STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

MOUNTAIN STATES HEALTH ALLIANCE: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
MOUNTAIN STATES HEALTH ALLIANCE (EIN 62-0476282)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-12
IRS object ID
201421329349302802
Schema version
2012v2.3
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-05-12T13:05:17-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN620476282EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MOUNTAIN STATES HEALTH ALLIANCEBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMOUNNameControl
Phone4233023372Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1400 N STATE OF FRANKLIN ROADAddressLine1
CityJOHNSON CITYCity
StateTNState
ZIP Code37604ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARVIN EICHORNName
TitleSENIOR VP & CFOTitle
Phone4233023372Phone
Date Signed2014-05-12DateSigned
Authorize Third PartyfalseAuthorizeThirdParty
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1JOHNSON CITY MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonALAN LEVINENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1303 MED TECH PARKWAY STE 300AddressLine1
CityJOHNSON CITYCity
StateTNState
ZIP Code37604ZIPCode
FieldValueIRS element (for citing)
Gross Receipts718141895GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.MSHA.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1945YearFormation
State Legal DomicileTNStateLegalDomicile
Activity Or Mission DescriptionPART I, LINE 1: MOUNTAIN STATES HEALTH ALLIANCE (MSHA) IS COMMITTED TO OUR MISSION OF BRINGING LOVING CARE TO HEALTH CARE. WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTHCARE NEEDS OF INDIVIDUALS AND COMMUNITIES IN THE 29-COUNTY AREA WE SERVE, HELPING THEM ATTAIN THEIR HIGHEST LEVEL OF HEALTH. MSHA DELIVERS THIS CARE THROUGH THE PHILOSOPHY OF PATIENT-CENTERED CARE, AND THE DEVELOPMENT OF COMPREHENSIVE STRATEGIC PLANNING AND IMPLEMENTATION. SEE ATTACHED NARRATIVE-PROGRAM SERVICE ACCOMPLISHMENTS.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees9102TotalNbrEmployees
Total Nbr Volunteers2897TotalNbrVolunteers
Total Gross UBI1245620TotalGrossUBI
Net Unrelated Business Txbl Income160672NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2745426ContributionsGrantsPriorYear
Contributions Grants Current Year2474339ContributionsGrantsCurrentYear
Program Service Revenue Prior Year697705296ProgramServiceRevenuePriorYear
Program Service Revenue CY674372724ProgramServiceRevenueCY
Investment Income Prior Year24259649InvestmentIncomePriorYear
Investment Income Current Year31675503InvestmentIncomeCurrentYear
Other Revenue Prior Year10171526OtherRevenuePriorYear
Other Revenue Current Year9360388OtherRevenueCurrentYear
Total Revenue Prior Year734881897TotalRevenuePriorYear
Total Revenue Current Year717882954TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year990095GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY405051GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year309796341SalariesEtcPriorYear
Salaries Etc Current Year305057437SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year1478925TotalFundrsngExpCurrentYear
Other Expense Prior Year372114544OtherExpensePriorYear
Other Expenses Current Year376841250OtherExpensesCurrentYear
Total Expenses Prior Year682900980TotalExpensesPriorYear
Total Expenses Current Year682303738TotalExpensesCurrentYear
Revenues Less Expenses Prior Year51980917RevenuesLessExpensesPriorYear
Revenues Less Expenses CY35579216RevenuesLessExpensesCY
Total Assets BOY1517954041TotalAssetsBOY
Total Assets EOY1599476991TotalAssetsEOY
Total Liabilities BOY1169345060TotalLiabilitiesBOY
Total Liabilities EOY1201894828TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY348608981NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY397582163NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionPART I, LINE 1: MOUNTAIN STATES HEALTH ALLIANCE (MSHA) IS COMMITTED TO OUR MISSION OF BRINGING LOVING CARE TO HEALTH CARE. WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTHCARE NEEDS OF INDIVIDUALS AND COMMUNITIES IN THE 29-COUNTY AREA WE SERVE, HELPING THEM ATTAIN THEIR HIGHEST LEVEL OF HEALTH. MSHA DELIVERS THIS CARE THROUGH THE PHILOSOPHY OF PATIENT-CENTERED CARE, AND THE DEVELOPMENT OF COMPREHENSIVE STRATEGIC PLANNING AND IMPLEMENTATION. SEE ATTACHED NARRATIVE-PROGRAM SERVICE ACCOMPLISHMENTS.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense568045112Expense
Grants405051Grants
Revenue674348316Revenue
DescriptionSEE ATTACHED DOCUMENT: MSHA - PROGRAM SERVICE ACCOMPLISHMENTS FOR GUIDESTAR READERS, OUR PROGRAM SERVICE ACCOMPLISHMENTS MAY BE FOUND AT THE END.Description
Total Program Service Expense568045112TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvesttrueReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondstrueInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPtrueLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationtrueBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096665NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees9102NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocstrueChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChapterstrueLocalChapters
Policies Reference ChapterstruePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledVAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMARVIN EICHORNNamePerson
Telephone Number4233023372TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1303 MED TECH PARKWAY SUITE 300AddressLine1
CityJOHNSON CITYCity
StateTNState
ZIP Code37604ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (30 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
DENNIS VONDERFECHT
CEO57.003.00XX3163747042698
JEFF FARROW MD
DIRECTOR5.00X4141300
CLEM WILKES JR
CHAIR11.003.00X000
GARY PEACOCK
DIRECTOR7.001.00X000
SANDRA BROOKS MD
DIRECTOR6.002.00X000
RICK STOREY
DIRECTOR6.00X000
THOMAS FOWLKES
DIRECTOR5.001.00X000
LINDA GARCEAU
DIRECTOR6.00X000
DONALD JEANES
PAST CHAIR1.00X000
JOANNE GILMER
VICE CHAIR9.001.00X000
DAVID MAY MD
DIRECTOR8.00X000
ROBERT FEATHERS
PAST CHAIR6.003.00X000
MICHAEL CHRISTIAN
TREASURER10.00X000
BARBARA ALLEN
SECRETARY8.00X000
MARVIN EICHORN
SENIOR VP/CF58.002.00X620102039538
CANDACE JENNINGS
SR. VP TN OP60.00504935077850X
ANN FLEMING
SR. VP53.506.50426280066282X
DAVID NICELY
VP/CEO WASHI55.00355009054424X
MONTY MCLAURIN
VP/IPMC CEO55.00326159058687X
LYNN KRUTAK
VP/CORP. CFO55.00252982034227X
SHANE HILTON
VP/TN CFO55.00239117036111X
MORRIS SELIGMAN MD
SR. VP/CMO60.00547923093706X
DOUGLAS EDEMA
VP PRES./CEO55.00408337056282X
JAMES PASKERT MD
VP/CMO WASHI55.00403873055967X
JOHN SCHARIO
SVP57.003.00401522031188X
KATHERINE BALL
FORMER VP/CM50.00398795021625X
DALE CLAYTORE
VP55.00231575013855X
PAT NIDAY
FORMER CNO W55.00196642033699X
BRAD NURKIN
FORMER CEO J55.0014126508180X
CYNTHIA SALYER
VP/CARDIO-PU237676022474X
FieldValueIRS element (for citing)
Total Reportable Comp From Org8897352TotalReportableCompFromOrg
Total Other Compensation746793TotalOtherCompensation
Number Individuals GT100 K200NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
SKANSKA USA BUILDING INC
1633 LITTLETON ROADPARSIPPANYNJ07054CONSTRUCTION14766320
ETSU COLLEGE OF MEDICINE
BOX 70732JOHNSON CITYTN37614PRIMARILY PHYS.9545066
MORRISON MANAGEMENT SPECIALISTS
PO BOX 102289ATLANTAGA30368DIETARY SERVICE5877388
ANESTHESIA PAIN CONSULTANTS
STE 4 1113 SUNSET DRIVEJOHNSON CITYTN37605PHYSICIAN SVC.4768017
HOSPITAL HOUSEKEEPING SYSTEMS LTD
P O BOX 826SAN ANTONIOTX78293HOUSEKEEPING3769628
FieldValueIRS element (for citing)
Number Of Contractors GT100 K138NumberOfContractorsGT100K
Related Organizations1599266RelatedOrganizations
Government Grants760280GovernmentGrants
All Other Contributions114793AllOtherContributions
Total Contributions2474339TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
PATIENT REVENUE-OTHER622110651506371651506371
WELLNESS PROGRAMS6221102067047820670478
P/S PROG. SERV. INCOME62211018206081820608
LAB UBI REVENUE622110313011313011
PREMIER PYMT D'S BOARD SERVCE5416106225662256
FieldValueIRS element (for citing)
Total Program Service Revenue674372724TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column15341173TotalRevenueColumn
Exclusion$15,341,173ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column173144TotalRevenueColumn
Exclusion$173,144ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real192727Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real107960Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real84767Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column84767TotalRevenueColumn
Unrelated Business Revenue40519UnrelatedBusinessRevenue
Exclusion$44,248ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities16185475Securities
Other126692Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other150981Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities16185475Securities
Other-24289Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column16161186TotalRevenueColumn
Related Or Exempt Function Income-24408RelatedOrExemptFunctionIncome
Exclusion$16,185,594ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
CAFE' SALES7222104331346$4,331,346
DIETARY,SECURITY,ENGIN., ETC.5419003104282$3,104,282
DAY CARE6244101010159$1,010,159

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column829834TotalRevenueColumn
Unrelated Business Revenue829834UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Other Revenue9275621TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column717882954TotalRevenueColumn
Related Or Exempt Function Income673973049RelatedOrExemptFunctionIncome
Unrelated Business Revenue1245620UnrelatedBusinessRevenue
Exclusion$40,189,946ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total405051Total
Program Services405051ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total6462311Total
Management And General6462311ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total233351875Total
Program Services224273412ProgramServices
Management And General8239250ManagementAndGeneral
Fundraising839213Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total11164364Total
Program Services10670589ProgramServices
Management And General453847ManagementAndGeneral
Fundraising39928Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total35505904Total
Program Services31443556ProgramServices
Management And General4027745ManagementAndGeneral
Fundraising34603Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total18572983Total
Program Services16436281ProgramServices
Management And General2087586ManagementAndGeneral
Fundraising49116Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1391092Total
Management And General1391092ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total291270Total
Management And General291270ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total139937Total
Program Services139937ProgramServices

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total1157590Total
Management And General1157590ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total92184405Total
Program Services84136191ProgramServices
Management And General7818901ManagementAndGeneral
Fundraising229313Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total2824684Total
Program Services2192837ProgramServices
Management And General618937ManagementAndGeneral
Fundraising12910Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total8187946Total
Program Services8071791ProgramServices
Management And General27997ManagementAndGeneral
Fundraising88158Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total16859971Total
Program Services11389567ProgramServices
Management And General5470404ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total14034081Total
Program Services11033941ProgramServices
Management And General2938607ManagementAndGeneral
Fundraising61533Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total2102709Total
Program Services1509361ProgramServices
Management And General560910ManagementAndGeneral
Fundraising32438Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total198260Total
Program Services131485ProgramServices
Management And General62957ManagementAndGeneral
Fundraising3818Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total41651661Total
Management And General41651661ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total51656821Total
Program Services27443317ProgramServices
Management And General24208361ManagementAndGeneral
Fundraising5143Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total791103Total
Program Services2777ProgramServices
Management And General788326ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
MEDICAL SUPPLIES & DRUGS1201846861199919721905892125
REPAIRS & MAINTENANCE150571431429633471624444565
DUES & SUBSCRIPTIONS4256550125492329984153212
ALL OTHER EXPENSES19543641942493-846620337

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1916977Total
Program Services1279297ProgramServices
Management And General625167ManagementAndGeneral
Fundraising12513Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total682303738Total
Program Services568045112ProgramServices
Management And General112779701ManagementAndGeneral
Fundraising1478925Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY39216743BOY
EOY53114956EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY248258BOY
EOY96609EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY103299284BOY
EOY117265071EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY6806393BOY
EOY8492454EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY15373693BOY
EOY17189476EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY15480550BOY
EOY15873411EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY3139089BOY
EOY4850577EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis998845770LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec480937560LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY494025566BOY
EOY517908210EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY271118030BOY
EOY285653065EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY307033212BOY
EOY313693918EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY143276118BOY
EOY144707541EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY118937105BOY
EOY120631703EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1517954041BOY
EOY1599476991EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY85554685BOY
EOY69022047EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY2928666BOY
EOY2130026EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY813947753BOY
EOY882984693EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY177320621BOY
EOY145411405EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY4437945BOY
EOY2319713EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY85155390BOY
EOY100026944EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1169345060BOY
EOY1201894828EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY348411488BOY
EOY397408151EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY197493BOY
EOY174012EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY348608981BOY
EOY397582163EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1517954041BOY
EOY1599476991EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses35579216ReconcilationRevenueExpenses
Reconciliation Unrealized Invest15510418ReconciliationUnrealizedInvest
Reconcilation Other Changes-2116452ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteers
Paid Staff Or ManagementtruePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorstrueDirectContactLegislators
Direct Contact Legislators$250,140DirectContactLegislatorsAmount
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB250140TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
Return ReferenceSCHEDULE C, PART II-B, LINE 1ReturnReference
ExplanationTHE COMMUNITY & GOVERNMENT RELATIONS VICE PRESIDENT AND/OR THE DEPARTMENT'S MANAGER OR DIRECTOR ATTENDED THE FOLLOWING LEGISLATIVE CONFERENCES: - PREMIER FEDERAL AFFAIRS NETWORK MEETING - AMERICAN HOSPITAL ASSOCIATION ANNUAL MEETING - TENNESSEE HOSPITAL ASSOCIATION LEGISLATIVE ADVOCACY DAY - TENNESSEE HOSPITAL ASSOCIATION ANNUAL MEETING - HOSPITAL ALLIANCE OF TENNESSEE ANNUAL MEETING - NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS AND RELATED INSTITUTIONS VIP ADVOCACY DAY - TENNESSEE PUBLIC & TEACHING HOSPITALS ASSOCIATION ANNUAL MEETING - VIRGINIA HOSPITAL & HEALTHCARE ASSOCIATION LEGISLATIVE ISSUES CONFERENCE - ASSOCIATION OF AMERICAN MEDICAL COLLEGES GOVERNMENT RELATIONS MEETING THE COMMUNITY & GOVERNMENT RELATIONS VICE PRESIDENT AND/OR DEPARTMENTAL STAFF ALSO CONTACTED CONGRESSIONAL OFFICES CONCERNING THE FOLLOWING ISSUES: - SUPPORT FOR PROVISIONS TO EXPAND INSURANCE COVERAGE (HEALTH INSURANCE EXCHANGES AND MEDICAID EXPANSION) - SUPPORT FOR INITIATIVES TO IMPROVE PAYMENT DELIVERY REDESIGN; SUCH AS ACCOUNTABLE CARE ORGANIZATION DEVELOPMENT - SUPPORT FOR CONTINUATION OF TENNESSEE MEDICAID DISPROPORTIONATE SHARE HOSPITAL PAYMENTS - OPPOSITION TO ADDITIONAL CUTS IN MEDICARE/MEDICAID - SUPPORT FOR REAUTHORIZATION AND FUNDING OF CHILDREN'S HOSPITAL GRADUATE MEDICAL EDUCATION - SUPPORT FEDERAL FUNDING FOR TRAUMA CARE - SUPPORT CONTINUATION OF GRADUATE MEDICAL EDUCATIONAL FUNDING - SUPPORT OF STATE MEDICAID PROVIDER TAX PROVISIONS - SUPPORT OF MEDICARE DEPENDENT HOSPITAL AND LOW-VOLUME DESIGNATIONS THE COMMUNITY & GOVERNMENT RELATIONS VICE PRESIDENT AND/OR THE DEPARTMENTAL DIRECTOR OR MANAGER RESPONDED VIA LETTER, PHONE, OR IN PERSON TO THE FOLLOWING TENNESSEE AND VIRGINIA LEGISLATIVE ISSUES: - SUPPORT OF MEDICAID EXPANSION - TENNESSEE AND VIRGINIA - SUPPORT OF STRONG CERTIFICATE OF NEED PROGRAMS IN TENNESSEE AND VIRGINIA - SUPPORT FOR CONTINUATION OF HOSPITAL ASSESSMENT FEE IN TENNESSEE - SUPPORT OF FUNDING FOR PERINATAL CENTERS IN TENNESSEE - SUPPORT OF SAFETY NET FUNDING FOR PROJECT ACCESS - SUPPORT OF STABLE MEDICAID RATES IN VIRGINIA - SUPPORT "SAFE HARBOR" LEGISLATION FOR DRUG ADDICTED PREGNANT WOMEN - SUPPORT HELMET REQUIREMENT FOR MOTORCYCLISTSExplanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis43542989OtherCostOrOtherBasis
Book Value43542989BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis514167381OtherCostOrOtherBasis
Depreciation158971778Depreciation
Book Value355195603BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis952503OtherCostOrOtherBasis
Depreciation482065Depreciation
Book Value470438BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis440182897OtherCostOrOtherBasis
Depreciation321483717Depreciation
Book Value118699180BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings517908210TotalOfBookValueLandBuildings

Investments Program Related InvestmentsProgramRelated (5 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
INVESTMENT IN JMH132000000C
INVESTMENT IN BRMMC100273634C
INVESTMENT IN SCCH67400494C
INVESTMENT IN ISHN14387897C
INVESTMENT IN OTHER-368107F
FieldValueIRS element (for citing)
Total Of Book Value Program Related313693918TotalOfBookValueProgramRelated

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
AWUL-UNDER BOND INDENTURE AGREEMENT70092718
AWUL - CURRENT20386338
DEFERRED CHARGES AND OTHER17755375
LONG TERM COMPENSATION INVESTMENT12397272
FieldValueIRS element (for citing)
Total Book Value Other Assets120631703TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
ACCRUED SALARIES, ABSENCES & W/H$40,208,513
DUE TO THIRD-PARTY PAYERS$25,496,463
ACCRUED INTEREST$19,498,959
EST. FAIR VALUE OF INT. RATE SWAP$8,219,935
OTHER LONG-TERM LIABILITIES$6,603,074
FieldValueIRS element (for citing)
Total Of Amounts100026944TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierLIABILITY UNDER FIN 48 FOOTNOTEIdentifier
Return ReferenceSCHEDULE D, PAGE 3, PART XReturnReference
Explanation"THE ALLIANCE IS CLASSIFIED AS AN ORGANIZATION EXEMPT FROM INCOME TAXES PURSUANT TO 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. TAXABLE ENTITIES ACCOUNT FOR INCOME TAXES IN ACCORDANCE WITH FASB ASC740, "INCOME TAXES" (NOTE L). THE ALLIANCE HAS NO UNCERTAIN TAX POSITIONS AT JUNE 30, 2013 AND 2012. TAX RETURNS FOR FISCAL YEARS 2009 THROUGH 2013 ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE".Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense17191567TotalCommunityBenefitExpense
Net Community Benefit Expense17191567NetCommunityBenefitExpense
Percent Of Total Expense0.02520PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense21036012TotalCommunityBenefitExpense
Direct Offsetting Revenue15635590DirectOffsettingRevenue
Net Community Benefit Expense5400422NetCommunityBenefitExpense
Percent Of Total Expense0.00790PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense76753019TotalCommunityBenefitExpense
Direct Offsetting Revenue52973261DirectOffsettingRevenue
Net Community Benefit Expense23779758NetCommunityBenefitExpense
Percent Of Total Expense0.03490PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense114980598TotalCommunityBenefitExpense
Direct Offsetting Revenue68608851DirectOffsettingRevenue
Net Community Benefit Expense46371747NetCommunityBenefitExpense
Percent Of Total Expense0.06800PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense4884433TotalCommunityBenefitExpense
Direct Offsetting Revenue447464DirectOffsettingRevenue
Net Community Benefit Expense4436969NetCommunityBenefitExpense
Percent Of Total Expense0.00650PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense14369294TotalCommunityBenefitExpense
Direct Offsetting Revenue3753039DirectOffsettingRevenue
Net Community Benefit Expense10616255NetCommunityBenefitExpense
Percent Of Total Expense0.01560PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense17414583TotalCommunityBenefitExpense
Direct Offsetting Revenue7191389DirectOffsettingRevenue
Net Community Benefit Expense10223194NetCommunityBenefitExpense
Percent Of Total Expense0.01500PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense347164TotalCommunityBenefitExpense
Direct Offsetting Revenue212960DirectOffsettingRevenue
Net Community Benefit Expense134204NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense186718TotalCommunityBenefitExpense
Net Community Benefit Expense186718NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense37202192TotalCommunityBenefitExpense
Direct Offsetting Revenue11604852DirectOffsettingRevenue
Net Community Benefit Expense25597340NetCommunityBenefitExpense
Percent Of Total Expense0.03750PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense152182790TotalCommunityBenefitExpense
Direct Offsetting Revenue80213703DirectOffsettingRevenue
Net Community Benefit Expense71969087NetCommunityBenefitExpense
Percent Of Total Expense0.10550PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Total Community Building Expense229332TotalCommunityBuildingExpense
Net Community Building Expense229332NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense229332TotalCommunityBuildingExpense
Net Community Building Expense229332NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$72,662,827BadDebtExpenseAmount
Amount Attributable To55223749AmountAttributableTo
Amount Reimbursed By Medicare178094047AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare183810040CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-5715993MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
MED'L SPEC OF JC LLC
MEDICAL SERVICES0.510000.49000
EMMAUS COMM HLTHCR
MEDICAL SERVICES0.750000.25000
FieldValueIRS element (for citing)
Number Of Hospital Facilities6NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (6 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalChildrens HospitalChildrensHospitalTeaching HospitalTeachingHospitalResearch FacilityResearchFacilityEr24 HoursEr24HoursOtherOtherCritical Access HospitalCriticalAccessHospital
JOHNSON CITY MEDICAL CENTER
1400 N STATE OF FRANKLIN ROADJOHNSON CITYTN37604XXXXXXREHABILITATION & MENTAL HEALTH
INDIAN PATH MEDICAL CENTER
22000 BROOKSIDE DRIVEKINGSPORTTN37660XXXX
FRANKLIN WOODS COMMUNITY HOSPITAL
3300 MED TECH PARKWAYJOHNSON CITYTN37604XXX
SYCAMORE SHOALS HOSPITAL
41501 W ELK AVENUEELIZABETHTONTN37643XXX
RUSSELL COUNTY MEDICAL CENTER
558 CARROLL STREETLEBANONVA24266XXX
JOHNSON COUNTY COMMUNITY HOSPITAL
616901 S SHADY STREETMOUNTAIN CITYTN37683XXX

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (6 entries)

Hospital Facility NumberHospitalFacilityNumberCHNA ConductedCHNAConductedCommunity DefinitionCommunityDefinitionCommunity DemographicsCommunityDemographicsExisting ResourcesExistingResourcesHow Data ObtainedHowDataObtainedCommunity Health NeedsCommunityHealthNeedsOther Health IssuesOtherHealthIssuesIdentifying ProcessIdentifyingProcessConsulting ProcessConsultingProcessNeeds Assessment ConductedNeedsAssessmentConductedTake Into AccountTakeIntoAccountOther FacilitiesOtherFacilitiesCHNA Widely AvailableCHNAWidelyAvailableOwn WebsiteOwnWebsiteOn RequestOnRequestAdopt Implement StrategyAdoptImplementStrategyExecute Implement StrategyExecuteImplementStrategyDevelop Community PlanDevelopCommunityPlanInclude Operational PlansIncludeOperationalPlansPrioritize Health NeedsPrioritizeHealthNeedsPrioritize ServicesPrioritizeServicesAll Needs AddressedAllNeedsAddressedOrganization Incur Excise TaxOrganizationIncurExciseTaxEligibility Criteria ExplainedEligibilityCriteriaExplainedUses FPG FreeUsesFPGFreeFPG Free PercentFPGFreePercentUses FPG DiscountedUsesFPGDiscountedFPG Discount PercentFPGDiscountPercentExplains BasisExplainsBasisIncome LevelIncomeLevelAsset LevelAssetLevelMedical IndigencyMedicalIndigencyInsurance StatusInsuranceStatusUninsured DiscountUninsuredDiscountState RegulationStateRegulationExplains Application MethodExplainsApplicationMethodIncludes Publicity MeasuresIncludesPublicityMeasuresPosted On WebsitePostedOnWebsitePosted In Emergency RoomPostedInEmergencyRoomPosted In Admission OfficePostedInAdmissionOfficeAvailable On RequestAvailableOnRequestOther PublicityOtherPublicityActions On NonpaymentActionsOnNonpaymentCollection ActivitiesCollectionActivitiesNondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicyUsed Other MethodUsedOtherMethodAmounts Generally BilledAmountsGenerallyBilledGross ChargesGrossCharges
JOHNSON CITY MEDICAL CENTER
1trueXXXXXXXX11truetruetrueXXXXXXXXfalsefalsetruetrue200.0true400.0trueXXXXXXtruetrueXXXXXtruefalsetrueXfalsefalse
INDIAN PATH MEDICAL CENTER
2trueXXXXXXXX11truetruetrueXXXXXXXXfalsefalsetruetrue200.0true400.0trueXXXXXXtruetrueXXXXXtruefalsetrueXfalsefalse
FRANKLIN WOODS COMMUNITY HOSPITAL
3trueXXXXXXXX11truetruetrueXXXXXXXXfalsefalsetruetrue200.0true400.0trueXXXXXXtruetrueXXXXXtruefalsetrueXfalsefalse
SYCAMORE SHOALS HOSPITAL
4trueXXXXXXXX11truetruetrueXXXXXXXXfalsefalsetruetrue200.0true400.0trueXXXXXXtruetrueXXXXXtruefalsetrueXfalsefalse
RUSSELL COUNTY MEDICAL CENTER
5trueXXXXXXXX11truetruetrueXXXXXXXXfalsefalsetruetrue200.0true400.0trueXXXXXXtruetrueXXXXXtruefalsetrueXfalsefalse
JOHNSON COUNTY COMMUNITY HOSPITAL
6trueXXXXXXXX11truetruetrueXXXXXXXXfalsefalsetruetrue200.0true400.0trueXXXXXXtruetrueXXXXXtruefalsetrueXfalsefalse

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities10NumberOfOtherFacilities

Other Facilities OtherFacilities (10 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
JCMC AMBULATORY SURGERY CENTER
400 N STATE OF FRANKLIN ROADJOHNSON CITYTN37604LICENSED AMBULATORY SURGERY CENTER
MOUNTAIN STATES IMAGING CENTER
301 MED TECH PARKWAY SUITE 100JOHNSON CITYTN37604LICENSED OUTPATIENT DIAGNOSTIC CENTER
PRINCETON TRANSITIONAL CARE
401 PRINCETON ROADJOHNSON CITYTN37601LICENSED SKILLED NURSING FACILITY
INDIAN PATH TRANSITIONAL CARE
2000 BROOKSIDE DRIVEKINGSPORTTN37660LICENSED SKILLED NURSING FACILITY
MEDICAL CNTR HOME CARE-JOHNSON CITY
101 MED TECH PARKWAY SUITE 100JOHNSON CITYTN37604LICENSED HOME HEALTH AGENCY
MEDICAL CNTR HOME CARE-KINGSPORT
2020 BROOKSIDE DRIVE 28KINGSPORTTN37660LICENSED HOME HEALTH AGENCY
RUSSELL CO MEDICAL CNTR HOME HLTH
116 FLANNAGAN AVENUELEBANONVA24266LICENSED HOME HEALTH AGENCY
MEDICAL CENTER HOSPICE
101 MED TECH PARKWAY SUITE 100JOHNSON CITYTN37604LICENSED HOSPICE AGENCY
JOHNSON COUNTY HOME HEALTH
1987 SOUTH SHADY STREETMOUNTAIN CITYTN37683LICENSED HOME HEALTH AGENCY
RUSSELL COUNTY MEDICAL CNTR HOSPICE
116 FLANNAGAN AVENUELABANONVA24266LICENSED HOSPICE AGENCY

Form990 Schedule H Part VI Form990ScheduleHPartVI (42 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
RELATED ORGANIZATION INFORMATIONPART I LINE 6AMOUNTAIN STATES HEALTH ALLIANCE HAS PREPARED AND MADE PUBLIC A COMMUNITY BENEFIT REPORT TO INCLUDE INFORMATION FOR ALL OF THE HOSPITALS WITHIN THE HEALTH SYSTEM
COSTING METHODOLOGY EXPLANATIONPART I LINE 7A COST TO CHARGE RATIO WAS USED TO CALCULATE LINES 7A AND B UTILIZING THE SCHEDULE H APPLICABLE WORKSHEETS INCLUDING WORKSHEET 2 A RATIO OF PATIENT CARE COST TO CHARGES LINES 7E F G AND H USED DIRECT COSTS OF SPECIFIC PROGRAMS LINE 7I REFLECTS CHARITABLE CONTRIBUTIONS AT COST WE SUBTRACTED LINES 7EI COLUMN C EXPENSE FROM WORKSHEET 2 LINE 4 SO THAT THE EXPENSE WOULD NOT BE DUBLICATED PART I LINE 7G JOHNSON COUNTY COMMUNITY HOSPITAL A FEDERALLY DESIGNATED CRITICAL ACCESS HOSPITAL OPERATES A PHYSICIAN SPECIALTY CLINIC WHICH INCURRED AN OPERATING LOSS OF 55015 FOR THE TWELVE MONTHS ENDING JUNE 30 2013 THE SPECIALTY CLINIC INCLUDES CARDIOLOGY GENERAL SURGERY PODIATRY AND OTHER SPECIALTY SERVICES THIS CONTINUES TO BE A VALUABLE RESOURCE TO THE RESIDENTS OF THE AREA BY AIDING WITH TRANSPORTATION ISSUES OTHER PHYSICIAN OFFICES ARE MORE THAN AN HOUR AWAY RESOLVING ACCESS LIMITATIONS FOR SPECIALTY SERVICES AND PROVIDING RELIEF TO THE SPECIAL HEALTH PROBLEMS OF A LARGELY ELDERLY POPULATION RUSSELL COUNTY MEDICAL CENTER OPERATES A RURAL HEALTH CLINIC LOCATED IN ST PAUL VA ON THE BORDER OF WISE AND RUSSELL COUNTIES RIVERSIDE CLINIC FIRST OPENED IN 1991 TO PROVIDE PRIMARY CARE SERVICES TO THIS ELDERLY UNDERSERVED POPULATION THE CLINICS LARGEST PAYOR IS MEDICARE WHICH ACCOUNTS FOR 51 OF PATIENT SERVICES DURING FY13 THE CLINIC INCURRED UNREIMBURSED EXPENSES OF 221246 SOME OTHER SUBSIDIZED SERVICES WITHIN MSHA INCLUDE SKILLED NURSING FACILITIES WITHIN TWO HOSPITALS OUR AIR TRANSPORT SERVICE WINGS BABYCHILD GROUND TRANSPORT AND MENTAL HEALTH
COMMUNITY BUILDING ACTIVITIESPART IIMSHA LEADERS SUPPORT AND ENCOURAGE ALL TEAM MEMBERS TO VOLUNTEER TIME MONEY AND SKILLS TO COMMUNITY SERVICE PROJECTS AND CHARITABLE ORGANIZATIONS SENIOR LEADERS AND BOARD MEMBERS SET A POSITIVE EXAMPLE FOR MSHA TEAM MEMBERS SERVING VOLUNTARILY ON COMMITTEES AND MANAGING BOARDS OF LOCAL SERVICE AND NONPROFIT ORGANIZATIONS MANY ALSO SERVE AS MEMBERS AND CONSULTANTS ON PROFESSIONAL COMMITTEES AND TASK FORCES THAT AFFECT REGIONAL DEVELOPMENT IN HEALTHCARE AND EDUCATION SOME OF THESE TEAM MEMBERS DEVOTE TWO WEEKS OF NORMAL WORK TIME TO OUTSIDE CHARITABLE ACTIVITIES MSHA IN COLLABORATION WITH AREA HEALTH AGENCIES AND PROVIDERS MAY OFFER ASSISTANCE WITH COORDINATION ADVOCACY AND PUBLICITY PROVIDE SPACE OR CONTRIBUTE SUPPLIES TO SUPPORT GROUPS FOR THEIR PROGRAM ACTIVITIES MSHA INCURRED EXPENSES OF ALMOST 2 MILLION ON PHYSICIAN RECRUITMENT TO REPLACE PHYSICIANS RETIRING OR LEAVING OUR SERVICE AREAS INCLUDING RECRUITMENT TO ONE OF OUR FEDERALLY DESIGNATED UNDERSERVED COMMUNITIES WITHOUT MSHAS DEDICATION TO RURAL HEALTH THERE WOULD NOT BE AN ADEQUATE NUMBER OF PHYSICIANS TO SERVE THIS PATIENT POPULATION MSHA SUPPORTS THE ECONOMIC DEVELOPMENT OF THE REGION BY PROVIDING FINANCIAL SUPPORT TO ECONOMIC DEVELOPMENT PROGRAMS EVIDENCE SHOWS THAT A HEALTHY ECONOMY RELATES TO A HEALTHIER POPULATION
BAD DEBT EXPENSE EXPLANATIONPART III LINE 4OUR VICE PRESIDENT OF PATIENT FINANCIAL SERVICES ESTIMATES THAT 76 OF BAD DEBT EXPENSE WAS ASSUMED ATTRIBUTABLE TO PATIENTS LIKELY ELIGIBLE FOR FINANCIAL ASSISTANCE WE HAVE MANY INSTANCES DURING THE YEAR 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 REGARDING LINE 3 IT IS IMPLAUSIBLE TO DETERMINE THE AMOUNT OF MSHAS 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 THE FOLLOWING TEXT IS INCLUDED IN MSHAS FY13 AUDITED FINANCIAL STATEMENTS FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRDPARTY COVERAGE THE ALLIANCE ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR BAD DEBTS IF NECESSARY FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLE ACCOUNTS FOR WHICH THE THIRDPARTY PAYER HAS NOT PAID OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY FOR RECEIVABLES ASSOCIATED WITH PATIENTS WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLES AND COPAYMENT BALANCES DUE FOR WHICH THIRDPARTY COVERAGE EXISTS FOR PART OF THE BILL THE ALLIANCE RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE THE FOOTNOTES TO THE AUDITED FINANCIAL STATEMENTS REPORT THE AMOUNT OF ESTIMATED UNCOLLECTIBLE SELFPAY AND EXPLAIN THAT UNCOLLECTIBLE PATIENT ACCOUNTS RECEIVABLE ESTIMATED RESERVES ARE BASED UPON PRIOR COLLECTION HISTORY FOR GROUPS OF RECEIVABLES KNOWN COLLECTION RISKS AND OTHER ENVIRONMENTAL FACTORS INCLUDING THE AGE OF THE RECEIVABLES
MEDICARE EXPLANATIONPART III LINE 8MEDICARE ALLOWABLE COSTS WERE REPORTED USING MSHAS FILED MEDICARE COST REPORT CR THE CR USES A COST TO CHARGE RATIO BASED ON A STEPDOWN ALLOCATION METHODOLOGY IN CARING FOR THE PATIENT THERE ARE SEVERAL SERVICES THAT ARE CONSIDERED NONALLOWABLE SUCH AS TRANSPORTATION OF A PATIENT COMFORT ITEMS TO INCLUDE A TELEVISION MAGAZINES OR A TELEPHONE ADDITIONAL NONALLOWABLE COSTS INCLUDE THE RECRUITMENT OF PHYSICIANS PHYSICIAN GUARANTEES AND A PORTION OF THE BAD DEBT 12 ASSOCIATED WITH THE CARE OF THE PATIENT MEDICARE LOSSES INCLUDING SOME NONALLOWABLE COSTS SHOULD BE COUNTED AS A COMMUNITY BENEFIT AS THIS IS THE COST OF CARE FOR SERVING THE AGING POPULATION AS A NOTFORPROFIT ORGANIZATION WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTH CARE NEEDS OF THE COMMUNITY AND THE INDIVIDUAL WHILE MAINTAINING A HIGH LEVEL OF HEALTH CARE SERVICES WITHOUT LOSSES SINCE LOSSES DO OCCUR THROUGH THE CMS SYSTEM OF REIMBURSEMENT THESE LOSSES ARE A COST OF DOING BUSINESS FOR OUR COMMUNITY AND SHOULD BE CONSIDERED A COMMUNITY BENEFIT AS A PARTICIPATING PROVIDER IN THE MEDICARE PROGRAM MSHA 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 MSHA TO REPORT THESE UNCOMPENSATED SERVICES AS A COMMUNITY BENEFIT ON THIS DOCUMENT BY MAKING THIS CHANGE NONPROFIT PROVIDERS WILL BE ENCOURAGED TO SUSTAIN IMPORTANT CARE DELIVERY MODELS FOR OUR AGING POPULATION IN SPITE OF THE FACT IT IS SOMETIMES ECONOMICALLY INJURIOUS
COLLECTION PRACTICES EXPLANATIONPART III LINE 9BMSHA FOLLOWS A STRONG COLLECTION PROGRAM THAT COMMUNICATES FINANCIAL RESPONSIBILITY TO THE PATIENT COLLECTION PRACTICES APPLY TO ALL PATIENTS CHARITY AND NONCHARITY CARE IN ROUTINE CIRCUMSTANCES WHEN IT IS DETERMINED THAT A PATIENT HAS NOT RESPONDED TO REQUESTS FOR PAYMENT AND HAS NOT PROVIDED INFORMATION TO ASCERTAIN ABILITY TO PAY AN ACCOUNT CAN BE REFERRED TO AN OUTSIDE COLLECTION AGENCY FOR COLLECTION ASSISTANCE MSHA ENSURES THAT OUTSIDE COLLECTION AGENCIES FOLLOW HOSPITAL BILLING AND COLLECTION GUIDELINES ONCE A DELINQUENT PATIENT ACCOUNT HAS BEEN SUBMITTED TO AN OUTSIDE AGENCY IT CAN BE ADJUSTED TO CHARITY IF THE DETERMINATION IS LATER MADE THAT THE PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE ALL REQUESTS FOR FINANCIAL ASSISTANCE MUST BE ACCOMPANIED BY A COMPLETED FINANCIAL ASSESSMENT FORM AND SUPPORTING DOCUMENTATION
NEEDS ASSESSMENTPART VIPART VI LINE 2 MSHA INCLUDED AMERICAS HEALTH RANKINGS AHR IN ITS ASSESSMENT IN ORDER TO BETTER DEFINE THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES TENNESSEE RANKS 42ND AND VIRGINIA RANKS 26TH HOWEVER IT SHOULD BE NOTED THAT SOUTHWEST VIRGINIA WHERE SOME OF MSHA FACILITIES ARE LOCATED CLOSELY RESEMBLES THE HEALTH RANKINGS FOR TENNESSEE AMERICAS 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 NONPROFIT DIRECTORS SCHOOL NURSES AND OFFICIALS AND BUSINESS LEADERS A SURVEY WAS GIVEN TO EACH INDIVIDUAL SEEKING FEEDBACK REGARDING AVAILABLE RESOURCES IN EACH AREA THE 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 SMOKEFREE AREAS PARTNER WITH LOCAL FARMERS MARKETS SHARE HEALTH INFORMATION BETWEEN PHARMACIES NETWORK WITH SMALL BUSINESSES AND NONPROFITS IN ORDER TO AVOID DUPLICATING RESOURCES AND PROVIDE EARLY SCREENINGS FOR THE UNINSURED OR UNDERINSURED OVERALL THE COMMUNITY MEMBERS GAVE MSHAS CORE SERVICE AREA A HEALTH STATUS RANKING OF 424 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 TENNESSEE AND VIRGINIA BOTH SAW AN INCREASE IN DIABETES AND OBESITY WITHIN THE PAST TEN YEARS TENNESSEE ALSO RANKS 44TH FOR CARDIOVASCULAR DISEASE AND 45TH FOR CANCER DEATHS AND 46TH FOR DIABETES VIRGINIA OVERALL HAS A BETTER RANKING IN THESE THREE CATEGORIES BUT AS STATED EARLIER SOUTHWEST VIRGINIA CLOSELY RESEMBLES TENNESSEE SINCE COMPLETION OF THE CHNA AND ITS IMPLEMENTATION PLAN MSHA HAS PARTNERED WITH SCHOOLS NONPROFIT AGENCIES AND OTHERS ON VARIOUS INITIATIVES TO ADDRESS HEALTH ISSUES CHILDHOOD OBESITY IN PARTICULAR
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEPART VIPART VI LINE 3 MSHA PROVIDES COMMUNICATION OF FINANCIAL ASSISTANCE ON ITS WEBSITE AND ON POSTERS LOCATED IN PROMINENT AREAS OF THE HOSPITALS SUCH AS ADMITTING AND THE EMERGENCY DEPARTMENTS PRINTED EDUCATIONAL MATERIALS INCLUDING FINANCIAL ASSISTANCE CONTACT INFORMATION ARE ALSO PROVIDED IN EACH PATIENTS PAPERWORK POSTERS AND REFERENCE MATERIALS ARE WRITTEN IN BOTH ENGLISH AND SPANISH ADMITTING STAFF ARE TRAINED TO EDUCATE PATIENTS ON MSHAS FINANCIAL ASSISTANCE POLICY MSHA ALSO HAS FINANCIAL COUNSELORS TO PROVIDE FURTHER INFORMATION AND ASSISTANCE TO MSHA PATIENTS REGARDING MSHAS 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 TNCAREMEDICAID IN ADDITION MSHA CONTRACTS WITH THE COMPANY FIRSTSOURCE SOLUTIONS USA TO WORK WITH SELFPAYING PATIENTS WHO HAVE LIMITED FINANCIAL RESOURCES FIRSTSOURCE SOLUTIONS DETERMINES A PATIENTS ELIGIBILITY IN MEDICAL COVERAGE OPTIONS AND ASSISTS WITH THEIR ENROLLMENT MSHA BEARS THE COST FOR THE FIRSTSOURCE SOLUTIONS PROGRAM
COMMUNITY INFORMATIONPART VIPART VI LINE 4 MSHA SERVES THE HEALTHCARE NEEDS OF 29 APPALACHIAN COUNTIES IN TENNESSEE SOUTHWEST VIRGINIA KENTUCKY AND NORTH CAROLINA SOME OF THE COUNTIES MSHA SERVES ARE FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREAS MSHA OPERATES 2 CRITICAL ACCESS HOSPITALS DICKENSON COMMUNITY HOSPITAL IN VIRGINIA AND JOHNSON COUNTY COMMUNITY HOSPITAL IN TENNESSEE THESE TWO FACILITIES OPERATE IN FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREAS THE HEALTH STATUS OF THE POPULATION IN MSHAS SERVICE AREA IS GENERALLY POOR THE SERVICE AREA EXTENDS TO SOME OF THE POOREST RURAL COUNTIES IN THE REGION WITH A POVERTY RATE OF ALMOST 30 SOME OF THE MOST WELL OFF COUNTIES IN MSHAS SERVICE AREA STILL HAVE A MEDIAN HOUSEHOLD INCOME LOWER THAN STATE AND NATIONAL AVERAGES RURAL SERVICE AREA COUNTIES SHARE COMMON CHALLENGES OF 1 HIGH RATES OF UNINSURED 2 HIGH PREVALENCE OF OBESITY 3 HIGH PREVALENCE OF DIABETES
HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSEPART VIPART VI LINE 5 MSHA IS DEDICATED TO OPERATING EFFICIENTLY SO THAT WASTE IS MINIMIZED MSHAS LEADERSHIP REMAINS MINDFUL OF MANAGING THE ALLIANCES LIMITED RESOURCES SO THAT ADEQUATE FACILITIES AND EQUIPMENT ARE AVAILABLE FOR THE CARE OF OUR PATIENTS VARIOUS CHECKS AND BALANCES ARE ESTABLISHED TO ENSURE THAT EXPENDITURES FOR OPERATING EXPENSES AND CAPITAL COSTS ARE REASONABLE AND NECESSARY SURPLUS FUNDS ARE INVESTED IN IMPROVING HEALTHCARE WITHIN OUR COMMUNITIES THE MAJORITY OF MSHAS GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATIONS PRIMARY SERVICE AREA PHYSICIANS THAT REQUEST PRIVILEGES WHO ARE QUALIFIED AND CREDENTIALED ARE EXTENDED PRIVILEGES BY MSHA
AFFILIATED HEALTH CARE INFORMATIONPART VIPART VI LINE 6 MSHA PROVIDES CARE TO PEOPLE IN 29 COUNTIES IN TENNESSEE VIRGINIA KENTUCKY AND NORTH CAROLINA EACH HOSPITAL IS FULLY ACCREDITED MOST BY THE JOINT COMMISSION MSHA IS INTEGRATED BOTH VERTICALLY AND HORIZONTALLY AND IS THE LARGEST REGIONAL HEALTHCARE SYSTEM WITH 13 HOSPITALS NINE FACILITIES ARE WHOLLYOWNED FACILITIES 8 FACILITIES IN TENNESSEE AND 1 IN VIRGINIA EACH FACILITY IN THIS FORM 990 IS ACCREDITED BY THE JOINT COMMISSION WITH THE EXCEPTION OF JCCH JCCH RECEIVES CERTIFICATION THROUGH THE STATE OF TENNESSEE SINCE IT IS A CRITICAL ACCESS HOSPITAL IN ADDITION TO THE WHOLLYOWNED HOSPITALS WITHIN THIS FORM 990 MSHA ALSO HAS MAJORITY OWNERSHIP IN 4 HOSPITALS IN SOUTHWEST VIRGINIA IN ADDITION TO OUR ACUTE CARE HOSPITALS OUR SYSTEM ALSO INCLUDES SUCH SERVICES AS PRIMARYSPECIALTY PHYSICIAN PRACTICES URGENT CARE CENTERS EMERGENCY DEPARTMENTS OCCUPATIONAL MEDICINE REHABILITATION OUTREACH LABORATORY MENTAL HEALTH NEONATAL INTENSIVE CARE A NACHRIAFFILIATED CHILDRENS HOSPITAL RENAL DIALYSIS ST JUDES ONCOLOGY INPATIENTOUTPATIENT SURGERY SKILLED NURSING HOME HEALTH AIR AMBULANCE TRANSPORT AND MORE WITH THESE ADDITIONAL FACILITIES AND SERVICES MSHA EXTENDS A HIGHLY EFFECTIVE HEALTH CARE DELIVERY SYSTEM SINCE OUR SYSTEM IS BOTH HORIZONTALLY AND VERTICALLY INTEGRATED PATIENTS CAN BE EFFICIENTLY MOVED ALONG AN INTEGRATED COMPREHENSIVE CONTINUUM OF CARE AS THEIR HEALTH STATUS DICTATES OUR FLAGSHIP FACILITY JOHNSON CITY MEDICAL CENTER IS AT THE CORE OF OUR SYSTEM OFFERING FULL SERVICE TERTIARY CARE IN ADDITION TO OUR HOSPITALS MSHA IS THE SOLE MEMBER OF BLUE RIDGE MEDICAL MANAGEMENT CORPORATION BRMMC MSHA EXTENDS AN INTEGRATED HEALTHCARE DELIVERY SYSTEM THROUGH BRMMC TO INCLUDE MULTIPLE PRIMARY AND SPECIALTY CARE PATIENT ACCESS CENTERS AND NUMEROUS OUTPATIENT CARE SITES INCLUDING URGENT CARE CENTERS OCCUPATIONAL MEDICINE SERVICES A SAME DAY SURGERY CENTER AND OUTPATIENT REHABILITATION MSHA COUNTYSPECIFIC OPERATIONS ARE GOVERNED BY A COMMUNITY BOARD OF DIRECTORS COUNTY BOARDS REPORT TO A SYSTEM LEVEL BOARD OF DIRECTORS ALL BOARDS ARE PRIMARILY COMPOSED OF LOCAL COMMUNITY RESIDENTS PART VI LINE 8 MSHA SUBMITS COMMUNITY BENEFIT DATA TO THE VIRGINIA HEALTH AND HOSPITAL ASSOCIATION VHHA AND THE HOSPITAL ALLIANCE OF TENNESSEE HAT VHHA COMBINES DATA FROM ALL SOURCES TO DEMONSTRATE THE COMMUNITY BENEFITS PROVIDED BY BOTH FORPROFIT AND NOTFORPROFIT HOSPITALS AND HEALTH SYSTEMS TO THE STATE OF VIRGINIA HAT PROVIDES ITS MEMBERS AND TENNESSEE LEGISLATORS WITH COMMUNITY BENEFIT DATA IN AN EFFORT TO PROVIDE A CLEAR PICTURE OF NOTFORPROFIT HEALTH SYSTEMS INVESTMENT IN THE COMMUNITIES THEY SERVE
LIST OF STATES WHERE COMMUNITY BENEFIT REPORT IS FILEDPART VITENNESSEE VIRGINIA
JOHNSON CITY MEDICAL CENTER LINE NUMBER 1 PART V LINE 3PART V LINE 3MSHA MET WITH TEN FOCUS GROUPS EACH REPRESENTING ONE OF THE TEN HOSPITAL FACILITIES INCLUDING ALL OF THE HOSPITALS INCLUDED IN THIS 990 LOCATED WITHIN THE CORE COUNTIES OF MSHA FACILITIES 16 COUNTIES EACH GROUP CONSISTED OF PUBLIC HEALTH LEADERS NURSES NONPROFIT 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 COUNTYS 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
JOHNSON CITY MEDICAL CENTER LINE NUMBER 1 PART V LINE 4PART V LINE 4EACH 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 JCMCS CHNA WAS CONDUCTED WITH ALL MSHA HOSPITALS TO INCLUDE FRANKLIN WOODS COMMUNITY HOSPITAL INDIAN PATH MEDICAL CENTER SYCAMORE SHOALS HOSPITAL JOHNSON COUNTY COMMUNITY HOSPITAL RUSSELL COUNTY MEDICAL CENTER JOHNSTON MEMORIAL HOSPITAL SMYTH COUNTY COMMUNITY HOSPITAL NORTON COMMUNITY HOSPITAL AND DICKENSON COMMUNITY HOSPITAL
JOHNSON CITY MEDICAL CENTER LINE NUMBER 1 PART V LINE 7PART V LINE 7MSHA 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 HOSPITALS 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
JOHNSON CITY MEDICAL CENTER LINE NUMBER 1 PART V LINE 14GPART V LINE 14GTHE MOUNTAIN STATES FINANCIAL ASSISTANCE POLICY HAS BEEN APPROVED BY THE BOARD OF DIRECTORS AND APPLIES TO ALL MSHA HOSPITALS DURING THE ADMISSION PROCESS PATIENTS ARE TOLD THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY AND ADMISSION PAPERS GIVEN TO EACH PATIENT ADVISES THEM OF THE POLICY BILLING CORRESPONDENCE ALSO ADVISES THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE A COMMUNITY RESOURCE GUIDE REPORTS THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY
JOHNSON CITY MEDICAL CENTER LINE NUMBER 1 PART V LINE 20DPART V LINE 20DUNINSURED PATIENTS RECEIVE A 62 DISCOUNT AND BASED ON OTHER FACTORS SUCH AS INCOME OR MEDICAL INDIGENCY MAY QUALIFY FOR AN ADDITIONAL DISCOUNT
INDIAN PATH MEDICAL CENTER LINE NUMBER 2 PART V LINE 3PART V LINE 3MSHA MET WITH TEN FOCUS GROUPS EACH REPRESENTING ONE OF THE TEN HOSPITAL FACILITIES INCLUDING ALL OF THE HOSPITALS INCLUDED IN THIS 990 LOCATED WITHIN THE CORE COUNTIES OF MSHA FACILITIES 16 COUNTIES EACH GROUP CONSISTED OF PUBLIC HEALTH LEADERS NURSES NONPROFIT 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 COUNTYS 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
INDIAN PATH MEDICAL CENTER LINE NUMBER 2 PART V LINE 4PART V LINE 4EACH 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 IPMCS CHNA WAS CONDUCTED WITH ALL MSHA HOSPITALS TO INCLUDE FRANKLIN WOODS COMMUNITY HOSPITAL JCMC SYCAMORE SHOALS HOSPITAL JOHNSON COUNTY COMMUNITY HOSPITAL RUSSELL COUNTY MEDICAL CENTER JOHNSTON MEMORIAL HOSPITAL SMYTH COUNTY COMMUNITY HOSPITAL NORTON COMMUNITY HOSPITAL AND DICKENSON COMMUNITY HOSPITAL
INDIAN PATH MEDICAL CENTER LINE NUMBER 2 PART V LINE 7PART V LINE 7MSHA 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 HOSPITALS 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
INDIAN PATH MEDICAL CENTER LINE NUMBER 2 PART V LINE 14GPART V LINE 14GDURING THE ADMISSION PROCESS PATIENTS ARE TOLD THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY AND ADMISSION PAPERS GIVEN TO EACH PATIENT ADVISES THEM OF THE POLICY BILLING CORRESPONDENCE ALSO ADVISES THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE A COMMUNITY RESOURCE GUIDE REPORTS THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY
INDIAN PATH MEDICAL CENTER LINE NUMBER 2 PART V LINE 20DPART V LINE 20DUNINSURED PATIENTS RECEIVE A 62 DISCOUNT AND BASED ON OTHER FACTORS SUCH AS INCOME OR MEDICAL INDIGENCY MAY QUALIFY FOR AN ADDITIONAL DISCOUNT
FRANKLIN WOODS COMMUNITY HOSPITAL LINE NUMBER 3 PART V LINE 3PART V LINE 3MSHA MET WITH TEN FOCUS GROUPS EACH REPRESENTING ONE OF THE TEN HOSPITAL FACILITIES INCLUDING ALL OF THE HOSPITALS INCLUDED IN THIS 990 LOCATED WITHIN THE CORE COUNTIES OF MSHA FACILITIES 16 COUNTIES EACH GROUP CONSISTED OF PUBLIC HEALTH LEADERS NURSES NONPROFIT 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 COUNTYS 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
FRANKLIN WOODS COMMUNITY HOSPITAL LINE NUMBER 3 PART V LINE 4PART V LINE 4EACH 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 FWCHS CHNA WAS CONDUCTED WITH ALL MSHA HOSPITALS TO INCLUDE JCMC INDIAN PATH MEDICAL CENTER SYCAMORE SHOALS HOSPITAL JOHNSON COUNTY COMMUNITY HOSPITAL RUSSELL COUNTY MEDICAL CENTER JOHNSTON MEMORIAL HOSPITAL SMYTH COUNTY COMMUNITY HOSPITAL NORTON COMMUNITY HOSPITAL AND DICKENSON COMMUNITY HOSPITAL
FRANKLIN WOODS COMMUNITY HOSPITAL LINE NUMBER 3 PART V LINE 7PART V LINE 7MSHA 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 HOSPITALS 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
FRANKLIN WOODS COMMUNITY HOSPITAL LINE NUMBER 3 PART V LINE 14GPART V LINE 14GDURING THE ADMISSION PROCESS PATIENTS ARE TOLD THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY AND ADMISSION PAPERS GIVEN TO EACH PATIENT ADVISES THEM OF THE POLICY BILLING CORRESPONDENCE ALSO ADVISES THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE A COMMUNITY RESOURCE GUIDE REPORTS THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY
FRANKLIN WOODS COMMUNITY HOSPITAL LINE NUMBER 3 PART V LINE 20DPART V LINE 20DUNINSURED PATIENTS RECEIVE A 62 DISCOUNT AND BASED ON OTHER FACTORS SUCH AS INCOME OR MEDICAL INDIGENCY MAY QUALIFY FOR AN ADDITIONAL DISCOUNT
SYCAMORE SHOALS HOSPITAL LINE NUMBER 4 PART V LINE 3PART V LINE 3MSHA MET WITH TEN FOCUS GROUPS EACH REPRESENTING ONE OF THE TEN HOSPITAL FACILITIES INCLUDING ALL OF THE HOSPITALS INCLUDED IN THIS 990 LOCATED WITHIN THE CORE COUNTIES OF MSHA FACILITIES 16 COUNTIES EACH GROUP CONSISTED OF PUBLIC HEALTH LEADERS NURSES NONPROFIT 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 COUNTYS 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
SYCAMORE SHOALS HOSPITAL LINE NUMBER 4 PART V LINE 4PART V LINE 4EACH 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 SSHS CHNA WAS CONDUCTED WITH ALL MSHA HOSPITALS TO INCLUDE FRANKLIN WOODS COMMUNITY HOSPITAL INDIAN PATH MEDICAL CENTER JCMC JOHNSON COUNTY COMMUNITY HOSPITAL RUSSELL COUNTY MEDICAL CENTER JOHNSTON MEMORIAL HOSPITAL SMYTH COUNTY COMMUNITY HOSPITAL NORTON COMMUNITY HOSPITAL AND DICKENSON COMMUNITY HOSPITAL
SYCAMORE SHOALS HOSPITAL LINE NUMBER 4 PART V LINE 7PART V LINE 7MSHA 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 HOSPITALS 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
SYCAMORE SHOALS HOSPITAL LINE NUMBER 4 PART V LINE 14GPART V LINE 14GDURING THE ADMISSION PROCESS PATIENTS ARE TOLD THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY AND ADMISSION PAPERS GIVEN TO EACH PATIENT ADVISES THEM OF THE POLICY BILLING CORRESPONDENCE ALSO ADVISES THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE A COMMUNITY RESOURCE GUIDE REPORTS THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY
SYCAMORE SHOALS HOSPITAL LINE NUMBER 4 PART V LINE 20DPART V LINE 20DUNINSURED PATIENTS RECEIVE A 62 DISCOUNT AND BASED ON OTHER FACTORS SUCH AS INCOME OR MEDICAL INDIGENCY MAY QUALIFY FOR AN ADDITIONAL DISCOUNT
RUSSELL COUNTY MEDICAL CENTER LINE NUMBER 5 PART V LINE 3PART V LINE 3MSHA MET WITH TEN FOCUS GROUPS EACH REPRESENTING ONE OF THE TEN HOSPITAL FACILITIES INCLUDING ALL OF THE HOSPITALS INCLUDED IN THIS 990 LOCATED WITHIN THE CORE COUNTIES OF MSHA FACILITIES 16 COUNTIES EACH GROUP CONSISTED OF PUBLIC HEALTH LEADERS NURSES NONPROFIT 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 COUNTYS 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
RUSSELL COUNTY MEDICAL CENTER LINE NUMBER 5 PART V LINE 4PART V LINE 4EACH 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 RCMCS CHNA WAS CONDUCTED WITH ALL MSHA HOSPITALS TO INCLUDE FRANKLIN WOODS COMMUNITY HOSPITAL INDIAN PATH MEDICAL CENTER SYCAMORE SHOALS HOSPITAL JOHNSON COUNTY COMMUNITY HOSPITAL JCMC JOHNSTON MEMORIAL HOSPITAL SMYTH COUNTY COMMUNITY HOSPITAL NORTON COMMUNITY HOSPITAL AND DICKENSON COMMUNITY HOSPITAL
RUSSELL COUNTY MEDICAL CENTER LINE NUMBER 5 PART V LINE 7PART V LINE 7MSHA 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 HOSPITALS 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
RUSSELL COUNTY MEDICAL CENTER LINE NUMBER 5 PART V LINE 14GPART V LINE 14GTHE MOUNTAIN STATES FINANCIAL ASSISTANCE POLICY HAS BEEN APPROVED BY THE BOARD OF DIRECTORS AND APPLIES TO ALL MSHA HOSPITALS DURING THE ADMISSION PROCESS PATIENTS ARE TOLD THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY AND ADMISSION PAPERS GIVEN TO EACH PATIENT ADVISES THEM OF THE POLICY BILLING CORRESPONDENCE ALSO ADVISES THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE A COMMUNITY RESOURCE GUIDE REPORTS THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY
RUSSELL COUNTY MEDICAL CENTER LINE NUMBER 5 PART V LINE 20DPART V LINE 20DUNINSURED PATIENTS RECEIVE A 62 DISCOUNT AND BASED ON OTHER FACTORS SUCH AS INCOME OR MEDICAL INDIGENCY MAY QUALIFY FOR AN ADDITIONAL DISCOUNT
JOHNSON COUNTY COMMUNITY HOSPITAL LINE NUMBER 6 PART V LINE 3PART V LINE 3MSHA MET WITH TEN FOCUS GROUPS EACH REPRESENTING ONE OF THE TEN HOSPITAL FACILITIES INCLUDING ALL OF THE HOSPITALS INCLUDED IN THIS 990 LOCATED WITHIN THE CORE COUNTIES OF MSHA FACILITIES 16 COUNTIES EACH GROUP CONSISTED OF PUBLIC HEALTH LEADERS NURSES NONPROFIT 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 COUNTYS 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
JOHNSON COUNTY COMMUNITY HOSPITAL LINE NUMBER 6 PART V LINE 4PART V LINE 4EACH 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 JCCHS CHNA WAS CONDUCTED WITH ALL MSHA HOSPITALS TO INCLUDE FRANKLIN WOODS COMMUNITY HOSPITAL INDIAN PATH MEDICAL CENTER SYCAMORE SHOALS HOSPITAL JCMC RUSSELL COUNTY MEDICAL CENTER JOHNSTON MEMORIAL HOSPITAL SMYTH COUNTY COMMUNITY HOSPITAL NORTON COMMUNITY HOSPITAL AND DICKENSON COMMUNITY HOSPITAL
JOHNSON COUNTY COMMUNITY HOSPITAL LINE NUMBER 6 PART V LINE 7PART V LINE 7MSHA 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 HOSPITALS 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
JOHNSON COUNTY COMMUNITY HOSPITAL LINE NUMBER 6 PART V LINE 14GPART V LINE 14GTHE MOUNTAIN STATES FINANCIAL ASSISTANCE POLICY HAS BEEN APPROVED BY THE BOARD OF DIRECTORS AND APPLIES TO ALL MSHA HOSPITALS DURING THE ADMISSION PROCESS PATIENTS ARE TOLD THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY AND ADMISSION PAPERS GIVEN TO EACH PATIENT ADVISES THEM OF THE POLICY BILLING CORRESPONDENCE ALSO ADVISES THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE A COMMUNITY RESOURCE GUIDE REPORTS THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY
JOHNSON COUNTY COMMUNITY HOSPITAL LINE NUMBER 6 PART V LINE 20DPART V LINE 20DUNINSURED PATIENTS RECEIVE A 62 DISCOUNT AND BASED ON OTHER FACTORS SUCH AS INCOME OR MEDICAL INDIGENCY MAY QUALIFY FOR AN ADDITIONAL DISCOUNT

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (16 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistanceDescription Of Non Cash AssistanceDescriptionOfNonCashAssistance
AMERICAN CANCER SOCIETY
508 PRINCETON RD SUITE 102JOHNSON CITYTN37601640329009501C320100PROGRAM SUPPORT
AMERICAN HEART ASSOCIATION
208 SUNSET DRIVEJOHNSON CITYTN37604135613797501C366250PROGRAM SUPPORT702PRINTING
BARTER THEATRE
PO BOX 867ABINGDONVA24212546000120501C319000CONTRIBUTIONPRINTING
BRISTOL FAMILY YMCA
400 ML KING JR BLVDBRISTOLTN37620620521204501C37000PROGRAM SUPPORT
COALITION FOR KIDS INC
PO BOX 3156JOHNSON CITYTN37602621765487501C32000FIGHT CHILD OBESITY5601PRINTING
EAST TENNESSEE STATE UNIVERSITY
PO BOX 70732JOHNSON CITYTN37614626021046501C311500SUPPORT FIT KIDS
ETSU FOUNDATION
P O BOX 70721JOHNSON CITYTN37614237092731501C310000ECONOMIC DEVELOPMENT
GOOD SAMARITAN MINISTRY
100 NORTH ROAN STREETJOHNSON CITYTN37601621233320501C3PROGRAM SUPPORT5657PRINTING
JOHNSON CITY PARKS & RECREATION
PO BOX 1535JOHNSON CITYTN37605626000320501C35000SPONSORSHIP405PRINTING
JOHNSON CITY SYMPHONY ORCHESTRA
PO BOX 533JOHNSON CITYTN37605620910261501C3PROGRAM SUPPORT5897PRINTING
MARCH OF DIMES
2313 BROWNS MILL ROADJOHNSON CITYTN37604131846366501C315000PROGRAM SUPPORT
MOUNTAIN STATES FOUNDATION
2335 KNOB CREEK ROAD SUITE 101JOHNSON CITYTN37604581418862501C359500PROGRAM SUPPORT
NORTHEAST STATE COMMUNITY COLLEGE
2425 HIGHWAY 75BLOUNTVILLETN37617621265326501C311000LAB EQUIPMENT
PREMIER PURCHASING
13034 BALLANTYNE CORPORATE PLACECHARLOTTENC28277330387407501C361052SUPPORT
SUSAN KOMEN BREAST CANCER FOUND
PO BOX 5835KINGSPORTTN37663841689067501C35000SPONSORSHIP590PRINTING
TOWN OF JONESBOROUGH
123 BOONE STREETJONESBOROUGHTN37659626000322501C3CONTRIBUTION10069PRINTING
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants16TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INSIDE THE UNITED STATESIdentifier
Return ReferenceSCHEDULE I, PAGE 1, PART I, LINE 2ReturnReference
ExplanationMSHA ADHERED TO THE FOLLOWING CRITERIA FOR OUR CONTRIBUTIONS TO ORGANIZATIONS IN THE REGION: HEALTHCARE: THE ORGANIZATION ENHANCED OR IMPROVED ACCESS FOR THE UNINSURED OR UNDERINSURED POPULATION OR SUPPORTED A PROGRAM TO IMPROVE THE HEALTH OF OUR CHILDREN (I.E., CHILDHOOD OBESITY PREVENTION). EDUCATION: THE ORGANIZATION PROVIDED A PROGRAM TO IMPROVE EDUCATION OF THE RESIDENTS IN OUR REGION ALL THE WAY TO COLLEGE AGE STUDENTS (SUCH AS RN NURSING AND LAB TECHNOLOGY PROGRAMS). QUALITY OF LIFE: THE ORGANIZATION SUPPORTED PROGRAMS TO ENHANCE THE QUALITY OF LIFE, WHICH IS IMPORTANT IN THE RECRUITMENT EFFORTS OF BUSINESSES IN THE REGION AS WE WORK TO ATTRACT AND RETAIN THE BEST TALENT. FOR THE SUPPORTED PROGRAMS, METRICS WERE ESTABLISHED TO DETERMINE THE SUCCESS (OR FAILURE) OF EACH PROGRAM TO WHICH MSHA CONTRIBUTES. AS DOWNWARD REIMBURSEMENT CONTINUED DURING FY13, THE CRITERIA USED IN THE DECISION MAKING PROCESS FOR LARGER DONATIONS WAS REVISED TO SUPPORT THOSE PROGRAMS WHICH FOCUSED ON HEALTH AND WELLNESS INITIATIVES, PARTICULARLY THOSE FIGHTING CHILDHOOD OBESITY.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
First Class Or Charter TravelXFirstClassOrCharterTravel
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (17 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgComp Report Prior990 Filing OrgCompReportPrior990FilingOrg
DENNIS VONDERFECHT
CEO777545190043148577120000226983206445125000
MARVIN EICHORN
SENIOR VPCFO44761494466780221500024538659640
CANDACE JENNINGS
SR VP TN OPERATIONS40211882014208035355724293582785
ANN FLEMING
SR VP35169751836227474842517857492562
DAVID NICELY
VPCEO WASHINGTON CO29102252219117682807326351409433
MONTY MCLAURIN
VPIPMC CEO26010951174148762844430243384846
LYNN KRUTAK
VPCORP CFO2130833790319961508919138287209
SHANE HILTON
VPTN CFO1986253661238801279423317275228
MORRIS SELIGMAN MD
SR VPCMO42144382938435425586237844641629
DOUGLAS EDEMA
VP PRESCEO MSPG32771862141184782918827094464619
JAMES PASKERT MD
VPCMO WASHINGTON CO34215349161125592996126006459840
JOHN SCHARIO
SVP326339686816502663024558432710
KATHERINE BALL
FORMER VPCMIO12409441113233588489716728420420
DALE CLAYTORE
VP1755203427821777105313324245430
PAT NIDAY
FORMER CNO WASH CO1520492635218241798525714230341
BRAD NURKIN
FORMER CEO JCMC1412658180149445
CYNTHIA SALYER
VPCARDIO-PULMONARY6379019891153995420618268260150

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
FRINGE OR EXPENSE EXPLANATIONSCHEDULE J, PAGE 1, PART I, LINE 1ABOARD MEMBERS AND TEAM MEMBERS OF MSHA ARE NOT PERMITTED TO TRAVEL FIRST-CLASS WITH THE EXCEPTION OF MSHA'S CEO. AS SANCTIONED BY MSHA'S BOARD OF DIRECTORS, MSHA'S CEO IS PERMITTED TO TRAVEL FIRST-CLASS WHEN THE FLIGHT'S DURATION IS GREATER THAN TWO HOURS. DUE TO THE LENGTH OF SUCH FLIGHTS, THE BOARD BELIEVES IT IS IN THE BEST INTEREST OF MSHA FOR THE CEO TO TRAVEL FIRST-CLASS. CHARTER TRAVEL IS LIMITED TO MSHA BUSINESS TRIPS THAT INCLUDE NUMEROUS TRAVELERS AND WHICH CAN BE JUSTIFIED BASED UPON FINANCIAL AND/OR ESSENTIAL TIME SAVINGS. CHARTER FLIGHTS MUST BE APPROVED BY THE CEO PRIOR TO BOOKING THE FLIGHT.
SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTSSCHEDULE J, PAGE 1, PART I, LINE 4CANDACE JENNINGS 0 41,057 0 ANN FLEMING 0 35,925 0 DAVID NICELY 0 14,885 0 MONTY MCLAURIN 0 13,518 0 MORRIS SELIGMAN, M.D. 0 43,110 0 DOUGLAS EDEMA 0 16,778 0 JAMES PASKERT, M.D. 0 17,385 0
OTHER ADDITIONAL INFORMATIONSCHEDULE J, PART IIIPART I, LINE 4B: DENNIS VONDERFECHT RECEIVED PAYMENT OF 1,683,614 DURING THE REPORTING PERIOD FROM A 457(F) DEFERRED COMPENSATION PLAN THAT SPANNED A NUMBER OF YEARS. MR. VONDERFECHT MET THE CONDITIONS FOR PAYOUT FROM THE AT-RISK PLAN AND MSHA WITHHELD FEDERAL, STATE AND LOCAL TAXES AS REQUIRED BY LAW. MR. VONDERFECHT SERVED AS MSHA'S CEO FOR 24 YEARS AND RETIRED AT THE END OF 2013. THE FOLLOWING EXECUTIVES LISTED IN SCHEDULE J, PART II PARTICIPATED IN A 457(F) RETIREMENT PLAN PROVIDED BY MOUNTAIN STATES HEALTH ALLIANCE (MSHA): DENNIS VONDERFECHT, ANN FLEMING, CANDACE JENNINGS, MONTY MCLAURIN, CINDY SALYER, MORRIS SELIGMAN, FRANK LAURO, DAVID NICELY, JAMES PASKERT, DOUGLAS EDEMA, AND CARL KILGORE. THE 457(F)PLAN IS A NONQUALIFIED TAX-DEFERRED COMPENSATION PLAN AVAILABLE TO A SELECT GROUP OF KEY EXECUTIVES FOR THE INTENT OF SUPPORTING RETENTION AND TO OFFER A COMPETITIVE TOTAL RETIREMENT PROGRAM. ACCOUNT BALANCES HAVE A "SUBSTANTIAL RISK OF FORFEITURE". IN ADDITION TO CREDITOR RISK, SUBSTANTIAL RISK OF FORFEITURE IS CREATED THROUGH DEFAULT RISK IF THE PARTICIPANT'S EMPLOYMENT WITH MSHA IS TERMINATED PRIOR TO AGE 65. HOWEVER, THE 457(F) PLAN CONTAINS A NON-COMPETE PROVISION THAT PROVIDES THE ACCOUNT BALANCE TO BE PAID IN A LUMP SUM AFTER THE EXECUTIVE SATISFIES THE TWO-YEAR NON-COMPETE PERIOD. THIS PROVISION APPLIES TO EMPLOYER CONTRIBUTIONS IF THE EXECUTIVE HAS PROVIDED ELIGIBLE SERVICE FOR SIX OR MORE YEARS. (ELIGIBLE SERVICE IS OFFICER SERVICE THAT PERMITTED THE EXECUTIVE TO PARTICIPATE IN THE PLAN.) THE EXECUTIVE WILL RECEIVE THE ENTIRE ACCOUNT BALANCE IF HE/SHE BECOMES DISABLED, DIES OR IF THE EXECUTIVE TERMINATES FOR "GOOD REASON" OR IS INVOLUNTARILY TERMINATED WITHOUT "GOOD CAUSE" WITHIN A 24 MONTH PERIOD AFTER A CHANGE-OF-CONTROL OCCURS. DISTRIBUTIONS FROM THIS PLAN ARE SUBJECT TO FEDERAL, STATE, AND LOCAL TAXES ON THE ENTIRE ACCOUNT BALANCE UPON DISTRIBUTION.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Bond ReferenceBondReferenceCdBusiness Name Line2IssuerName/BusinessNameLine2Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
HLTH & EDU FACIL BD 2011A&B&C&D
AOF THE CITY OF JOHNSON CITY TN621464028478271JS92011-10-19195840000CONSTRUCTION & EQUIP.falsefalsefalse
HLTH & EDU FACILITIES BD 2010A&B
B621464028478271JH32010-04-29205877528PARTIAL REFUNDINGfalsefalsefalse
HLTH & EDU FACILIT BD 2009AB&C
C621464028478271HT92009-03-31124301533CONSTRUCTION & EQUIP.falsefalsefalse
HLTH & EDU FACILITIES BD 2008A&B
D621464028478271HL62008-02-20127000000ACQUIRE, CONSTRUCTfalsefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Bond ReferenceBondReferenceCdAmount RetiredAmountRetiredTotal ProceedsTotalProceedsIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsAmount UnspentAmountUnspentCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindCapitalized InterestCapitalizedInterestCredit EnhancementCreditEnhancementYear Of Subst CompletionYearOfSubstCompletion
A49750001958400002353905157897590341665051422000truefalsefalsetrue
B1707000020613269934746441974610058297792truefalsefalsetrue
C2435000125642956248170699702968150966668361616falsefalsefalsetrue
D6179000012970030619535637739402247308380falsefalsetruetrue27193653249752012

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyEngage Bond Counsel ContractsEngageBondCounselContractsAny Research AgreementsAnyResearchAgreementsBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropRemedial Action TakenRemedialActionTakenNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
Afalsefalsetruetruefalsefalsefalsefalsetrue
Bfalsefalsetruetruefalsefalsefalsefalsetrue
Cfalsefalsetruetruefalsefalsefalsefalsetrue
Dfalsefalsetruetruefalsefalsefalsefalsetrue

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqsBusiness Name Line2NameOfHedgeProvider/BusinessNameLine2Term Of HedgeTermOfHedgeSuperintegrated HedgeSuperintegratedHedgeHedge TerminatedHedgeTerminated
(no name)
Afalsetruefalsefalsetruefalsefalsefalsetrue
(no name)
Bfalsetruefalsefalsefalsefalsefalsetruetrue
(no name)
Cfalsetruefalsefalsefalsefalsefalsetruetrue
MERRILL LYNCH
DfalsefalsefalsetruetruetruefalsetruetrueCAPITAL SERVICES INC30.4falsefalse

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Proc To Undertk Corrective ActiontrueProcToUndertkCorrectiveAction

Form990 Schedule K Part VI Form990ScheduleKPartVI (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
PURPOSE OF ISSUE DESCRIPTIONSCHEDULE KHLTH EDU FACIL BD 2011ABCD LINE A CONSTRUCT AND EQUIP HOSPITAL FACILITIESINCLUDING REFINANCING TAXABLE DEBT RELATING THERETO REFUND BONDS ISSUED 12012001 REFINANCING LOANS AND EQUIPMENT LEASES HLTH EDU FACILITIES BD 2010AB LINE B PARTIAL REFUNDING OF BONDS ISSUED 12142007 2007A AND 2007C AND 2202008 2008A HLTH EDU FACILIT BD 2009ABC LINE C CONSTRUCT AND EQUIP HOSPITAL FACILITIESINCLUDING REFINANCING OF TAXABLE INDEBTEDNESS RELATING THERETO HLTH EDU FACILITIES BD 2008AB LINE D ACQUIRE CONSTRUCT AND EQUIP HOSPITAL FACILITIES INCLUDING REFINANCING OF TAXABLE INDEBTEDNESS RELATING THERETO AND WORKING CAPITAL EXPENDITURES RELATING TO CAPITAL EXPENDITURES HLTH EDU FACILITIES BD 2006A LINE E CONSTRUCT AND EQUIP HOSPITAL FACILITIESINCLUDING REFINANCING TAXABLE DEBT RELATING THERETO AND COST OF INTEREST RATE HEDGE REFUND BONDS ISSUED 32801 70103 70804 112304 9705 AND 112305 HLTH EDU FACILIL BD 2012ABC LINE F CONSTRUCT AND EQUIP SURGERY CENTER AT JCMC CONSTRUCT AND EQUIP HOSPITAL FACILITIES INCLUDING REFINANCING OF INDEBTEDNESS RELATING THERETO
DATE REBATE COMPUTATION PERFORMEDSCHEDULE KHLTH EDU FACILITIES BD 2008AB 022013 HLTH EDU FACILITIES BD 2006A 021710
ADDITIONAL INFORMATIONSCHEDULE KHLTH EDU FACILITIES BD 2006A SCHEDULE K PART VI 1COMMENT ON SCHEDULE K PART I LINES A B C D AND F MOUNTAIN STATES HEALTH ALLIANCE OWNS ANDOR OPERATES HOSPITALS IN A NUMBER OF DIFFERENT LOCATIONS BOTH IN TENNESSEE AND IN VIRGINIA AS A RESULT MOUNTAIN STATES HEALTH ALLIANCE MUST UTILIZE CONDUIT GOVERNMENTAL BOND ISSUERS IN A NUMBER OF JURISDICTIONS IN ORDER TO FINANCE IMPROVEMENTS TO ITS HOSPITAL FACILITIES IN 2008 2009 2010 2011 AND 2012 MOUNTAIN STATES HEALTH ALLIANCE WAS THE CONDUIT BORROWER OF TAXEXEMPT BONDS ISSUED BY MULTIPLE ISSUERS IN TENNESSEE AND VIRGINIA FOR FEDERAL TAX PURPOSES EVEN THOUGH DIFFERENT GOVERNMENT ISSUERS WERE INVOLVED THESE MULTIPLE ISSUES IN EACH YEAR WERE REQUIRED TO BE TREATED AND WERE TREATED AS A SINGLE ISSUE BECAUSE THEY MET THE SINGLE ISSUE TEST UNDER THE APPLICABLE FEDERAL TAX REGULATIONS THEREFORE MULTIPLE ISSUERS ARE LISTED UNDER LINES A B C D AND F BECAUSE THE BONDS THAT WERE ISSUED WERE PART OF A SINGLE ISSUE FOR FEDERAL TAX PURPOSES 2COMMENT ON SCHEDULE K PART II LINE 3 FOR THE BOND ISSUES LISTED IN LINES B C D E AND F DOES NOT MATCH THE APPLICABLE ISSUE PRICE FOR EACH SUCH BOND ISSUE BECAUSE OF INTEREST EARNINGS EARNED ON THE SALE PROCEEDS OF EACH SERIES OF BONDS 3COMMENT ON SCHEDULE K PART II LINES 9 THROUGH 11 THE INSTRUCTIONS ARE UNCLEAR AS TO WHETHER AMOUNTS USED TO REFINANCE SHORTTERM TAXABLE LOANS INCURRED TO TEMPORARILY FINANCE ELIGIBLE COSTS SHOULD BE SHOWN AS CAPITAL EXPENDITURES AND WORKING CAPITAL LINES 9 AND 10 OR AS OTHER SPENT PROCEEDS LINE 11 BASED UPON A REVIEW OF OTHER 990 FILINGS IT APPEARS THAT MOST REPORTING ENTITIES HAVE LISTED THE APPLICATION OF PROCEEDS FOR SUCH PURPOSE UNDER OTHER SPENT PROCEEDS LINE 11 THIS FILING TAKES THAT APPROACH 4COMMENT ON SCHEDULE K PART II LINE 12 IT IS UNCLEAR UNDER THE INSTRUCTIONS WHETHER TRANSFERRED PROCEEDS SHOULD BE TREATED AS OTHER UNSPENT PROCEEDS FOR REPORTING PURPOSES ON LINE 12 AS AN ABUNDANCE OF CAUTION TRANSFERRED PROCEEDS HAVE BEEN INCLUDED ON LINE 12 FOR EACH ISSUE TO THE EXTENT APPLICABLE DURING THE FISCAL YEAR AS TO WHICH THIS SCHEDULE RELATES MOUNTAIN STATES HEALTH ALLIANCE WAS ABLE TO REMOVE THE REQUIREMENT THAT CERTAIN DEBT SERVICE RESERVE FUNDS BE MAINTAINED AS A RESULT MOUNTAIN STATES HEALTH ALLIANCE WAS ABLE TO TRANSFER PROCEEDS FROM DEBT SERVICE RESERVE FUNDS FOR CERTAIN ISSUES TO BOND SINKING FUNDS FOR THOSE ISSUES TO PAY PRINCIPAL ON THE ISSUE AND TO REDUCE THE AMOUNT OF TAXEXEMPT BONDS OUTSTANDING IN THE MARKET AS A RESULT UNSPENT PROCEEDS HAVE INCREASED FOR CERTAIN ISSUES WHILE SUCH FUNDS ARE HELD IN THE BOND SINKING FUNDS AND THE AMOUNTS PREVIOUSLY HELD IN DEBT SERVICE RESERVE FUNDS FOR SUCH ISSUES HAVE BEEN REDUCED MOUNTAIN STATES HEALTH ALLIANCE IS USING SUCH PROCEEDS TO PAY PRINCIPAL AS QUICKLY ON THOSE ISSUES AS THE BOND DOCUMENTS PERMIT 5COMMENT ON SCHEDULE K PART IV LINE 1 PRIOR TO JUNE 30 2013 THE REPORTING DATE OF THE 990 THE ONLY ARBITRAGE REBATE CALCULATIONS THAT WERE REQUIRED RELATED TO THE BONDS DESCRIBED IN LINES D AND E OF PART I THE SERIES 2006 AND 2008 BONDS MOUNTAIN STATES HEALTH ALLIANCE RETAINED A REBATE CALCULATION AGENT TO CALCULATE WHETHER ANY ARBITRAGE REBATE WAS DUE WITH RESPECT TO THOSE BONDS AND THERE WAS NEGATIVE ARBITRAGE REBATE LIABILITY IN A SIGNIFICANT AMOUNT THEREFORE NO FORM 8038T WAS REQUIRED TO BE FILED WITH RESPECT TO THOSE BOND ISSUES 6COMMENT ON SCHEDULE K PART IV LINE 4D PART IV LINE 4D RELATIVE TO THE BOND ISSUE DESCRIBED ON LINE E SHOWS THAT THE REGULATORY SAFE HARBOR FOR ESTABLISHING FAIR MARKET VALUE OF THE GIC DESCRIBED IN LINE 4A WAS NOT SATISFIED DUE TO MARKET CONDITIONS AT THE TIME MOUNTAIN STATES HEALTH ALLIANCE DID NOT RECEIVE THREE BIDS FOR THIS GIC HOWEVER THE YIELD ON THE GIC WAS SO SUBSTANTIALLY BELOW THE YIELD ON THE RELEVANT BONDS THAT THERE WAS NO DOUBT THAT THE YIELD ON THE GIC DID NOT EXCEED THE APPROPRIATE YIELD ON THE RELEVANT BONDS 7COMMENT ON SCHEDULE K PART IV LINE 5 THE BOND ISSUES DESCRIBED IN LINES B C AND D OF PART I FINANCED SIGNIFICANT CAPITAL IMPROVEMENTS TO HOSPITAL FACILITIES THERE HAVE BEEN UNEXPECTED DELAYS IN THE CONSTRUCTION AND EQUIPPING OF CERTAIN OF THESE HOSPITAL FACILITIES AND THEREFORE NOT ALL OF THE BOND PROCEEDS WERE SPENT WITHIN THE THREEYEAR TEMPORARY PERIOD RELATIVE TO CONSTRUCTION PROJECTS HOWEVER MOUNTAIN STATES HEALTH ALLIANCE HAS YIELD RESTRICTED THESE PROCEEDS AFTER THE END OF THE APPLICABLE TEMPORARY PERIOD ANDOR WILL BE MAKING A YIELD REDUCTION PAYMENT WITH RESPECT TO THOSE PROCEEDS IF REQUIRED

Schedule L IRS990ScheduleL

Loan Table LoanTable (6 entries)

Purpose Of LoanPurposeOfLoanLoan From OrganizationLoanFromOrganizationOriginal PrincipalOriginalPrincipalAmountBalance DueBalanceDueDefaultDefaultApproved By BoardApprovedByBoardWritten AgreementWrittenAgreement
DENNIS VONDERFECHT
SPLIT LIFE INSUR.LOAN,INCL.PR.YRSX$6,444,8057367035falsetruetrue
MARVIN EICHORN
SPLIT DOLLAR LIFE INSURANCE LOANX$350,000360710falsetruetrue
MARVIN EICHORN
SPLIT DOLLAR LIFE INSURANCE LOANX$304,332304332falsetruetrue
MARVIN EICHORN
SPLIT DOLLAR LIFE INSURANCE LOANX$272,483272483falsetruetrue
MARVIN EICHORN
SPLIT DOLLAR LIFE INSURANCE LOANX$91,68293947falsetruetrue
MARVIN EICHORN
SPLIT DOLLAR LIFE INSURANCE LOANX$91,68293947falsetruetrue
FieldValueIRS element (for citing)
Total Balance Due8492454TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (8 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
WATAUGA PATHOLOGY ASSOC PC
M.D. SERVICES340304SEE PART Vfalse
MATTHEW MARTIN
FAMILY MEMBER18268SEE PART Vfalse
MITCH HATHAWAY
FAMILY MEMBER98315SEE PART Vfalse
SYCAMORE SHOALS ANESTHESIA ASSOC
M.D. SERVICES819996SEE PART Vfalse
PAULA CLAYTORE
FAMILY MEMBER272107SEE PART Vfalse
CLEM WILKES III
FAMILY MEMBER65040SEE PART Vfalse
JAMES TEIXEIRA
FAMILY MEMBER76017SEE PART Vfalse
WORKSPACE INTERIORS INC
VENDOR645484SEE PART Vfalse

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
IdentifierADDITIONAL INFORMATIONIdentifier
Return ReferenceSCHEDULE L PART VReturnReference
Explanation1 SANDRA BROOKS MD MSHA BOARD MEMBER IS A PARTNER WITH OWNERSHIP INTEREST IN WATAUGA PATHOLOGY ASSOCIATES PC WATAUGA PATHOLOGY ASSOCIATES PC PROVIDES MEDICAL SERVICES TO MSHA 2 JOANNE GILMER VICECHAIR MSHA BOARD OF DIRECTORS IS A FAMILY MEMBER OF MATTHEW MARTIN AN EMPLOYEE OF MSHA 3 JOANNE GILMER VICECHAIR MSHA BOARD OF DIRECTORS IS A FAMILY MEMBER OF MITCH HATHAWAY AN EMPLOYEE OF MSHA 4 DAVID MAY MD MSHA BOARD MEMBER SERVES AS BOARD CHAIR FOR SYCAMORE SHOALS ANESTHESIA ASSOCIATES PC AND HAS AN OWNERSHIP SHARE IN THE PROFESSIONAL CORPORATION SYCAMORE SHOALS ANESTHESIA ASSOCIATES PC PROVIDES MEDICAL SERVICES TO MSHA 5 DALE CLAYTORE FORMER KEY EMPLOYEE OF MSHA IS A FAMILY MEMBER OF PAULA CLAYTORE AN EMPLOYEE OF MSHA 6 CLEM WILKES JR TREASURER OF THE MSHA BOARD OF DIRECTORS IS A FAMILY MEMBER OF CLEM WILKES III AN EMPLOYEE OF MSHA 7 PAT NIDAY FORMER KEY EMPLOYEE OF MSHA IS A FAMILY MEMBER OF JAMES TEIXEIRA AN EMPLOYEE OF MSHA 8 ROBERT FEATHERS MSHA BOARD MEMBER IS OWNER OF WORKSPACE INTERIORS INC WHICH PROVIDES COMMERCIAL FURNISHINGS AND DESIGN SERVICES TO MSHA TRANSACTIONS ARE CONDUCTED AT ARMSLENGTHExplanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (14 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DOING BUSINESS ASFORM 990, PAGE 1, ITEM CNISWONGER CHILDREN'S HOSPITAL; QUILLEN REHABILITATION HOSPITAL; FRANKLIN WOODS COMMUNITY HOSPITAL; INDIAN PATH MEDICAL CENTER; SYCAMORE SHOALS HOSPITAL; WOODRIDGE HOSPITAL FOR BEHAVIORAL HEALTH SERVICES; JOHNSON COUNTY COMMUNITY HOSPITAL; RUSSELL COUNTY MEDICAL CENTER
ORGANIZATION'S MISSIONFORM 990 - ORGANIZATION'S MISSIONPART I, LINE 1: MOUNTAIN STATES HEALTH ALLIANCE (MSHA) IS COMMITTED TO OUR MISSION OF BRINGING LOVING CARE TO HEALTH CARE. WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTHCARE NEEDS OF INDIVIDUALS AND COMMUNITIES IN THE 29-COUNTY AREA WE SERVE, HELPING THEM ATTAIN THEIR HIGHEST LEVEL OF HEALTH. MSHA DELIVERS THIS CARE THROUGH THE PHILOSOPHY OF PATIENT-CENTERED CARE, AND THE DEVELOPMENT OF COMPREHENSIVE STRATEGIC PLANNING AND IMPLEMENTATION. SEE ATTACHED NARRATIVE-PROGRAM SERVICE ACCOMPLISHMENTS.
SIGNIFICANT CHANGES TO ORGANIZATIONAL DOCUMENTSFORM 990, PAGE 6, PART VI, LINE 4BY OPERATION OF THE CHARTER OF THE ORGANIZATION, THE VOTING MEMBERSHIP OF THE ORGANIZATION CEASED TO EXIST DURING THIS FISCAL YEAR. AS A RESULT OF THIS OCCURRENCE, THE ORGANIZATION BECAME A NON-MEMBERSHIP CORPORATION UNDER TENNESSEE LAW, AND THE BOARD OF DIRECTORS BECAME A SELF PERPETUATING BOARD. AS A RESULT, THE CHARTER AND BYLAWS OF THE ORGANIZATION WERE MODIFIED TO REFLECT THE CURRENT STRUCTURE OF THE ORGANIZATION.
CLASSES OF MEMBERS OR STOCKHOLDERSFORM 990, PAGE 6, PART VI, LINE 6DURING A PORTION OF THIS FISCAL YEAR, THE ORGANIZATION DID HAVE MEMBERS, BUT THE MEMBERSHIP CEASED TO EXIST DURING THE YEAR, AND THE ORGANIZATION BECAME A NON-MEMBERSHIP CORPORATION.
ELECTION OF MEMBERS AND THEIR RIGHTSFORM 990, PAGE 6, PART VI, LINE 7ADURING A PORTION OF THE YEAR, THE ORGANIZATION HAD MEMBERS. AS A RESULT, THE ANSWER TO THIS QUESTION IS YES, BUT FOR ONLY A PORTION OF THE YEAR. DURING THE PERIOD WHEN MSHA HAD MEMBERS, THE CLASS A MEMBERS ANNUALLY ELECTED MEMBERS TO THE BOARD OF DIRECTORS.
DECISIONS SUBJECT TO APPROVAL OF MEMBERSFORM 990, PAGE 6, PART VI, LINE 7BDURING A PORTION OF THE YEAR, THE ORGANIZATION HAD MEMBERS. CERTAIN DECISIONS OF THE BOARD ARE, PURSUANT TO TENNESSEE STATUTE, SUBJECT TO APPROVAL BY THE CLASS A 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.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BTHE CFO AND SENIOR VP REVIEWED THE FORM 990 WITH THE BOARD OF DIRECTORS PRIOR TO FILING AND THE RETURN WAS MADE AVAILABLE TO EACH BOARD MEMBER IN AN ELECTRONIC FORMAT PRIOR TO THE REVIEW.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CANNUALLY, THE CORPORATE AUDIT AND COMPLIANCE DEPARTMENT OF MSHA FORWARDS THE CONFLICT OF INTEREST POLICY AND DISCLOSURE FORM TO ALL MSHA MANAGEMENT TEAM MEMBERS AND BOARD MEMBERS. 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.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15ATHE CEO'S COMPENSATION AND BENEFITS 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. THE BOARD OF DIRECTORS MONITORS THE PERFORMANCE OF THE SENIOR MANAGEMENT TEAM ON AN ONGOING BASIS, BUT AT LEAST ANNUALLY.
COMPENSATION PROCESS FOR OFFICERSFORM 990, PAGE 6, PART VI, LINE 15BSIMILAR 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.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE UPON REQUEST TO APPROPRIATE PARTIES REQUESTING THEM. FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST TO APPROPRIATE PARTIES REQUESTING THEM, AND THEY ARE MADE AVAILABLE TO THOSE PARTIES WHO OWN INDEBTEDNESS OF THE COMPANY ON A QUARTERLY BASIS.
GROUP RETURN EXPLANATIONFORM 990, PAGE 7, PART VIIOFFICER, KEY EMPLOYEE & HIGHEST PAID COMPENSATION: LYNN KRUTAK, CFO AND MSHA KEY EMPLOYEE, IS PAID BY MSHA. BLUE RIDGE MEDICAL MANAGEMENT CORPORATION (BRMMC) REIMBURSES MSHA FOR 50% OF KRUTAK'S SALARY AND BENEFITS. MSHA IS THE SOLE MEMBER OF BRMMC. KRUTAK DEVOTES AN EQUAL AMOUNT OF TIME BETWEEN MSHA AND BRMMC. DR. DOUGLAS EDEMA, REPORTABLE AS A HIGHEST COMPENSATED EMPLOYEE, IS PAID BY MSHA AND HIS SALARY AND BENEFITS ARE FULLY REIMBURSED TO MSHA BY BRMMC. CERTAIN EXECUTIVES OF THE ORGANIZATION, SUCH AS THE CEO AND SR VP/CFO, PROVIDE SERVICES TO SOME OR ALL OF THE ORGANIZATIONS RELATED TO MSHA.
OTHER FEES FOR SERVICESFORM 990, PART IX, LINE 11G84,136,191 7,818,901 229,313
OTHER CHANGES IN NET ASSETS EXPLANATIONFORM 990, PART XI, LINE 9PARTNERSHIP CHARITABLE CONTRIBUTION NOT ON BOOKS 61,080 PORTFOLIO EXPENSES NOT ON BOOKS 5 PARTNERSHIP GAIN NOT ON BOOKS -119 CHANGE IN FAIR VALUE OF DERIVATIVES -29,805 P/S ORDINARY INCOME/LOSS-NOT ON BOOKS -2,104,308 P/S INTEREST INCOME-NOT ON BOOKS -19,823 TEMPORARILY RESTRICTED GRANTS 23,482 TOTAL TO FORM 990, PART XI, LINE 9 -2,116,452

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
DICKENSON COMMUNITY HOSPITAL
ONE HOSPITAL DRIVECLINTWOODVA24228770599553HOSPITALVA501C33NCHfalse
MOUNTAIN STATES FOUNDATION
2335 KNOB CREEK ROAD STE 101JOHNSON CITYTN37604581418862FUNDRAISERTN501C311ANAfalse
MSHA AUXILIARY
400 N STATE OF FRANKLIN ROADJOHNSON CITYTN37604581418345SUPPORTTN501C311ANAfalse
SMYTH COUNTY COMMUNITY HOSPITAL
245 MEDICAL PARK DRIVEMARIONVA24354540794913HOSPITALVA501C33MSHAfalse
NORTON COMMUNITY HOSPITAL
100 15TH STREET NWNORTONVA24273540566029HOSPITALVA501C33NAfalse
JOHNSTON MEMORIAL HOSPITAL
16000 JOHNSTON MEMORIAL DRIVEABINGDONVA24211540544705HOSPITALVA501C33NAfalse
ABINGDON PHYSICIAN PARTNERS
16000 JOHNSTON MEMORIAL DRIVEABINGDONVA24211205485346MED. SERV.VA501C311AJMHfalse
APPALACHIAN EMERGENCY PHYSICIANS
1021 W OAKLAND AVENUE STE 207JOHNSON CITYTN37604800592504MED. SERVVA501C311ANAfalse

Form990 Schedule R Part III Form990ScheduleRPartIII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
INTEGRATED SOLUTIONS HEALTH NETWORK
400 N STATE OF FRANKLIN ROADJOHNSON CITYTN37604621711997INVESTMENTTNNAEXCLUDED-179855942091falsefalse0.99170
EMMAUS COMMUNITY HEALTHCARE LLC
6070 HWY 11EPINEY FLATSTN37686200577483MED. SERV.TNNAfalsefalse
MEDICAL SPECIALISTS OF JC LLC
2528 WESLEY STREET SUITE 2JOHNSON CITYTN37601272199037MED. SERV.TNNAEXCLUDED-23441981508falsefalse0.51000
INTEGRATED SOLUTIONS HEALTH NETWORK
400 N STATE OF FRANKLIN ROADJOHNSON CITYTN37604621711997INVESTMENTTNNAEXCLUDED-179855942091falsefalse0.99170
EMMAUS COMMUNITY HEALTHCARE LLC
6070 HWY 11EPINEY FLATSTN37686200577483MED. SERV.TNNAfalsefalse
MEDICAL SPECIALISTS OF JC LLC
2528 WESLEY STREET SUITE 2JOHNSON CITYTN37601272199037MED. SERV.TNNAEXCLUDED-23441981508falsefalse0.51000

Form990 Schedule R Part IV Form990ScheduleRPartIV (16 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipControlled OrgControlledOrg
BLUE RIDGE MEDICAL MANAGEMENT CORP
1021 W OAKLAND AVENUE STE 207JOHNSON CITYTN37604621490616MED. SERV.TNNAC CORP1050589612031418891.00000false
MEDISERVE MEDICAL EQUIPMENT
1021 W OAKLAND AVENUE SUITE 207JOHNSON CITYTN37604621212286DMETNBRMMCC CORP506556542791861.00000false
MOUNTAIN STATES PROPERTIES
1021 W OAKLAND AVENUE SUITE 207JOHNSON CITYTN37604621845895PROP. MGMTTNBRMMCC CORP147865751491562491.00000false
MOUNTAIN STATES PHYSICIAN GROUP
1021 W OAKLAND AVENUE SUITE 207JOHNSON CITYTN37604621700412MED. SERV.TNBRMMCC CORP5944691761314111.00000false
COMMUNITY HOME CARE INC
1460 PARK AVENUENORTONVA24273541453810DMEVANCHC CORP3750023823700.50100false
SOUTHWEST COMMUNITY HEALTH SERV
PO BOX 880MARIONVA24354541460695MED. SERV.VASCCHC CORP19085210982140.80000false
WILSON PHARMACY INC
PO BOX 5289JOHNSON CITYTN37604620329587PHARMACYTNBRMMCC CORP478218129036511.00000false
CRESTPOINT HEALTH INSURANCE COMPANY
208 SUNSET DRIVE SUITE 101JOHNSON CITYTN37604620381170INSURANCETNISHNC CORP0.99170false
BLUE RIDGE MEDICAL MANAGEMENT CORP
1021 W OAKLAND AVENUE STE 207JOHNSON CITYTN37604621490616MED. SERV.TNNAC CORP1050589612031418891.00000false
MEDISERVE MEDICAL EQUIPMENT
1021 W OAKLAND AVENUE SUITE 207JOHNSON CITYTN37604621212286DMETNBRMMCC CORP506556542791861.00000false
MOUNTAIN STATES PROPERTIES
1021 W OAKLAND AVENUE SUITE 207JOHNSON CITYTN37604621845895PROP. MGMTTNBRMMCC CORP147865751491562491.00000false
MOUNTAIN STATES PHYSICIAN GROUP
1021 W OAKLAND AVENUE SUITE 207JOHNSON CITYTN37604621700412MED. SERV.TNBRMMCC CORP5944691761314111.00000false
COMMUNITY HOME CARE INC
1460 PARK AVENUENORTONVA24273541453810DMEVANCHC CORP3750023823700.50100false
SOUTHWEST COMMUNITY HEALTH SERV
PO BOX 880MARIONVA24354541460695MED. SERV.VASCCHC CORP19085210982140.80000false
WILSON PHARMACY INC
PO BOX 5289JOHNSON CITYTN37604620329587PHARMACYTNBRMMCC CORP478218129036511.00000false
CRESTPOINT HEALTH INSURANCE COMPANY
208 SUNSET DRIVE SUITE 101JOHNSON CITYTN37604620381170INSURANCETNISHNC CORP0.99170false
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiestrueReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgtrueLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgtrueSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgtruePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (376 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
MSHA AUXILIARY
P71464
MSHA AUXILIARY
Q279988
BLUE RIDGE MEDICAL MANAGMENT CORP
L10728044
BLUE RIDGE MEDICAL MANAGEMENT CORP
M37124494
BLUE RIDGE MEDICAL MANAGEMENT CORP
O1980659
BLUE RIDGE MEDICAL MANAGEMENT CORP
Q8844230
HEALTH PLUS
J57281
HEALTHPLUS
L408335
HEALTHPLUS
M332150
HEALTHPLUS
O103659
HEALTHPLUS
P68399
HEALTHPLUS
Q12333583
HEALTHPLUS
R621612
MEDISERVE
K179587
MEDISERVE
L169719
MEDISERVE
O53550
MEDISERVE
P193553
MEDISERVE
Q2441200
MOUNTAIN STATES PROPERTIES
G941514
MOUNTAIN STATES PROPERTIES
K2070952
MOUNTAIN STATES PROPERTIES
L249140
MOUNTAIN STATES PROPERTIES
O73430
MOUNTAIN STATES PROPERTIES
Q745635
MOUNTAIN STATES PROPERTIES
R736347
MOUNTAIN STATES FOUNDATION
B58000
MOUNTAIN STATES FOUNDATION
C1513427
NORTON COMMUNITY HOSPITAL
D21238380
NORTON COMMUNITY HOSPITAL
L5850147
NORTON COMMUNITY HOSPTIAL
N482656
NORTON COMMUNITY HOSPITAL
P6856647
NORTON COMMUNITY HOSPITAL
Q691339
DICKENSON COMMUNITY HOSPITAL
P982689
ISHN
A50000
ISHN
B6882150
ISHN
L232591
ISHN
M2158748
ISHN
P133333
ISHN
Q1351630
SMYTH COUNTY COMMUNITY HOSPITAL
D16208216
SMYTH COUNTY COMMUNITY HOSPITAL
L4757932
SMYTH COUNTY COMMUNITY HOSPITAL
Q67367
JOHNSTON MEMORIAL HOSPITAL
L10436254
JOHNSTON MEMORIAL HOSPTIAL
O887811
JOHNSTON MEMORIAL HOSPITAL
P72637
JOHNSTON MEMORIAL HOSPITAL
R216014
APP
M1078900
APP
L1927539
MSHA AUXILIARY
P71464
MSHA AUXILIARY
Q279988
BLUE RIDGE MEDICAL MANAGMENT CORP
L10728044
BLUE RIDGE MEDICAL MANAGEMENT CORP
M37124494
BLUE RIDGE MEDICAL MANAGEMENT CORP
O1980659
BLUE RIDGE MEDICAL MANAGEMENT CORP
Q8844230
HEALTH PLUS
J57281
HEALTHPLUS
L408335
HEALTHPLUS
M332150
HEALTHPLUS
O103659
HEALTHPLUS
P68399
HEALTHPLUS
Q12333583
HEALTHPLUS
R621612
MEDISERVE
K179587
MEDISERVE
L169719
MEDISERVE
O53550
MEDISERVE
P193553
MEDISERVE
Q2441200
MOUNTAIN STATES PROPERTIES
G941514
MOUNTAIN STATES PROPERTIES
K2070952
MOUNTAIN STATES PROPERTIES
L249140
MOUNTAIN STATES PROPERTIES
O73430
MOUNTAIN STATES PROPERTIES
Q745635
MOUNTAIN STATES PROPERTIES
R736347
MOUNTAIN STATES FOUNDATION
B58000
MOUNTAIN STATES FOUNDATION
C1513427
NORTON COMMUNITY HOSPITAL
D21238380
NORTON COMMUNITY HOSPITAL
L5850147
NORTON COMMUNITY HOSPTIAL
N482656
NORTON COMMUNITY HOSPITAL
P6856647
NORTON COMMUNITY HOSPITAL
Q691339
DICKENSON COMMUNITY HOSPITAL
P982689
ISHN
A50000
ISHN
B6882150
ISHN
L232591
ISHN
M2158748
ISHN
P133333
ISHN
Q1351630
SMYTH COUNTY COMMUNITY HOSPITAL
D16208216
SMYTH COUNTY COMMUNITY HOSPITAL
L4757932
SMYTH COUNTY COMMUNITY HOSPITAL
Q67367
JOHNSTON MEMORIAL HOSPITAL
L10436254
JOHNSTON MEMORIAL HOSPTIAL
O887811
JOHNSTON MEMORIAL HOSPITAL
P72637
JOHNSTON MEMORIAL HOSPITAL
R216014
APP
M1078900
APP
L1927539
MSHA AUXILIARY
P71464
MSHA AUXILIARY
Q279988
BLUE RIDGE MEDICAL MANAGMENT CORP
L10728044
BLUE RIDGE MEDICAL MANAGEMENT CORP
M37124494
BLUE RIDGE MEDICAL MANAGEMENT CORP
O1980659
BLUE RIDGE MEDICAL MANAGEMENT CORP
Q8844230
HEALTH PLUS
J57281
HEALTHPLUS
L408335
HEALTHPLUS
M332150
HEALTHPLUS
O103659
HEALTHPLUS
P68399
HEALTHPLUS
Q12333583
HEALTHPLUS
R621612
MEDISERVE
K179587
MEDISERVE
L169719
MEDISERVE
O53550
MEDISERVE
P193553
MEDISERVE
Q2441200
MOUNTAIN STATES PROPERTIES
G941514
MOUNTAIN STATES PROPERTIES
K2070952
MOUNTAIN STATES PROPERTIES
L249140
MOUNTAIN STATES PROPERTIES
O73430
MOUNTAIN STATES PROPERTIES
Q745635
MOUNTAIN STATES PROPERTIES
R736347
MOUNTAIN STATES FOUNDATION
B58000
MOUNTAIN STATES FOUNDATION
C1513427
NORTON COMMUNITY HOSPITAL
D21238380
NORTON COMMUNITY HOSPITAL
L5850147
NORTON COMMUNITY HOSPTIAL
N482656
NORTON COMMUNITY HOSPITAL
P6856647
NORTON COMMUNITY HOSPITAL
Q691339
DICKENSON COMMUNITY HOSPITAL
P982689
ISHN
A50000
ISHN
B6882150
ISHN
L232591
ISHN
M2158748
ISHN
P133333
ISHN
Q1351630
SMYTH COUNTY COMMUNITY HOSPITAL
D16208216
SMYTH COUNTY COMMUNITY HOSPITAL
L4757932
SMYTH COUNTY COMMUNITY HOSPITAL
Q67367
JOHNSTON MEMORIAL HOSPITAL
L10436254
JOHNSTON MEMORIAL HOSPTIAL
O887811
JOHNSTON MEMORIAL HOSPITAL
P72637
JOHNSTON MEMORIAL HOSPITAL
R216014
APP
M1078900
APP
L1927539
MSHA AUXILIARY
P71464
MSHA AUXILIARY
Q279988
BLUE RIDGE MEDICAL MANAGMENT CORP
L10728044
BLUE RIDGE MEDICAL MANAGEMENT CORP
M37124494
BLUE RIDGE MEDICAL MANAGEMENT CORP
O1980659
BLUE RIDGE MEDICAL MANAGEMENT CORP
Q8844230
HEALTH PLUS
J57281
HEALTHPLUS
L408335
HEALTHPLUS
M332150
HEALTHPLUS
O103659
HEALTHPLUS
P68399
HEALTHPLUS
Q12333583
HEALTHPLUS
R621612
MEDISERVE
K179587
MEDISERVE
L169719
MEDISERVE
O53550
MEDISERVE
P193553
MEDISERVE
Q2441200
MOUNTAIN STATES PROPERTIES
G941514
MOUNTAIN STATES PROPERTIES
K2070952
MOUNTAIN STATES PROPERTIES
L249140
MOUNTAIN STATES PROPERTIES
O73430
MOUNTAIN STATES PROPERTIES
Q745635
MOUNTAIN STATES PROPERTIES
R736347
MOUNTAIN STATES FOUNDATION
B58000
MOUNTAIN STATES FOUNDATION
C1513427
NORTON COMMUNITY HOSPITAL
D21238380
NORTON COMMUNITY HOSPITAL
L5850147
NORTON COMMUNITY HOSPTIAL
N482656
NORTON COMMUNITY HOSPITAL
P6856647
NORTON COMMUNITY HOSPITAL
Q691339
DICKENSON COMMUNITY HOSPITAL
P982689
ISHN
A50000
ISHN
B6882150
ISHN
L232591
ISHN
M2158748
ISHN
P133333
ISHN
Q1351630
SMYTH COUNTY COMMUNITY HOSPITAL
D16208216
SMYTH COUNTY COMMUNITY HOSPITAL
L4757932
SMYTH COUNTY COMMUNITY HOSPITAL
Q67367
JOHNSTON MEMORIAL HOSPITAL
L10436254
JOHNSTON MEMORIAL HOSPTIAL
O887811
JOHNSTON MEMORIAL HOSPITAL
P72637
JOHNSTON MEMORIAL HOSPITAL
R216014
APP
M1078900
APP
L1927539
MSHA AUXILIARY
P71464
MSHA AUXILIARY
Q279988
BLUE RIDGE MEDICAL MANAGMENT CORP
L10728044
BLUE RIDGE MEDICAL MANAGEMENT CORP
M37124494
BLUE RIDGE MEDICAL MANAGEMENT CORP
O1980659
BLUE RIDGE MEDICAL MANAGEMENT CORP
Q8844230
HEALTH PLUS
J57281
HEALTHPLUS
L408335
HEALTHPLUS
M332150
HEALTHPLUS
O103659
HEALTHPLUS
P68399
HEALTHPLUS
Q12333583
HEALTHPLUS
R621612
MEDISERVE
K179587
MEDISERVE
L169719
MEDISERVE
O53550
MEDISERVE
P193553
MEDISERVE
Q2441200
MOUNTAIN STATES PROPERTIES
G941514
MOUNTAIN STATES PROPERTIES
K2070952
MOUNTAIN STATES PROPERTIES
L249140
MOUNTAIN STATES PROPERTIES
O73430
MOUNTAIN STATES PROPERTIES
Q745635
MOUNTAIN STATES PROPERTIES
R736347
MOUNTAIN STATES FOUNDATION
B58000
MOUNTAIN STATES FOUNDATION
C1513427
NORTON COMMUNITY HOSPITAL
D21238380
NORTON COMMUNITY HOSPITAL
L5850147
NORTON COMMUNITY HOSPTIAL
N482656
NORTON COMMUNITY HOSPITAL
P6856647
NORTON COMMUNITY HOSPITAL
Q691339
DICKENSON COMMUNITY HOSPITAL
P982689
ISHN
A50000
ISHN
B6882150
ISHN
L232591
ISHN
M2158748
ISHN
P133333
ISHN
Q1351630
SMYTH COUNTY COMMUNITY HOSPITAL
D16208216
SMYTH COUNTY COMMUNITY HOSPITAL
L4757932
SMYTH COUNTY COMMUNITY HOSPITAL
Q67367
JOHNSTON MEMORIAL HOSPITAL
L10436254
JOHNSTON MEMORIAL HOSPTIAL
O887811
JOHNSTON MEMORIAL HOSPITAL
P72637
JOHNSTON MEMORIAL HOSPITAL
R216014
APP
M1078900
APP
L1927539
MSHA AUXILIARY
P71464
MSHA AUXILIARY
Q279988
BLUE RIDGE MEDICAL MANAGMENT CORP
L10728044
BLUE RIDGE MEDICAL MANAGEMENT CORP
M37124494
BLUE RIDGE MEDICAL MANAGEMENT CORP
O1980659
BLUE RIDGE MEDICAL MANAGEMENT CORP
Q8844230
HEALTH PLUS
J57281
HEALTHPLUS
L408335
HEALTHPLUS
M332150
HEALTHPLUS
O103659
HEALTHPLUS
P68399
HEALTHPLUS
Q12333583
HEALTHPLUS
R621612
MEDISERVE
K179587
MEDISERVE
L169719
MEDISERVE
O53550
MEDISERVE
P193553
MEDISERVE
Q2441200
MOUNTAIN STATES PROPERTIES
G941514
MOUNTAIN STATES PROPERTIES
K2070952
MOUNTAIN STATES PROPERTIES
L249140
MOUNTAIN STATES PROPERTIES
O73430
MOUNTAIN STATES PROPERTIES
Q745635
MOUNTAIN STATES PROPERTIES
R736347
MOUNTAIN STATES FOUNDATION
B58000
MOUNTAIN STATES FOUNDATION
C1513427
NORTON COMMUNITY HOSPITAL
D21238380
NORTON COMMUNITY HOSPITAL
L5850147
NORTON COMMUNITY HOSPTIAL
N482656
NORTON COMMUNITY HOSPITAL
P6856647
NORTON COMMUNITY HOSPITAL
Q691339
DICKENSON COMMUNITY HOSPITAL
P982689
ISHN
A50000
ISHN
B6882150
ISHN
L232591
ISHN
M2158748
ISHN
P133333
ISHN
Q1351630
SMYTH COUNTY COMMUNITY HOSPITAL
D16208216
SMYTH COUNTY COMMUNITY HOSPITAL
L4757932
SMYTH COUNTY COMMUNITY HOSPITAL
Q67367
JOHNSTON MEMORIAL HOSPITAL
L10436254
JOHNSTON MEMORIAL HOSPTIAL
O887811
JOHNSTON MEMORIAL HOSPITAL
P72637
JOHNSTON MEMORIAL HOSPITAL
R216014
APP
M1078900
APP
L1927539
MSHA AUXILIARY
P71464
MSHA AUXILIARY
Q279988
BLUE RIDGE MEDICAL MANAGMENT CORP
L10728044
BLUE RIDGE MEDICAL MANAGEMENT CORP
M37124494
BLUE RIDGE MEDICAL MANAGEMENT CORP
O1980659
BLUE RIDGE MEDICAL MANAGEMENT CORP
Q8844230
HEALTH PLUS
J57281
HEALTHPLUS
L408335
HEALTHPLUS
M332150
HEALTHPLUS
O103659
HEALTHPLUS
P68399
HEALTHPLUS
Q12333583
HEALTHPLUS
R621612
MEDISERVE
K179587
MEDISERVE
L169719
MEDISERVE
O53550
MEDISERVE
P193553
MEDISERVE
Q2441200
MOUNTAIN STATES PROPERTIES
G941514
MOUNTAIN STATES PROPERTIES
K2070952
MOUNTAIN STATES PROPERTIES
L249140
MOUNTAIN STATES PROPERTIES
O73430
MOUNTAIN STATES PROPERTIES
Q745635
MOUNTAIN STATES PROPERTIES
R736347
MOUNTAIN STATES FOUNDATION
B58000
MOUNTAIN STATES FOUNDATION
C1513427
NORTON COMMUNITY HOSPITAL
D21238380
NORTON COMMUNITY HOSPITAL
L5850147
NORTON COMMUNITY HOSPTIAL
N482656
NORTON COMMUNITY HOSPITAL
P6856647
NORTON COMMUNITY HOSPITAL
Q691339
DICKENSON COMMUNITY HOSPITAL
P982689
ISHN
A50000
ISHN
B6882150
ISHN
L232591
ISHN
M2158748
ISHN
P133333
ISHN
Q1351630
SMYTH COUNTY COMMUNITY HOSPITAL
D16208216
SMYTH COUNTY COMMUNITY HOSPITAL
L4757932
SMYTH COUNTY COMMUNITY HOSPITAL
Q67367
JOHNSTON MEMORIAL HOSPITAL
L10436254
JOHNSTON MEMORIAL HOSPTIAL
O887811
JOHNSTON MEMORIAL HOSPITAL
P72637
JOHNSTON MEMORIAL HOSPITAL
R216014
APP
M1078900
APP
L1927539
MSHA AUXILIARY
P71464
MSHA AUXILIARY
Q279988
BLUE RIDGE MEDICAL MANAGMENT CORP
L10728044
BLUE RIDGE MEDICAL MANAGEMENT CORP
M37124494
BLUE RIDGE MEDICAL MANAGEMENT CORP
O1980659
BLUE RIDGE MEDICAL MANAGEMENT CORP
Q8844230
HEALTH PLUS
J57281
HEALTHPLUS
L408335
HEALTHPLUS
M332150
HEALTHPLUS
O103659
HEALTHPLUS
P68399
HEALTHPLUS
Q12333583
HEALTHPLUS
R621612
MEDISERVE
K179587
MEDISERVE
L169719
MEDISERVE
O53550
MEDISERVE
P193553
MEDISERVE
Q2441200
MOUNTAIN STATES PROPERTIES
G941514
MOUNTAIN STATES PROPERTIES
K2070952
MOUNTAIN STATES PROPERTIES
L249140
MOUNTAIN STATES PROPERTIES
O73430
MOUNTAIN STATES PROPERTIES
Q745635
MOUNTAIN STATES PROPERTIES
R736347
MOUNTAIN STATES FOUNDATION
B58000
MOUNTAIN STATES FOUNDATION
C1513427
NORTON COMMUNITY HOSPITAL
D21238380
NORTON COMMUNITY HOSPITAL
L5850147
NORTON COMMUNITY HOSPTIAL
N482656
NORTON COMMUNITY HOSPITAL
P6856647
NORTON COMMUNITY HOSPITAL
Q691339
DICKENSON COMMUNITY HOSPITAL
P982689
ISHN
A50000
ISHN
B6882150
ISHN
L232591
ISHN
M2158748
ISHN
P133333
ISHN
Q1351630
SMYTH COUNTY COMMUNITY HOSPITAL
D16208216
SMYTH COUNTY COMMUNITY HOSPITAL
L4757932
SMYTH COUNTY COMMUNITY HOSPITAL
Q67367
JOHNSTON MEMORIAL HOSPITAL
L10436254
JOHNSTON MEMORIAL HOSPTIAL
O887811
JOHNSTON MEMORIAL HOSPITAL
P72637
JOHNSTON MEMORIAL HOSPITAL
R216014
APP
M1078900
APP
L1927539