TAKOMA REGIONAL HOSPITAL INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization: TAKOMA REGIONAL HOSPITAL INC (EIN 51-0603966)
Tax period: 2013-07-01 to 2014-06-30
Filed: 2015-05-15
IRS object ID: 201521359349304962
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 L
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2015-05-15T12:42:20-05:00	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	510603966	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	TAKOMA REGIONAL HOSPITAL INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Business Name Control	TAKO	BusinessNameControlTxt
Phone	4236362350	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	401 TAKOMA AVENUE	AddressLine1
City	GREENEVILLE	City
State	TN	State
ZIP Code	377434647	ZIPCode

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	DANIEL WOLCOTT	PersonNm
Person Title	CEO	PersonTitleTxt
Phone	4236362350	PhoneNum
Signature	2015-05-15	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	DANIEL WOLCOTT	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	401 TAKOMA AVENUE	AddressLine1
City	GREENEVILLE	City
State	TN	State
ZIP Code	377434647	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	$55,538,999	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.TAKOMA.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	2006	FormationYr
Legal Domicile State	TN	LegalDomicileStateCd
Activity Or Mission	THE PROVISION OF MEDICAL CARE TO THE COMMUNITY THROUGH THE OPERATION OF A 100 BED HOSPITAL.	ActivityOrMissionDesc
Voting Members Governing Body	15	VotingMembersGoverningBodyCnt
Voting Members Independent	12	VotingMembersIndependentCnt
Total Employee	618	TotalEmployeeCnt
Total Volunteers	54	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$456	PYContributionsGrantsAmt
CY Contributions Grants	$0	CYContributionsGrantsAmt
PY Program Service Revenue	$49,493,427	PYProgramServiceRevenueAmt
CY Program Service Revenue	$55,164,522	CYProgramServiceRevenueAmt
PY Investment Income	-$6,221	PYInvestmentIncomeAmt
CY Investment Income	-$2,463	CYInvestmentIncomeAmt
PY Other Revenue	$1,162,982	PYOtherRevenueAmt
CY Other Revenue	$376,940	CYOtherRevenueAmt
PY Total Revenue	$50,650,644	PYTotalRevenueAmt
CY Total Revenue	$55,538,999	CYTotalRevenueAmt
PY Grants And Similar Paid	$51,405	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$62,082	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$29,740,061	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$34,410,848	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$21,837,307	PYOtherExpensesAmt
CY Other Expenses	$22,899,201	CYOtherExpensesAmt
PY Total Expenses	$51,628,773	PYTotalExpensesAmt
CY Total Expenses	$57,372,131	CYTotalExpensesAmt
PY Revenues Less Expenses	-$978,129	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$1,833,132	CYRevenuesLessExpensesAmt
Total Assets BOY	$27,273,866	TotalAssetsBOYAmt
Total Assets EOY	$29,044,477	TotalAssetsEOYAmt
Total Liabilities BOY	$8,105,057	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$11,704,023	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$19,168,809	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$17,340,454	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	TAKOMA REGIONAL HOSPITAL EXISTS TO EXTEND THE HEALING MINISTRY OF CHRIST BY CARING FOR THOSE WHO ARE ILL AND BY NURTURING THE HEALTH OF THE PEOPLE IN OUR COMMUNITIES. AS A MEMBER OF THE ADVENTIST HEALTH SYSTEM AND WELLMONT HEALTH SYSTEM, TAKOMA REGIONAL HOSPITAL (TRH) STRIVES TO CREATE EXCELLENT EXPERIENCES FOR EACH PERSON WHO CHOOSES TO ACCESS OUR SERVICES. TRH WILL BE A LEADER IN PATIENT SAFETY AND HEALTHCARE QUALITY. TRH WILL BE THE BEST PLACE TO WORK, PRACTICE MEDICINE, AND RECEIVE CARE.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$52,977,743	ExpenseAmt
Grant	$62,082	GrantAmt
Revenue	$55,519,862	RevenueAmt
Desc	TAKOMA REGIONAL HOSPITAL, INC. OPERATES A 100 BED ACUTE CARE HOSPITAL IN GREENEVILLE, TN. IN THE CURRENT YEAR, THERE WERE 2,407 ADMISSIONS, 11,481 PATIENT DAYS, AND 75,575 OUTPATIENT VISITS.	Desc
Total Program Service Expenses	$52,977,743	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	0	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	0	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (1)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	0	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	0	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	86	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	618	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	15	GoverningBodyVotingMembersCnt
Independent Voting Member	12	IndependentVotingMemberCnt
Family Or Business Rln	Yes (1)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	0	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	TN	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

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

Field	Value	IRS element (for citing)
Phone	4236362350	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	401 TAKOMA AVE	AddressLine1
City	GREENEVILLE	City
State	TN	State
ZIP Code	37743	ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
BALLARD JOEY
DIRECTOR	0.40	0.00	Yes (X)	$0	$0	$0
BUNCH JAMES A JIMM
DIRECTOR	0.40	0.00	Yes (X)	$0	$0	$0
DENARVAEZ MARGARET DENNY
CHAIRMAN/DIRECTOR	0.40	0.00	Yes (X)	$0	$0	$0
FOLK SHARON
DIRECTOR	0.40	0.00	Yes (X)	$0	$0	$0
GILES AL
DIRECTOR	0.40	0.00	Yes (X)	$0	$0	$0
HOWARD JOHN
DIRECTOR	0.40	0.00	Yes (X)	$0	$0	$0
KILGORE PHD JAMES
DIRECTOR (END 11/13)	0.20	0.00	Yes (X)	$0	$0	$0
MCKINNEY MD JR
DIRECTOR	40.00	0.00	Yes (X)	$148,311	$0	$4,516
NORRIS TODD
DIRECTOR	0.40	0.00	Yes (X)	$0	$0	$0
POPE ALICE
DIRECTOR	0.40	0.00	Yes (X)	$0	$0	$0
RANDOLPH KARSTEN
DIRECTOR	0.40	0.00	Yes (X)	$0	$0	$0
REINER RICHARD
VICE CHAIRMAN/DIRECTOR	0.40	0.00	Yes (X)	$0	$0	$0
SMITH DON
DIRECTOR	0.40	0.00	Yes (X)	$0	$0	$0
UHL MD GREGORY
DIRECTOR/CHIEF OF STAFF (END 12/13)	65.00	0.00	Yes (X)	$382,715	$0	$36,508
WILLIAMS MARK
DIRECTOR	0.40	0.00	Yes (X)	$0	$0	$0
WRIGHT ED
DIRECTOR	0.40	0.00	Yes (X)	$0	$0	$0
WOLCOTT DANIEL
CEO/DIRECTOR	50.00	0.00	Yes (X)	$316,711	$0	$64,928	Yes (X)
MILLER STEVEN
CFO	50.00	0.00		$107,850	$0	$30,485	Yes (X)
LEWIS MD DANIEL
CMO	50.00	0.00		$268,375	$0	$34,519		Yes (X)
ALBRIGHT TAMMY
CNO	50.00	0.00		$152,897	$0	$37,376		Yes (X)
BRIDGES MD WILLIAM ROBERT
PHYSICIAN	50.00	0.00		$490,556	$0	$35,062			Yes (X)
MARSA MD GORDON L
PHYSICIAN	50.00	0.00		$353,935	$0	$32,246			Yes (X)
KRETSCHMAR MD JOSEPH M
PHYSICIAN	50.00	0.00		$345,693	$0	$33,361			Yes (X)
DEOSS DO DEBORAH J
PHYSICIAN	50.00	0.00		$307,391	$0	$34,362			Yes (X)
MORELOCK BROOKS G
PHYSICIAN	50.00	0.00		$279,711	$0	$35,626			Yes (X)
VANDENHOVEN THOMAS P
FORMER CFO	0.00	0.00		$120,811	$0	$14,584				Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$3,274,956	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$393,573	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	31	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	Yes (1)	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1	CityContractorAddress/USAddress/City	StateContractorAddress/USAddress/State	ZIP CodeContractorAddress/USAddress/ZIPCode	ServicesServicesDesc	CompensationCompensationAmt
ARUP LABORATORIES
PO BOX 27964	SALT LAKE CITY	UT	84127	LAB SERVICES	$226,448
GE HEALTHCARE
PO BOX 96483	CHICAGO	IL	60693	SERVICE MAINTENANCE AGREEMENT	$213,801
JACKSON & COKER LOCUMTENE
PO BOX 277638	ATLANTA	GA	30384	HOSPITALISTS SERVICES	$204,493
VALLEY EMERGENCY PHYSICIANS TENNESSEE P
1990 N CALIFORNIA BLVD STE 400	WALNUT CREEK	CA	94596	ED PHYSICIAN SERVICES	$175,000
MEDICAL LAUNDRY
1905 AMERICAN WAY	KINGSPORT	TN	37660	LAUNDRY SERVICE	$171,628

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	12	CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT REVENUE	900099	$54,945,978	$54,945,978
SATISFACTION OF PROGRAM RESTRICTI	900099	$59,586	$59,586
CAFETERIA REVENUE	900099	$56,249	$56,249
GIFT SHOP REVENUE	900099	$43,748	$43,748

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$58,961	TotalRevenueColumnAmt
Related Or Exempt Func Income	$58,961	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$55,164,522	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$14,182	TotalRevenueColumnAmt
Exclusion	-$14,182	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$21,600	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$21,600	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$21,600	TotalRevenueColumnAmt
Exclusion	$21,600	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$11,719	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$0	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	$11,719	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$11,719	TotalRevenueColumnAmt
Exclusion	$11,719	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	EHR REVENUE	Desc
Business	900099	BusinessCd
Total Revenue Column	$355,340	TotalRevenueColumnAmt
Related Or Exempt Func Income	$355,340	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$355,340	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$55,538,999	TotalRevenueColumnAmt
Related Or Exempt Func Income	$55,519,862	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$19,137	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	$62,082	TotalAmt
Program Services	$62,082	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$1,585,190	TotalAmt
Management And General	$1,585,190	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$24,524,807	TotalAmt
Program Services	$24,524,807	ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$874,475	TotalAmt
Program Services	$874,475	ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$5,641,741	TotalAmt
Program Services	$5,581,177	ProgramServicesAmt
Management And General	$60,564	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$1,784,635	TotalAmt
Program Services	$1,784,635	ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$44,357	TotalAmt
Management And General	$44,357	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$6,298,674	TotalAmt
Program Services	$4,846,853	ProgramServicesAmt
Management And General	$1,451,821	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$211,824	TotalAmt
Management And General	$211,824	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,565,138	TotalAmt
Program Services	$1,192,972	ProgramServicesAmt
Management And General	$372,166	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$1,929,400	TotalAmt
Program Services	$1,592,316	ProgramServicesAmt
Management And General	$337,084	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$2,129,236	TotalAmt
Program Services	$2,129,236	ProgramServicesAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$149,402	TotalAmt
Management And General	$149,402	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$6,049	TotalAmt
Program Services	$6,049	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$1,584,786	TotalAmt
Program Services	$1,584,786	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$150,964	TotalAmt
Program Services	$143,764	ProgramServicesAmt
Management And General	$7,200	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$4,665,050	$4,665,050
STATE TAX INDIGENT ASSE	$2,742,563	$2,742,563
REPAIRS & MAINTENANCE	$1,246,978	$1,246,978
PURCHASED SERVICES	$66,238		$66,238

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$108,542	TotalAmt
Management And General	$108,542	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$57,372,131	TotalAmt
Program Services	$52,977,743	ProgramServicesAmt
Management And General	$4,394,388	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$3,113	BOYAmt
EOY	$3,146	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$4,696,076	BOYAmt
EOY	$3,444,994	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$6,395	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$5,603,641	BOYAmt
EOY	$6,363,071	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$4,797	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$1,021,323	BOYAmt
EOY	$1,097,974	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$167,873	BOYAmt
EOY	$167,821	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$45,642,293	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$30,213,185	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$15,128,939	BOYAmt
EOY	$15,429,108	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$641,709	BOYAmt
EOY	$2,538,363	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$27,273,866	BOYAmt
EOY	$29,044,477	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$3,105,692	BOYAmt
EOY	$4,407,915	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$4,999,365	BOYAmt
EOY	$7,296,108	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$8,105,057	BOYAmt
EOY	$11,704,023	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$18,911,291	BOYAmt
EOY	$17,101,916	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$257,518	BOYAmt
EOY	$238,538	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$19,168,809	BOYAmt
EOY	$17,340,454	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$27,273,866	BOYAmt
EOY	$29,044,477	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$1,833,132	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$4,777	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	0	FSAuditedInd
Federal Grant Audit Required	0	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	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$9,456	OtherActivitiesAmt
Total Lobbying Expenditures	$9,456	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	REPRESENTS THE AMOUNT OF TOTAL DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION, HOSPITAL ALLIANCE OF TENNESSEE, AND TENNESSEE HOSPITAL ASSOCIATION THAT IS COMPRISED OF LOBBYING EXPENDITURES.	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,604,550	OtherCostOrOtherBasisAmt
Book Value	$2,604,550	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$16,527,321	OtherCostOrOtherBasisAmt
Depreciation	$8,388,268	DepreciationAmt
Book Value	$8,139,053	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$24,992,200	OtherCostOrOtherBasisAmt
Depreciation	$20,835,651	DepreciationAmt
Book Value	$4,156,549	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,518,222	OtherCostOrOtherBasisAmt
Depreciation	$989,266	DepreciationAmt
Book Value	$528,956	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$15,429,108	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDesc	Book ValueBookValueAmt
OTHER RECEIVABLES	$21,021
DUE FROM RELATED	$299,339
RECEIVABLE FROM THIRD PARTIES	$1,984,110
INVESTMENT IN FOUNDATION	$181,393
INVESTMENT IN IPA	$52,500

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$2,538,363	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDesc	AmtAmt
CREDIT BALANCES IN A/R	$347,960
LEASES PAYABLE	$389,342
DUE TO AFFILIATED	$2,223,675
PAYABLE TO THIRD PARTIES	$1,741,903
OTHER NONCURRENT LIABILITIES	$2,593,228

Field	Value	IRS element (for citing)
Total Liability	$7,296,108	TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART X	FormAndLineReferenceDesc
Explanation	AS NOTED IN OUR RESPONSE TO FORM 990 PART VI, SECTION C, LINE 19, THE FINANCIAL STATEMENTS OF THE FILING ORGANIZATION ARE NOT CONSOLIDATED WITHIN THE FINANCIAL STATEMENTS OF EITHER OF ITS MEMBERS. ADDITIONALLY, THE FILING ORGANIZATION DID NOT RECEIVE A SEPARATE AUDITED FINANCIAL STATEMENT FOR THE 6/30/2014 TAX YEAR. ACCORDINGLY, THERE IS NO APPLICABLE FIN 48 FOOTNOTE FOR THIS FILING ORGANIZATION.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (1)	ExpensesExceedBudgetInd
Unable To Provide Care	0	UnableToProvideCareInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	0	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,501,705	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,501,705	NetCommunityBenefitExpnsAmt
Total Expense	0.04360	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$9,499,639	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,774,464	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,725,175	NetCommunityBenefitExpnsAmt
Total Expense	0.03010	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$12,001,344	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,774,464	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,226,880	NetCommunityBenefitExpnsAmt
Total Expense	0.07370	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$103,792	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$103,792	NetCommunityBenefitExpnsAmt
Total Expense	0.00180	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$103,792	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$103,792	NetCommunityBenefitExpnsAmt
Total Expense	0.00180	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$12,105,136	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,774,464	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,330,672	NetCommunityBenefitExpnsAmt
Total Expense	0.07550	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$3,216,358	BadDebtExpenseAmt
Bad Debt Expense Attributable	$436,828	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$11,275,901	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$10,533,445	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$742,456	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 (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	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	TAKOMA REGIONAL HOSPITAL	BusinessNameLine1

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	401 TAKOMA AVENUE	AddressLine1
City	GREENEVILLE	City
State	TN	State
ZIP Code	37743	ZIPCode

Field	Value	IRS element (for citing)
Website Address	WWW.TAKOMA.ORG	WebsiteAddressTxt
State License	86	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	TAKOMA REGIONAL HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
CHNA Conducted	Yes (1)	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 (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	HTTP://WWW.TAKOMA.ORG/ABOUT-US/COMMUNITY-	OwnWebsiteURLTxt
Rpt Available Upon Request	Yes (X)	RptAvailableUponRequestInd
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Adopt Implementation Strategy	Yes (X)	AdoptImplementationStrategyInd
Exec Implementation Strategy	Yes (X)	ExecImplementationStrategyInd
Develop Community Wide Plan	Yes (X)	DevelopCommunityWidePlanInd
Exec Community Wide Plan	Yes (X)	ExecCommunityWidePlanInd
Include Operational Plan	Yes (X)	IncludeOperationalPlanInd
Adopt Budget	Yes (X)	AdoptBudgetInd
Prioritize Health Needs	Yes (X)	PrioritizeHealthNeedsInd
Prioritize Services	Yes (X)	PrioritizeServicesInd
All Needs Addressed	0	AllNeedsAddressedInd
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Used Deter Elig Free Care	Yes (1)	FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care	200.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt Care	Yes (1)	FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care	400.000000000000	FPGFamilyIncmLmtDscntCarePct
Explained Basis	Yes (1)	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
Medicaid Medicare	Yes (X)	MedicaidMedicareInd
State Regulation	Yes (X)	StateRegulationInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
Posted On Website	Yes (X)	PostedOnWebsiteInd
Available On Request	Yes (X)	AvailableOnRequestInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Collection Activities	0	CollectionActivitiesInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Other Method Used	Yes (X)	OtherMethodUsedInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
TAKOMA REGIONAL HOSPITAL	PART V, SECTION B, LINE 3: IN CONJUNCTION WITH CONDUCTING THEIR INITIAL COMMUNITY HEALTH NEEDS ASSESSMENT, TAKOMA REGIONAL HOSPITAL, INC. (TRH OR THE HOSPITAL) CREATED A COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE (CHNAC) TO PROVIDE INPUT AND GUIDE THE HEALTH NEEDS ASSESSMENT PROCESS. ORGANIZATIONS AND INDIVIDUALS SERVING ON THE CHNAC INCLUDED REPRESENTATIVES FROM COUNTY AND CITY GOVERNMENT, THE GREENE COUNTY PUBLIC HEALTH DEPARTMENT, A GREENE COUNTY PUBLIC SCHOOL HEALTH COORDINATOR AND A NURSE EDUCATOR. THE SPECIFIC ORGANIZATIONS AND INDIVIDUALS PARTICIPATING IN THE CHNAC AND REPRESENTING THE MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS AND POPULATIONS WITH CHRONIC DISEASE INCLUDED REPRESENTATIVES FROM FRONTIER HEALTH, A PROVIDER OF BEHAVIORAL HEALTH SERVICES, THE GREENE COUNTY FOOD BANK, RURAL RESOURCES, AN ORGANIZATION SERVING AS A RESOURCE AND EDUCATOR WITH RESPECT TO SUSTAINABLE AGRICULTURAL PRACTICES, AND WESLEY HEIGHTS, A LOWER-INCOME NEIGHBORHOOD LOCATED WITHIN THE HOSPITAL'S COMMUNITY. THE LISTING BELOW REFLECTS ALL OF THE ORGANIZATIONS/COMMUNITY AREAS REPRESENTED ON THE HOSPITAL'S CHNAC: TRH REPRESENTATIVES; GREENE COUNTY MAYOR'S OFFICE; RURAL RESOURCES; GREENE COUNTY HEALTH DEPARTMENT; CITY OF GREENEVILLE MAYOR'S OFFICE; TUSCULUM COLLEGE OF NURSING; GREENE COUNTY PARTNERSHIP; LAUGHLIN MEMORIAL HOSPITAL REPRESENTATIVES; FRONTIER HEALTH; WESLEY HEIGHTS; GREENE COUNTY FOOD BANK; AND GREENE COUNTY PUBLIC SCHOOLS.PRIMARY AND SECONDARY DATA WERE COLLECTED FOR THE PURPOSE OF THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. IN ADDITION TO THE INPUT RECEIVED FROM INDIVIDUALS/ORGANIZATIONS SERVING ON THE CHNAC, PRIMARY DATA WAS COLLECTED. PRIMARY DATA CONSISTED OF GROUP INTERVIEWS AND A COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY THAT GATHERED 263 RESPONDENTS. THE INTERVIEWS INCLUDED A CROSS SECTION OF INDIVIDUALS WHO WERE ASSOCIATED WITH ORGANIZATIONS THAT SERVED THE MEDICALLY UNDERSERVED, LOW INCOME, AND MINORITY AND CHRONICALLY DISEASED POPULATIONS. A SURVEY MONKEY QUESTIONNAIRE WAS ALSO DEVELOPED AND DISTRIBUTED TO INDIVIDUALS AND POSTED ON THE HOSPITAL'S FACEBOOK SITE. THE SURVEY WAS MADE AVAILABLE TO ALL ZIP CODES WITHIN THE HOSPITAL'S PRIMARY MARKET AREA. OVER 10% OF THE SURVEYS INCLUDED POPULATIONS OF MINORITIES AND MEDICALLY UNDERSERVED.
TAKOMA REGIONAL HOSPITAL	PART V, SECTION B, LINE 4: THE COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED BY TAKOMA REGIONAL HOSPITAL, INC. (THE HOSPITAL) WAS BASED UPON THE HOSPITAL'S INVOLVEMENT AND ENRICHMENT OF THOSE WHO LIVE WITHIN GREENE COUNTY, TENNESSEE. THE PRIMARY SERVICE AREA IS SHARED BY LAUGHLIN MEMORIAL HOSPITAL AND THUS THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED IN COOPERATION WITH BOTH LOCAL HOSPITALS.
TAKOMA REGIONAL HOSPITAL	PART V, SECTION B, LINE 5D: TAKOMA REGIONAL HOSPITAL, INC. (THE HOSPITAL) HAS ADOPTED A POLICY THAT ADDRESSES THE PUBLIC POSTING REQUIREMENTS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT. UNDER THIS POLICY, THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT MUST BE POSTED ON THE HOSPITAL'S WEBSITE BY THE END OF THE YEAR IN WHICH IT IS CONDUCTED. THE HOSPITAL WILL MAKE A COPY OF ITS COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AVAILABLE UPON REQUEST. THE HOSPITAL WILL ALSO MAKE A PAPER COPY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AVAILABLE FOR PUBLIC INSPECTION AT THE HOSPITAL FACILITY.
TAKOMA REGIONAL HOSPITAL	PART V, SECTION B, LINE 7: THROUGH THE COLLECTION OF PRIMARY DATA (FOCUS GROUPS, INTERVIEWS AND A HEALTH QUESTIONNAIRE/SURVEY) ALONG WITH THE REVIEW OF SECONDARY DATA (HEALTH AND DEMOGRAPHIC DATA), TAKOMA REGIONAL HOSPITAL, INC. (THE HOSPITAL) IDENTIFIED A TOTAL OF 10 RECOGNIZED HEALTH PRIORITIES IN GREENE COUNTY, TENNESSEE. UPON REVIEW OF THE 10 RECOGNIZED HEALTH PRIORITIES, THE COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE AND THE HOSPITAL HEALTH NEEDS ASSESSMENT COMMITTEE (THE COMMITTEES) DETERMINED THROUGH EXTENSIVE DIALOGUE AND REVIEW OF DATA THAT THE TOP THREE HEALTH ISSUES WERE TOBACCO USE, DIABETES AND OBESITY. WITH RESPECT TO EACH OF THE TEN RECOGNIZED HEALTH PRIORITIES, A DECISION TREE WAS UTILIZED TO DETERMINE IF THE PRIORITY WOULD BECOME A TOP THREE COMMUNITY HEALTH NEEDS PROJECT. THE DECISION TREE WALKED BOTH THE COMMITTEES THROUGH A PROCESS THAT DETERMINED IF THERE WERE PROGRAMS ALREADY AVAILABLE TO HELP MEET THE IDENTIFIED HEALTH NEEDS IN THE COMMUNITY OR WHETHER IT WAS FEASIBLE TO USE THE HOSPITAL'S RESOURCES TO MEET THE IDENTIFIED HEALTH NEEDS OR BOTH. THE DECISION TREE ALSO TOOK THE COMMITTEES THROUGH THE PROCESS OF DETERMINING WHETHER THEY SHOULD TRY TO MEET THE HEALTH NEED BY THEMSELVES, PARTNER WITH AN EXISTING ORGANIZATION TO MEET THE HEALTH NEED OR JUST SUPPORT OTHERS IN MEETING THE NEED. AS IT RELATES TO DETERMINING THE TOP THREE HEALTH PRIORITIES, THE COMMITTEES' RATIONALE WAS AS FOLLOWS: THE NUMBER ONE HEALTH ISSUE WAS THE UNINSURED/UNEMPLOYED AND THOSE BELOW THE POVERTY LEVEL. AFTER MUCH DISCUSSION THE COMMITTEES DECIDED THAT THIS WAS A LARGE GROUP THAT HAD PROGRAMS AVAILABLE TO HELP MEET THEIR NEEDS AND THAT THE RESOURCES OF THE HOSPITAL COULD BE USED IN OTHER AREAS TO HELP MEET THE DIRECT NEEDS OF THE COMMUNITY. THE SECOND HEALTH ISSUE WAS OBESITY AND BOTH THE COMMITTEES FELT THAT SINCE OBESITY IS SO INTEGRATED IN MANY OTHER DISEASES AND IS A MAJOR ISSUE IN GREENE COUNTY, IT SHOULD BE ONE OF THE PROJECTS SELECTED FROM THE LIST OF TEN HEALTH ISSUES FOR THE COMMUNITY HEALTH PLAN. THE THIRD HEALTH ISSUE WAS DIABETES AND THERE WAS VIGOROUS DISCUSSION THAT DIABETES SHOULD BE ONE OF THE PLANNED PROJECTS IN THE COMMUNITY HEALTH PLAN. THE FOURTH HEALTH ISSUE WAS POOR NUTRITION. THE COMMITTEES FELT THAT THIS HEALTH ISSUE WOULD BE ADDRESSED IN THE OBESITY AND DIABETES HEALTH PLAN. THE FIFTH HEALTH ISSUE WAS MENTAL HEALTH. THE FEELING OF THE COMMITTEES WAS THAT MENTAL HEALTH ISSUES WERE SIGNIFICANT IN GREENE COUNTY BUT THAT THERE WERE PROGRAMS AVAILABLE TO ADDRESS THE EXISTING MENTAL HEALTH PROBLEMS. THE HOSPITAL AND LAUGHLIN MEMORIAL HOSPITAL AGREED THAT THE TRAINING OF PHYSICIANS ON MENTAL HEALTH ISSUES WOULD BE A WORTHWHILE PURSUIT. THE SIXTH HEALTH ISSUE WAS SMOKING AND RESPIRATORY DISEASE. THE DISCUSSION FROM THE COMMITTEES CENTERED ON GREENE COUNTY'S HIGH TOBACCO USE OF 30%. AFTER A THOUGHTFUL DISCUSSION, THE USE OF TOBACCO WAS DETERMINED TO BE THE NUMBER ONE ISSUE FOR THE COMMUNITY HEALTH PLAN. THERE IS CURRENTLY VERY LITTLE BEING DONE TO OFFSET THE DEVASTATING IMPACT THAT TOBACCO IS HAVING ON OUR COMMUNITY. CANCER WAS OUR SEVENTH HEALTH ISSUE. LAUGHLIN MEMORIAL HOSPITAL HAS AN EXCELLENT CANCER PROGRAM AND IT WAS FELT THAT THE SCOPE OF CANCER WAS TOO LARGE FOR OUR COMMUNITY HEALTH PLAN AT THIS TIME. THE EIGHTH HEALTH ISSUE WAS CARDIOVASCULAR DISEASE. WHILE THE COMMITTEES FELT THAT HEART DISEASE SHOULD HAVE BEEN AT THE TOP OF THE LIST, MANY MEMBERS EXPRESSED THEIR CONCERN AT HOW MANY OF THE HEALTH ISSUES WERE INTER-RELATED. THE NINTH HEALTH ISSUE WAS THE LACK OF DENTAL CARE AND THE COMMITTEES FELT THAT THERE WERE CURRENTLY AMPLE HEALTH CLINICS AVAILABLE ALONG WITH THE COUNTY HEALTH DEPARTMENT'S PROGRAMS. THE TENTH HEALTH ISSUE WAS LACK OF PHYSICAL ACTIVITY AND THE COMMITTEES FELT THAT THIS ISSUE WOULD BE ADDRESSED WITH THE TOP THREE HEALTH ISSUES THAT WERE CHOSEN. THEREFORE, THE COMMITTEES DECIDED THAT WHILE THE TOP THREE HEALTH PRIORITIES WOULD BE TOBACCO, OBESITY AND DIABETES, THESE WOULD ALL FALL UNDER THE UMBRELLA OF CARDIOVASCULAR DISEASE AND THAT BY PROVIDING SUPPORT FOR THE TOP THREE HEALTH ISSUES, ULTIMATELY HEART DISEASE WOULD BE POSITIVELY IMPACTED.
TAKOMA REGIONAL HOSPITAL	PART V, SECTION B, LINE 14G: TAKOMA REGIONAL HOSPITAL HAS DEVELOPED A PATIENT-FRIENDLY SUMMARY VERSION OF ITS FINANCIAL ASSISTANCE POLICY (FAP). THE FILING ORGANIZATION'S FAP PROVIDES THAT ITS HOSPITAL FACILITY WILL MAKE PAPER COPIES OF ITS FAP AND PATIENT-FRIENDLY SUMMARY VERSION AND ITS FINANCIAL ASSISTANCE APPLICATION FORMS AVAILABLE IN PUBLIC LOCATIONS IN THE HOSPITAL AND AVAILABLE BY MAIL. IN ADDITION, THE FAP OF THE HOSPITAL FACILITY STATES THAT SIGNAGE REGARDING THE AVAILABILITY OF THE HOSPITAL FACILITY'S FAP WILL BE VISIBLE AT POINTS OF ADMISSION AND REGISTRATION, INCLUDING THE EMERGENCY DEPARTMENT.
TAKOMA REGIONAL HOSPITAL	PART V, SECTION B, LINE 20D: IN DETERMINING THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO FINANCIAL ASSISTANCE POLICY-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE, THE HOSPITAL USES THE FOLLOWING METHODOLOGY:THE HOSPITAL IDENTIFIES ALL COMMERCIAL PAYORS THAT HAD ANY ACTIVITY WITH THE HOSPITAL DURING THE TAXABLE YEAR. FOR THOSE IDENTIFIED COMMERCIAL PAYORS, AN AVERAGE OF THE NEGOTIATED COMMERCIAL INSURANCE RATES IS DETERMINED. THE AVERAGE OF ALL OF THE NEGOTIATED COMMERCIAL INSURANCE RATES FOR THOSE IDENTIFIED COMMERCIAL PAYORS DETERMINES THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO PATIENTS ELIGIBLE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY.

Field	Value	IRS element (for citing)
Facility	3	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	FacilityFacilityTxt
TAKOMA MEDICAL ASSOCIATES
438 E VANN ROAD	GREENEVILLE	TN	37743	PHYSICIAN SERVICES
GREENEVILLE URGENT CARE & OCCUPATIONAL
1021 COOLIDGE STREET	GREENEVILLE	TN	37743	OUTPATIENT CLINIC
TAKOMA OUT PATIENT REHABILITATION
108W SUMMERS STREET	GREENEVILLE	TN	37743	REHABILITATION SERVICES

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 7:	THE AMOUNTS OF COSTS REPORTED IN THE TABLE IN LINE 7 OF PART I OF SCHEDULE H WERE DETERMINED BY UTILIZING A COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES, CONTAINED IN THE SCHEDULE H INSTRUCTIONS.
PART III, LINE 2:	THE AMOUNT OF BAD DEBT EXPENSE, REPORTED ON LINE 2 OF SECTION A OF PART III IS RECORDED IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS ADJUSTMENTS TO REVENUE, NOT BAD DEBT EXPENSE.
PART III, LINE 3:	METHODOLOGY FOR DETERMINING THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE THAT MAY REPRESENT PATIENTS WHO COULD HAVE QUALIFIED UNDER THE FILING ORGANIZATION'S CHARITY CARE POLICY:SELF-PAY PATIENTS ARE REQUIRED TO COMPLETE A PATIENT FINANCIAL ASSISTANCE APPLICATION SHORT FORM (PFAA). IF THE PFAA IS NOT COMPLETED AFTER REASONABLE ATTEMPTS TO OBTAIN IT ARE EXHAUSTED, PATIENT INFORMATION IS PROCESSED THROUGH A SCORER PRODUCT. THE SCORER PRODUCT UTILIZES PUBLICLY AVAILABLE DATA, SUCH AS CREDIT REPORTS, TO ASSESS AN INDIVIDUAL PATIENT'S FINANCIAL VIABILITY. PATIENTS WHO EARN A CERTAIN SCORE ON THE SCORER PRODUCT ARE CONSIDERED TO QUALIFY AS NON-STATE CHARITY PATIENTS. GENERALLY, $200 OF SUCH A PATIENT'S BILL IS WRITTEN OFF AS BAD DEBT EXPENSE, WHILE THE REMAINING PORTION OF THE PATIENT'S BILL IS CONSIDERED TO BE NON-STATE CHARITY. THE AMOUNT WRITTEN OFF AS BAD DEBT EXPENSE FOR THOSE PATIENTS WHO POTENTIALLY QUALIFY AS NON-STATE CHARITY USING THE SCORER PRODUCT IS THE AMOUNT SHOWN ON LINE 3 OF SECTION A OF PART III. RATIONALE FOR INCLUDING CERTAIN BAD DEBTS IN COMMUNITY BENEFIT:THE FILING ORGANIZATION IS DEDICATED TO THE VIEW THAT MEDICALLY NECESSARY HEALTH CARE FOR EMERGENCY AND NON-ELECTIVE PATIENTS SHOULD BE ACCESSIBLE TO ALL, REGARDLESS OF AGE, GENDER, GEOGRAPHIC LOCATION, CULTURAL BACKGROUND, PHYSICIAN MOBILITY, OR ABILITY TO PAY. THE FILING ORGANIZATION TREATS EMERGENCY AND NON-ELECTIVE PATIENTS REGARDLESS OF THEIR ABILITY TO PAY OR THE AVAILABILITY OF THIRD-PARTY COVERAGE. BY PROVIDING HEALTH CARE TO ALL WHO REQUIRE EMERGENCY OR NON-ELECTIVE CARE IN A NON-DISCRIMINATORY MANNER, THE FILING ORGANIZATION IS PROVIDING HEALTH CARE TO THE BROAD COMMUNITY IT SERVES. AS A 501(C)(3) HOSPITAL ORGANIZATION, THE FILING ORGANIZATION MAINTAINS A 24/7 EMERGENCY ROOM PROVIDING CARE TO ALL WHOM PRESENT. WHEN A PATIENT'S ARRIVAL AND/OR ADMISSION TO THE FACILITY BEGINS WITHIN THE EMERGENCY DEPARTMENT, TRIAGE AND MEDICAL SCREENING ARE ALWAYS COMPLETED PRIOR TO REGISTRATION STAFF PROCEEDING WITH THE DETERMINATION OF A PATIENT'S SOURCE OF PAYMENT. IF THE PATIENT REQUIRES ADMISSION AND CONTINUED NON-ELECTIVE CARE, THE FILING ORGANIZATION PROVIDES THE NECESSARY CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY. THE FILING ORGANIZATION'S OPERATION OF A 24/7 EMERGENCY DEPARTMENT THAT ACCEPTS ALL INDIVIDUALS IN NEED OF CARE PROMOTES THE HEALTH OF THE COMMUNITY THROUGH THE PROVISION OF CARE TO ALL WHOM PRESENT. CURRENT INTERNAL REVENUE SERVICE GUIDANCE THAT TAX-EXEMPT HOSPITALS MAINTAIN SUCH EMERGENCY ROOMS WAS ESTABLISHED TO ENSURE THAT EMERGENCY CARE WOULD BE PROVIDED TO ALL WITHOUT DISCRIMINATION. THE TREATMENT OF ALL AT THE FILING ORGANIZATION'S EMERGENCY DEPARTMENT IS A COMMUNITY BENEFIT. UNDER THE FILING ORGANIZATION'S CHARITY CARE POLICY, EVERY EFFORT IS MADE TO OBTAIN A PATIENT'S NECESSARY FINANCIAL INFORMATION TO DETERMINE ELIGIBILITY FOR CHARITY CARE. HOWEVER, NOT ALL PATIENTS WILL COOPERATE WITH SUCH EFFORTS AND A CHARITY CARE ELIGIBILITY DETERMINATION CAN NOT BE MADE. IN THIS CASE, A PATIENT'S PORTION OF A BILL THAT REMAINS UNPAID FOR A CERTAIN STIPULATED TIME PERIOD IS WHOLLY OR PARTIALLY CLASSIFIED AS BAD DEBT. BAD DEBTS ASSOCIATED WITH PATIENTS WHO HAVE RECEIVED CARE THROUGH THE FILING ORGANIZATION'S EMERGENCY DEPARTMENT SHOULD BE CONSIDERED TO BE COMMUNITY BENEFIT AS CHARITABLE HOSPITALS EXIST TO PROVIDE SUCH CARE IN PURSUIT OF THEIR PURPOSE OF MEETING THE NEED FOR EMERGENCY MEDICAL CARE SERVICES AVAILABLE TO ALL IN THE COMMUNITY.
PART III, LINE 4:	THE FILING ORGANIZATION DID NOT HAVE AUDITED FINANCIAL STATEMENTS; THEREFORE, THERE IS NOT A FOOTNOTE TO DESCRIBE BAD DEBT EXPENSE.
PART III, LINE 8:	COSTING METHODOLOGY:MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST-TO-CHARGE RATIO.
PART III, LINE 9B:	AT THE TIME OF PATIENT REGISTRATION, NON-ELECTIVE SELF-PAY PATIENTS ARE INFORMED OF THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY AND TOLD THAT THEY WILL BE REQUIRED TO SUBMIT NECESSARY FINANCIAL DATA IN ORDER TO POTENTIALLY RECEIVE ANY DISCOUNTS. UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, PERCENTAGE DISCOUNTS ARE APPLIED TO A PATIENT'S ACCOUNT BASED UPON AMOUNTS GENERALLY BILLED TO INDIVIDUALS WHO HAVE INSURANCE COVERING SUCH CARE.UNDER THE FILING ORGANIZATION'S POLICIES, PAYMENT PLANS FOR PARTIAL CHARITY ACCOUNTS WILL BE INDIVIDUALLY DEVELOPED WITH THE PATIENT. PARTIAL CHARITY ACCOUNTS RESULT WHEN A FINANCIAL ASSISTANCE ELIGIBILITY DETERMINATION ALLOWS FOR A PERCENTAGE REDUCTION BUT LEAVES THE PATIENT WITH A SELF-PAY BALANCE. IF THE PATIENT COMPLIES WITH THE AGREED-UPON PAYMENT PLAN, THE FILING ORGANIZATION DOES NOT PURSUE ANY COLLECTION ACTION WITH RESPECT TO THE PATIENT. THE FILING ORGANIZATION DOES NOT PURSUE COLLECTION OF AMOUNTS FROM PATIENTS DETERMINED TO QUALIFY FOR A 100% REDUCTION IN CHARGES UNDER ITS FINANCIAL ASSISTANCE POLICY.
SUPPLEMENTAL SCHEDULE TO SCHEDULE H, PART III, SECTION B	RECONCILIATION OF SCHEDULE H REPORTED MEDICARE SURPLUS/(SHORTFALL) TO UNREIMBURSED MEDICARE COSTS ASSOCIATED WITH THE PROVISION OF SERVICESTO ALL MEDICARE BENEFICIARIES:THE MEDICARE REVENUE AND ALLOWABLE COSTS OF CARE REPORTED IN SECTION B OF PART III OF SCHEDULE H ARE BASED UPON THE AMOUNTS REPORTED IN THE FILING ORGANIZATION'S MEDICARE COST REPORT IN ACCORDANCE WITH THE IRS INSTRUCTIONS FOR SCHEDULE H. ON AN ANNUAL BASIS, THE FILING ORGANIZATION ALSO DETERMINES ITS TOTAL UNREIMBURSED COSTS ASSOCIATED WITH PROVIDING SERVICES TO ALL MEDICARE PATIENTS. THE PRIMARY RECONCILING ITEMS BETWEEN THE MEDICARE SURPLUS/(SHORTFALL) SHOWN ON LINE 7 OF SECTION B OF PART III OF SCHEDULE H AND THE FILING ORGANIZATION'S UNREIMBURSED COSTS OF SERVICES PROVIDED TO MEDICARE PATIENTS ARE AS FOLLOWS:- MEDICARE SURPLUS/(SHORTFALL) SHOWN ON LINE 7 OF SECTION B OF SCHEDULE H: $ 742,456- DIFFERENCE IN COSTING METHODOLOGY: ( 353,163)- UNREIMBURSED COSTS INCURRED FOR SERVICES PROVIDED TO MEDICARE PATIENTS THAT ARE NOT INCLUDED IN THE ORGANIZATION'S MEDICARE COST REPORT: (2,475,204) -------------TOTAL UNREIMBURSED COSTS OF SERVING ALL MEDICARE PATIENTS: $(2,085,911)AS INDICATED ABOVE, THE PRIMARY DIFFERENCES BETWEEN THE MEDICARE SURPLUS/(SHORTFALL) REPORTED ON SCHEDULE H, PART III, SECTION B, LINE 7 AND THE FILING ORGANIZATION'S TOTAL UNREIMBURSED COSTS ASSOCIATED WITH PROVIDING SERVICES TO ALL MEDICARE PATIENTS IS DUE TO A DIFFERENCE IN THE COSTING METHODOLOGY AND DIFFERENCES IN THE POPULATION OF MEDICARE PATIENTS WITHIN THE CALCULATION. THE COST METHODOLOGY UTILIZED IN CALCULATING THE TOTAL UNREIMBURSED COSTS ASSOCIATED WITH PROVIDING SERVICES TO ALL MEDICARE PATIENTS IS BASED UPON THE COST-TO-CHARGE RATIO OUTLINED IN WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. THE SAME COST-TO-CHARGE RATIO IS USED TO DETERMINE THE COSTS ASSOCIATED WITH SERVICES PROVIDED TO CHARITY CARE PATIENTS AND MEDICAID PATIENTS AS REPORTED IN SCHEDULE H, PART I, LINE 7. IN ADDITION, THE MEDICARE COST REPORT EXCLUDES SERVICES PROVIDED TO MEDICARE PATIENTS FOR PHYSICIAN SERVICES, SERVICES PROVIDED TO PATIENTS ENROLLED IN MEDICARE HMOS, AND CERTAIN SERVICES PROVIDED BY OUTPATIENT DEPARTMENTS OF THE FILING ORGANIZATION THAT ARE REIMBURSED ON A FEE SCHEDULE.
PART VI, LINE 2:	AS REPORTED IN SCHEDULE H, PART V, SECTION B, LINES 1-8, TAKOMA REGIONAL HOSPITAL, INC. (THE HOSPITAL) CONDUCTED ITS INITIAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING ITS 2012/2013 FISCAL YEAR. ITS INITIAL CHNA WAS ADOPTED BY ITS GOVERNING BOARD BY JUNE 30, 2013, THE END OF THE HOSPITAL'S TAXABLE YEAR IN WHICH IT CONDUCTED THE CHNA. THE HOSPITAL'S INITIAL CHNA COMPLIED WITH THE GUIDANCE SET FORTH BY THE IRS IN PROPOSED REGULATION SECTION 1.501(R)-(1)-(3). IN ADDITION TO THE CHNA DISCUSSED ABOVE, A VARIETY OF PRACTICES AND PROCESSES ARE IN PLACE TO ENSURE THAT THE FILING ORGANIZATION IS RESPONSIVE TO THE HEALTH NEEDS OF ITS COMMUNITY. SUCH PRACTICES AND PROCESSES INVOLVE THE FOLLOWING:1. A HOSPITAL OPERATING/COMMUNITY BOARD COMPOSED OF INDIVIDUALS BROADLY REPRESENTATIVE OF THE COMMUNITY, COMMUNITY LEADERS, AND THOSE WITH SPECIALIZED MEDICAL TRAINING AND EXPERTISE;2. POST-DISCHARGE PATIENT FOLLOW-UP RELATED TO THE ON-GOING CARE AND TREATMENT OF PATIENTS WHO SUFFER FROM CHRONIC DISEASES; 3. SPONSORSHIP AND PARTICIPATION IN COMMUNITY HEALTH AND WELLNESS ACTIVITIES THAT REACH A BROAD SPECTRUM OF THE FILING ORGANIZATION'S COMMUNITY; AND 4. COLLABORATION WITH OTHER LOCAL COMMUNITY GROUPS TO ADDRESS THE HEALTH CARE NEEDS OF THE FILING ORGANIZATION'S COMMUNITY.
PART VI, LINE 3:	TAKOMA REGIONAL HOSPITAL HAS A PROCESS IN PLACE WHEREBY PATIENTS ARE INFORMED ABOUT THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. SIGNAGE IS POSTED IN THE EMERGENCY ROOM INDICATING THAT FINANCIAL ASSISTANCE IS AVAILABLE FOR THOSE SELF-PAY PATIENTS MEETING ELIGIBILITY REQUIREMENTS. AFTER EMTALA MEDICAL SCREENING AND STABILIZATION REQUIREMENTS ARE MET, REGISTRATION PERSONNEL WILL SECURE FINANCIAL INFORMATION ON AS MANY SELF-PAY PATIENTS AS POSSIBLE AT THE TIME OF SERVICE. FOR THOSE WHO APPEAR TO QUALIFY FOR MEDICAID OR UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, THE FINANCIAL COUNSELORS WILL CONTINUE TO WORK WITH THOSE PATIENTS UNTIL FINAL ACCOUNT RESOLUTION IS ACHIEVED. ALL OTHER SELF-PAY PATIENTS ARE COVERED UNDER THIS PROCESS. AT ANY TIME DURING THE PROCESS THAT DATA IS PROVIDED SHOWING THAT A PATIENT QUALIFIES FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY THE DISCOUNTS EXTENDED UNDER THAT POLICY WILL BE APPLIED.AS PART OF THE BILLING PROCESS, THE HOSPITAL INCLUDES THE APPLICATION FOR FINANCIAL ASSISTANCE ALONG WITH THE INITIAL PATIENT BILL. THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION IS ALSO AVAILABLE TO PATIENTS ON THE HOSPITAL'S WEB-SITE IN BOTH AN ENGLISH AND SPANISH VERSION. ADDITIONALLY, THE HOSPITAL'S FINANCIAL COUNSELORS ARE AVAILABLE TO WORK WITH EVERY PATIENT DURING THE FIRST 120 DAYS OF THE BILLING PROCESS TO ASSIST THE PATIENT WITH COMPLETING FINANCIAL ASSISTANCE APPLICATIONS AND INVESTIGATING OTHER POTENTIAL SOURCES OF THIRD-PARTY ASSISTANCE. THE DETERMINATION OF A PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE IS MADE ON A CASE-BY-CASE BASIS. VARIOUS FACTORS ARE CONSIDERED IN THAT DETERMINATION. EACH INDIVIDUAL PATIENT WHO IS IDENTIFIED AS POTENTIALLY BEING ELIGIBLE TO RECEIVE FINANCIAL ASSISTANCE IS SEEN BY A FINANCIAL COUNSELOR AT THE HOSPITAL. THE FINANCIAL COUNSELOR WILL WORK WITH THE PATIENT TO MAKE SURE THAT OTHER SOURCES OF ASSISTANCE (PUBLIC OR OTHERWISE) HAVE BEEN SOUGHT TO THE FULLEST EXTENT POSSIBLE. WHEN OTHER FORMS OF ASSISTANCE ARE NOT AVAILABLE OR HAVE BEEN EXHAUSTED, THE HOSPITAL WILL GATHER CERTAIN FINANCIAL INFORMATION FROM THE PATIENT TO DETERMINE THE PATIENT'S ABILITY TO PAY BASED UPON LEVEL OF INCOME.
PART VI, LINE 4:	TAKOMA REGIONAL HOSPITAL (THE HOSPITAL) IS A 100-BED ACUTE CARE FACILITY THAT HAS PROVIDED QUALITY HEALTH CARE SERVICES TO THE RESIDENTS OF NORTHEASTERN TENNESSEE FOR OVER 81 YEARS. IN 1974, TAKOMA ADVENTIST HOSPITAL BECAME A MEMBER OF THE SOUTHERN ADVENTIST HEALTH AND HOSPITAL SYSTEM. MAY OF 2007 BROUGHT ADDITIONAL CHANGE TO TAKOMA WHEN WELLMONT HEALTH SYSTEM BOUGHT A 60% SHARE OF THE HOSPITAL AND TAKOMA ADVENTIST HOSPITAL BECAME TAKOMA REGIONAL HOSPITAL. THE HOSPITAL IS LOCATED IN THE FOOTHILLS OF THE GREAT SMOKEY MOUNTAINS IN HISTORIC GREENEVILLE, TENNESSEE. THE HOSPITAL'S PRIMARY MARKET HAS A POPULATION OF APPROXIMATELY 74,000, WITH AN ESTIMATED 13,000 OVER THE AGE OF 65.THE HOSPITAL IS A CRUCIAL COMMUNITY AND REGIONAL ASSET. TAKOMA REGIONAL HOSPITAL IS ONE OF TWO HOSPITALS IN GREENEVILLE, TN. THE NEAREST PROVIDER DOES NOT OFFER MANY OF THE SERVICES OFFERED AT THE HOSPITAL, SUCH AS GERIATRIC PSYCHIATRIC INPATIENT SERVICES, OUTPATIENT BEHAVIORAL SERVICES, AND A CENTER FOR INPATIENT REHABILITATION. THE HOSPITAL IS ALSO ONE OF THE LARGEST EMPLOYERS IN THE CITY OF GREENEVILLE, TN.THE CITY OF GREENEVILLE, TN COVERS 15.1 SQUARE MILES. THE WEIGHTED AVERAGE HOUSEHOLD INCOME, BASED ON POPULATION, IN THE PRIMARY MARKET IS APPROXIMATELY $34,600. ABOUT 15% OF GREENE COUNTY'S RESIDENTS HAVE INCOMES BELOW THE FEDERAL POVERTY LEVEL. HIGH SCHOOL GRADUATES ACCOUNT FOR APPROXIMATELY 51% OF GREENE COUNTY, WITH AN ESTIMATED 2% HAVING A BACHELOR'S DEGREE OR HIGHER. GREENE COUNTY'S CURRENT UNEMPLOYMENT RATE IS ABOUT 7%. APPROXIMATELY 50% OF THE HOSPITAL'S PATIENTS DURING FISCAL YEAR ENDING JUNE 30, 2014 WERE MEDICARE PATIENTS, ABOUT 17% WERE MEDICAID PATIENTS, ABOUT 7% WERE SELF-PAY PATIENTS, AND THE REMAINING PERCENTAGE WERE PATIENTS COVERED UNDER COMMERCIAL INSURANCE. APPROXIMATELY 67.5% OF THE HOSPITAL'S IN-PATIENTS ARE ADMITTED THROUGH THE EMERGENCY DEPARTMENT.
PART VI, LINE 5:	THE PROVISION OF COMMUNITY BENEFIT IS CENTRAL TO TAKOMA REGIONAL HOSPITAL'S MISSION OF SERVICE AND COMPASSION. RESTORING AND PROMOTING THE HEALTH AND QUALITY OF LIFE OF THOSE IN THE COMMUNITIES SERVED BY THE HOSPITAL IS A FUNCTION OF "EXTENDING THE HEALING MINISTRY OF CHRIST" AND EMBODIES THE HOSPITAL'S COMMITMENT TO ITS VALUES AND PRINCIPLES. THE HOSPITAL COMMITS SUBSTANTIAL RESOURCES TO PROVIDE A BROAD RANGE OF SERVICES TO BOTH THE UNDERPRIVILEGED AS WELL AS THE BROADER COMMUNITY. IN ADDITION TO THE COMMUNITY BENEFIT INFORMATION PROVIDED IN PARTS I, II AND III OF THIS SCHEDULE H, THE HOSPITAL CAPTURES THE BENEFITS PROVIDED TO ITS COMMUNITY THROUGH FAITH-BASED CARE. EXAMPLES OF SUCH BENEFITS INCLUDE THE COST ASSOCIATED WITH CHAPLAINCY CARE PROGRAMS AND MISSION PEER REVIEWS AND MISSION CONFERENCES. DURING THE CURRENT YEAR, HOSPITAL PROVIDED $40,534 OF BENEFIT WITH RESPECT TO THE FAITH-BASED AND SPIRITUAL NEEDS OF THE COMMUNITY IN CONJUNCTION WITH ITS OPERATION OF A COMMUNITY HOSPITAL. THE HOSPITAL ALSO PROVIDES BENEFITS TO ITS COMMUNITY'S INFRASTRUCTURE BY INVESTING IN CAPITAL IMPROVEMENTS TO ENSURE THAT FACILITIES AND TECHNOLOGY PROVIDE THE BEST POSSIBLE CARE TO THE COMMUNITY. DURING THE CURRENT YEAR, THE HOSPITAL EXPENDED $1,611,204 IN NEW CAPITAL IMPROVEMENTS. AS A FAITH-BASED MISSION-DRIVEN COMMUNITY HOSPITAL, THE HOSPITAL IS CONTINUALLY INVOLVED IN MONITORING ITS COMMUNITY, IDENTIFYING UNMET HEALTH CARE NEEDS AND DEVELOPING SOLUTIONS AND PROGRAMS TO ADDRESS THOSE NEEDS. IN ACCORDANCE WITH ITS CONSERVATIVE APPROACH TO FISCAL RESPONSIBILITY, SURPLUS FUNDS OF THE HOSPITAL ARE CONTINUALLY BEING INVESTED IN RESOURCES THAT IMPROVE THE AVAILABILITY AND QUALITY OF DELIVERY OF HEALTH CARE SERVICES AND PROGRAMS TO ITS COMMUNITY.
PART VI, LINE 6:	AS EXPLAINED IN OUR RESPONSE TO FORM 990, PART VI, SECTION A, LINE 6, TAKOMA REGIONAL HOSPITAL (TRH OR THE HOSPITAL) HAS TWO MEMBERS. THE MEMBERS ARE ADVENTIST HEALTH SYSTEM/SUNBELT, INC. AND WELLMONT HEALTH SYSTEM. TRH IS ABLE TO DRAW UPON THE EXPERTISE AND LEADERSHIP OF BOTH ITS HEALTH SYSTEM MEMBERS IN ITS EFFORT TO CREATE EXCELLENT PATIENT EXPERIENCES AND OFFER A BROAD SPECTRUM OF HEALTH SERVICES NEEDED IN ITS COMMUNITY.PRIOR TO FEBRUARY 15, 2013, TRH WAS PRIMARILY MANAGED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). AHSSHC IS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). AHSSHC AND ITS SUBSIDIARY ORGANIZATIONS OPERATE 44 HOSPITALS IN 10 STATES THROUGHOUT THE U.S., PRIMARILY IN THE SOUTHEASTERN PORTION OF THE U.S. AHSSHC AND ITS SUBSIDIARIES ALSO OPERATE 16 NURSING HOME FACILITIES AND OTHER ANCILLARY HEALTH CARE PROVIDER FACILITIES, SUCH AS AMBULATORY SURGERY CENTERS AND DIAGNOSTIC IMAGING CENTERS. EFFECTIVE FEBRUARY 15, 2013, CERTAIN MANAGEMENT RESPONSIBILITIES WERE TRANSFERRED TO WELLMONT HEALTH SYSTEM (WELLMONT) IN CONNECTION WITH THE DAY-TO-DAY OPERATIONS OF THE HOSPITAL. WHILE THE EXECUTIVE LEADERSHIP TEAM OF THE HOSPITAL REMAINED ON THE PAYROLL OF AHSSHC, THE CEO OF THE HOSPITAL REPORTS TO THE PRESIDENT OF WELLMONT. IN ADDITION, VARIOUS CONSULTING SERVICES NOT GENERALLY PROVIDED ON SITE AT THE HOSPITAL, SUCH AS CASE MANAGEMENT, COMPLIANCE, INVESTMENT AND LEGAL SERVICES, ARE NOW PROVIDED BY WELLMONT. WELLMONT IS A NOT-FOR-PROFIT INTEGRATED HEALTH SYSTEM SERVING THE TRI-CITIES REGION OF NORTHEAST TENNESSEE AND SOUTHWEST VIRGINIA. WELLMONT IS GUIDED BY ITS MISSION TO DELIVER SUPERIOR HEALTH CARE WITH COMPASSION AND A VISION TO DELIVER THE BEST HEALTH CARE ANYWHERE. THE READER OF THIS FORM 990 SHOULD KEEP IN MIND THAT THIS REPORTING ENTITY MAY DIFFER IN CERTAIN AREAS FROM THAT OF A STAND-ALONE HOSPITAL ORGANIZATION DUE TO ITS MANAGEMENT BY AHSSHC AND WELLMONT. THE FILING ORGANIZATION BENEFITS FROM REDUCED COSTS DUE TO ITS AFFILIATION WITH ITS TWO MEMBERS, SUCH AS LARGE GROUP PURCHASING DISCOUNTS, AND THE AVAILABILITY OF INTERNAL RESOURCES SUCH AS INTERNAL LEGAL COUNSEL. TAKOMA REGIONAL HOSPITAL PAYS A MANAGEMENT FEE TO AHSSHC AND WELLMONT FOR THE SERVICES PROVIDED. AS A RESULT, MANAGEMENT FEE EXPENSE REPORTED BY TAKOMA REGIONAL HOSPITAL MAY APPEAR GREATER IN RELATION TO MANAGEMENT FEE EXPENSE THAT MAY BE REPORTED BY A SINGLE STAND-ALONE HOSPITAL WITH NO SUCH AFFILIATION. THE SINGLE STAND-ALONE HOSPITAL WOULD LIKELY REPORT COSTS ASSOCIATED WITH MANAGEMENT AND OTHER PROFESSIONAL SERVICES ON VARIOUS EXPENSE LINE ITEMS IN ITS STATEMENT OF REVENUE AND EXPENSE AS OPPOSED TO REPORTING SUCH COSTS IN MANAGEMENT FEE EXPENSE.
PART VI, LINE 7:	THE COMMUNITY BENEFIT REPORT PREPARED BY TAKOMA REGIONAL HOSPITAL, INC. IS NOT FILED WITH ANY STATE AGENCIES.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
GREENEVILLE CITY SCHOOLS FOUNDATION
PO BOX 1420	GREENEVILLE	TN	37744	621672018	501(C)(3)	$6,750	GENERAL SUPPORT
BOYS AND GIRLS CLUB OF GREENEVILLE GREENE COUNTY
PO BOX 1977	GREENEVILLE	TN	37744	621706248	501(C)(3)	$6,080	GENERAL SUPPORT

Field	Value	IRS element (for citing)
Total501c3 Org	2	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	GRANTS ARE GENERALLY MADE TO AFFILIATED ORGANIZATIONS THAT ARE EXEMPT FROM FEDERAL INCOME TAX UNDER 501(C)(3) OR TO LOCAL 501(C)(3) COMMUNITY ORGANIZATIONS. ACCORDINGLY, THE FILING ORGANIZATION HAS NOT ESTABLISHED SPECIFIC PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE UNITED STATES AS THE FILING ORGANIZATION DOES NOT HAVE A GRANT MAKING PROGRAM THAT WOULD NECESSITATE SUCH PROCEDURES.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Travel For Companions	Yes (X)	TravelForCompanionsInd
Idemnification Gross Up Pmts	Yes (X)	IdemnificationGrossUpPmtsInd
Discretionary Spending Acct	Yes (X)	DiscretionarySpendingAcctInd
Housing Allowance Or Residence	Yes (X)	HousingAllowanceOrResidenceInd
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (1)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (1)	SubstantiationRequiredInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
MCKINNEY MD JR
DIRECTOR	$143,806	$0	$4,388	$0	$117	$0	$4,372	$0	$144	$0	$152,827	$0	$0	$0
UHL MD GREGORY
DIRECTOR/CHIEF OF STAFF (END 12/13)	$375,003	$0	$0	$0	$7,712	$0	$13,850	$0	$22,658	$0	$419,223	$0	$0	$0
WOLCOTT DANIEL
CEO/DIRECTOR	$239,929	$0	$55,905	$0	$20,877	$0	$26,084	$0	$38,844	$0	$381,639	$0	$11,487	$0
LEWIS MD DANIEL
CMO	$214,177	$0	$26,549	$0	$27,649	$0	$13,621	$0	$20,898	$0	$302,894	$0	$0	$0
ALBRIGHT TAMMY
CNO	$124,857	$0	$22,639	$0	$5,401	$0	$7,598	$0	$29,778	$0	$190,273	$0	$0	$0
BRIDGES MD WILLIAM ROBERT
PHYSICIAN	$310,003	$0	$137,844	$0	$42,709	$0	$13,850	$0	$21,212	$0	$525,618	$0	$0	$0
MARSA MD GORDON L
PHYSICIAN	$277,992	$0	$68,294	$0	$7,649	$0	$13,850	$0	$18,396	$0	$386,181	$0	$0	$0
KRETSCHMAR MD JOSEPH M
PHYSICIAN	$298,622	$0	$40,922	$0	$6,149	$0	$13,850	$0	$19,511	$0	$379,054	$0	$0	$0
DEOSS DO DEBORAH J
PHYSICIAN	$206,080	$0	$23,281	$0	$78,030	$0	$13,850	$0	$20,512	$0	$341,753	$0	$0	$0
MORELOCK BROOKS G
PHYSICIAN	$199,781	$0	$21,354	$0	$58,576	$0	$13,850	$0	$21,776	$0	$315,337	$0	$0	$0
VANDENHOVEN THOMAS P
FORMER CFO	$65,965	$0	$26,787	$0	$28,059	$0	$5,636	$0	$8,948	$0	$135,395	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 1A	THE FILING ORGANIZATION IS 40% OWNED BY ADVENTIST HEALTH SYSTEM/SUNBELT, INC. (AHSSI). AHSSI IS PART OF THE SYSTEM OF HEALTHCARE ORGANIZATIONS KNOWN AS ADVENTIST HEALTH SYSTEM (AHS) WHOSE PARENT IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). IN CONJUNCTION WITH THE MANAGEMENT AGREEMENT WITH AHSSHC AND WELLMONT HEALTH SYSTEM, MEMBERS OF THE FILING ORGANIZATION'S EXECUTIVE MANAGEMENT TEAM THAT HOLD THE POSITION OF VICE-PRESIDENT OR ABOVE ARE COMPENSATED BY AND ON THE PAYROLL OF AHSSHC. AHSSHC IS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). THE FILING ORGANIZATION REIMBURSES AHSSHC FOR THE SALARY AND BENEFIT COST OF THOSE EXECUTIVES ON THE PAYROLL OF AHSSHC THAT PROVIDE SERVICES AND ARE ON THE MANAGEMENT TEAM OF THE FILING ORGANIZATION. TRAVEL FOR COMPANIONS: AHSSHC HAS A CORPORATE EXECUTIVE POLICY THAT PROVIDES A BENEFIT TO ALLOW FOR A TRAVELING AHSSHC EXECUTIVE TO HAVE HIS OR HER SPOUSE ACCOMPANY THE EXECUTIVE ON TWO BUSINESS TRIPS EACH YEAR. TYPICALLY, REIMBURSEMENT IS ONLY PROVIDED TO VICE PRESIDENTS AND ABOVE AND IS LIMITED TO ONE BUSINESS TRIP PER YEAR AND THE ANNUAL AHS PRESIDENT'S COUNCIL BUSINESS MEETING. THE AHSSHC CORPORATE EXECUTIVE SPOUSAL TRAVEL POLICY WAS ORIGINALLY APPROVED AND REVIEWED BY THE AHSSHC BOARD COMPENSATION COMMITTEE, AN INDEPENDENT BODY OF THE AHSSHC BOARD OF DIRECTORS. ALL SPOUSAL TRAVEL COSTS REIMBURSED TO THE EXECUTIVE ARE CONSIDERED TAXABLE COMPENSATION TO THE EXECUTIVE. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: AHS HAS A SYSTEM-WIDE POLICY ADDRESSING GROSS-UP PAYMENTS PROVIDED IN CONNECTION WITH EMPLOYER-PROVIDED BENEFITS/OTHER TAXABLE ITEMS. UNDER THE POLICY, CERTAIN TAXABLE BUSINESS-RELATED REIMBURSEMENTS (I.E. TAXABLE BUSINESS-RELATED MOVING EXPENSES, TAXABLE ITEMS PROVIDED IN CONNECTION WITH EMPLOYMENT) PROVIDED TO ANY EMPLOYEE MAY BE GROSSED-UP AT A 25% RATE UPON APPROVAL OF THE FILING ORGANIZATION'S CEO AND CFO. ADDITIONALLY, EMPLOYEES AT THE DIRECTOR LEVEL AND ABOVE ARE ELIGIBLE FOR GROSS-UP PAYMENTS ON GIFTS RECEIVED FOR BOARD OF DIRECTOR SERVICES. DISCRETIONARY SPENDING ACCOUNT: A NOMINAL DISCRETIONARY SPENDING AMOUNT WAS PROVIDED IN THE CURRENT YEAR TO ALL ELIGIBLE EXECUTIVES WHO ATTEND THE ANNUAL AHS PRESIDENT'S COUNCIL BUSINESS MEETING ($500 PER EXECUTIVE). OTHER DISCRETIONARY SPENDING ACCOUNTS MAY BE PROVIDED IN CONNECTION WITH OTHER AHS SPONSORED CONFERENCES BUT TYPICALLY DO NOT EXCEED $200 PER PARTICIPANT. ELIGIBLE EXECUTIVES INCLUDE ALL AHSSHC VICE PRESIDENTS AND ABOVE AND ALL AHSSHC SUBSIDIARY ORGANIZATION CEOS AND REGIONAL CFOS. THE PAYMENT PROVIDED TO EACH EXECUTIVE WAS CONSIDERED TAXABLE COMPENSATION TO THE EXECUTIVE. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE: AHSSHC HAS A CORPORATE EXECUTIVE POLICY THAT ADDRESSES ASSISTANCE TO EXECUTIVES WHO HAVE BEEN RELOCATED BY THE COMPANY DURING THE YEAR. RELOCATION ASSISTANCE PROVIDED TO EXECUTIVES MAY INCLUDE RELOCATION ALLOWANCES TO ASSIST WITH DUPLICATE HOUSING EXPENSES. RELOCATION ASSISTANCE IS ADMINISTERED PER AHSSHC POLICY BY AN EXTERNAL RELOCATION COMPANY. ANY TAXABLE REIMBURSEMENTS MADE TO EXECUTIVES IN CONNECTION WITH RELOCATION ASSISTANCE ARE TREATED AS WAGES TO THE EXECUTIVE AND ARE SUBJECT TO ALL PAYROLL WITHHOLDING AND REPORTING REQUIREMENTS. HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES: AHSSHC HAS A CORPORATE EXECUTIVE POLICY THAT ADDRESSES BUSINESS DEVELOPMENT EXPENDITURES. UNDER THIS POLICY, CERTAIN AHS ELIGIBLE EXECUTIVES MAY BE REIMBURSED FOR MEMBER DUES AND USAGE CHARGES FOR A COUNTRY CLUB OR OTHER SOCIAL CLUB UPON AUTHORIZATION. CLUB MEMBERSHIPS MUST BE RECOMMENDED BY THE CEO OF THE AHS HOSPITAL ORGANIZATION AND APPROVED BY THE CHAIRMAN OF THE BOARD OF DIRECTORS OF THE ORGANIZATION. IN ADDITION, THE PROPOSED MEMBERSHIP MUST BE APPROVED ANNUALLY BY THE AHSSHC BOARD COMPENSATION COMMITTEE, AN INDEPENDENT COMMITTEE OF THE BOARD OF DIRECTORS OF AHSSHC. ELIGIBLE EXECUTIVES ARE LIMITED TO CERTAIN SENIOR LEVEL EXECUTIVES (HOSPITAL ORGANIZATION CEOS, THE CEO OF THE NURSING HOME DIVISION OF AHS, SENIOR VICE PRESIDENTS AT THREE LARGE HOSPITAL ORGANIZATIONS, REGIONAL CEOS AND CFOS AND THE PRESIDENT AND SENIOR VICE PRESIDENTS OF AHSSHC). IN THE CURRENT YEAR, FOR THIS FILING ORGANIZATION, ONE EXECUTIVE WAS ELIGIBLE TO RECEIVE REIMBURSEMENT FOR CLUB FEES. EACH AHS EXECUTIVE WHO IS APPROVED FOR A CLUB MEMBERSHIP MUST SUBMIT AN ANNUAL REPORT TO THE AHSSHC BOARD COMPENSATION COMMITTEE THAT DESCRIBES HOW THE MEMBERSHIP BENEFITED THEIR ORGANIZATION DURING THE PRECEDING YEAR.
PART I, LINE 3	THE INDIVIDUAL WHO SERVES AS THE CEO OF THE FILING ORGANIZATION IS COMPENSATED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC) FOR THAT INDIVIDUAL'S ROLE IN SERVING AS THE CEO. COMPENSATION AND BENEFITS PROVIDED TO THIS INDIVIDUAL ARE DETERMINED PURSUANT TO POLICIES, PROCEDURES, AND PROCESSES OF AHSSHC THAT ARE DESIGNED TO ENSURE COMPLIANCE WITH THE INTERMEDIATE SANCTIONS LAWS AS SET FORTH IN IRC SECTION 4958. AHSSHC HAS TAKEN STEPS TO ENSURE THAT PROCESSES ARE IN PLACE TO SATISFY THE REBUTTABLE PRESUMPTION OF REASONABLENESS STANDARD AS SET FORTH IN TREASURY REGULATION 53.4958-6 WITH RESPECT TO ITS ACTIVE EXECUTIVE-LEVEL POSITIONS. THE AHSSHC BOARD COMPENSATION COMMITTEE (THE COMMITTEE) SERVES AS THE GOVERNING BODY FOR ALL EXECUTIVE COMPENSATION MATTERS. THE COMMITTEE IS COMPOSED OF CERTAIN MEMBERS OF THE BOARD OF DIRECTORS (THE BOARD) OF AHSSHC. VOTING MEMBERS OF THE COMMITTEE INCLUDE ONLY INDIVIDUALS WHO SERVE ON THE BOARD AS INDEPENDENT REPRESENTATIVES OF THE COMMUNITY, WHO HOLD NO EMPLOYMENT POSITIONS WITH AHSSHC AND WHO DO NOT HAVE RELATIONSHIPS WITH ANY OF THE INDIVIDUALS WHOSE COMPENSATION IS UNDER THEIR REVIEW THAT IMPACTS THEIR BEST INDEPENDENT JUDGMENT AS FIDUCIARIES OF AHSSHC. THE COMMITTEE'S ROLE IS TO REVIEW AND APPROVE ALL COMPONENTS OF THE EXECUTIVE COMPENSATION PLAN OF AHSSHC. AS AN INDEPENDENT GOVERNING BODY WITH RESPECT TO EXECUTIVE COMPENSATION, IT SHOULD BE NOTED THAT THE COMMITTEE WILL OFTEN CONFER IN EXECUTIVE SESSIONS ON MATTERS OF COMPENSATION POLICY AND POLICY CHANGES. IN SUCH EXECUTIVE SESSIONS, NO MEMBERS OF MANAGEMENT OF AHSSHC ARE PRESENT. THE COMMITTEE IS ADVISED BY AN INDEPENDENT THIRD PARTY COMPENSATION ADVISOR. THIS ADVISOR PREPARES ALL THE BENCHMARK STUDIES FOR THE COMMITTEE. COMPENSATION LEVELS ARE BENCHMARKED WITH A NATIONAL PEER GROUP OF OTHER NOT-FOR-PROFIT HEALTHCARE SYSTEMS AND HOSPITALS OF SIMILAR SIZE AND COMPLEXITY TO AHS AND EACH OF ITS AFFILIATED ENTITIES. THE FOLLOWING PRINCIPLES GUIDE THE ESTABLISHMENT OF INDIVIDUAL EXECUTIVE COMPENSATION: - THE SALARY OF THE PRESIDENT/CEO OF AHS WILL NOT EXCEED THE 40TH PERCENTILE OF COMPARABLE SALARIES PAID BY SIMILARLY SITUATED ORGANIZATIONS; AND - OTHER EXECUTIVE SALARIES SHALL BE ESTABLISHED USING MARKET MEDIANS. THE COMPENSATION PHILOSOPHY, POLICIES, AND PRACTICES OF AHSSHC ARE CONSISTENT WITH THE ORGANIZATION'S FAITH-BASED MISSION AND CONFORM TO APPLICABLE LAWS, REGULATIONS, AND BUSINESS PRACTICES. AS A FAITH-BASED ORGANIZATION SPONSORED BY THE SEVENTH-DAY ADVENTIST CHURCH (THE CHURCH), AHSSHC'S PHILOSOPHY AND PRINCIPLES WITH RESPECT TO ITS EXECUTIVE COMPENSATION PRACTICES REFLECT THE CONSERVATIVE APPROACH OF THE CHURCH'S MISSION OF SERVICE AND WERE DEVELOPED IN COUNSEL WITH THE CHURCH'S LEADERSHIP.
FORM 990, PART VII, SECTION A, LINE 4B:	AS DISCUSSED IN OUR RESPONSE TO SCHEDULE J, PART I, LINE 1A; 40% OF THE MEMBERSHIP INTEREST IN THE FILING ORGANIZATION IS HELD BY ADVENTIST HEALTH SYSTEM/SUNBELT, INC.(AHSSI). AHSSI IS A WHOLLY-OWNED SUBSIDIARY OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). BOTH AHSSI AND AHSSHC ARE ORGANIZATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). THE FOLLOWING INDIVIDUAL OFFICERS OF THE FILING ORGANIZATION ARE ON THE PAYROLL OF AND COMPENSATED BY AHSSHC FOR SERVICES PROVIDED TO THE FILING ORGANIZATION: - DANIEL WOLCOTT - TOM VANDENHOVEN (FORMER CFO) - STEVEN MILLER THE TYPE AND AMOUNT OF COMPENSATION PAID TO EACH OF THE INDIVIDUALS LISTED ABOVE BY AHSSHC FOR SERVICES RENDERED TO THE FILING ORGANIZATION IS DETAILED IN PART II OF THIS SCHEDULE J. AHSSHC PROVIDES ELIGIBLE EXECUTIVES AN OPPORTUNITY TO PARTICIPATE IN THE AHS EXECUTIVE FLEX BENEFIT PROGRAM (THE PLAN). THE PURPOSE OF THE PLAN IS TO OFFER ELIGIBLE EXECUTIVES AN OPPORTUNITY TO ELECT FROM AMONG A VARIETY OF SUPPLEMENTAL BENEFITS, INCLUDING DEFERRED COMPENSATION BENEFITS TAXABLE UNDER INTERNAL REVENUE CODE (IRC) SECTION 457(F), TO INDIVIDUALLY TAILOR A BENEFITS PROGRAM APPROPRIATE TO EACH EXECUTIVE'S NEEDS. THE PLAN PROVIDES ELIGIBLE PARTICIPANTS A PRE-DETERMINED BENEFITS ALLOWANCE CREDIT THAT IS EQUAL TO A PERCENTAGE OF THE EXECUTIVE'S BASE PAY FROM WHICH IS DEDUCTED THE COST OF MANDATORY AND ELECTIVE EMPLOYEE BENEFITS. THE PRE-DETERMINED BENEFITS ALLOWANCE CREDIT PERCENTAGE IS APPROVED BY THE AHSSHC BOARD COMPENSATION COMMITTEE, AN INDEPENDENT COMMITTEE OF THE BOARD OF DIRECTORS OF AHSSHC. ANY FUNDS THAT REMAIN AFTER THE COST OF MANDATORY AND ELECTIVE BENEFITS ARE SUBTRACTED FROM THE ANNUAL PRE-DETERMINED BENEFITS ALLOWANCE ARE CONTRIBUTED, AT THE EMPLOYEE'S OPTION, TO EITHER AN IRC 457(F) DEFERRED COMPENSATION ACCOUNT OR TO AN IRC 457(B) ELIGIBLE DEFERRED COMPENSATION PLAN. UPON ATTAINMENT OF AGE 65, ALL PREVIOUS 457(F) DEFERRED AMOUNTS ARE PAID IMMEDIATELY TO THE PARTICIPANT AND ANY FUTURE EMPLOYER CONTRIBUTIONS ARE MADE QUARTERLY FROM THE PLAN DIRECTLY TO THE PARTICIPANT. THE PLAN DOCUMENTS DEFINE AN EMPLOYEE WHO IS ELIGIBLE TO PARTICIPATE IN THE PLAN TO GENERALLY INCLUDE THE CHIEF EXECUTIVE OFFICERS OF AHS ENTITIES AND VICE PRESIDENTS OF ALL AHS ENTITIES WHOSE BASE SALARY IS AT LEAST $218,000. THE PLAN PROVIDES FOR A CLASS YEAR VESTING SCHEDULE (2 YEARS FOR EACH CLASS YEAR) WITH RESPECT TO AMOUNTS ACCUMULATED IN THE EXECUTIVE'S 457(F) DEFERRED COMPENSATION ACCOUNT. DISTRIBUTIONS COULD ALSO BE MADE FROM THE EXECUTIVE'S 457(F) DEFERRED COMPENSATION ACCOUNT UPON ATTAINMENT OF AGE 65 OR UPON AN INVOLUNTARY SEPARATION. THE ACCOUNT IS FORFEITED BY THE EXECUTIVE UPON A VOLUNTARY SEPARATION. DURING 2013, DANIEL WOLCOTT PARTICIPATED IN THE AHS EXECUTIVE FLEX BENEFIT PROGRAM. EMPLOYER CONTRIBUTIONS TO THE PLAN WERE $12,234 DURING 2013. MR. WOLCOTT RECEIVED A DISTRIBUTION OF $11,493 FROM THE PLAN IN 2013.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Field	Value	IRS element (for citing)
Person	ELIZABETH A WILLIAMS	PersonNm

Field	Value	IRS element (for citing)
Relationship Description	FAMILY OF BOARD MEMBER	RelationshipDescriptionTxt
Transaction	$13,922	TransactionAmt
Transaction	EMPLOYEE COMPENSATION	TransactionDesc
Sharing Of Revenues	0	SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART IV, LINE 20B:	TAKOMA REGIONAL HOSPITAL, INC. (TRH OR THE HOSPITAL) DID NOT UNDERGO AN INDEPENDENT FINANCIAL STATEMENT AUDIT FOR ITS TAX YEAR BEGINNING JULY 1, 2013 AND ENDING JUNE 30, 2014. TRH IS A NOT-FOR-PROFIT MEMBERSHIP ORGANIZATION WITH TWO MEMBERS. THE MEMBERS OF THE FILING ORGANIZATION ARE ADVENTIST HEALTH SYSTEM /SUNBELT, INC. (AHSSI) AND WELLMONT HEALTH SYSTEM (WHS) (COLLECTIVELY, THE MEMBERS). BOTH AHSSI AND WHS ARE NOT-FOR-PROFIT CORPORATIONS THAT ARE EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3). EACH OF THE TWO MEMBERS HAS THE RIGHT TO ELECT, APPOINT OR REMOVE ANY THREE OF THE SIX MEMBERS OF THE BOARD OF DIRECTORS OF TRH. BASED UPON THIS DIVISION OF CONTROL OVER THE POWER TO APPOINT THE GOVERNING BODY OF THE HOSPITAL, BOTH OF THE MEMBERS ACCOUNT FOR THEIR INTEREST IN TRH USING THE EQUITY METHOD AND DO NOT CONSOLIDATE TRH INTO THEIR OWN FINANCIAL STATEMENTS OR FINANCIAL STATEMENT AUDITS. IRC SECTION 6033(B)(15)(B) STATES THAT A FORM 990 FILING ORGANIZATION THAT IS SUBJECT TO THE REQUIREMENTS OF IRC SECTION 501(R) MUST ATTACH A COPY OF ITS AUDITED FINANCIAL STATEMENTS (OR, IN THE CASE OF ANY ORGANIZATION THE FINANCIAL STATEMENTS OF WHICH ARE INCLUDED IN A CONSOLIDATED FINANCIAL STATEMENT WITH OTHER ORGANIZATIONS, SUCH CONSOLIDATED FINANCIAL STATEMENT). TO DATE, THE HOSPITAL IS NOT AWARE OF ANY GUIDANCE THAT HAS BEEN ISSUED BY THE IRS THAT ADDRESSES A SITUATION IN WHICH A HOSPITAL ORGANIZATION SUBJECT TO THE REQUIREMENTS OF SECTION 501(R) DOES NOT RECEIVE A SEPARATE AUDITED FINANCIAL STATEMENT AND IS NOT INCLUDED IN A CONSOLIDATED FINANCIAL STATEMENT WITH OTHER ORGANIZATIONS. THERE IS NO STATED REQUIREMENT IN IRC SECTIONS 501(R) OR 6033(B)(15) THAT REQUIRES A FINANCIAL STATEMENT AUDIT FOR A HOSPITAL ORGANIZATION SUBJECT TO THE PROVISIONS OF SECTION 501(R). THE 2013 FORM 990 INSTRUCTIONS STATE THAT IF THE FILING ORGANIZATION OPERATED ONE OR MORE HOSPITAL FACILITIES AT ANY TIME DURING THE TAX YEAR, THEN IT MUST ATTACH A COPY OF ITS MOST RECENT AUDITED FINANCIAL STATEMENT. AS NOTED IN OUR SCHEDULE O DISCLOSURE WITH RESPECT TO FORM 990, PART VI, SECTION B, LINE 15, ADVENTIST HEALTH SYSTEM/SUNBELT, INC. (AHSSI) HOLDS A 40% MEMBER INTEREST IN THE FILING ORGANIZATION. THE TOP TIER PARENT OF AHSSI IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION, D/B/A ADVENTIST HEALTH SYSTEM (AHSSHC). BOTH AHSSI AND AHSSHC ARE ORGANIZATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). AHSSHC PROVIDES EXECUTIVE AND CERTAIN OTHER MANAGEMENT SERVICES TO THE FILING ORGANIZATION. THE CONSOLIDATED 2013 FINANCIAL STATEMENT AUDIT FOR AHSSHC AND ITS CONTROLLED ENTITIES HAS BEEN ATTACHED TO THIS FORM 990. AS NOTED ABOVE, THE FILING ORGANIZATION IS ACCOUNTED FOR ON THE EQUITY METHOD IN THE ATTACHED AUDITED CONSOLIDATED FINANCIAL STATEMENTS FOR AHSSHC AND ITS CONTROLLED ENTITIES.
FORM 990, PART VI, SECTION A, LINE 2	MARK WILLIAMS AND TOM VANDENHOVEN - BUSINESS RELATIONSHIP TODD NORRIS AND MARGARET DENARVAEZ - BUSINESS RELATIONSHIP TODD NORRIS AND JOHN HOWARD - BUSINESS RELATIONSHIP TODD NORRIS AND ALICE POPE - BUSINESS RELATIONSHIP
FORM 990, PART VI, SECTION A, LINE 6	TAKOMA REGIONAL HOSPITAL, INC. (THE FILING ORGANIZATION) HAS TWO MEMBERS. THE MEMBERS OF THE FILING ORGANIZATION ARE ADVENTIST HEALTH SYSTEM/SUNBELT, INC. (AHSSI) AND WELLMONT HEALTH SYSTEM (WHS). BOTH AHSSI AND WHS ARE NOT-FOR-PROFIT CORPORATIONS THAT ARE EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3). THERE ARE NO OTHER CLASSES OF MEMBERSHIP IN THE FILING ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7A	THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION ARE APPOINTED BY AHSSI AND WHS, THE TWO MEMBERS OF THE FILING ORGANIZATION. EACH OF THE TWO MEMBERS HAS THE RIGHT TO ELECT, APPOINT OR REMOVE ANY THREE OF THE SIX MEMBERS OF THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION. IN ADDITION, THE MEMBERS OF THE FILING ORGANIZATION APPOINT THE MEMBERS OF THE FILING ORGANIZATION'S HOSPITAL COMMUNITY BOARD.
FORM 990, PART VI, SECTION B, LINE 11	THE FILING ORGANIZATION'S CURRENT YEAR FORM 990 WAS REVIEWED BY THE BOARD OF DIRECTORS PRIOR TO ITS FILING WITH THE IRS. THE REVIEW CONDUCTED BY THE BOARD OF DIRECTORS DID NOT INCLUDE THE REVIEW OF ANY SUPPORTING WORKPAPERS THAT WERE USED IN PREPARATION OF THE CURRENT YEAR FORM 990, BUT DID INCLUDE A REVIEW OF THE ENTIRE FORM 990 AND ALL SUPPORTING SCHEDULES.
FORM 990, PART VI, SECTION B, LINE 12C	THE CONFLICT OF INTEREST POLICY OF THE FILING ORGANIZATION APPLIES TO MEMBERS OF ITS BOARD OF DIRECTORS, HOSPITAL COMMUNITY BOARD, AND ITS PRINCIPAL OFFICERS (TO BE KNOWN AS INTERESTED PERSONS). IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTERESTS, ANY INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF ANY FINANCIAL INTEREST WITH THE FILING ORGANIZATION AND MUST BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS CONCERNING THE FINANCIAL INTEREST/ARRANGEMENT TO THE BOARD OF DIRECTORS/HOSPITAL COMMUNITY BOARD OF THE FILING ORGANIZATION OR TO ANY MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS THAT IS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. SUBSEQUENT TO ANY DISCLOSURE OF ANY FINANCIAL INTEREST/ARRANGEMENT AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE RELEVANT BOARD MEMBER OR PRINCIPAL OFFICER, THE REMAINING MEMBERS OF THE BOARD OF DIRECTORS/HOSPITAL COMMUNITY BOARD OR COMMITTEE WITH BOARD DELEGATED POWERS SHALL DISCUSS, ANALYZE, AND VOTE UPON THE POTENTIAL FINANCIAL INTEREST/ARRANGEMENT TO DETERMINE IF A CONFLICT OF INTEREST EXISTS. ACCORDING TO THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY, AN INTERESTED PERSON MAY MAKE A PRESENTATION TO THE BOARD OF DIRECTORS/HOSPITAL COMMUNITY BOARD (OR COMMITTEE WITH BOARD DELEGATED POWERS), BUT AFTER SUCH PRESENTATION, SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN A CONFLICT OF INTEREST. EACH INTERESTED PERSON, AS DEFINED UNDER THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY, SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICT OF INTERESTS POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE FILING ORGANIZATION IS A CHARITABLE ORGANIZATION THAT MUST PRIMARILY ENGAGE IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS EXEMPT PURPOSES. THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY ALSO REQUIRES THAT PERIODIC REVIEWS SHALL BE CONDUCTED TO ENSURE THAT THE FILING ORGANIZATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES.
FORM 990, PART VI, SECTION B, LINE 15	ADVENTIST HEALTH SYSTEM/SUNBELT, INC. (AHSSI) HOLDS A 40% MEMBER INTEREST IN THE FILING ORGANIZATION. THE TOP-TIER PARENT OF AHSSI IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). AHSSHC IS THE PARENT ORGANIZATION OF A HEALTHCARE SYSTEM, KNOWN AS ADVENTIST HEALTH SYSTEM, THAT OPERATES HOSPITALS, NURSING HOME FACILITIES, AND OTHER HEALTHCARE PROVIDER ORGANIZATIONS. AHSSHC IS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3) PURSUANT TO A GROUP RULING ISSUED TO THE GENERAL CONFERENCE OF SEVENTH-DAY ADVENTISTS. PURSUANT TO AN EXECUTIVE MANAGEMENT AGREEMENT, THE FILING ORGANIZATION'S CEO, OTHER OFFICERS AND KEY EMPLOYEES ARE ON THE PAYROLL OF AHSSHC. PLEASE SEE THE DISCUSSION CONCERNING THE PROCESS FOLLOWED BY AHSSHC IN DETERMINING EXECUTIVE COMPENSATION IN OUR RESPONSE TO SCHEDULE J, LINE 3.
FORM 990, PART VI, SECTION C, LINE 19	THE FINANCIAL STATEMENTS OF THE FILING ORGANIZATION ARE NOT GENERALLY MADE AVAILABLE TO THE PUBLIC AS A WHOLE. AS NOTED PREVIOUSLY IN OUR RESPONSES TO QUESTION 6 OF SECTION A OF PART VI OF THIS FORM 990, THE FILING ORGANIZATION HAS TWO MEMBERS. AS NEITHER MEMBER IS CONSIDERED TO CONTROL THE FILING ORGANIZATION; THE FINANCIAL STATEMENTS OF THE FILING ORGANIZATION ARE NOT CONSOLIDATED WITHIN THE FINANCIAL STATEMENTS OF EITHER MEMBER. EACH MEMBER ACCOUNTS FOR ITS PROPORTIONATE OWNERSHIP SHARE OF THE EQUITY OF THE FILING ORGANIZATION IN ITS FINANCIAL STATEMENTS. THE FILING ORGANIZATION DOES NOT GENERALLY MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC.
FORM 990, PART IX, LINE 11G	RECRUITING : PROGRAM SERVICE EXPENSES 111,708. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 111,708. MISC PURCHASED SERVICE : PROGRAM SERVICE EXPENSES 73,284. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 73,284. PAYMENTS TO HEALTHCARE PROFESSIONAL : PROGRAM SERVICE EXPENSES 1,568,476. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,568,476. PROFESSIONAL FEES : PROGRAM SERVICE EXPENSES 2,199,046. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,199,046. PURCHASED MEDICAL SERVICES : PROGRAM SERVICE EXPENSES 860,385. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 860,385. ENVIRONMENTAL SERVICES : PROGRAM SERVICE EXPENSES 33,954. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 33,954. AHS/WHS MGMT FEES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 328,591. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 328,591. BILLING & COLLECTION SERVICES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,123,230. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,123,230.
FORM 990, PART XI, LINE 9:	OTHER DECREASE IN FUND BALANCE -28,833. CHANGE IN INTEREST IN FOUNDATION 21,074. GIFTS 72,119. TRANSFER TO UNRESTRICTED FOR CREATION HEALTH GRANT -59,586. ROUNDING 3.
PART VI, SECTION A, LINE 1A	THE GOVERNMENT AND MANAGEMENT OF THE AFFAIRS OF TAKOMA REGIONAL HOSPITAL (TRH) IS VESTED IN ITS BOARD OF DIRECTORS. THE BOARD OF DIRECTORS HAS SUPERVISION, CONTROL AND DIRECTION OF THE MANAGEMENT, AFFAIRS AND PROPERTY OF THE CORPORATION; SHALL DETERMINE ITS POLICIES AND PERIODICALLY REVIEW THEM, AND SHALL ACTIVELY PURSUE ITS POLICIES AND OBJECTIVES AND SUPERVISE THE DISBURSEMENT OF ITS FUNDS. THE BOARD OF DIRECTORS IS COMPOSED OF SIX INDIVIDUALS WHO VOTE ON ALL MATTERS THAT COME BEFORE THIS GOVERNING BODY. THE BYLAWS OF TRH ALSO PROVIDE FOR A HOSPITAL COMMUNITY BOARD THAT MAY INCLUDE UP TO FIFTEEN VOTING MEMBERS. THE HOSPITAL COMMUNITY BOARD IS APPOINTED BY THE MEMBERS OF TRH, NAMELY ADVENTIST HEALTH SYSTEM/SUNBELT, INC. AND WELLMONT HEALTH SYSTEM. THE HOSPITAL COMMUNITY BOARD IS RESPONSIBLE TO OVERSEE THE OPERATION OF THE HOSPITAL AND POSSESSES ALL POWER RELATED TO THE MEDICAL STAFF OF THE HOSPITAL, INCLUDING THE POWER TO APPROVE ALL BYLAWS, RULES AND REGULATIONS WITH RESPECT TO THE MEDICAL STAFF.