUTION

Field	Value	IRS element (for citing)
Total501c3 Org	19	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	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 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 CHNA, ETC. MSHA ADHERED TO THE FOLLOWING CRITERIA FOR OUR CONTRIBUTIONS TO ORGANIZATIONS IN THE REGION: HEALTHCARE: THE ORGANIZATION ENHANCED OR IMPROVED ACCESS FOR THE UNINSURED OR UNDERINSURED POPULATION OR SUPPORTED A PROGRAM TO IMPROVE THE HEALTH OF OUR RESIDENTS. EDUCATION: THE ORGANIZATION PROVIDED A PROGRAM TO IMPROVE EDUCATION OF THE RESIDENTS IN OUR REGION ALL THE WAY TO COLLEGE AGE STUDENTS (SUCH AS A NURSING PROGRAM). LARGE DONATIONS WERE MADE DURING THE YEAR TO SUPPORT HEALTH PROFESSIONS PROGRAMS AT LOCAL UNIVERSITIES AND COLLEGES. FOR EXAMPLE, A PHARMACY PROGRAM, A NURSING PROGRAM, AND A NEW PHYSICIAN ASSISTANT PROGRAM. QUALITY OF LIFE: THE ORGANIZATION SUPPORTED PROGRAMS TO ENHANCE THE QUALITY OF LIFE, WHICH IS IMPORTANT IN THE RECRUITMENT EFFORTS OF BUSINESSES IN THE REGION AS WE WORK TO ATTRACT AND RETAIN THE BEST TALENT.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
First Class Or Charter Travel	Yes (X)	FirstClassOrCharterTravelInd
Written Policy Ref T And E Expnss	Yes (true)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (true)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
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 (21 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt
ALAN LEVINE
PRESIDENT & CEO	$763,535	$250,724	$117,716	$120,750	$43,318	$1,274,384
MARVIN EICHORN
EVP/COO	$513,864	$140,426	$51,080	$18,788	$46,674	$747,495
LYNN KRUTAK
SVP/CFO	$329,541	$57,373	$3,668	$48,125	$18,275	$456,982
DENNIS VONDERFECHT
CEO (RETIRED FY14)	$32,486	$149,231	$156,617		$8,600	$342,634
ANN FLEMING
SVP/CONSULTANT	$319,105	$108,007	$122,727	$10,125	$12,733	$572,697	$39,222
CANDACE JENNINGS
SR. VP TN OPERATIONS	$268,263		$83,556	$5,421	$17,075	$374,315
MONTY MCLAURIN
VP/CEO NW MKT	$268,960	$61,819	$20,342	$29,617	$24,717	$405,455
SHANE HILTON
VP/TN CFO	$287,587	$51,843	$8,724	$32,472	$23,154	$403,780
TONY BENTON
VP/COO WASH. CO MKT	$273,318	$54,994	$4,525	$16,463	$21,783	$371,083
LINDA WHITE
VP & CEO, FWCH/WR	$212,669	$48,277	$6,173	$23,936	$19,871	$310,926
LEMMIE TAYLOR
VP/CEO SE MKT	$190,518	$41,701	$2,396	$25,604	$20,883	$281,102
RHONDA MANN
JCMC CNO	$157,558	$14,837	$15,059	$11,133	$15,017	$213,604
DRU MALCOLM
VP & CNO JCMC/WR	$152,064	$6,550	$7,083	$12,247	$5,389	$183,333
STEVE SAWYER
AVP/CFO NW MKT	$150,118	$6,550	$8,816	$6,418	$17,630	$189,532
MORRIS SELIGMAN MD
EVP/CMO	$435,096	$123,037	$24,872	$56,066	$19,118	$658,189
FRANK LAURO MD
VP/MED. DIR. CARDIO	$366,216	$80,526	$6,731	$19,873	$24,533	$497,879
STEVE KILGORE
PRES./CEO BRMMC	$331,273	$71,259	$17,311	$44,102	$22,404	$486,349
MARK WILKINSON MD
VP/CMO	$336,139	$79,140	$4,266	$11,203	$24,094	$454,842
CLAY RUNNELS MD
VP/CMO WASH. CO.	$342,450	$68,903	$2,895	$11,338	$23,920	$449,506
DALE CLAYTORE
VP RESOURCE MGMT.	$186,696	$42,215	$9,841	$11,202	$4,758	$252,333
PAT NIDAY
FORMER CNO WASH. CO.	$155,750	$29,901	$19,997	$8,012	$18,122	$231,782

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE J, PAGE 1, PART I, LINE 1A	BOARD MEMBERS AND TEAM MEMBERS OF MSHA ARE NOT PERMITTED TO TRAVEL FIRST- CLASS WITH THE EXCEPTION OF MSHA'S CEO. AS SANCTIONED BY MSHA'S BOARD OF DIRECTORS, MSHA'S CEO IS PERMITTED TO TRAVEL FIRST-CLASS WHEN THE FLIGHT'S DURATION IS GREATER THAN TWO HOURS. DUE TO THE LENGTH OF SUCH FLIGHTS, THE BOARD BELIEVES IT IS IN THE BEST INTEREST OF MSHA FOR THE CEO TO TRAVEL FIRST-CLASS. CHARTER TRAVEL IS LIMITED TO MSHA BUSINESS TRIPS THAT INCLUDE NUMEROUS TRAVELERS AND WHICH CAN BE JUSTIFIED BASED UPON FINANCIAL AND/OR ESSENTIAL TIME SAVINGS. CHARTER FLIGHTS MUST BE APPROVED BY THE CEO PRIOR TO BOOKING THE FLIGHT.
SCHEDULE J, PAGE 1, PART I, LINE 4	ALAN LEVINE 0 120,750 0 LYNN KRUTAK 0 24,856 0 MONTY MCLAURIN 0 13,992 0 SHANE HILTON 0 14,760 0 LINDA WHITE 0 10,880 0 LEMMIE TAYLOR 0 9,848 0 MORRIS SELIGMAN, M.D. 0 43,960 0 STEVE KILGORE 0 24,472 0
SCHEDULE J, PART III	THE FOLLOWING EXECUTIVES LISTED IN SCHEDULE J, PART II PARTICIPATED IN A 457(F) RETIREMENT PLAN PROVIDED BY MOUNTAIN STATES HEALTH ALLIANCE (MSHA): ALAN LEVINE, LYNN KRUTAK, MONTY MCLAURIN, SHANE HILTON, LINDA WHITE, LEMMIE TAYLOR, MORRIS SELIGMAN, AND STEVE KILGORE. 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 K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCd	Business Name Line2IssuerName/BusinessNameLine2Txt	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
HLTH & EDU FACIL BD 2011A&B&C&D
A	OF THE CITY OF JOHNSON CITY TN	621464028	478271JS9	2011-10-19	$195,840,000	CONSTRUCTION & EQUIP.	false	false	false
HLTH & EDU FACIL BD 2010A&B
B		621464028	478271JH3	2010-04-29	$205,877,528	PARTIAL REFUNDING	false	false	false
HLTH & EDU FACIL BD 2009A&B&C
C		621464028	478271HT9	2009-03-31	$124,301,533	CONSTRUCTION & EQUIP.	false	false	false
HLTH & EDU FACIL BD 2006A
D		621464028	478271GX1	2006-02-14	$178,614,171	CONSTRUCTION & EQUIP.	false	false	false

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	Current RefundingCurrentRefundingInd	Advance RefundingAdvanceRefundingInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	UnspentUnspentAmt	Substantial CompletionSubstantialCompletionYr
A	$121,045,000	$195,841,616	$2,353,905	$158,517,509	$34,166,505	Yes (true)	false	Yes (true)	Yes (true)
B	$32,185,000	$206,153,675	$3,474,644		$202,679,030	Yes (true)	false	Yes (true)	Yes (true)
C	$7,610,000	$125,817,329	$2,481,706	$100,727,095	$20,428,687	false	false	Yes (true)	Yes (true)	$2,179,840	2014
D	$6,010,000	$185,446,812	$2,383,533	$101,295,664	$65,532,086	Yes (true)	Yes (true)	Yes (true)	Yes (true)	$16,235,529	2011

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd	Any Research AgreementsAnyResearchAgreementsInd	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropPct	Remedial Action TakenRemedialActionTakenInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	false	false	Yes (true)	Yes (true)	false	false	Yes (true)	0.00020	false	Yes (true)
B	false	false	Yes (true)	Yes (true)	false	false	Yes (true)	0.00020	false	Yes (true)
C	false	false	Yes (true)	Yes (true)	false	false	false			Yes (true)
D	false	false	Yes (true)	Yes (true)	false	false	Yes (true)	0.00130	false	Yes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A	false	false	false	false	Yes (true)	false	false	false	Yes (true)
B	false	Yes (true)	false	Yes (true)	false	false	false	Yes (true)	Yes (true)
C	false	Yes (true)	false	Yes (true)	false	false	false	Yes (true)	Yes (true)
D	false	Yes (true)	false	Yes (true)	false	false	false	Yes (true)	Yes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (true)
B	Yes (true)
C	Yes (true)
D	Yes (true)

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE K - PURPOSE OF ISSUE DESCRIPTION	HLTH & EDU. FACIL. BD. 2011A&B&C&D (PAGE 1 - LINE A) CONSTRUCT AND EQUIP HOSPITAL FACILITIES,INCLUDING REFINANCING TAXABLE DEBT RELATING THERETO, REFUND BONDS ISSUED 12/01/2001; REFINANCING LOANS AND EQUIPMENT LEASES. HLTH & EDU. FACIL. BD. 2010A&B (PAGE 1 - LINE B) PARTIAL REFUNDING OF BONDS ISSUED 12/14/2007 (2007A) AND (2007C) AND 2/20/2008 (2008A). HLTH & EDU. FACIL. BD. 2009A&B&C (PAGE 1 - LINE C) CONSTRUCT AND EQUIP HOSPITAL FACILITIES,INCLUDING REFINANCING OF TAXABLE INDEBTEDNESS RELATING THERETO. HLTH & EDU. FACIL. BD. 2006A (PAGE 1 - LINE D) CONSTRUCT AND EQUIP HOSPITAL FACILITIES,INCLUDING REFINANCING TAXABLE DEBT RELATING THERETO, AND COST OF INTEREST RATE HEDGE, REFUND BONDS ISSUED 3/28/01, 7/01/03, 7/08/04, 11/23/04, 9/7/05 AND 11/23/05. HLTH & EDU. FACIL. BD. 2012A&B&C (PAGE 2 - LINE A) CONSTRUCT AND EQUIP SURGERY CENTER AT JCMC; CONSTRUCT AND EQUIP HOSPITAL FACILITIES, INCLUDING REFINANCING OF INDEBTEDNESS RELATING THERETO. HLTH & EDU. FACIL. BD. 2013A&C&D&E (PAGE 2 - LINE B) CONSTRUCT & EQUIP HOSPITAL FACILITIES, INCLUDING REFINANCING OF INDEBTEDNESS RELATING THERETO, REFUND BONDS ISSUED 2/20/08, 10/19/11 & 9/18/12
SCHEDULE K - DATE REBATE COMPUTATION PERFORMED	HLTH & EDU. FACIL. BD. 2010A&B 02/25/15 HLTH & EDU. FACIL. BD. 2009A&B&C 03/21/14 HLTH & EDU. FACIL. BD. 2006A 02/17/11
SCHEDULE K - ADDITIONAL INFORMATION	HLTH & EDU. FACIL. BD. 2011A&B&C&D SCHEDULE K PART VI: 1.COMMENT ON SCHEDULE K, PART I, MOUNTAIN STATES HEALTH ALLIANCE OWNS AND/OR OPERATES HOSPITALS IN A NUMBER OF DIFFERENT LOCATIONS BOTH IN TENNESSEE AND IN VIRGINIA. AS A RESULT, MOUNTAIN STATES HEALTH ALLIANCE MUST UTILIZE CONDUIT GOVERNMENTAL BOND ISSUERS IN A NUMBER OF JURISDICTIONS IN ORDER TO FINANCE IMPROVEMENTS TO ITS HOSPITAL FACILITIES. IN 2009, 2010, 2011, 2012 AND 2013, MOUNTAIN STATES HEALTH ALLIANCE WAS THE CONDUIT BORROWER OF TAX-EXEMPT BONDS ISSUED BY MULTIPLE ISSUERS IN TENNESSEE AND VIRGINIA. FOR FEDERAL TAX PURPOSES, EVEN THOUGH DIFFERENT GOVERNMENT ISSUERS WERE INVOLVED, THESE MULTIPLE ISSUES IN EACH YEAR WERE REQUIRED TO BE TREATED, AND WERE TREATED, AS A SINGLE "ISSUE" BECAUSE THEY MET THE SINGLE "ISSUE" TEST UNDER THE APPLICABLE FEDERAL TAX REGULATIONS. THEREFORE, MULTIPLE ISSUERS ARE LISTED BECAUSE THE BONDS THAT WERE ISSUED WERE PART OF A SINGLE "ISSUE" FOR FEDERAL TAX PURPOSES. 2.COMMENT ON SCHEDULE K, PART II. LINE 3 FOR EACH THE LISTED BOND ISSUES DOES NOT MATCH THE APPLICABLE ISSUE PRICE FOR EACH SUCH BOND ISSUE BECAUSE OF INTEREST EARNINGS EARNED ON THE PROCEEDS OF EACH SERIES OF BONDS. 3.COMMENT ON SCHEDULE K, PART II, LINE 9 THROUGH 11. THE INSTRUCTIONS ARE UNCLEAR AS TO WHETHER AMOUNTS USED TO REFINANCE SHORT-TERM TAXABLE LOANS INCURRED TO TEMPORARILY FINANCE ELIGIBLE COSTS SHOULD BE SHOWN AS CAPITAL EXPENDITURES AND WORKING CAPITAL (LINES 9 AND 10) OR AS OTHER SPENT PROCEEDS (LINE 11). BASED UPON A REVIEW OF OTHER 990 FILINGS, IT APPEARS THAT MOST REPORTING ENTITIES HAVE LISTED THE APPLICATION OF PROCEEDS FOR SUCH PURPOSE UNDER OTHER SPENT PROCEEDS (LINE 11). THIS FILING TAKES THAT APPROACH. 4.COMMENT ON SCHEDULE K, PART II, LINE 12. IT IS UNCLEAR UNDER THE INSTRUCTIONS WHETHER TRANSFERRED PROCEEDS SHOULD BE TREATED AS OTHER UNSPENT PROCEEDS FOR REPORTING PURPOSES ON LINE 12. AS AN ABUNDANCE OF CAUTION, TRANSFERRED PROCEEDS HAVE BEEN INCLUDED ON LINE 12 FOR THE 2013 AND 2012 BONDS TO THE EXTENT APPLICABLE. ALSO, DURING ITS 2013 FISCAL YEAR, MOUNTAIN STATES HEALTH ALLIANCE WAS ABLE TO REMOVE THE REQUIREMENT THAT CERTAIN DEBT SERVICE RESERVE FUNDS BE MAINTAINED. AS A RESULT, MOUNTAIN STATES HEALTH ALLIANCE WAS ABLE TO TRANSFER PROCEEDS FROM DEBT SERVICE RESERVE FUNDS FOR CERTAIN ISSUES TO BOND SINKING FUNDS FOR THOSE ISSUES TO PAY PRINCIPAL ON THE ISSUE AND TO REDUCE THE AMOUNT OF TAX-EXEMPT BONDS OUTSTANDING IN THE MARKET. AS A RESULT, UNSPENT PROCEEDS WERE INCREASED FOR CERTAIN ISSUES WHILE SUCH FUNDS ARE HELD IN THE BOND SINKING FUNDS, AND THE AMOUNTS PREVIOUSLY HELD IN DEBT SERVICE RESERVE FUNDS FOR SUCH ISSUES WERE REDUCED. MOUNTAIN STATES HEALTH ALLIANCE IS USING SUCH PROCEEDS TO PAY PRINCIPAL AS QUICKLY ON THOSE ISSUES AS THE BOND DOCUMENTS PERMIT. 5.COMMENT ON SCHEDULE K, PART III, LINE 8C. A VERY SMALL AMOUNT OF EQUIPMENT THAT WAS FINANCED OR REFINANCED WITH THE PROCEEDS OF THE 2013, 2011, 2009, AND 2006A BONDS WERE DISPOSED OF DURING THE FISCAL YEAR. NO REMEDIAL ACTION WAS TAKEN PURSUANT TO SECTIONS 1.141-12 AND 1.145-2 OF THE TREASURY REGULATIONS BECAUSE THE DISPOSITION OF SUCH EQUIPMENT DID NOT RESULT IN THE PRIVATE BUSINESS USE TEST THRESHOLD BEING EXCEEDED. THEREFORE, SUCH REGULATIONS WERE INAPPLICABLE. HOWEVER, AS A PRECAUTION, MOUNTAIN STATES HEALTH ALLIANCE ALLOCATED FROM THE PROCEEDS OF THE SALE OF THE FINANCED EQUIPMENT AND OTHER EQUIPMENT, AN AMOUNT EQUAL TO THE DEPRECIATED BOOK VALUE OF SUCH FINANCED EQUIPMENT TO NEW EQUIPMENT ACQUIRED DURING THE FISCAL YEAR BY MOUNTAIN STATES HEALTH ALLIANCE. 6.COMMENT ON SCHEDULE K, PART IV, LINE 1. PRIOR TO JUNE 30, 2015, THE REPORTING DATE OF THE 990, THE ONLY ARBITRAGE REBATE CALCULATIONS THAT WERE REQUIRED RELATED TO THE BONDS FOR THE SERIES 2006, 2009 AND 2010 BONDS. MOUNTAIN STATES HEALTH ALLIANCE RETAINED A REBATE CALCULATION AGENT TO CALCULATE WHETHER ANY ARBITRAGE REBATE WAS DUE WITH RESPECT TO THOSE BONDS, AND THERE WAS NEGATIVE ARBITRAGE REBATE LIABILITY IN A SIGNIFICANT AMOUNT. THEREFORE, NO FORM 8038-T WAS REQUIRED TO BE FILED WITH RESPECT TO THOSE BOND ISSUES. 7.COMMENT ON SCHEDULE K, PART IV, LINE 6. THE 2013 AND 2012 BOND ISSUES HAVE TRANSFERRED PROCEEDS OF PRIOR BOND ISSUES THAT FINANCED SIGNIFICANT CAPITAL IMPROVEMENTS TO HOSPITAL FACILITIES OR PROCEEDS THAT ARE TO BE USED FOR SUCH PURPOSES. THERE HAVE BEEN UNEXPECTED DELAYS IN THE CONSTRUCTION AND EQUIPPING OF CERTAIN OF THESE HOSPITAL FACILITIES, AND THEREFORE NOT ALL OF SUCH PROCEEDS WERE SPENT WITHIN THE THREE-YEAR TEMPORARY PERIOD RELATIVE TO CONSTRUCTION PROJECTS. HOWEVER, MOUNTAIN STATES HEALTH ALLIANCE HAS YIELD RESTRICTED THESE PROCEEDS AFTER THE END OF THE APPLICABLE TEMPORARY PERIOD AND/OR WILL BE MAKING A YIELD REDUCTION PAYMENT WITH RESPECT TO THOSE PROCEEDS, IF REQUIRED. ALSO, THE PROCEEDS HELD IN THE BOND SINKING FUNDS AS DESCRIBED IN COMMENT 4 ABOVE ARE NO LONGER ELIGIBLE FOR ANY TEMPORARY PERIOD AND WILL BE INVESTED AT A RESTRICTED YIELD OR WILL BE SUBJECT TO A YIELD REDUCTION PAYMENT.

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (5 entries)

Loan PurposeLoanPurposeTxt	Loan From OrganizationLoanFromOrganizationInd	Original PrincipalOriginalPrincipalAmt	Balance DueBalanceDueAmt	DefaultDefaultInd	Board Or Committee ApprovalBoardOrCommitteeApprovalInd	Written AgreementWrittenAgreementInd
DENNIS VONDERFECHT
SPLIT LIFE INSUR.LOAN,INCL.PR.YRS	Yes (X)	$7,205,125	$8,295,295	false	Yes (true)	Yes (true)
MARVIN EICHORN
SPLIT DOLLAR LIFE INSURANCE LOAN	Yes (X)	$700,000	$1,410,710	false	Yes (true)	Yes (true)
MARVIN EICHORN
SPLIT DOLLAR LIFE INSURANCE LOAN	Yes (X)	$183,364	$374,136	false	Yes (true)	Yes (true)
MARVIN EICHORN
SPLIT DOLLAR LIFE INSURANCE LOAN	Yes (X)	$304,332	$304,332	false	Yes (true)	Yes (true)
MARVIN EICHORN
SPLIT LIFE INSUR.LOAN,INCL.PR.YRS	Yes (X)	$296,183	$296,183	false	Yes (true)	Yes (true)

Field	Value	IRS element (for citing)
Total Balance Due	$10,680,656	TotalBalanceDueAmt

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (5 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
WORKSPACE INTERIORS INC
VENDOR	$422,524	SEE PART V	false
MATTHEW MARTIN
FAMILY MEMBER	$26,019	SEE PART V	false
CLEM WILKES III
FAMILY MEMBER	$130,195	SEE PART V	false
PAULA CLAYTORE
FAMILY MEMBER	$278,296	SEE PART V	false
SCOTT PETERS
FAMILY MEMBER	$28,841	SEE PART V	false

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE L, PART V	FormAndLineReferenceDesc
Explanation	(1) ROBERT FEATHERS, VICE CHAIR OF THE MSHA BOARD OF DIRECTORS, IS OWNER OF WORKSPACE INTERIORS,INC. WHICH PROVIDES COMMERCIAL FURNISHINGS AND DESIGN SERVICES TO MSHA. TRANSACTIONS ARE CONDUCTED AT ARMS-LENGTH. (2) JOANNE GILMER, SECRETARY OF THE MSHA BOARD OF DIRECTORS, IS A FAMILY MEMBER OF MATTHEW MARTIN, AN EMPLOYEE OF MSHA. (3) CLEM WILKES, JR., PAST CHAIR OF THE MSHA BOARD OF DIRECTORS, IS A FAMILY MEMBER OF CLEM WILKES III, AN EMPLOYEE OF MSHA. (4) DALE CLAYTORE, FORMER KEY EMPLOYEE OF MSHA, IS A FAMILY MEMBER OF PAULA CLAYTORE, AN EMPLOYEE OF MSHA. (5) LEMMIE TAYLOR, KEY EMPLOYEE OF MSHA, IS A FAMILY MEMBER OF SCOTT PETERS, AN EMPLOYEE OF MSHA.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PAGE 1, ITEM C	NISWONGER CHILDREN'S HOSPITAL; FRANKLIN WOODS COMMUNITY HOSPITAL; INDIAN PATH MEDICAL CENTER; SYCAMORE SHOALS HOSPITAL; WOODRIDGE HOSPITAL FOR BEHAVIORAL HEALTH SERVICES; JOHNSON COUNTY COMMUNITY HOSPITAL; RUSSELL COUNTY MEDICAL CENTER; UNICOI COUNTY MEMORIAL HOSPITAL
FORM 990 - ORGANIZATION'S MISSION	MOUNTAIN STATES HEALTH ALLIANCE (MSHA) IS COMMITTED TO OUR MISSION OF BRINGING LOVING CARE TO HEALTH CARE. WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTHCARE NEEDS OF INDIVIDUALS AND COMMUNITIES IN THE 29-COUNTY AREA WE SERVE, HELPING THEM ATTAIN THEIR HIGHEST LEVEL OF HEALTH. MSHA DELIVERS THIS CARE THROUGH THE PHILOSOPHY OF PATIENT-CENTERED CARE, AND THE DEVELOPMENT OF COMPREHENSIVE STRATEGIC PLANNING AND IMPLEMENTATION. SEE ATTACHED NARRATIVE "PROGRAM SERVICE ACCOMPLISHMENTS".
FORM 990, PAGE 6, PART VI, LINE 11B	THE CFO/SENIOR VP REVIEWED THE FORM 990 WITH THE BOARD OF DIRECTORS PRIOR TO FILING AND THE RETURN WAS MADE AVAILABLE TO EACH BOARD MEMBER IN AN ELECTRONIC FORMAT PRIOR TO THE REVIEW.
FORM 990, PAGE 6, PART VI, LINE 12C	ANNUALLY, THE CORPORATE AUDIT AND COMPLIANCE DEPARTMENT OF MSHA FORWARDS THE CONFLICT OF INTEREST POLICY AND DISCLOSURE FORM TO ALL MSHA MANAGEMENT TEAM MEMBERS AND BOARD MEMBERS. 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	THE MSHA BOARD OF DIRECTORS APPROVES THE TOTAL COMPENSATION OF MSHA'S PRESIDENT/CEO, INCLUDING ANY INCENTIVE COMPENSATION PROGRAM PAY OUTS. MSHA'S INCENTIVE PLAN IS 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. THE EXECUTIVE COMMITTEE OF MSHA'S BOARD OF DIRECTORS IS THE DESIGNATED COMPENSATION COMMITTEE FOR MSHA. MSHA USES AN INDEPENDENT OUTSIDE COMPENSATION CONSULTING FIRM AND THIS FIRM USES INDUSTRY DATA TO ASSIST IN DETERMINING REASONABLE COMPENSATION FOR OUR CEO AND OTHER EXECUTIVES. THERE IS A WRITTEN EMPLOYMENT AGREEMENT BETWEEN MSHA AND ITS CEO. ALL MSHA EXECUTIVE PAY IS EVALUATED ON AN ANNUAL OR NEAR ANNUAL BASIS.
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. HER PAY IS SET AT A MARKET PERCENTILE SPECIFIC TO HER 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, OFFICERS, KEY EMPLOYEES, & HIGHEST PAID COMPENSATION: STEVE KILGORE, REPORTABLE AS A HIGHEST COMPENSATED EMPLOYEE, IS PAID BY MSHA AND HIS SALARY AND BENEFITS ARE FULLY REIMBURSED TO MSHA BY BRMMC. CERTAIN EXECUTIVES OF THE ORGANIZATION, SUCH AS THE HEALTH SYSTEM'S CEO, SVP/CFO, EVP/COO, ETC. PROVIDE SERVICES TO SOME OR ALL OF THE ORGANIZATIONS RELATED TO MSHA.
FORM 990, PART IX, LINE 11G	PHYSICIAN FEES 33,899,403 0 0 DIETARY SERVICES 7,665,258 0 0 CONSULTING SERVICES 0 4,179,386 0 ENVIRONMENTAL SERVICES 4,464,795 0 0 LAUNDRY SERVICES 2,773,289 0 0 COLLECTION SERVICES 3,354,117 0 0 PHARMACY 1,880,859 0 0 LABORATORY SERVICES 3,095,892 0 0 CONTRACT LABOR 2,123,325 0 0 PATIENT RESOURCE SERVICES 748,304 0 0 TRANSCRIPTION SERVICES 1,614,515 0 0 PHYSICIAN LOAN FORGIVENESS 716,579 0 0 SURGERY 353,600 0 0 EMERGENCY 140,239 0 0 NUC. MED./RADIOLOGY/MRI 225,747 0 0 ENGINEERING SERVICES 0 1,525,958 0 OTHER FEES 34,338,095 2,512,940 5,077
FORM 990, PART XI, LINE 9	PARTNERSHIP CHARITABLE CONTRIBUTION NOT ON BOOKS 2,590 PARTNERSHIP ORDINARY LOSS NOT ON BOOKS 92,628 ADJUST ACQUISITION INVESTMENT-UMCH 10,790 TEMPORARILY RESTRICTED GRANTS 35,932 CUMULATIVE EFFECT OF CHANGE IN ACCTG. PRINCIPLE 317,644 CHANGE IN FAIR VALUE OF DERIVATIVES 7,718,029 TOTAL TO FORM 990, PART XI, LINE 9 8,177,613

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 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
DICKENSON COMMUNITY HOSPITAL
ONE HOSPITAL DRIVE	CLINTWOOD	VA	24228	770599553	HOSPITAL	VA	501C3	3	NCH	false
MOUNTAIN STATES FOUNDATION
2335 KNOB CREEK ROAD STE 101	JOHNSON CITY	TN	37604	581418862	FUNDRAISER	TN	501C3	11A	MSHA	false
MSHA AUXILIARY
400 N STATE OF FRANKLIN ROAD	JOHNSON CITY	TN	37604	581418345	SUPPORT	TN	501C3	11A	MSHA	false
SMYTH COUNTY COMMUNITY HOSPITAL
245 MEDICAL PARK DRIVE	MARION	VA	24354	540794913	HOSPITAL	VA	501C3	3	MSHA	false
NORTON COMMUNITY HOSPITAL
100 15TH STREET NW	NORTON	VA	24273	540566029	HOSPITAL	VA	501C3	3	NA	false
JOHNSTON MEMORIAL HOSPITAL
16000 JOHNSTON MEMORIAL DRIVE	ABINGDON	VA	24211	540544705	HOSPITAL	VA	501C3	3	NA	false
ABINGDON PHYSICIAN PARTNERS
16000 JOHNSTON MEMORIAL DRIVE	ABINGDON	VA	24211	205485346	MED. SERV.	VA	501C3	11A	JMH	false
APPALACHIAN EMERGENCY PHYSICIANS
1021 W OAKLAND AVENUE STE 207	JOHNSON CITY	TN	37604	800592504	MED. SERV	VA	501C3	11A	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	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct
INTEGRATED SOLUTIONS HEALTH NETWORK
509 MED TECH PARKWAY SUITE 100	JOHNSON CITY	TN	37604	621711997	INVESTMENT	TN	MSHA	EXCLUDED	-$86,761	$14,318,070	false	false	0.99890
EMMAUS COMMUNITY HEALTHCARE LLC
6070 HWY 11E	PINEY FLATS	TN	37686	200577483	MED. SERV.	TN	NA				false	false
MEDICAL SPECIALISTS OF JC LLC
2528 WESLEY STREET SUITE 2	JOHNSON CITY	TN	37601	272199037	MED. SERV.	TN	MSHA	EXCLUDED	-$157,730	-$11,783	false	false	0.51000
EAST TN AMBULATORY SURGERY CNTR
701 MED TECH PARKWAY SUITE 100	JOHNSON CITY	TN	37604	621787537	MED. SERV.	TN	NA				false	false

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 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
BLUE RIDGE MEDICAL MANAGEMENT CORP
1021 W OAKLAND AVENUE STE 207	JOHNSON CITY	TN	37604	621490616	MED. SERV.	TN	MSHA	C CORP	$119,370,052	$228,517,067	1.00000	false
MEDISERVE MEDICAL EQUIPMENT
1021 W OAKLAND AVENUE SUITE 207	JOHNSON CITY	TN	37604	621212286	DME	TN	BRMMC	C CORP	$4,008,809	$4,671,094	1.00000	false
MOUNTAIN STATES PROPERTIES
1021 W OAKLAND AVENUE SUITE 207	JOHNSON CITY	TN	37604	621845895	PROP. MGMT	TN	BRMMC	C CORP	$13,981,453	$147,505,563	1.00000	false
MOUNTAIN STATES PHYSICIAN GROUP
1021 W OAKLAND AVENUE SUITE 207	JOHNSON CITY	TN	37604	621700412	MED. SERV.	TN	BRMMC	C CORP	$66,186,365	$7,659,924	1.00000	false
COMMUNITY HOME CARE INC
1460 PARK AVENUE	NORTON	VA	24273	541453810	DME	VA	NCH	C CORP	$353,069	$538,579	0.50100	false
SOUTHWEST COMMUNITY HEALTH SERV
PO BOX 880	MARION	VA	24354	541460695	MED. SERV.	VA	SCCH	C CORP	$197		0.80000	false
WILSON PHARMACY INC
PO BOX 5289	JOHNSON CITY	TN	37604	620329587	PHARMACY	TN	BRMMC	C CORP	$4,253,522	$5,521,875	1.00000	false
CRESTPOINT HEALTH INSURANCE COMPANY
509 MED TECH PARKWAY SUITE 100	JOHNSON CITY	TN	37604	620381170	INSURANCE	TN	ISHN	C CORP	$23,249,905	$13,651,783	0.99830	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	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (true)	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	Yes (true)	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (true)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (true)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	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	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	Yes (true)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (48 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt
MSHA AUXILIARY
C	$82,748
MSHA AUXILIARY
P	$85,863
MSHA AUXILIARY
Q	$1,151,233
BLUE RIDGE MEDICAL MANAGMENT CORP
A	$149,979
BLUE RIDGE MEDICAL MANAGMENT CORP
G	$4,392,033
BLUE RIDGE MEDICAL MANAGMENT CORP
L	$6,136,116
BLUE RIDGE MEDICAL MANAGEMENT CORP
M	$35,160,355
BLUE RIDGE MEDICAL MANAGEMENT CORP
O	$543,798
BLUE RIDGE MEDICAL MANAGEMENT CORP
P	$68,312
BLUE RIDGE MEDICAL MANAGEMENT CORP
Q	$28,710,238
BLUE RIDGE MEDICAL MANAGMENT CORP
S	$6,498,719
HEALTHPLUS
J	$53,370
HEALTHPLUS
L	$86,008
HEALTHPLUS
M	$291,320
HEALTHPLUS
O	$189,279
HEALTHPLUS
P	$98,284
HEALTHPLUS
Q	$16,973,900
HEALTHPLUS
R	$140,295
MEDISERVE
K	$167,860
MEDISERVE
L	$71,328
MEDISERVE
Q	$3,182,570
MOUNTAIN STATES PROPERTIES
G	$1,362,238
MOUNTAIN STATES PROPERTIES
K	$2,576,614
MOUNTAIN STATES PROPERTIES
L	$496,039
MOUNTAIN STATES PROPERTIES
M	$261,908
MOUNTAIN STATES PROPERTIES
O	$497,165
MOUNTAIN STATES PROPERTIES
Q	$5,638,833
MOUNTAIN STATES PROPERTIES
R	$63,481
MOUNTAIN STATES FOUNDATION
C	$348,706
NORTON COMMUNITY HOSPITAL
D	$21,095,386
NORTON COMMUNITY HOSPITAL
L	$5,489,324
NORTON COMMUNITY HOSPITAL
O	$190,493
NORTON COMMUNITY HOSPITAL
P	$501,546
NORTON COMMUNITY HOSPITAL
Q	$27,309,250
NORTON COMMUNITY HOSPITAL
R	$217,629
DICKENSON COMMUNITY HOSPITAL
L	$797,476
ISHN
B	$10,274,850
ISHN
J	$205,671
ISHN
L	$232,298
ISHN
M	$3,186,946
ISHN
Q	$7,752,487
SMYTH COUNTY COMMUNITY HOSPITAL
D	$15,965,896
SMYTH COUNTY COMMUNITY HOSPITAL
L	$4,334,405
SMYTH COUNTY COMMUNITY HOSPITAL
Q	$61,084
JOHNSTON MEMORIAL HOSPITAL
L	$10,802,688
JOHNSTON MEMORIAL HOSPTIAL
O	$263,704
JOHNSTON MEMORIAL HOSPITAL
R	$106,338
APP
L	$140,618