SMYTH COUNTY COMMUNITY HOSPITAL: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization: SMYTH COUNTY COMMUNITY HOSPITAL (EIN 54-0794913)
Tax period: 2013-07-01 to 2014-06-30
Filed: 2015-05-06
IRS object ID: 201511269349300121
Schema version: 2013v4.0
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 O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2015-05-06T09:41:07-05:00	ReturnTs
Tax Period End	2014-06-30	TaxPeriodEndDt
Return Type	990	ReturnTypeCd
Tax Period Begin	2013-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	540794913	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SMYTH COUNTY COMMUNITY HOSPITAL	BusinessNameLine1

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

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 880	AddressLine1
City	MARION	City
State	VA	State
ZIP Code	24354	ZIPCode

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	JOHN JETER	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	2763781202	PhoneNum
Signature	2015-05-06	SignatureDt

Field	Value	IRS element (for citing)
Tax	2013	TaxYr
Build TS	2016-02-25 16:41:14Z	BuildTS

Form 990 IRS990

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

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 880	AddressLine1
City	MARION	City
State	VA	State
ZIP Code	24354	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	$44,757,812	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.MSHA.COM	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1961	FormationYr
Legal Domicile State	VA	LegalDomicileStateCd
Activity Or Mission	PART I, LINE I - ORGANIZATION'S MISSION: SMYTH COUNTY COMMUNITY HOSPITAL (SCCH) IS COMMITTED TO BRINGING LOVING CARE TO HEALTH CARE. WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTH CARE NEEDS OF INDIVIDUALS AND COMMUNITIES IN OUR REGION AND TO ASSIST THEM IN ATTAINING THEIR HIGHEST POSSIBLE LEVEL OF HEALTH.	ActivityOrMissionDesc
Voting Members Governing Body	13	VotingMembersGoverningBodyCnt
Voting Members Independent	8	VotingMembersIndependentCnt
Total Employee	1	TotalEmployeeCnt
Total Volunteers	80	TotalVolunteersCnt
Total Gross UBI	$126,208	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$42,986	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$106,933	PYContributionsGrantsAmt
CY Contributions Grants	$63,167	CYContributionsGrantsAmt
PY Program Service Revenue	$44,574,461	PYProgramServiceRevenueAmt
CY Program Service Revenue	$42,512,540	CYProgramServiceRevenueAmt
PY Investment Income	$565,379	PYInvestmentIncomeAmt
CY Investment Income	$1,272,026	CYInvestmentIncomeAmt
PY Other Revenue	$675,303	PYOtherRevenueAmt
CY Other Revenue	$601,310	CYOtherRevenueAmt
PY Total Revenue	$45,922,076	PYTotalRevenueAmt
CY Total Revenue	$44,449,043	CYTotalRevenueAmt
PY Grants And Similar Paid	$10,732	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$45,627	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$22,759,121	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$21,563,319	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$24,328,438	PYOtherExpensesAmt
CY Other Expenses	$24,806,946	CYOtherExpensesAmt
PY Total Expenses	$47,098,291	PYTotalExpensesAmt
CY Total Expenses	$46,415,892	CYTotalExpensesAmt
PY Revenues Less Expenses	-$1,176,215	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$1,966,849	CYRevenuesLessExpensesAmt
Total Assets BOY	$104,424,818	TotalAssetsBOYAmt
Total Assets EOY	$104,960,023	TotalAssetsEOYAmt
Total Liabilities BOY	$22,633,834	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$22,752,602	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$81,790,984	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$82,207,421	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	PART I, LINE I - ORGANIZATION'S MISSION: SMYTH COUNTY COMMUNITY HOSPITAL (SCCH) IS COMMITTED TO BRINGING LOVING CARE TO HEALTH CARE. WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTH CARE NEEDS OF INDIVIDUALS AND COMMUNITIES IN OUR REGION AND TO ASSIST THEM IN ATTAINING THEIR HIGHEST POSSIBLE LEVEL OF HEALTH.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$37,209,374	ExpenseAmt
Grant	$45,627	GrantAmt
Revenue	$43,560,758	RevenueAmt
Desc	SMYTH COUNTY COMMUNITY HOSPITAL (SCCH) HAS A 45-PLUS YEAR HISTORY OF PROVIDING HEALTHCARE SERVICES WITHIN THE COMMUNITY OF MARION, VIRGINIA. SCCH IS A 44-BED COMMUNITY-BASED HOSPITAL THAT OFFERS BOTH ACUTE CARE AND INPATIENT REHABILITATION CARE. THE HOSPITAL PROVIDES COMPREHENSIVE OUTPATIENT SERVICES AND A VARIETY OF OUTREACH PROGRAMS SUCH AS HOMECARE. ADDITIONALLY, SCCH HAS A 109-BED NURSING CARE FACILITY, FRANCIS MARION MANOR HEALTH AND REHABILITATION (FMM). FMM PROVIDES BOTH SKILLED-LEVEL AND NURSING FACILITY-LEVEL HEALTH CARE SERVICES. (CONTINUED ON SCHEDULE O) AS A NOT-FOR-PROFIT HOSPITAL, ALL OF SCCH'S NET INCOME IS INVESTED IN IMPROVING HEALTHCARE IN THE COMMUNITY. WITH A STRONG COMMITMENT TO QUALITY PATIENT CARE AND A HERITAGE OF SERVICES, SCCH CONTINUES TO MEET THE HEALTHCARE NEEDS OF SMYTH AND THE ADJOINING COUNTIES. FOR THE YEAR ENDING JUNE 30, 2014, SCCH RECORDED 1,608 INPATIENT ADMISSIONS, AND PROVIDED FOR 81,279 OUTPATIENT VISITS. THERE WERE 17,159 EMERGENCY VISITS, 13,348 HOME HEALTH VISITS AND 334 NURSING HOME ADMISSIONS. THROUGHOUT THE YEAR, SCCH PROVIDES A RANGE OF EVENTS AND PROGRAMS TO BENEFIT THE COMMUNITY. SOME EXAMPLES ARE: SCCH SERVES AS A CLINICAL TRAINING FACILITY FOR HEALTH PROFESSIONAL EDUCATION STUDENTS. SCCH HAS DEDICATED STAFF TO WORK WITH REGIONAL COLLEGES AND UNIVERSITIES TO COORDINATE THE PLACEMENT OF HEALTHCARE PROFESSIONAL STUDENTS AS PART OF THEIR EDUCATIONAL CURRICULUM. IN ADDITION TO CLINICAL TRAINING, THE HEALTH CARE STUDENTS ENTERING OUR SYSTEM ARE REQUIRED TO HAVE ORIENTATION AND COMPUTER TRAINING. PARTICIPANTS RECEIVING CLINICAL EXPERIENCE AT SCCH DURING FY14 INCLUDED 101 NURSING STUDENTS FROM VARIOUS COLLEGES, UNIVERSITIES AND PROGRAMS. THIS NURSING CLINICAL EXPERIENCE REQUIRED EXTENSIVE SCCH NURSING STAFF INVOLVEMENT. THE CLINICAL SETTING AND HANDS-ON INSTRUCTION COST SCCH 208,026. SCCH PROVIDED A CLINICAL SETTING FOR ANOTHER 84 STUDENTS TRAINING IN HEALTH-RELATED PROGRAMS SUCH AS RADIOLOGY, PHARMACY, PHYSICAL THERAPY, EMT/PARAMEDIC AND OTHER ALLIED-HEALTH DISCIPLINES. THESE ADDITIONAL CLINICAL STUDENTS COST SCCH 86,804. SCCH'S FORMER FOUR-STORY HOSPITAL BUILDING AND ADJOINING 15 ACRES, WHICH WAS VACATED IN 2012 WHEN THE NEW SCCH HOSPITAL FACILITY WAS OPENED, WAS DONATED IN FY14 TO EMORY & HENRY COLLEGE. THE COLLEGE PARTNERED WITH COMMUNITY LEADERS, MUNICIPALITIES AND ORGANIZATIONS TO FUND THE RENOVATION OF THE BUILDING TO HOUSE THE NEW EMORY & HENRY SCHOOL OF HEALTH SCIENCES. SCCH AND MSHA ADMINISTRATION FELT THIS DONATION WAS AN IMPORTANT STEP IN DEVELOPING MUCH-NEEDED HEALTHCARE PROFESSIONALS FOR THE COMMUNITY. IN FURTHERANCE OF OUR COMMITMENT TO AREA SCHOOLS WITH HEALTH PROFESSIONS PROGRAMS, SCCH PLEDGED 30,000 A YEAR FOR THREE YEARS TO VIRGINIA HIGHLANDS COMMUNITY COLLEGE TO SUPPORT ITS NURSING PROGRAM. WITH HEALTHCARE INSURANCE COVERAGE CHANGING RAPIDLY, PATIENT PAYMENT RESPONSIBILTY IS INCREASING AT A RATE OF 5 TO 6 PERCENT EACH YEAR. MOUNTAIN STATES INTRODUCED A NEW PAYMENT OPTION THAT OFFERS MORE FLEXIBILITY TO OUR PATIENTS - THE ABILITY TO SPREAD PAYMENTS OVER A 36-MONTH PERIOD WITH NO INTEREST CHARGED. OF COURSE, FOR PATIENTS THAT ARE UNABLE TO PAY THEIR ACCOUNT BALANCES, PATIENT RESPRESENTATIVES ARE AVAILABLE TO DISCUSS FINANCIAL ASSISTANCE PROGRAMS. SCCH HAS PARTNERED WITH THE COMPANY, FIRSTSOURCE SOLUTIONS USA, TO WORK WITH SELF-PAYING PATIENTS WHO HAVE LIMITED FINANCIAL RESOURCES. DURING FY14, FIRST SOURCE REPRESENTATIVES WERE ABLE TO DETERMINE GOVERNMENTAL MEDICAL ASSISTANCE (MEDICAID) ELIGIBILITY, AND TO HELP WITH THE APPLICATION PROCESS AND FOLLOW-UP. DURING FY14, 258 PATIENTS WERE APPROVED FOR COVERAGE. ONCE A PERSON IS APPROVED FOR MEDICAID THROUGH THIS PROGRAM OFFERED THROUGH SCCH, THEY RETAIN COVERAGE FOR FUTURE MEDICAL CARE. FIRSTSOURCE IS COMPENSATED BY SCCH. DURING FY14, SCCH'S COST FOR THIS PROGRAM WAS 33,458. SMYTH COUNTY'S FIRST URGENT CARE FACILITY WAS OPENED IN SEPTEMBER 2014 TO OFFER THE COMMUNITY ACCESS TO LOCAL PRIMARY CARE PROVIDERS AFTER NORMAL BUSINESS HOURS. THE STATE-OF-THE-ART FACILITY IS LOCATED ON THE SCCH GROUNDS AND OFFERS TREATMENT OF MINOR ILLNESSES AND INJURIES IN A SETTING THAT IS BOTH CONVENIENT AND COST EFFECTIVE. LAB AND X-RAY SERVICES ARE AVAILABLE ON-SITE. DURING FY14, SCCH, ALONG WITH MSHA'S OTHER HOSPITALS, IMPLEMENTED AN ONLINE TOOL CALLED OWL (ONLINE WELLNESS LINK). OWL PROVIDES INPATIENTS WITH BETTER ACCESS TO THEIR HEALTH CARE INFORMATION SO THEY CAN VIEW A PORTION OF THEIR HEALTH CARE RECORD ONLINE, INCLUDING: - A CONTINUITY OF CARE DOCUMENT WHICH PROVIDES A SUMMARY OF THE HOSPITAL VISIT - CURRENT MEDICATIONS - ALLERGIES AND ADVERSE REACTIONS - PAST MEDICAL HISTORY - CERTAIN LABORATORY AND RADIOLOGY RESULTS THE OWL PORTAL ALSO ALLOWS SCCH CAREGIVERS TO EXCHANGE HEALTH INFORMATION, WHICH HAS LED TO SAFER, MORE QUALITY-ORIENTED AND STREAMLINED CARE FOR OUR PATIENTS. PREMIER HEALTHCARE ALLIANCE'S 2014 AWARD WINNERS INCLUDED SMYTH COUNTY COMMUNITY HOSPITAL. SCCH EARNED THE HIGHEST HONOR BY ACHIEVING TOP PERFORMANCE IN ALL OF THE SIX AREAS MEASURED IN PREMIER'S QUEST COLLABORATIVE. SCCH, ALONG WITH SYCAMORE SHOALS HOSPITAL (ANOTHER MOUNTAIN STATES HEALTH ALLIANCE HOSPITAL) WERE AMONG ONLY 18 HOSPITALS NATIONWIDE TO RECEIVE THE QUEST AWARD FOR HIGH-VALUE HEALTHCARE. THE HIGH-VALUE HEALTHCARE AWARDS ARE DETERMINED BASED ON SIX MEAURES: COST OF CARE, EVIDENCE-BASED CARE; MORTALITY; POTENTIAL HARM; PATIENT EXPERIENCE; AND, READMISSIONS. THE MOUNTAIN STATES HEALTH ALLIANCE HEAL (HEALTHY EATING ACTIVE LIVING) APPALACHIA PROGRAM WAS SELECTED AS A 2014 INDUCTEE INTO THE FIRST LADY OF VIRGINIA'S OPPORTUNITY HALL OF FAME. HEAL APPALACHIA IS A COLLABORATIVE EFFORT OF SCCH AND OTHER MSHA HOSPITALS AND EAST TENNESSEE STATE UNIVERSITY TO BATTLE CHILDHOOD OBESITY IN SOUTHWEST VIRGINIA AND NORTHEAST TENNESSEE. THE HONOR COMES FROM THE FLITE (FIRST LADY'S INITIATIVES TEAM EFFORT) FOUNDATION, WHICH IS MADE UP OF ONE HUNDRED WOMEN FROM ACROSS THE COMMENWEALTH OF VIRGINIA. FLITE RECOGNIZES PEOPLE AND ORGANIZATIONS WHO EMBODY THE IDEAL OF GETTING INVOLVED AND GIVING BACK. HEAL APPALACHIA WAS RECOGNIZED FOR PREVENTIVE HEALTH CARE AND WELLNESS, ONE OF THE FOUR FOCUS AREAS OF THE FLIGHT FOUNDATION. FLIGHT RECOGNIZED PROGRAMS ARE NAMED TO THE FIRST LADY OF VIRGINIA'S OPPORTUNITY HALL OF FAME. FOR MANY YEARS, SCCH HAS PROVIDED ASSISTANCE TO LOCAL LIFESAVING ORGANIZATIONS SUCH AS AMBULANCE SERVICES, FIRE DEPARTMENTS AND RESCUE SQUADS. SCCH DONATES FREE MEDICATIONS AND PHARMACEUTICAL SUPPLIES TO THESE NON-PROFIT ORGANIZATIONS. THE COST OF DONATED MEDICATIONS TO RESCUE ORGANIZATIONS DURING FY14 WAS ALMOST 11,000. A VARIETY OF SCREENINGS, SUPPORT GROUPS, HEALTH EDUCATION, AND HEALTH FAIRS WERE PROVIDED ON AN ONGOING BASIS THROUGHOUT THE YEAR. SOME OF THE SERVICES PROVIDED DURING THE YEAR INCLUDE: LAB SERVICES FOR A FREE PUBLIC CLINIC, CPR TRAINING TO THE PUBLIC, AND FIRST AID CLASSES. THE COST OF PROVIDING THESE FREE SERVICES WAS JUST UNDER 26,000. SCCH HOSTS AN ANNUAL ADVANCED DIRECTIVES DAY TO EDUCATE COMMUNITY MEMBERS ABOUT LEGAL DOCUMENTS THEY MAY WISH TO HAVE IN ORDER TO EXPRESS THE TYPE OF MEDICAL CARE WANTED WHEN ILL AND TO MAKE CLEAR THEIR DECISIONS FOR THEIR OWN END OF LIFE CARE. SINCE A MEDICAL CRISIS CAN OCCUR AT ANY AGE, THIS ADVANCED CARE PLANNING IS AN IMPORTANT STEP TOWARD ENSURING AN INDIVIDUAL'S WISHES ARE FOLLOWED IF HE/SHE IS TOO ILL TO MAKE HIS/HER OWN HEALTHCARE DECISIONS. TWELVE SCCH TEAM MEMBERS WERE INVOLVED WITH THIS EDUCATION DAY. IN FY14 SCCH HOSTED AN OLDER AMERICANS DAY. TWO RN'S PROVIDED SENIOR CITIZENS WITH FREE BLOOD PRESSURE AND OXYGEN SATURATION CHECKS. A SOCIAL WORKER WAS ALSO PRESENT TO PROVIDE INFORMATION ABOUT HOMECARE, REHABILITATION, NURSING HOME AND OTHER GERIATRIC SERVICES. APPROXIMATELY 250 PEOPLE ATTENDED THE EVENT. SCCH TEAM MEMBERS PARTICIPATE IN A LOCAL NUTRITION NETWORK, A COLLABORATION OF SPONSORS AND AGENCIES WHO GRAPPLE WITH THE ISSUES OF POVERTY, HUNGER, AND LACK OF KNOWLEDGE REGARDING HEALTH CONSEQUENCES OF POOR NUTRITION. THE NETWORK SERVES TO EDUCATE THE COMMUNITY ABOUT OBESITY RELATED HEALTH PROBLEMS SUCH AS DIABETES, HYPERTENSION, HIGH CHOLESTEROL, AND HEART DISEASE. THE NETWORK'S GOAL IS TO ADDRESS POVERTY AND THE WIDESPREAD USE OF INEXPENSIVE, PROCESSED FOODS WHICH CONTRIBUTE TO THE OBESITY RISK. SINCE THE SOLUTION TO OBESITY AND ITS RELATED DISEASES DOES NOT REQUIRE HIGH TECH TREATMENT OR CUTTING EDGE MEDICATIONS, REPRESENTATIVES FROM SCCH, VIRGINIA DEPARTMENT OF HEALTH, VIRGINIA TECH, FARMERS MARKETS AND GROCERY STORES, LOCAL SCHOOLS AND CHARITY ORGANIZATIONS ARE DEEMED TO BE THE BEST PLACE TO START THE PROCESS OF REDUCING OBESITY WITHIN THE COMMUNITY. SCCH OFFERS A SUPPORT GROUP FOR PEOPLE WITH DIABETES. EVERY OTHER MONTH A SCCH TEAM MEMBER PROVIDES EDUCATION REGARDING SELF-CARE, INCLUDING NUTRITION COUNSELING. SCCH ALSO OFFERS A MONTHLY CANCER SUPPORT GROUP, WHICH IS HOSTED BY HOSPITAL EMPLOYEES, INCLUDING A NURSE PRACTITIONER OR PHYSICIAN AND A LPN. VARIOUS TOPICS RELATED TO CANCER ARE DISCUSSED EA	Desc
Total Program Service Expenses	$37,209,374	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	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	87	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	1	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	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	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	VA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

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

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 880	AddressLine1
City	MARION	City
State	VA	State
ZIP Code	24354	ZIPCode

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

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
ANN FLEMING
DIRECTOR	0.50	59.50	Yes (X)	$0	$753,909	$73,411
ERIC SACKNOFF MD
DIRECTOR	0.50		Yes (X)	$0	$443,703	$36,232
JOHN DOYLE
SECRETARY	0.50	49.50	Yes (X)	$0	$254,343	$34,109
CHELSEA HAMMAN MD
DIRECTOR	0.50		Yes (X)	$2,375	$0	$0
ALLEN ABEL
DIRECTOR	1.00		Yes (X)	$0	$0	$0
JIM BEAR JR
TREASURER	0.50		Yes (X)	$0	$0	$0
RUTH COX
DIRECTOR	0.50		Yes (X)	$0	$0	$0
BOB FEATHERS
DIRECTOR	0.50	6.00	Yes (X)	$0	$0	$0
JOANNE GROSECLOSE
VICE CHAIR	0.50		Yes (X)	$0	$0	$0
ANDY BLEVINS
DIRECTOR	0.50		Yes (X)	$0	$0	$0
JIM MCDOWELL MD
DIRECTOR	0.50		Yes (X)	$0	$0	$0
JAMES PATTERSON MD
DIRECTOR	1.00		Yes (X)	$0	$0	$0
BOB SHULTS
CHAIRMAN	1.00		Yes (X)	$0	$0	$0
CLEM WILKES JR
DIRECTOR	0.50	8.00	Yes (X)	$0	$0	$0
LINDA WHITE
VP/CEO	55.00			$0	$227,197	$41,290	Yes (X)
JEFFREY HUNDMAN
CFO	50.00			$0	$113,813	$23,315	Yes (X)
BELDON FLEMING
	40.00			$0	$137,187	$33,926		Yes (X)
CATHY MAINE
	40.00			$0	$132,450	$10,931		Yes (X)
BRUCE BRIGGS
	40.00			$0	$122,038	$29,387		Yes (X)
JEANIE GONZALEZ
	40.00			$0	$116,493	$17,637		Yes (X)
ROBERT O'DONNELL
	40.00			$0	$114,429	$26,364		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,375	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$2,415,562	TotReportableCompRltdOrgAmt
Total Other Compensation	$326,602	TotalOtherCompensationAmt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1	CityContractorAddress/USAddress/City	StateContractorAddress/USAddress/State	ZIP CodeContractorAddress/USAddress/ZIPCode	ServicesServicesDesc	CompensationCompensationAmt
VIRGINIA HIGHLANDS ANESTHESIA
PO BOX 1476	ABINGDON	VA	242121476	ANESTHESIA SVCS	$604,305
CROTHALL LAUNDRY SERVICES EAST TN
13028 COLLECTIONS CENTER DRIVE	CHICAGO	IL	60693	LINEN SERVICES	$239,237
SIMPLER NORTH AMERICA LP
PO BOX 643979	PITTSBURGH	PA	152643979	CONSULTING SVCS	$180,905
EXECUTIVE HEALTH RESOURCES
15 CAMPUS BOULEVARD SUITE 200	NEWTOWN SQUARE	PA	19073	CONSULTING SVCS	$121,512
UMS UROLOGY SERVICES OF SMYTH COUNTY
1700 WEST PARK DRIVE SUITE 410	WESTBOROUGH	MA	01581	LITHOTRIPSY SVC	$104,302

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	5	CntrctRcvdGreaterThan100KCnt
Related Organizations	$24,216	RelatedOrganizationsAmt
Government Grants	$32,143	GovernmentGrantsAmt
All Other Contributions	$6,808	AllOtherContributionsAmt
Total Contributions	$63,167	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT SERVICES	622110	$41,140,596	$41,140,596
WELLNESS PROGRAMS	622110	$1,160,325	$1,160,325
LABORATORY	621500	$127,490		$127,490
P/S INCOME PREMIER & ISHN	900099	$83,118	$84,400	-$1,282
RENTAL TO EXEMPT AFFILIATE	531120	$1,011	$1,011

Field	Value	IRS element (for citing)
Total Program Service Revenue	$42,512,540	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$377,214	TotalRevenueColumnAmt
Exclusion	$377,214	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$299,119	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$126,143	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$172,976	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$172,976	TotalRevenueColumnAmt
Exclusion	$172,976	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$1,057,260	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$162,448	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	-$162,448	SecuritiesAmt
Other	$1,057,260	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$894,812	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,045,941	RelatedOrExemptFuncIncomeAmt
Exclusion	-$151,129	ExclusionAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$22,455	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$20,178	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,277	TotalRevenueColumnAmt
Related Or Exempt Func Income	$2,277	RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
CAFETERIA SALES	722210	$274,637	$274,637
PREMIER IPO VENDOR INCENTIVE	900099	$226,763	$226,763
MANAGEMENT FEES	561000	$79,446	$79,446

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$154,789	TotalRevenueColumnAmt
Exclusion	-$154,789	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$426,057	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$44,449,043	TotalRevenueColumnAmt
Related Or Exempt Func Income	$43,434,550	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$126,208	UnrelatedBusinessRevenueAmt
Exclusion	$825,118	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	$45,627	TotalAmt
Program Services	$45,627	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$379,624	TotalAmt
Program Services	$1,750	ProgramServicesAmt
Management And General	$377,874	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$17,623,234	TotalAmt
Program Services	$14,487,746	ProgramServicesAmt
Management And General	$3,135,488	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$519,536	TotalAmt
Program Services	$438,281	ProgramServicesAmt
Management And General	$81,255	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$1,907,170	TotalAmt
Program Services	$1,781,179	ProgramServicesAmt
Management And General	$125,991	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$1,133,755	TotalAmt
Program Services	$1,079,894	ProgramServicesAmt
Management And General	$53,861	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$31,902	TotalAmt
Management And General	$31,902	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$12,881	TotalAmt
Management And General	$12,881	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$15,544	TotalAmt
Management And General	$15,544	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$22,346	TotalAmt
Management And General	$22,346	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$9,345,982	TotalAmt
Program Services	$9,332,560	ProgramServicesAmt
Management And General	$13,422	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$102,756	TotalAmt
Program Services	$6,476	ProgramServicesAmt
Management And General	$96,280	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$316,300	TotalAmt
Program Services	$271,775	ProgramServicesAmt
Management And General	$44,525	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$237,613	TotalAmt
Program Services	$234,366	ProgramServicesAmt
Management And General	$3,247	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,089,364	TotalAmt
Program Services	$934,006	ProgramServicesAmt
Management And General	$155,358	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$148,208	TotalAmt
Program Services	$130,786	ProgramServicesAmt
Management And General	$17,422	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$2,462	TotalAmt
Program Services	$2,251	ProgramServicesAmt
Management And General	$211	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$141,896	TotalAmt
Management And General	$141,896	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$4,237,244	TotalAmt
Program Services	$1,917,438	ProgramServicesAmt
Management And General	$2,319,806	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$132,284	TotalAmt
Management And General	$132,284	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES & DRUGS	$5,206,331	$5,194,381	$11,950
MANAGEMENT FEES	$2,320,349	$46,040	$2,274,309
REPAIRS & MAINTENANCE	$975,264	$952,511	$22,753
UBI TAXES	$14,360		$14,360

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$453,860	TotalAmt
Program Services	$352,307	ProgramServicesAmt
Management And General	$101,553	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$46,415,892	TotalAmt
Program Services	$37,209,374	ProgramServicesAmt
Management And General	$9,206,518	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

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

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$2,388,481	BOYAmt
EOY	$2,081,936	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$7,640,675	BOYAmt
EOY	$7,098,784	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$915,788	BOYAmt
EOY	$918,723	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$351,420	BOYAmt
EOY	$264,367	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$118,254,111	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$47,435,960	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$73,346,371	BOYAmt
EOY	$70,818,151	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$18,545,937	BOYAmt
EOY	$21,335,171	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$710,615	BOYAmt
EOY	$741,011	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$525,531	BOYAmt
EOY	$1,701,880	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$104,424,818	BOYAmt
EOY	$104,960,023	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$4,596,331	BOYAmt
EOY	$4,311,972	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
EOY	$909,430	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$16,208,215	BOYAmt
EOY	$17,067,737	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,829,288	BOYAmt
EOY	$463,463	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$22,633,834	BOYAmt
EOY	$22,752,602	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$81,755,141	BOYAmt
EOY	$82,197,669	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$35,843	BOYAmt
EOY	$9,752	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$81,790,984	BOYAmt
EOY	$82,207,421	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$104,424,818	BOYAmt
EOY	$104,960,023	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$1,966,849	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$1,956,427	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$426,859	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

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

Schedule A IRS990ScheduleA

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

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

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

Contributor US Address ContributorUSAddress

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

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

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	Yes (true)	GrantsOtherOrganizationsInd
Grants Other Organizations	$2,243	GrantsOtherOrganizationsAmt
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	false	OtherActivitiesInd
Total Lobbying Expenditures	$2,243	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	PORTION OF DUES PAID TO VIRGINIA HOSPITAL AND HEALTHCARE ASSOCIATION THAT ARE ATTRIBUTABLE TO DIRECT LOBBYING.	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,176,861	OtherCostOrOtherBasisAmt
Book Value	$2,176,861	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$56,912,743	OtherCostOrOtherBasisAmt
Depreciation	$6,514,147	DepreciationAmt
Book Value	$50,398,596	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$65,442	OtherCostOrOtherBasisAmt
Depreciation	$65,268	DepreciationAmt
Book Value	$174	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$58,384,376	OtherCostOrOtherBasisAmt
Depreciation	$40,274,045	DepreciationAmt
Book Value	$18,110,331	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$714,689	OtherCostOrOtherBasisAmt
Depreciation	$582,500	DepreciationAmt
Book Value	$132,189	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$70,818,151	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
OTHER LONG-TERM LIABILITIES	$428,358
DUE TO THIRD-PARTY	$35,105

Field	Value	IRS element (for citing)
Total Liability	$463,463	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, 2014 AND 2013. AT JUNE 30, 2014, TAX RETURNS FOR 2010 THROUGH 2013 ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE."	ExplanationTxt

Schedule H IRS990ScheduleH

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

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$723,228	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$723,228	NetCommunityBenefitExpnsAmt
Total Expense	0.01560	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$7,188,485	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,803,172	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,385,313	NetCommunityBenefitExpnsAmt
Total Expense	0.02980	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$7,911,713	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,803,172	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,108,541	NetCommunityBenefitExpnsAmt
Total Expense	0.04540	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$44,525	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$44,525	NetCommunityBenefitExpnsAmt
Total Expense	0.00100	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$295,145	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$295,145	NetCommunityBenefitExpnsAmt
Total Expense	0.00640	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,734,660	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,068,534	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,666,126	NetCommunityBenefitExpnsAmt
Total Expense	0.03590	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$42,542	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$42,542	NetCommunityBenefitExpnsAmt
Total Expense	0.00090	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,116,872	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,068,534	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,048,338	NetCommunityBenefitExpnsAmt
Total Expense	0.04410	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$14,028,585	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$9,871,706	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,156,879	NetCommunityBenefitExpnsAmt
Total Expense	0.08960	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$4,137,806	BadDebtExpenseAmt
Bad Debt Expense Attributable	$2,482,684	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$13,011,160	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$13,162,786	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$151,626	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SMYTH COUNTY COMMUNITY HOSPITAL	BusinessNameLine1

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 880	AddressLine1
City	MARIN	City
State	VA	State
ZIP Code	24354	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	SMYTH COUNTY COMMUNITY HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
CHNA Conducted	12	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	WWW.MSHA.COM	OwnWebsiteURLTxt
Rpt Available Upon Request	Yes (X)	RptAvailableUponRequestInd
Adopt Implementation Strategy	Yes (X)	AdoptImplementationStrategyInd
Exec Implementation Strategy	Yes (X)	ExecImplementationStrategyInd
Prioritize Health Needs	Yes (X)	PrioritizeHealthNeedsInd
Prioritize Services	Yes (X)	PrioritizeServicesInd
All Needs Addressed	false	AllNeedsAddressedInd
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Used Deter Elig Free Care	Yes (true)	FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care	200.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt Care	Yes (true)	FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care	400.000000000000	FPGFamilyIncmLmtDscntCarePct
Explained Basis	Yes (true)	ExplainedBasisInd
Income Level	Yes (X)	IncomeLevelInd
Asset Level	Yes (X)	AssetLevelInd
Medical Indigency	Yes (X)	MedicalIndigencyInd
Insurance Status	Yes (X)	InsuranceStatusInd
Uninsured Discount	Yes (X)	UninsuredDiscountInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
Posted On Website	Yes (X)	PostedOnWebsiteInd
Posted In Emergency Room	Yes (X)	PostedInEmergencyRoomInd
Posted In Admission Office	Yes (X)	PostedInAdmissionOfficeInd
Provided On Admission	Yes (X)	ProvidedOnAdmissionInd
Available On Request	Yes (X)	AvailableOnRequestInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Collection Activities	false	CollectionActivitiesInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Other Method Used	Yes (X)	OtherMethodUsedInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FACILITY 1, SMYTH COUNTY COMMUNITY HOSPITAL - PART V, LINE 3	MSHA MET WITH TEN FOCUS GROUPS, EACH REPRESENTING ONE OF THE TEN HOSPITAL FACILITIES, INCLUDING SCCH, 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. EACH GROUP RANGED IN ATTENDANCE FROM 6 TO 21 INDIVIDUALS. PARTICIPANTS WERE GIVEN SURVEYS TO DETERMINE A COUNTY'S HEALTH STATUS RATING, AVAILABLE RESOURCES, TOP HEALTH PRIORITIES, AND SUGGESTIONS FOR IMPROVEMENT. OPEN DISCUSSION FOLLOWED. THE COLLECTED INFORMATION WAS THEN PAIRED WITH STATISTICAL DATA IN ORDER TO PRIORITIZE HEALTH NEEDS. THE SPECIFIC NEEDS FOR EACH COUNTY WERE INCLUDED IN THE APPROPRIATE FACILITY IMPLEMENTATION PLAN.
FACILITY 1, SMYTH COUNTY COMMUNITY HOSPITAL - PART V, LINE 4	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 AND FRANKLIN WOODS COMMUNITY HOSPITAL ARE BOTH LOCATED IN WASHINGTON COUNTY, TENNESSEE. WE SURVEYED 21 INDIVIDUALS FROM WASHINGTON COUNTY IN ORDER TO DETERMINE HEALTH PRIORITIES FOR THIS REGION. DICKENSON COMMUNITY HOSPITAL AND NORTON COMMUNITY HOSPITAL ALSO HAD ONE COMMUNITY GROUP SURVEYED. THESE TWO COUNTIES SERVE SIMILAR COMMUNITIES, AND HAVE SIMILAR HEALTH RANKINGS ACCORDING TO AMERICA'S HEALTH RANKINGS. EVEN THOUGH ONLY TWO COMMUNITY GROUPS SERVED ON BEHALF OF THE FOUR HOSPITALS LISTED, STATISTICAL DATA WAS COLLECTED FOR EACH INDIVIDUALLY. SCCH'S CHNA WAS CONDUCTED WITH ALL MSHA HOSPITALS TO INCLUDE: JOHNSON CITY MEDICAL CENTER, FRANKLIN WOODS COMMUNITY HOSPITAL, INDIAN PATH MEDICAL CENTER, SYCAMORE SHOALS HOSPITAL, JOHNSON COUNTY COMMUNITY HOSPITAL, RUSSELL COUNTY MEDICAL CENTER, JOHNSTON MEMORIAL HOSPITAL, NORTON COMMUNITY HOSPITAL AND DICKENSON COMMUNITY HOSPITAL.
FACILITY 1, SMYTH COUNTY COMMUNITY HOSPITAL - PART V, LINE 7	MSHA PUBLISHED ITS COMMUNITY HEALTH NEEDS ASSESSMENT ON JUNE 29 OF FY12. THE DATA INCLUDED WAS COLLECTED OVER THE COURSE OF 2011 AND 2012. AN IMPLEMENTATION PLAN WAS CREATED FOR EACH HOSPITAL, AND EACH HOSPITAL'S BOARD APPROVED THE IMPLEMENTATION PLAN DURING THE MONTHS OF MAY AND JUNE 2012. MSHA ANNUALLY TRACKS PROGRESS OF IMPLEMENTATION STRATEGIES FOR EACH HOSPITAL. DUE TO LACK OF RESOURCES, SOME OF MSHA FACILITIES WERE UNABLE TO ADDRESS ISSUES THAT WERE IDENTIFIED.
FACILITY 1, SMYTH COUNTY COMMUNITY HOSPITAL - PART V, LINE 20D	UNINSURED PATIENTS RECEIVE A 63% 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	1	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	FRANCIS MARION MANOR HEALTH &	BusinessNameLine1

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	REHABILITATION	AddressLine1
Address Line2	100 FRANCIS MARION LANE	AddressLine2
City	MARION	City
State	VA	State
ZIP Code	24354	ZIPCode

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

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 6A - RELATED ORGANIZATION INFORMATION	A COMMUNITY BENEFIT REPORT WAS NOT COMPLETED DURING FY14. A COMMUNITY BENEFIT REPORT WILL BE COMPLETED IN FY15.
PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION	A COST TO CHARGE RATIO (WORKSHEET 2 "RATIO OF PATIENT CARE COST TO CHARGES") WAS USED TO CALCULATE LINE 7A FINANCIAL ASSISTANCE (CHARITY CARE) COST AND LINE 7B UNREIMBURSED MEDICAID. LINE 7E COMMUNITY HEALTH IMPROVEMENT INCLUDES NUMEROUS SERVICES AND THESE COSTS ARE TAKEN DIRECTLY FROM ACTUAL EXPENSE REPORTS, WITH NO ADDITIONAL OVERHEAD INCLUDED IN THE COST. MOST OF THESE SERVICES DO NOT HAVE OFFSETTING REVENUE TO REPORT. LINE 7F HEALTH PROFESSIONS EDUCATION IS COMPRISED OF INTERNSHIPS WITH SCHOOLS AND UNIVERSITIES, ALLOWING THEIR HEALTH PROFESSION STUDENTS TO GET HANDS-ON TRAINING AT A HOSPITAL AS PART OF THEIR EDUCATION AND TRAINING. OUR ORGANIZATIONAL DEVELOPMENT DEPARTMENT KEEPS DETAILED RECORDS ON HOURS SPENT ON THESE STUDENT ACTIVITIES, THE NUMBER OF STUDENTS THAT ROTATE THROUGH OUR HOSPITAL, ETC. INFORMATION IS MAINTAINED FOR EACH HOSPITAL AND HOSPITAL UNIT THAT PARTICIPATES. WE ONLY INCLUDE LABOR COSTS AND WE ONLY ASSUME A PERCENTAGE OF OUR TEAM MEMBERS' TIME IS DEVOTED TO THESE STUDENTS. FOR LINE 7G SUBSIDIZED HEALTH CARE SERVICES, WE USE OUR COST ACCOUNTING SYSTEM FOR MOST OF THE REPORTED SERVICES. OUR COST ACCOUNTING SYSTEM INCLUDES ALL PATIENT SEGMENTS (INPATIENT, OUTPATIENT, EMERGENCY ROOM, ETC. AND ALL PAYER SOURCES, INCLUDING SELF-PAY). WE ARE CAREFUL TO ENSURE NO DOUBLE COUNTING OF COST (FOR EXAMPLE, WE DO NOT INCLUDE CHARITY AND MEDICAID/TENNCARE ALREADY REPORTED ON LINES 7A AND 7B). ALTHOUGH WE HAVE MANY SERVICE LINES WITHIN OUR HOSPITAL THAT LOSE MONEY, WE DO NOT REPORT AS COMMUNITY BENEFIT SURGERY OR OTHER SERVICES THAT HOSPITALS ARE REQUIRED BY STATE LICENSURE TO PROVIDE. THERE ARE A FEW OTHER SERVICES NOT SEPARATELY TRACKED BY OUR COST ACCOUNTING SYSTEM; FOR THESE, WE USE THEIR ACTUAL DEPARTMENTAL EXPENSE, WHICH DOES NOT INCLUDE AN OVERHEAD ALLOCATION. LINE 7I CASH AND IN-KIND CONTRIBUTIONS ARE VALUED AT ACTUAL COST.
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 DEDUCTIBLES AND/OR CO-PAYMENTS. OTHER SELF-PAY ACCOUNTS ARE FROM PATIENTS WITH NO INSURANCE OR THIRD-PARTY COVERAGE. ALL PATIENTS WITH NO FORM OF THIRD-PARTY PAYER COVERAGE RECEIVE A 63% DISCOUNT, AS REQUIRED BY TENNESSEE LAW. MSHA APPLIES TENNESSEE LAW TO OUR VIRGINIA HOSPITAL PATIENT ACCOUNTS AS WELL. AFTER THE NORMAL COLLECTION PROCESS HAS INDICATED AN ACCOUNT IS UNCOLLECTIBLE, SCCH WRITES THE ACCOUNT OFF TO BAD DEBT. THE HOSPITAL'S OVERALL SELF-PAY ACCOUNTS RECEIVABLE BALANCE IS EVALUATED ON AN ONGOING BASIS TO GATHER HISTORICAL INFORMATION TO APPLY TO THE CURRENT BALANCE. IN OTHER WORDS, THE HOSPITAL EVALUATES PAST COLLECTION HISTORY ON ACCOUNTS WRITTEN OFF TO BAD DEBT AND APPLIES THE HISTORICAL UNPAID RATE TO THE CURRENT SELF-PAY ACCOUNTS RECEIVABLE BALANCE.
PART III, LINE 3 BAD DEBT EXPENSE, PATIENTS ELIGIBLE FOR ASSISTANCE	MSHA'S PATIENT FINANCIAL SERVICES MANAGEMENT ESTIMATE THAT 60% OF TOTAL BAD DEBT EXPENSE WAS ASSUMED ATTRIBUTABLE TO PATIENTS LIKELY ELIGIBLE FOR FINANCIAL ASSISTANCE. WE HAVE MANY INSTANCES OF PATIENTS WITH LARGE ACCOUNT BALANCES AND NO HEALTH INSURANCE COVERAGE THAT WE ARE SURE WOULD QUALIFY FOR CHARITY CARE. ALTHOUGH HOSPITAL TEAM MEMBERS ENCOURAGE THESE INDIVIDUALS TO COMPLETE OUR FINANCIAL ASSISTANCE APPLICATION, MANY WILL NOT DO SO. EVEN WHEN THESE INDIVIDUALS ARE TOLD WE FEEL SURE THEY DO QUALIFY FOR FULL OR PARTIAL ASSISTANCE, THEY STILL REFUSE TO COMPLETE OUR FINANCIAL ASSISTANCE APPLICATION. IT IS IMPLAUSIBLE TO DETERMINE THE AMOUNT OF SCCH'S BAD DEBT ASSOCIATED WITH THOSE PATIENTS WHO MAY HAVE MET THE CRITERIA SET FORTH IN OUR FINANCIAL ASSISTANCE POLICY WITHOUT HAVING A COMPLETED FINANCIAL ASSESSMENT. WE ARE UNABLE TO DETERMINE OUR PATIENTS' FINANCIAL CIRCUMSTANCES UNLESS A COMPLETED FINANCIAL ASSESSMENT FORM IS VOLUNTARILY PROVIDED TO US. WE CAN ASSERT THAT MORE THAN 97% OF OUR PATIENTS WHO HAVE PROVIDED COMPLETED FINANCIAL ASSESSMENT FORMS HAVE BEEN APPROVED FOR AT LEAST PARTIAL FINANCIAL ASSISTANCE.
BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS	THE TEXT OF MSHA'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE APPEARS ON PAGES 15-16 IN OUR MOST RECENT AUDITED FINANCIAL STATEMENTS (ATTACHED).
PART III, LINE 8 - MEDICARE EXPLANATION	MEDICARE ALLOWABLE COSTS WERE REPORTED USING SCCH'S FILED MEDICARE COST REPORT (C/R). THE C/R USES A COST TO CHARGE RATIO BASED ON A STEP-DOWN ALLOCATION METHODOLOGY. IN CARING FOR THE PATIENT, THERE ARE SEVERAL SERVICES THAT ARE CONSIDERED NON-ALLOWABLE SUCH AS TRANSPORTATION OF A PATIENT, COMFORT ITEMS TO INCLUDE A TELEVISION, MAGAZINES, OR A TELEPHONE. ADDITIONAL NON-ALLOWABLE COSTS INCLUDE THE RECRUITMENT OF PHYSICIANS, PHYSICIAN GUARANTEES AND A PORTION (ALMOST 16%) OF THE BAD DEBT ASSOCIATED WITH THE CARE OF THE PATIENT. MEDICARE LOSSES, INCLUDING SOME NON-ALLOWABLE COSTS, SHOULD BE COUNTED AS A COMMUNITY BENEFIT AS THIS IS THE COST OF CARE FOR SERVING THE AGING POPULATION. AS A PARTICIPATING PROVIDER IN THE MEDICARE PROGRAM, SCCH IS REQUIRED TO PROVIDE THE FULL REGIMEN OF CARE FOR OUR MEDICARE POPULATION. THERE ARE A NUMBER OF CARE REGIMENS THAT ARE COMPENSATED BY THE MEDICARE PROGRAM AT LEVELS BELOW OUR COST. THEREFORE IT IS ONLY LOGICAL TO ALLOW SCCH 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	SCCH HAS ESTABLISHED A STRONG COMMITMENT TO MEET THE MEDICAL NEEDS OF THE COMMUNITIES WE SERVE. ALL REQUESTS FOR FINANCIAL ASSISTANCE ARE EVALUATED USING ESTABLISHED GENERAL GUIDELINES, WHILE ALLOWING FOR UNIQUE FINANCIAL CIRCUMSTANCES. SCCH RECOGNIZES ITS OBLIGATION TO PROVIDE QUALITY HEALTH CARE TO THOSE WHO ARE UNABLE TO PAY. CHARITY ELIGIBILITY DETERMINATION IS MADE ON AN EPISODIC BASIS WITH SOME EXCEPTIONS, SUCH AS: ONCOLOGY SERVICES, WHICH REMAIN IN EFFECT FOR SIX MONTHS OR THE DURATION OF TREATMENT REGIMENS; PATIENTS REFERRED TO SCCH BY APPALACHIAN MOUNTAIN PROJECT ACCESS, AN ORGANIZATION WITH THE PURPOSE OF INCREASING ACCESS TO MEDICAL CARE TO LOW INCOME, UNINSURED RESIDENTS; AND, OTHER SPECIFIC CASES. 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. SCCH CHARITY GUIDELINES ARE BASED ON THE NATIONAL PROVERTY 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 SERVICES. 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. VIRGINIA RANKS 21ST AND TENNESSEE RANKS 45TH; HOWEVER, IT SHOULD BE NOTED THAT SOUTHWEST VIRGINIA (WHERE 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 67 INDIVIDUALS REPRESENTING THE NINE 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 HEALTH STATUS, HEALTH PRIORITIES, AND SUGGESTIONS FOR IMPROVEMENT. THE MAJORITY OF RESPONSES SUGGESTED FOCUSING ON EDUCATION IN ORDER TO PROMOTE HEALTHY HABITS. 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 4.24 OUT OF 10 (1 BEING THE LOWEST, 10 BEING THE HIGHEST). ALSO, ALL 67 PARTICIPANTS AGREED THAT OBESITY, CANCER, HEART DISEASE AND DIABETES WERE THE TOP HEALTH PRIORITIES IN EACH COUNTY. AHR REPORTS THAT VIRGINIA AND TENNESSEE BOTH SAW AN INCREASE IN DIABETES AND OBESITY WITHIN THE PAST TEN YEARS. VIRGINIA RANKS 25TH FOR CARDIOVASCULAR DEATHS, 23RD FOR CANCER DEATHS (24TH FOR SMOKING) AND 26TH FOR DIABETES. AHR REPORTS 22% OF THE CITIZENS IN SMYTH COUNTY SMOKE COMPARED TO 18% IN THE STATE OF VIRGINIA, AND 31% OF THE ADULTS IN OUR COUNTY WERE CONSIDERED OBESE. MSHA HAS PARTNERED WITH SCHOOLS, NON-PROFIT AGENCIES AND OTHERS ON VARIOUS INITIATIVES TO ADDRESS HEALTH ISSUES, CHILDHOOD OBESITY IN PARTICULAR.
PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	SCCH PROVIDES COMMUNICATION OF FINANCIAL ASSISTANCE ON ITS WEBSITE, AND ON POSTERS LOCATED IN PROMINENT AREAS OF THE HOSPITAL SUCH AS ADMITTING AND THE EMERGENCY DEPARTMENT. PRINTED EDUCATIONAL MATERIALS INCLUDING FINANCIAL ASSISTANCE CONTACT INFORMATION ARE ALSO PROVIDED IN EACH PATIENT'S PAPERWORK. POSTERS AND REFERENCE MATERIALS ARE WRITTEN IN BOTH ENGLISH AND SPANISH. ADMITTING STAFF ARE TRAINED TO EDUCATE PATIENTS ON SCCH'S FINANCIAL ASSISTANCE POLICY. SCCH ALSO HAS FINANCIAL COUNSELORS TO PROVIDE FURTHER INFORMATION AND ASSISTANCE TO PATIENTS REGARDING SCCH'S FINANCIAL ASSISTANCE POLICY. THESE COUNSELORS ALSO HELP UNINSURED PATIENTS DETERMINE SOURCES OF PAYMENT FOR MEDICAL BILLS AND HELP PATIENTS DETERMINE ELIGIBILITY FOR PROGRAMS SUCH AS MEDICAID. IN ADDITION, SCCH HAS PARTNERED WITH THE COMPANY FIRSTSOURCE SOLUTIONS USA, TO WORK WITH SELF-PAYING PATIENTS WHO HAVE LIMITED FINANCIAL RESOURCES. DURING FY14, FIRSTSOURCE REPRESENTATIVES WERE AVAILABLE AT SCCH. FIRSTSOURCE REPRESENTATIVES WERE ABLE TO DETERMINE GOVERNMENTAL MEDICAL ASSISTANCE (MEDICAID OR TENNCARE) ELIGIBILITY, AND TO HELP WITH THE APPLICATION PROCESS AND FOLLOW-UP. DURING FY14, 258 PATIENTS WERE APPROVED FOR COVERAGE. ONCE A PERSON IS APPROVED FOR MEDICAID OR TENNCARE THROUGH THIS PROGRAM OFFERED THROUGH SCCH, THEY RETAIN COVERAGE FOR FUTURE MEDICAL CARE. FIRSTSOURCE IS COMPENSATED BY SCCH. DURING FY14, SCCH'S COST FOR THIS PROGRAM WAS 33,458.
PART VI, LINE 4 - COMMUNITY INFORMATION	SCCH IS LOCATED IN MARION, SMYTH COUNTY, WHICH IS IN RURAL SOUTHWEST VIRGINIA. SOUTHWEST VIRGINIA (SWVA) IS LOCATED WITHIN THE APPALACHIAN MOUNTAINS, SPECIFICALLY THE BLUE RIDGE MOUNTAIN REGION. SWVA IS CONSIDERED RURAL AND MUCH DIFFERENT THAN THE REST OF THE STATE. SWVA HAS BEEN AND REMAINS A MAJOR COAL MINING REGION. SMYTH COUNTY IS A FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREA AND HAS A HIGH RATE OF INDIVIDUALS WHO ARE UNINSURED. THE POPULATION OF SMYTH COUNTY IS JUST UNDER 32,000 AND ACCORDING TO THE U.S. CENSUS BUREAU THE TOWN OF MARION HAS A POPULATION OF 5,905. THE LATEST CENSUS BUREAU DATA ESTIMATES THE MEDIAN AGE OF RESIDENTS OF SMYTH COUNTY IS 43.6 WHICH IS OLDER THAN THE MEDIAN AGE OF 37.5 IN VIRGINIA. THE BUREAU ESTIMATES SMYTH COUNTY MEDIAN HOUSEHOLD INCOME AT 37,219, COMPARED TO 62,666 FOR THE STATE OF VIRGINIA. 26% OF SMYTH COUNTY'S CHILDREN LIVE IN POVERTY COMPARED TO 16% STATEWIDE.
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH	SCCH IS DEDICATED TO OPERATING EFFICIENTLY SO THAT WASTE IS MINIMIZED AND SURPLUSES MAY BE APPLIED TO MAINTAINING ADEQUATE FACILITIES AND EQUIPMENT 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. THE MAJORITY OF SCCH'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREAS. PHYSICIANS THAT REQUEST PRIVILEGES WHO ARE QUALIFIED AND CREDENTIALED ARE EXTENDED PRIVILEGES BY SCCH.
PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM	SCCH IS A 44-BED, ACUTE-CARE FACILITY OPERATED UNDER THE DIRECTION OF A 13-MEMBER BOARD OF DIRECTORS PRIMARILY COMPRISED OF LOCAL COMMUNITY RESIDENTS. ADDITIONALLY, SCCH HAS A 109-BED NURSING CARE FACILITY THAT OFFERS BOTH SKILLED NURSING CARE AND NURSING CARE. SCCH IS MAJORITY OWNED BY MOUNTAIN STATES HEALTH ALLIANCE (MSHA) BASED IN JOHNSON CITY, TENNESSEE. MSHA IS INTEGRATED BOTH VERTICALLY AND HORIZONTALLY AND IS THE LARGEST REGIONAL HEALTHCARE SYSTEM WITH 14 HOSPITALS. MSHA PROVIDES CARE TO PEOPLE IN 29 COUNTIES IN TENNESSEE, VIRGINIA, KENTUCKY, AND NORTH CAROLINA. SCCH SERVES AS THE COUNTY'S PRIMARY HEALTH SERVICE PROVIDER. PATIENTS BENEFIT FROM SCCH'S AFFILIATION WITH A HEALTHCARE SYSTEM WHERE THEY CAN BE EFFICIENTLY MOVED ALONG AN INTEGRATED, COMPREHENSIVE CONTINUUM OF CARE AS THEIR HEALTH STATUS DICTATES. PATIENTS CAN BE MOVED TO THE SYSTEM'S FLAGSHIP FACILITY, JOHNSON CITY MEDICAL CENTER, WHICH IS A TERTIARY CARE FACILITY PROVIDING ADVANCED TREATMENT OPTIONS.
PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT	VIRGINIA

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Non Cash AssistanceNonCashAssistanceAmt	Non Cash AssistanceNonCashAssistanceDesc	Purpose Of GrantPurposeOfGrantTxt	Cash GrantCashGrantAmt
MARION LIFESAVING CREW
PO BOX 784	MARION	VA	24354	541115428	501C3	$6,230	MED SUPPLIES	PROGRAM SUPPORT
VIRGINIA HIGHLANDS COMM COLLEGE
PO BOX 828	ABINGDON	VA	24212	541268289	501C3			PROGRAM SUPPORT	$30,000

Field	Value	IRS element (for citing)
Total501c3 Org	2	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, INCLUDING SCCH, 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. FOR MANY YEARS, SCCH HAS MADE DONATIONS OF MEDICATIONS TO AREA NON-PROFIT EMERGENCY MEDICAL SERVICE COMPANIES. THESE MEDICATION DONATIONS COMPRISE A SIGNIFICANT PORTION OF OUR DONATIONS. IN FY14, WE PLEDGED 30,000 A YEAR FOR THREE YEARS TO A LOCAL COMMUNITY COLLEGE TO SUPPORT ITS NURSING PROGRAM. ON OCCASION, WE MAKE A SMALL NUMBER OF MODEST CASH DONATIONS TO OTHER NON-PROFIT ORGANIZATIONS.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
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 (6 entries)

TitleTitleTxt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ANN FLEMING
DIRECTOR	$383,151	$87,911	$282,847	$55,452	$17,959	$827,320	$242,724
ERIC SACKNOFF MD
DIRECTOR	$429,000		$14,703	$17,268	$18,964	$479,935
JOHN DOYLE
SECRETARY	$205,695	$36,289	$12,359	$11,861	$22,248	$288,452
LINDA WHITE
VP/CEO	$187,888	$29,892	$9,417	$20,738	$20,552	$268,487
BELDON FLEMING
	$135,927	$1,260		$8,475	$25,451	$171,113
BRUCE BRIGGS
	$121,538	$500		$7,398	$21,989	$151,425

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

SCHEDULE J, PAGE 1, PART I, LINE 4

ANN FLEMING 0 39,222 0 LINDA WHITE 0 9,624 0

SCHEDULE J, PART III

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

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990 - ORGANIZATION'S MISSION	PART I, LINE I - ORGANIZATION'S MISSION: SMYTH COUNTY COMMUNITY HOSPITAL (SCCH) IS COMMITTED TO BRINGING LOVING CARE TO HEALTH CARE. WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTH CARE NEEDS OF INDIVIDUALS AND COMMUNITIES IN OUR REGION AND TO ASSIST THEM IN ATTAINING THEIR HIGHEST POSSIBLE LEVEL OF HEALTH.
FORM 990, PAGE 2, PART III, LINE 4A	AS A NOT-FOR-PROFIT HOSPITAL, ALL OF SCCH'S NET INCOME IS INVESTED IN IMPROVING HEALTHCARE IN THE COMMUNITY. WITH A STRONG COMMITMENT TO QUALITY PATIENT CARE AND A HERITAGE OF SERVICES, SCCH CONTINUES TO MEET THE HEALTHCARE NEEDS OF SMYTH AND THE ADJOINING COUNTIES. FOR THE YEAR ENDING JUNE 30, 2014, SCCH RECORDED 1,608 INPATIENT ADMISSIONS, AND PROVIDED FOR 81,279 OUTPATIENT VISITS. THERE WERE 17,159 EMERGENCY VISITS, 13,348 HOME HEALTH VISITS AND 334 NURSING HOME ADMISSIONS. THROUGHOUT THE YEAR, SCCH PROVIDES A RANGE OF EVENTS AND PROGRAMS TO BENEFIT THE COMMUNITY. SOME EXAMPLES ARE: SCCH SERVES AS A CLINICAL TRAINING FACILITY FOR HEALTH PROFESSIONAL EDUCATION STUDENTS. SCCH HAS DEDICATED STAFF TO WORK WITH REGIONAL COLLEGES AND UNIVERSITIES TO COORDINATE THE PLACEMENT OF HEALTHCARE PROFESSIONAL STUDENTS AS PART OF THEIR EDUCATIONAL CURRICULUM. IN ADDITION TO CLINICAL TRAINING, THE HEALTH CARE STUDENTS ENTERING OUR SYSTEM ARE REQUIRED TO HAVE ORIENTATION AND COMPUTER TRAINING. PARTICIPANTS RECEIVING CLINICAL EXPERIENCE AT SCCH DURING FY14 INCLUDED 101 NURSING STUDENTS FROM VARIOUS COLLEGES, UNIVERSITIES AND PROGRAMS. THIS NURSING CLINICAL EXPERIENCE REQUIRED EXTENSIVE SCCH NURSING STAFF INVOLVEMENT. THE CLINICAL SETTING AND HANDS-ON INSTRUCTION COST SCCH 208,026. SCCH PROVIDED A CLINICAL SETTING FOR ANOTHER 84 STUDENTS TRAINING IN HEALTH-RELATED PROGRAMS SUCH AS RADIOLOGY, PHARMACY, PHYSICAL THERAPY, EMT/PARAMEDIC AND OTHER ALLIED-HEALTH DISCIPLINES. THESE ADDITIONAL CLINICAL STUDENTS COST SCCH 86,804. SCCH'S FORMER FOUR-STORY HOSPITAL BUILDING AND ADJOINING 15 ACRES, WHICH WAS VACATED IN 2012 WHEN THE NEW SCCH HOSPITAL FACILITY WAS OPENED, WAS DONATED IN FY14 TO EMORY & HENRY COLLEGE. THE COLLEGE PARTNERED WITH COMMUNITY LEADERS, MUNICIPALITIES AND ORGANIZATIONS TO FUND THE RENOVATION OF THE BUILDING TO HOUSE THE NEW EMORY & HENRY SCHOOL OF HEALTH SCIENCES. SCCH AND MSHA ADMINISTRATION FELT THIS DONATION WAS AN IMPORTANT STEP IN DEVELOPING MUCH-NEEDED HEALTHCARE PROFESSIONALS FOR THE COMMUNITY. IN FURTHERANCE OF OUR COMMITMENT TO AREA SCHOOLS WITH HEALTH PROFESSIONS PROGRAMS, SCCH PLEDGED 30,000 A YEAR FOR THREE YEARS TO VIRGINIA HIGHLANDS COMMUNITY COLLEGE TO SUPPORT ITS NURSING PROGRAM. WITH HEALTHCARE INSURANCE COVERAGE CHANGING RAPIDLY, PATIENT PAYMENT RESPONSIBILTY IS INCREASING AT A RATE OF 5 TO 6 PERCENT EACH YEAR. MOUNTAIN STATES INTRODUCED A NEW PAYMENT OPTION THAT OFFERS MORE FLEXIBILITY TO OUR PATIENTS - THE ABILITY TO SPREAD PAYMENTS OVER A 36-MONTH PERIOD WITH NO INTEREST CHARGED. OF COURSE, FOR PATIENTS THAT ARE UNABLE TO PAY THEIR ACCOUNT BALANCES, PATIENT RESPRESENTATIVES ARE AVAILABLE TO DISCUSS FINANCIAL ASSISTANCE PROGRAMS. SCCH HAS PARTNERED WITH THE COMPANY, FIRSTSOURCE SOLUTIONS USA, TO WORK WITH SELF-PAYING PATIENTS WHO HAVE LIMITED FINANCIAL RESOURCES. DURING FY14, FIRST SOURCE REPRESENTATIVES WERE ABLE TO DETERMINE GOVERNMENTAL MEDICAL ASSISTANCE (MEDICAID) ELIGIBILITY, AND TO HELP WITH THE APPLICATION PROCESS AND FOLLOW-UP. DURING FY14, 258 PATIENTS WERE APPROVED FOR COVERAGE. ONCE A PERSON IS APPROVED FOR MEDICAID THROUGH THIS PROGRAM OFFERED THROUGH SCCH, THEY RETAIN COVERAGE FOR FUTURE MEDICAL CARE. FIRSTSOURCE IS COMPENSATED BY SCCH. DURING FY14, SCCH'S COST FOR THIS PROGRAM WAS 33,458. SMYTH COUNTY'S FIRST URGENT CARE FACILITY WAS OPENED IN SEPTEMBER 2014 TO OFFER THE COMMUNITY ACCESS TO LOCAL PRIMARY CARE PROVIDERS AFTER NORMAL BUSINESS HOURS. THE STATE-OF-THE-ART FACILITY IS LOCATED ON THE SCCH GROUNDS AND OFFERS TREATMENT OF MINOR ILLNESSES AND INJURIES IN A SETTING THAT IS BOTH CONVENIENT AND COST EFFECTIVE. LAB AND X-RAY SERVICES ARE AVAILABLE ON-SITE. DURING FY14, SCCH, ALONG WITH MSHA'S OTHER HOSPITALS, IMPLEMENTED AN ONLINE TOOL CALLED OWL (ONLINE WELLNESS LINK). OWL PROVIDES INPATIENTS WITH BETTER ACCESS TO THEIR HEALTH CARE INFORMATION SO THEY CAN VIEW A PORTION OF THEIR HEALTH CARE RECORD ONLINE, INCLUDING: - A CONTINUITY OF CARE DOCUMENT WHICH PROVIDES A SUMMARY OF THE HOSPITAL VISIT - CURRENT MEDICATIONS - ALLERGIES AND ADVERSE REACTIONS - PAST MEDICAL HISTORY - CERTAIN LABORATORY AND RADIOLOGY RESULTS THE OWL PORTAL ALSO ALLOWS SCCH CAREGIVERS TO EXCHANGE HEALTH INFORMATION, WHICH HAS LED TO SAFER, MORE QUALITY-ORIENTED AND STREAMLINED CARE FOR OUR PATIENTS. PREMIER HEALTHCARE ALLIANCE'S 2014 AWARD WINNERS INCLUDED SMYTH COUNTY COMMUNITY HOSPITAL. SCCH EARNED THE HIGHEST HONOR BY ACHIEVING TOP PERFORMANCE IN ALL OF THE SIX AREAS MEASURED IN PREMIER'S QUEST COLLABORATIVE. SCCH, ALONG WITH SYCAMORE SHOALS HOSPITAL (ANOTHER MOUNTAIN STATES HEALTH ALLIANCE HOSPITAL) WERE AMONG ONLY 18 HOSPITALS NATIONWIDE TO RECEIVE THE QUEST AWARD FOR HIGH-VALUE HEALTHCARE. THE HIGH-VALUE HEALTHCARE AWARDS ARE DETERMINED BASED ON SIX MEAURES: COST OF CARE, EVIDENCE-BASED CARE; MORTALITY; POTENTIAL HARM; PATIENT EXPERIENCE; AND, READMISSIONS. THE MOUNTAIN STATES HEALTH ALLIANCE HEAL (HEALTHY EATING ACTIVE LIVING) APPALACHIA PROGRAM WAS SELECTED AS A 2014 INDUCTEE INTO THE FIRST LADY OF VIRGINIA'S OPPORTUNITY HALL OF FAME. HEAL APPALACHIA IS A COLLABORATIVE EFFORT OF SCCH AND OTHER MSHA HOSPITALS AND EAST TENNESSEE STATE UNIVERSITY TO BATTLE CHILDHOOD OBESITY IN SOUTHWEST VIRGINIA AND NORTHEAST TENNESSEE. THE HONOR COMES FROM THE FLITE (FIRST LADY'S INITIATIVES TEAM EFFORT) FOUNDATION, WHICH IS MADE UP OF ONE HUNDRED WOMEN FROM ACROSS THE COMMENWEALTH OF VIRGINIA. FLITE RECOGNIZES PEOPLE AND ORGANIZATIONS WHO EMBODY THE IDEAL OF GETTING INVOLVED AND GIVING BACK. HEAL APPALACHIA WAS RECOGNIZED FOR PREVENTIVE HEALTH CARE AND WELLNESS, ONE OF THE FOUR FOCUS AREAS OF THE FLIGHT FOUNDATION. FLIGHT RECOGNIZED PROGRAMS ARE NAMED TO THE FIRST LADY OF VIRGINIA'S OPPORTUNITY HALL OF FAME. FOR MANY YEARS, SCCH HAS PROVIDED ASSISTANCE TO LOCAL LIFESAVING ORGANIZATIONS SUCH AS AMBULANCE SERVICES, FIRE DEPARTMENTS AND RESCUE SQUADS. SCCH DONATES FREE MEDICATIONS AND PHARMACEUTICAL SUPPLIES TO THESE NON-PROFIT ORGANIZATIONS. THE COST OF DONATED MEDICATIONS TO RESCUE ORGANIZATIONS DURING FY14 WAS ALMOST 11,000. A VARIETY OF SCREENINGS, SUPPORT GROUPS, HEALTH EDUCATION, AND HEALTH FAIRS WERE PROVIDED ON AN ONGOING BASIS THROUGHOUT THE YEAR. SOME OF THE SERVICES PROVIDED DURING THE YEAR INCLUDE: LAB SERVICES FOR A FREE PUBLIC CLINIC, CPR TRAINING TO THE PUBLIC, AND FIRST AID CLASSES. THE COST OF PROVIDING THESE FREE SERVICES WAS JUST UNDER 26,000. SCCH HOSTS AN ANNUAL ADVANCED DIRECTIVES DAY TO EDUCATE COMMUNITY MEMBERS ABOUT LEGAL DOCUMENTS THEY MAY WISH TO HAVE IN ORDER TO EXPRESS THE TYPE OF MEDICAL CARE WANTED WHEN ILL AND TO MAKE CLEAR THEIR DECISIONS FOR THEIR OWN END OF LIFE CARE. SINCE A MEDICAL CRISIS CAN OCCUR AT ANY AGE, THIS ADVANCED CARE PLANNING IS AN IMPORTANT STEP TOWARD ENSURING AN INDIVIDUAL'S WISHES ARE FOLLOWED IF HE/SHE IS TOO ILL TO MAKE HIS/HER OWN HEALTHCARE DECISIONS. TWELVE SCCH TEAM MEMBERS WERE INVOLVED WITH THIS EDUCATION DAY. IN FY14 SCCH HOSTED AN OLDER AMERICANS DAY. TWO RN'S PROVIDED SENIOR CITIZENS WITH FREE BLOOD PRESSURE AND OXYGEN SATURATION CHECKS. A SOCIAL WORKER WAS ALSO PRESENT TO PROVIDE INFORMATION ABOUT HOMECARE, REHABILITATION, NURSING HOME AND OTHER GERIATRIC SERVICES. APPROXIMATELY 250 PEOPLE ATTENDED THE EVENT. SCCH TEAM MEMBERS PARTICIPATE IN A LOCAL NUTRITION NETWORK, A COLLABORATION OF SPONSORS AND AGENCIES WHO GRAPPLE WITH THE ISSUES OF POVERTY, HUNGER, AND LACK OF KNOWLEDGE REGARDING HEALTH CONSEQUENCES OF POOR NUTRITION. THE NETWORK SERVES TO EDUCATE THE COMMUNITY ABOUT OBESITY RELATED HEALTH PROBLEMS SUCH AS DIABETES, HYPERTENSION, HIGH CHOLESTEROL, AND HEART DISEASE. THE NETWORK'S GOAL IS TO ADDRESS POVERTY AND THE WIDESPREAD USE OF INEXPENSIVE, PROCESSED FOODS WHICH CONTRIBUTE TO THE OBESITY RISK. SINCE THE SOLUTION TO OBESITY AND ITS RELATED DISEASES DOES NOT REQUIRE HIGH TECH TREATMENT OR CUTTING EDGE MEDICATIONS, REPRESENTATIVES FROM SCCH, VIRGINIA DEPARTMENT OF HEALTH, VIRGINIA TECH, FARMERS MARKETS AND GROCERY STORES, LOCAL SCHOOLS AND CHARITY ORGANIZATIONS ARE DEEMED TO BE THE BEST PLACE TO START THE PROCESS OF REDUCING OBESITY WITHIN THE COMMUNITY. SCCH OFFERS A SUPPORT GROUP FOR PEOPLE WITH DIABETES. EVERY OTHER MONTH A SCCH TEAM MEMBER PROVIDES EDUCATION REGARDING SELF-CARE, INCLUDING NUTRITION COUNSELING. SCCH ALSO OFFERS A MONTHLY CANCER SUPPORT GROUP, WHICH IS HOSTED BY HOSPITAL EMPLOYEES, INCLUDING A NURSE PRACTITIONER OR PHYSICIAN AND A LPN. VARIOUS TOPICS RELATED TO CANCER ARE DISCUSSED EACH MONTH. SMYTH COUNTY LPN STUDENTS RECEIVE THEIR CLINICAL TRAINING AT SCCH. BECAUSE OF THE CLOSE TIE BETWEEN THE STUDENTS AND SCCH, THE STUDENTS ALWAYS ASK TO HAVE THEIR GRADUATION CEREMONY HELD AT THE HOSPITAL. THE HOSPITAL IS VERY PLEASED TO HOST THE CEREMONY FOR THE STUDENTS AND THEIR FAMILIES. REFRESHMENTS ARE PROVIDED AND SCCH'S CEO AND CNO ATTEND THE CEREMONY.
FORM 990, PAGE 6, PART VI, LINE 6	MOUNTAIN STATES HEALTH ALLIANCE IS THE 80% MEMBER OF SMYTH COUNTY COMMUNITY HOSPITAL. SMYTH COUNTY COMMUNITY HOSPITAL FOUNDATION IS THE 20% MEMBER OF SMYTH COUNTY COMMUNITY HOSPITAL.
FORM 990, PAGE 6, PART VI, LINE 7A	THERE ARE TWO CLASSES OF MEMBERS, AND EACH CLASS IS ENTITLED TO ELECT A SPECIFIED NUMBER OF DIRECTORS TO THE BOARD. THE MOUNTAIN STATES HEALTH ALLIANCE (MSHA) CLASS IS ELECTED BY THE MSHA BOARD OF DIRECTORS AND THE SMYTH COUNTY COMMUNITY HOSPITAL CLASS IS ELECTED BY THE SMYTH COUNTY COMMUNITY HOSPITAL FOUNDATION BOARD OF DIRECTORS. NEITHER SIDE CAN VETO AN APPOINTMENT.
FORM 990, PAGE 6, PART VI, LINE 7B	CERTAIN DECISIONS OF THE BOARD ARE, PURSUANT TO CHARTER AND VIRGINIA STATUTE, SUBJECT TO APPROVAL OF THE MEMBERS. THESE DECISIONS INCLUDE: DISSOLUTION OF THE CORPORATION; MERGER OF THE CORPORATION; NON-ORDINARY COURSE OF BUSINESS SALE OF ASSETS; ETC. NO ORDINARY, DAY-TO-DAY DECISIONS ARE SUBJECT TO MEMBER APPROVAL.
FORM 990, PAGE 6, PART VI, LINE 11B	THE CFO REVIEWED THE FORM 990 WITH THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS AND THE RETURN WAS MADE AVAILABLE TO EACH BOARD MEMBER IN AN ELECTRONIC FORMAT PRIOR TO THE REVIEW.
FORM 990, PAGE 6, PART VI, LINE 12C	ANNUALLY, THE CORPORATE AUDIT AND COMPLIANCE DEPARTMENT OF MSHA FORWARDS THE CONFLICT OF INTEREST POLICY AND DISCLOSURE FORM TO ALL MSHA MANAGEMENT TEAM MEMBERS AND BOARD MEMBERS, INCLUDING THOSE AT SCCH. EMPLOYEES AND BOARD MEMBERS MUST NOTE ANY CONFLICTS OR ATTEST THEY HAVE "NONE", AND RETURN THE FORM TO THE AUDIT AND COMPLIANCE DEPARTMENT. ANY NOTED DISCLOSURES ARE FORWARDED TO THE APPROPRIATE MANAGEMENT OR BOARD PERSONNEL TO EVALUATE AND UTILIZE WHEN A TRANSACTION INVOLVING A CONFLICTED PERSON ARISES. ADDITIONALLY, PERSONNEL WHO HAVE A CONFLICT ARISE BETWEEN THE ANNUAL DISTRIBUTION OF THE POLICY AND FORMS ARE REQUIRED TO DISCLOSE THE CONFLICT AND WOULD BE DISCIPLINED IN ANY INSTANCE WHERE THEY HAVE NOT DISCLOSED AND ENGAGED IN A CONFLICTED TRANSACTION.
FORM 990, PAGE 6, PART VI, LINE 15A	THE COMPENSATION AND BENEFITS OF SCCH'S CEO ARE SUBJECT TO THE EXECUTIVE COMPENSATION POLICY OF MOUNTAIN STATES HEALTH ALLIANCE (MSHA). THE POLICY WAS ESTABLISHED BY MSHA'S BOARD OF DIRECTORS AND IS ALLIGNED WITH THE MSHA MISSION, VISION, AND VALUES, SUPPORTING THE ACHIEVEMENT OF THE HEALTH SYSTEM'S STRATEGIC PLANS AND ANNUAL GOALS AND OBJECTIVES. THE POLICY ENSURES THAT MSHA'S EXECUTIVE COMPENSATION IS COMPLIANT WITH THE LEGAL, REGULATORY, AND STATUTORY ENVIRONMENT AFFECTING COMPENSATION. MSHA'S PRESIDENT AND CEO MAKES RECOMMENDATIONS TO THE EXECUTIVE COMMITTEE OF THE MSHA BOARD FOR ALL ELEMENTS OF COMPENSATION FOR THE SENIOR MANAGEMENT TEAM, INCLUDING SCCH'S CEO. THE BOARD OF DIRECTORS MONITORS THE PERFORMANCE OF THE SENIOR MANAGEMENT TEAM ON AN ONGOING BASIS, BUT AT LEAST ANNUALLY.
FORM 990, PAGE 6, PART VI, LINE 15B	SIMILAR TO THE CEO'S COMPENSATION, THE CFO RECEIVES COMPENSATION AND BENEFITS THAT COMPLY WITH MSHA'S SALARY POLICY. HIS PAY IS SET AT A MARKET PERCENTILE SPECIFIC TO HIS POSITION.
FORM 990, PAGE 6, PART VI, LINE 19	GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE UPON REQUEST TO APPROPRIATE PARTIES REQUESTING THEM. FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THOSE PARTIES WHO OWN INDEBTEDNESS OF THE COMPANY ON A QUARTERLY BASIS.
FORM 990, PART VII	PART VII, LINE 2 MSHA, SCCH'S MAJORITY OWNER, PROCESSES PAYROLL FOR SCCH. SCCH REIMBURSES MSHA FOR ALL SALARY AND BENEFITS. THE SALARY AND BENEFITS ARE RECORDED ON SCCH'S BOOKS.
FORM 990, PAGE 7, PART VII	TRUSTEE COMPENSATION: HOSPITAL BOARD OF TRUSTEES MEMBERS ANN FLEMING AND JOHN DOYLE HAVE FORM 990 REPORTABLE COMPENSATION DERIVED FROM SERVICES THEY PROVIDED TO RELATED ORGANIZATIONS. THEY DO NOT RECEIVE COMPENSATION FOR SERVICES AS HOSPITAL BOARD TRUSTEES.
FORM 990, PART IX, LINE 11G	HOSPITAL SUPPORTED CLINICS 4,269,580 0 0 PHYSICIAN FEES 2,889,673 0 0 DIETARY FEES 1,402,027 0 0 OTHER FEES 771,280 13,422 0
FORM 990, PART X	PART X, LINE 20 TAX EXEMPT BOND LIABILITY THE TAX EXEMPT BOND LIABILITY REFLECTS THE PORTION OF BONDS ISSUED BY MOUNTAIN STATES HEALTH ALLIANCE, SCCH'S MAJORITY OWNER, LOANED TO SCCH FOR CAPITAL NEEDS. SCCH PAYS ALL COSTS RELATED TO THIS PORTION OF THE BOND ISSUE.
FORM 990, PART XI, LINE 9	PARTNERSHIP INCOME NOT ON BOOKS -83,118 PARTNERSHIP INTEREST INCOME NOT ON BOOKS -929 PARTNERSHIP CAPITAL GAINS NOT ON BOOKS -11,319 PARTNERSHIP CHARITABLE CONTRIBUTIONS NOT ON BOOKS 11 ELIMINATION OF INTERCOMPANY REC/PAY 548,305 TEMPORARILY RESTRICTED GRANTS -26,091 TOTAL TO FORM 990, PART XI, LINE 9 426,859

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd
MOUNTAIN STATES HEALTH ALLIANCE
400 N STATE OF FRANKLIN ROAD	JOHNSON CITY	TN	37604	620476282	HOSPITAL	TN	501C3	3	MSHA	false
SMYTH COUNTY COMM FOUNDATION
1 HEALTH WAY	MARION	VA	24354	311650055	SUPPORT	VA	501C3	11A	NA	false
NORTON COMMUNITY HOSPITAL
100 15TH STREET NORTHWEST	NORTON	VA	24273	540566029	HOSPITAL	VA	501C3	3	NA	false
DICKENSON COMMUNITY HOSPITAL
ONE HOSPITAL DRIVE	CLINTWOOD	VA	24238	770599553	HOSPITAL	VA	501C3	3	NCH	false
JOHNSTON MEMORIAL HOSPITAL
16000 JOHNSTON MEMORIAL DRIVE	ABINGDON	VA	24211	540544705	HOSPITAL	VA	501C3	3	NA	false
ABINGDON PHYSICIAN PARTNERS
16000 JOHNSTON MEMORIAL DRIVE	ABINGDON	VA	24211	205485346	MED. SERV.	VA	501C3	11A	JMH	false
MOUNTAIN STATES FOUNDATION
2335 KNOB CREEK ROAD STE 101	JOHNSON CITY	TN	37604	581418862	FUNDRAISER	TN	501C3	11A	MSHA	false
MSHA AUXILIARY
400 N STATE OF FRANKLIN ROAD	JOHNSON CITY	TN	37604	581418345	SUPPORT	TN	501C3	11A	MSHA	false
APPALACHIAN EMERGENCY PHYSICIANS
1021 W OAKLAND AVENUE STE 207	JOHNSON CITY	TN	37604	800592504	MED. SERV	VA	501C3	11A		false	N/A

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd
INTEGRATED SOLUTIONS HLTH NTWK LLC
509 MED TECH PARKWAY SUITE 100	JOHNSON CITY	TN	37604	621711997	INVESTMENT	TN	NA	EXCLUDED	$394	false	false
EMMAUS COMMUNITY HEALTHCARE PLLC
6070 HWY 11E	PINEY FLATS	TN	37686	200577483	MED. SERV.	TN	NA			false	false
MEDICAL SPECIALISTS OF J C LLC
2528 WESLEY STREET SUITE 2	JOHNSON CITY	TN	37604	272199037	MED. SERV.	TN	NA			false	false
EAST TN AMBULATORY SURGERY CNTR
701 MED TECH PARKWAY SUITE 100	JOHNSON CITY	TN	37604	621787537	MED. SERV.	TN	NA			false	false

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd
SOUTHWEST COMMUNITY HEALTH SERVICES
P O BOX 880	MARION	VA	24354	541460695	MED. SERV.	VA	SCCH	C CORP	$95,250	$740,490	1.00000	false
BLUE RIDGE MEDICAL MANAGEMENT CORP
1021 W OAKLAND AVENUE SUITE 207	JOHNSON CITY	TN	37604	621490616	MED. SERV.	TN	NA	C CORP				false
MEDISERVE MED EQUIP OF KINGSPORT
1021 W OAKLAND AVENUE SUITE 207	JOHNSON CITY	TN	37604	621212286	DME	TN	NA	C CORP				false
MOUNTAIN STATES PROPERTIES
1021 W OAKLAND AVENUE SUITE 207	JOHNSON CITY	TN	37604	621845895	PROP MGMT	TN	NA	C CORP				false
MOUNTAIN STATES PHYSICIANS GRP INC
1021 W OAKLAND AVENUE SUITE 207	JOHNSON CITY	TN	37604	621700412	HEALTHCARE	TN	NA	C CORP				false
COMMUNITY HOME CARE INC
1460 PARK AVENUE	NORTON	VA	24273	541453810	MED. EQUIP	TN	NA	C CORP				false
WILSON PHARMACY INC
PO BOX 5289	JOHNSON CITY	TN	37602	620329587	PHARMACY	TN	NA	C CORP				false
CRESTPOINT HEALTH INSURANCE CO INC
509 MED TECH PARKWAY SUITE 100	JOHNSON CITY	TN	37604	620381170	INSURANCE	TN	NA	C CORP				false

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	Yes (true)	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (true)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	false	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	Yes (true)	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	Yes (true)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt
SOUTHWEST COMMUNITY HEALTH SERVICES
A	$2,168
SOUTHWEST COMMUNITY HEALTH SERVICES
B	$548,305