2014-05-12T13:05:17-05:00 2013-06-30 990 2012-07-01 620476282 MOUNTAIN STATES HEALTH ALLIANCE MOUN 4233023372 400 N STATE OF FRANKLIN ROAD JOHNSON CITY TN 37604 MARVIN EICHORN 4233023372 2014-05-12 false 2012 2015-11-30 17:44:51Z JOHNSON CITY MEDICAL CENTER ALAN LEVINE 303 MED TECH PARKWAY STE 300 JOHNSON CITY TN 37604 718141895 false X WWW.MSHA.COM X 1945 TN PART 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. 14 7 9102 2897 1245620 160672 2745426 2474339 697705296 674372724 24259649 31675503 10171526 9360388 734881897 717882954 990095 405051 0 309796341 305057437 0 1478925 372114544 376841250 682900980 682303738 51980917 35579216 1517954041 1599476991 1169345060 1201894828 348608981 397582163 X PART 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. false false 568045112 405051 674348316 SEE ATTACHED DOCUMENT: MSHA - PROGRAM SERVICE ACCOMPLISHMENTS FOR GUIDESTAR READERS, OUR PROGRAM SERVICE ACCOMPLISHMENTS MAY BE FOUND AT THE END. 568045112 true true false true false false false false false false true false true true true true false true false false false false false false false false true true true false true true true false false false false true false true true true false false false false false true true true false false true 665 0 true 9102 true true true false false false false false false false false false X 14 7 false false true false true true true true true false true true true true true true true true true true true true VA X MARVIN EICHORN 4233023372 303 MED TECH PARKWAY SUITE 300 JOHNSON CITY TN 37604 X DENNIS VONDERFECHT 57.00 3.00 X X 3163747 0 42698 JEFF FARROW MD 5.00 X 41413 0 0 CLEM WILKES JR 11.00 3.00 X 0 0 0 GARY PEACOCK 7.00 1.00 X 0 0 0 SANDRA BROOKS MD 6.00 2.00 X 0 0 0 RICK STOREY 6.00 X 0 0 0 THOMAS FOWLKES 5.00 1.00 X 0 0 0 LINDA GARCEAU 6.00 X 0 0 0 DONALD JEANES 1.00 X 0 0 0 JOANNE GILMER 9.00 1.00 X 0 0 0 DAVID MAY MD 8.00 X 0 0 0 ROBERT FEATHERS 6.00 3.00 X 0 0 0 MICHAEL CHRISTIAN 10.00 X 0 0 0 BARBARA ALLEN 8.00 X 0 0 0 MARVIN EICHORN 58.00 2.00 X 620102 0 39538 CANDACE JENNINGS 60.00 X 504935 0 77850 ANN FLEMING 53.50 6.50 X 426280 0 66282 DAVID NICELY 55.00 X 355009 0 54424 MONTY MCLAURIN 55.00 X 326159 0 58687 LYNN KRUTAK 55.00 X 252982 0 34227 SHANE HILTON 55.00 X 239117 0 36111 MORRIS SELIGMAN MD 60.00 X 547923 0 93706 DOUGLAS EDEMA 55.00 X 408337 0 56282 JAMES PASKERT MD 55.00 X 403873 0 55967 JOHN SCHARIO 57.00 3.00 X 401522 0 31188 KATHERINE BALL 50.00 X 398795 0 21625 DALE CLAYTORE 55.00 X 231575 0 13855 PAT NIDAY 55.00 X 196642 0 33699 BRAD NURKIN 55.00 X 141265 0 8180 CYNTHIA SALYER X 237676 0 22474 8897352 746793 200 true true false SKANSKA USA BUILDING INC 1633 LITTLETON ROAD PARSIPPANY NJ 07054 CONSTRUCTION 14766320 ETSU COLLEGE OF MEDICINE BOX 70732 JOHNSON CITY TN 37614 PRIMARILY PHYS. 9545066 MORRISON MANAGEMENT SPECIALISTS PO BOX 102289 ATLANTA GA 30368 DIETARY SERVICE 5877388 ANESTHESIA PAIN CONSULTANTS STE 4 1113 SUNSET DRIVE JOHNSON CITY TN 37605 PHYSICIAN SVC. 4768017 HOSPITAL HOUSEKEEPING SYSTEMS LTD P O BOX 826 SAN ANTONIO TX 78293 HOUSEKEEPING 3769628 138 1599266 760280 114793 2474339 PATIENT REVENUE-OTHER 622110 651506371 651506371 WELLNESS PROGRAMS 622110 20670478 20670478 P/S PROG. SERV. INCOME 622110 1820608 1820608 LAB UBI REVENUE 622110 313011 313011 PREMIER PYMT D'S BOARD SERVCE 541610 62256 62256 674372724 15341173 15341173 173144 173144 192727 107960 84767 84767 40519 44248 16185475 126692 150981 16185475 -24289 16161186 -24408 16185594 CAFE' SALES 722210 4331346 4331346 DIETARY,SECURITY,ENGIN., ETC. 541900 3104282 3104282 DAY CARE 624410 1010159 1010159 829834 829834 9275621 717882954 673973049 1245620 40189946 X 405051 405051 6462311 6462311 233351875 224273412 8239250 839213 11164364 10670589 453847 39928 35505904 31443556 4027745 34603 18572983 16436281 2087586 49116 1391092 1391092 291270 291270 139937 139937 1157590 1157590 92184405 84136191 7818901 229313 2824684 2192837 618937 12910 8187946 8071791 27997 88158 16859971 11389567 5470404 14034081 11033941 2938607 61533 2102709 1509361 560910 32438 198260 131485 62957 3818 41651661 41651661 51656821 27443317 24208361 5143 791103 2777 788326 MEDICAL SUPPLIES & DRUGS 120184686 119991972 190589 2125 REPAIRS & MAINTENANCE 15057143 14296334 716244 44565 DUES & SUBSCRIPTIONS 4256550 1254923 2998415 3212 ALL OTHER EXPENSES 1954364 1942493 -8466 20337 1916977 1279297 625167 12513 682303738 568045112 112779701 1478925 39216743 53114956 248258 96609 103299284 117265071 6806393 8492454 15373693 17189476 15480550 15873411 3139089 4850577 998845770 480937560 494025566 517908210 271118030 285653065 307033212 313693918 143276118 144707541 118937105 120631703 1517954041 1599476991 85554685 69022047 2928666 2130026 813947753 882984693 177320621 145411405 4437945 2319713 85155390 100026944 1169345060 1201894828 X 348411488 397408151 197493 174012 348608981 397582163 1517954041 1599476991 X 35579216 15510418 -2116452 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false false true 250140 false false 250140 false SCHEDULE C, PART II-B, LINE 1 THE COMMUNITY & GOVERNMENT RELATIONS VICE PRESIDENT AND/OR THE DEPARTMENT'S MANAGER OR DIRECTOR ATTENDED THE FOLLOWING LEGISLATIVE CONFERENCES: - PREMIER FEDERAL AFFAIRS NETWORK MEETING - AMERICAN HOSPITAL ASSOCIATION ANNUAL MEETING - TENNESSEE HOSPITAL ASSOCIATION LEGISLATIVE ADVOCACY DAY - 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 MOTORCYCLISTS 43542989 43542989 514167381 158971778 355195603 952503 482065 470438 440182897 321483717 118699180 517908210 INVESTMENT IN JMH 132000000 C INVESTMENT IN BRMMC 100273634 C INVESTMENT IN SCCH 67400494 C INVESTMENT IN ISHN 14387897 C INVESTMENT IN OTHER -368107 F 313693918 AWUL-UNDER BOND INDENTURE AGREEMENT 70092718 AWUL - CURRENT 20386338 DEFERRED CHARGES AND OTHER 17755375 LONG TERM COMPENSATION INVESTMENT 12397272 120631703 ACCRUED SALARIES, ABSENCES & W/H 40208513 DUE TO THIRD-PARTY PAYERS 25496463 ACCRUED INTEREST 19498959 EST. FAIR VALUE OF INT. RATE SWAP 8219935 OTHER LONG-TERM LIABILITIES 6603074 100026944 X LIABILITY UNDER FIN 48 FOOTNOTE SCHEDULE D, PAGE 3, PART X "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". true true X true X true X true true false true true 17191567 17191567 0.02520 21036012 15635590 5400422 0.00790 76753019 52973261 23779758 0.03490 114980598 68608851 46371747 0.06800 4884433 447464 4436969 0.00650 14369294 3753039 10616255 0.01560 17414583 7191389 10223194 0.01500 347164 212960 134204 0.00020 186718 186718 0.00030 37202192 11604852 25597340 0.03750 152182790 80213703 71969087 0.10550 229332 229332 0.00030 229332 229332 0.00030 true 72662827 55223749 178094047 183810040 -5715993 X true true MED'L SPEC OF JC LLC MEDICAL SERVICES 0.51000 0.49000 EMMAUS COMM HLTHCR MEDICAL SERVICES 0.75000 0.25000 6 1 JOHNSON CITY MEDICAL CENTER

400 N STATE OF FRANKLIN ROAD JOHNSON CITY TN 37604

X X X X X X REHABILITATION & MENTAL HEALTH 2 INDIAN PATH MEDICAL CENTER

2000 BROOKSIDE DRIVE KINGSPORT TN 37660

X X X X 3 FRANKLIN WOODS COMMUNITY HOSPITAL

300 MED TECH PARKWAY JOHNSON CITY TN 37604

X X X 4 SYCAMORE SHOALS HOSPITAL

1501 W ELK AVENUE ELIZABETHTON TN 37643

X X X 5 RUSSELL COUNTY MEDICAL CENTER

58 CARROLL STREET LEBANON VA 24266

X X X 6 JOHNSON COUNTY COMMUNITY HOSPITAL

16901 S SHADY STREET MOUNTAIN CITY TN 37683

X X X JOHNSON CITY MEDICAL CENTER 1 true X X X X X X X X 11 true true true X X X X X X X X false false true true 200.0 true 400.0 true X X X X X X true true X X X X X true false true X false false INDIAN PATH MEDICAL CENTER 2 true X X X X X X X X 11 true true true X X X X X X X X false false true true 200.0 true 400.0 true X X X X X X true true X X X X X true false true X false false FRANKLIN WOODS COMMUNITY HOSPITAL 3 true X X X X X X X X 11 true true true X X X X X X X X false false true true 200.0 true 400.0 true X X X X X X true true X X X X X true false true X false false SYCAMORE SHOALS HOSPITAL 4 true X X X X X X X X 11 true true true X X X X X X X X false false true true 200.0 true 400.0 true X X X X X X true true X X X X X true false true X false false RUSSELL COUNTY MEDICAL CENTER 5 true X X X X X X X X 11 true true true X X X X X X X X false false true true 200.0 true 400.0 true X X X X X X true true X X X X X true false true X false false JOHNSON COUNTY COMMUNITY HOSPITAL 6 true X X X X X X X X 11 true true true X X X X X X X X false false true true 200.0 true 400.0 true X X X X X X true true X X X X X true false true X false false 10 JCMC AMBULATORY SURGERY CENTER

400 N STATE OF FRANKLIN ROAD JOHNSON CITY TN 37604

LICENSED AMBULATORY SURGERY CENTER MOUNTAIN STATES IMAGING CENTER

301 MED TECH PARKWAY SUITE 100 JOHNSON CITY TN 37604

LICENSED OUTPATIENT DIAGNOSTIC CENTER PRINCETON TRANSITIONAL CARE

401 PRINCETON ROAD JOHNSON CITY TN 37601

LICENSED SKILLED NURSING FACILITY INDIAN PATH TRANSITIONAL CARE

2000 BROOKSIDE DRIVE KINGSPORT TN 37660

LICENSED SKILLED NURSING FACILITY MEDICAL CNTR HOME CARE-JOHNSON CITY

101 MED TECH PARKWAY SUITE 100 JOHNSON CITY TN 37604

LICENSED HOME HEALTH AGENCY MEDICAL CNTR HOME CARE-KINGSPORT

2020 BROOKSIDE DRIVE 28 KINGSPORT TN 37660

LICENSED HOME HEALTH AGENCY RUSSELL CO MEDICAL CNTR HOME HLTH

116 FLANNAGAN AVENUE LEBANON VA 24266

LICENSED HOME HEALTH AGENCY MEDICAL CENTER HOSPICE

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LICENSED HOSPICE AGENCY JOHNSON COUNTY HOME HEALTH

1987 SOUTH SHADY STREET MOUNTAIN CITY TN 37683

LICENSED HOME HEALTH AGENCY RUSSELL COUNTY MEDICAL CNTR HOSPICE

116 FLANNAGAN AVENUE LABANON VA 24266

LICENSED HOSPICE AGENCY RELATED ORGANIZATION INFORMATION PART I LINE 6A MOUNTAIN 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 EXPLANATION PART I LINE 7 A 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 ACTIVITIES PART II MSHA LEADERS SUPPORT AND ENCOURAGE ALL TEAM MEMBERS TO VOLUNTEER TIME MONEY AND SKILLS TO COMMUNITY SERVICE PROJECTS AND CHARITABLE ORGANIZATIONS SENIOR LEADERS AND BOARD MEMBERS SET A POSITIVE EXAMPLE FOR MSHA TEAM MEMBERS SERVING VOLUNTARILY ON COMMITTEES AND MANAGING BOARDS OF LOCAL SERVICE AND 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 EXPLANATION PART III LINE 4 OUR 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 EXPLANATION PART III LINE 8 MEDICARE 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 EXPLANATION PART III LINE 9B MSHA 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 ASSESSMENT PART VI PART 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 ASSISTANCE PART VI PART 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 INFORMATION PART VI PART 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 PURPOSE PART VI PART 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 INFORMATION PART VI PART 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 FILED PART VI TENNESSEE VIRGINIA JOHNSON CITY MEDICAL CENTER LINE NUMBER 1 PART V LINE 3 PART V LINE 3 MSHA 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 4 PART V LINE 4 EACH HOSPITAL WITHIN THE MSHA SYSTEM COMPLETED A CHNA FOR THOSE HOSPITALS THAT ARE LOCATED IN THE SAME COUNTY ONLY ONE COMMUNITY GROUP WAS SURVEYED FOR INSTANCE JOHNSON CITY MEDICAL CENTER AND FRANKLIN WOODS COMMUNITY HOSPITAL ARE BOTH LOCATED IN WASHINGTON COUNTY TENNESSEE WE SURVEYED 21 INDIVIDUALS FROM WASHINGTON COUNTY IN ORDER TO DETERMINE HEALTH PRIORITIES 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 7 PART V LINE 7 MSHA PUBLISHED ITS COMMUNITY HEALTH NEEDS ASSESSMENT ON JUNE 29 OF FY12 THE DATA INCLUDED WAS COLLECTED OVER THE COURSE OF 2011 AND 2012 AN IMPLEMENTATION PLAN WAS CREATED FOR EACH HOSPITAL AND EACH 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 14G PART V LINE 14G THE 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 20D PART V LINE 20D UNINSURED 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 3 PART V LINE 3 MSHA 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 4 PART V LINE 4 EACH HOSPITAL WITHIN THE MSHA SYSTEM COMPLETED A CHNA FOR THOSE HOSPITALS THAT ARE LOCATED IN THE SAME COUNTY ONLY ONE COMMUNITY GROUP WAS SURVEYED FOR INSTANCE JOHNSON CITY MEDICAL CENTER AND FRANKLIN WOODS COMMUNITY HOSPITAL ARE BOTH LOCATED IN WASHINGTON COUNTY TENNESSEE WE SURVEYED 21 INDIVIDUALS FROM WASHINGTON COUNTY IN ORDER TO DETERMINE HEALTH PRIORITIES 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 7 PART V LINE 7 MSHA PUBLISHED ITS COMMUNITY HEALTH NEEDS ASSESSMENT ON JUNE 29 OF FY12 THE DATA INCLUDED WAS COLLECTED OVER THE COURSE OF 2011 AND 2012 AN IMPLEMENTATION PLAN WAS CREATED FOR EACH HOSPITAL AND EACH 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 14G PART V LINE 14G 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 INDIAN PATH MEDICAL CENTER LINE NUMBER 2 PART V LINE 20D PART V LINE 20D UNINSURED 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 3 PART V LINE 3 MSHA 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 4 PART V LINE 4 EACH HOSPITAL WITHIN THE MSHA SYSTEM COMPLETED A CHNA FOR THOSE HOSPITALS THAT ARE LOCATED IN THE SAME COUNTY ONLY ONE COMMUNITY GROUP WAS SURVEYED FOR INSTANCE JOHNSON CITY MEDICAL CENTER AND FRANKLIN WOODS COMMUNITY HOSPITAL ARE BOTH LOCATED IN WASHINGTON COUNTY TENNESSEE WE SURVEYED 21 INDIVIDUALS FROM WASHINGTON COUNTY IN ORDER TO DETERMINE HEALTH PRIORITIES 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 7 PART V LINE 7 MSHA PUBLISHED ITS COMMUNITY HEALTH NEEDS ASSESSMENT ON JUNE 29 OF FY12 THE DATA INCLUDED WAS COLLECTED OVER THE COURSE OF 2011 AND 2012 AN IMPLEMENTATION PLAN WAS CREATED FOR EACH HOSPITAL AND EACH 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 14G PART V LINE 14G 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 FRANKLIN WOODS COMMUNITY HOSPITAL LINE NUMBER 3 PART V LINE 20D PART V LINE 20D UNINSURED 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 3 PART V LINE 3 MSHA 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 4 PART V LINE 4 EACH HOSPITAL WITHIN THE MSHA SYSTEM COMPLETED A CHNA FOR THOSE HOSPITALS THAT ARE LOCATED IN THE SAME COUNTY ONLY ONE COMMUNITY GROUP WAS SURVEYED FOR INSTANCE JOHNSON CITY MEDICAL CENTER AND FRANKLIN WOODS COMMUNITY HOSPITAL ARE BOTH LOCATED IN WASHINGTON COUNTY TENNESSEE WE SURVEYED 21 INDIVIDUALS FROM WASHINGTON COUNTY IN ORDER TO DETERMINE HEALTH PRIORITIES 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 7 PART V LINE 7 MSHA PUBLISHED ITS COMMUNITY HEALTH NEEDS ASSESSMENT ON JUNE 29 OF FY12 THE DATA INCLUDED WAS COLLECTED OVER THE COURSE OF 2011 AND 2012 AN IMPLEMENTATION PLAN WAS CREATED FOR EACH HOSPITAL AND EACH 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 14G PART V LINE 14G 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 SYCAMORE SHOALS HOSPITAL LINE NUMBER 4 PART V LINE 20D PART V LINE 20D UNINSURED 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 3 PART V LINE 3 MSHA 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 4 PART V LINE 4 EACH HOSPITAL WITHIN THE MSHA SYSTEM COMPLETED A CHNA FOR THOSE HOSPITALS THAT ARE LOCATED IN THE SAME COUNTY ONLY ONE COMMUNITY GROUP WAS SURVEYED FOR INSTANCE JOHNSON CITY MEDICAL CENTER AND FRANKLIN WOODS COMMUNITY HOSPITAL ARE BOTH LOCATED IN WASHINGTON COUNTY TENNESSEE WE SURVEYED 21 INDIVIDUALS FROM WASHINGTON COUNTY IN ORDER TO DETERMINE HEALTH PRIORITIES 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 7 PART V LINE 7 MSHA PUBLISHED ITS COMMUNITY HEALTH NEEDS ASSESSMENT ON JUNE 29 OF FY12 THE DATA INCLUDED WAS COLLECTED OVER THE COURSE OF 2011 AND 2012 AN IMPLEMENTATION PLAN WAS CREATED FOR EACH HOSPITAL AND EACH 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 14G PART V LINE 14G THE 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 20D PART V LINE 20D UNINSURED 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 3 PART V LINE 3 MSHA 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 4 PART V LINE 4 EACH HOSPITAL WITHIN THE MSHA SYSTEM COMPLETED A CHNA FOR THOSE HOSPITALS THAT ARE LOCATED IN THE SAME COUNTY ONLY ONE COMMUNITY GROUP WAS SURVEYED FOR INSTANCE JOHNSON CITY MEDICAL CENTER AND FRANKLIN WOODS COMMUNITY HOSPITAL ARE BOTH LOCATED IN WASHINGTON COUNTY TENNESSEE WE SURVEYED 21 INDIVIDUALS FROM WASHINGTON COUNTY IN ORDER TO DETERMINE HEALTH PRIORITIES 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 7 PART V LINE 7 MSHA PUBLISHED ITS COMMUNITY HEALTH NEEDS ASSESSMENT ON JUNE 29 OF FY12 THE DATA INCLUDED WAS COLLECTED OVER THE COURSE OF 2011 AND 2012 AN IMPLEMENTATION PLAN WAS CREATED FOR EACH HOSPITAL AND EACH 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 14G PART V LINE 14G THE 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 20D PART V LINE 20D UNINSURED PATIENTS RECEIVE A 62 DISCOUNT AND BASED ON OTHER FACTORS SUCH AS INCOME OR MEDICAL INDIGENCY MAY QUALIFY FOR AN ADDITIONAL DISCOUNT true AMERICAN CANCER SOCIETY 508 PRINCETON RD SUITE 102 JOHNSON CITY TN 37601 640329009 501C3 20100 PROGRAM SUPPORT AMERICAN HEART ASSOCIATION 208 SUNSET DRIVE JOHNSON CITY TN 37604 135613797 501C3 66250 702 PRINTING PROGRAM SUPPORT BARTER THEATRE PO BOX 867 ABINGDON VA 24212 546000120 501C3 19000 PRINTING CONTRIBUTION BRISTOL FAMILY YMCA 400 ML KING JR BLVD BRISTOL TN 37620 620521204 501C3 7000 PROGRAM SUPPORT COALITION FOR KIDS INC PO BOX 3156 JOHNSON CITY TN 37602 621765487 501C3 2000 5601 PRINTING FIGHT CHILD OBESITY EAST TENNESSEE STATE UNIVERSITY PO BOX 70732 JOHNSON CITY TN 37614 626021046 501C3 11500 SUPPORT FIT KIDS ETSU FOUNDATION P O BOX 70721 JOHNSON CITY TN 37614 237092731 501C3 10000 ECONOMIC DEVELOPMENT GOOD SAMARITAN MINISTRY 100 NORTH ROAN STREET JOHNSON CITY TN 37601 621233320 501C3 5657 PRINTING PROGRAM SUPPORT JOHNSON CITY PARKS & RECREATION PO BOX 1535 JOHNSON CITY TN 37605 626000320 501C3 5000 405 PRINTING SPONSORSHIP JOHNSON CITY SYMPHONY ORCHESTRA PO BOX 533 JOHNSON CITY TN 37605 620910261 501C3 5897 PRINTING PROGRAM SUPPORT MARCH OF DIMES 2313 BROWNS MILL ROAD JOHNSON CITY TN 37604 131846366 501C3 15000 PROGRAM SUPPORT MOUNTAIN STATES FOUNDATION 2335 KNOB CREEK ROAD SUITE 101 JOHNSON CITY TN 37604 581418862 501C3 59500 PROGRAM SUPPORT NORTHEAST STATE COMMUNITY COLLEGE 2425 HIGHWAY 75 BLOUNTVILLE TN 37617 621265326 501C3 11000 LAB EQUIPMENT PREMIER PURCHASING 13034 BALLANTYNE CORPORATE PLACE CHARLOTTE NC 28277 330387407 501C3 61052 SUPPORT SUSAN KOMEN BREAST CANCER FOUND PO BOX 5835 KINGSPORT TN 37663 841689067 501C3 5000 590 PRINTING SPONSORSHIP TOWN OF JONESBOROUGH 123 BOONE STREET JONESBOROUGH TN 37659 626000322 501C3 10069 PRINTING CONTRIBUTION 16 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INSIDE THE UNITED STATES SCHEDULE I, PAGE 1, PART I, LINE 2 MSHA ADHERED TO THE FOLLOWING CRITERIA FOR OUR CONTRIBUTIONS TO ORGANIZATIONS IN THE REGION: HEALTHCARE: THE ORGANIZATION ENHANCED OR IMPROVED ACCESS FOR THE UNINSURED OR UNDERINSURED POPULATION OR SUPPORTED A PROGRAM TO IMPROVE THE HEALTH OF OUR 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. X true true X X X X X false true false false false false false false false DENNIS VONDERFECHT 777545 1900431 485771 20000 22698 3206445 125000 MARVIN EICHORN 447614 94466 78022 15000 24538 659640 CANDACE JENNINGS 402118 82014 20803 53557 24293 582785 ANN FLEMING 351697 51836 22747 48425 17857 492562 DAVID NICELY 291022 52219 11768 28073 26351 409433 MONTY MCLAURIN 260109 51174 14876 28444 30243 384846 LYNN KRUTAK 213083 37903 1996 15089 19138 287209 SHANE HILTON 198625 36612 3880 12794 23317 275228 MORRIS SELIGMAN MD 421443 82938 43542 55862 37844 641629 DOUGLAS EDEMA 327718 62141 18478 29188 27094 464619 JAMES PASKERT MD 342153 49161 12559 29961 26006 459840 JOHN SCHARIO 326339 68681 6502 6630 24558 432710 KATHERINE BALL 124094 41113 233588 4897 16728 420420 DALE CLAYTORE 175520 34278 21777 10531 3324 245430 PAT NIDAY 152049 26352 18241 7985 25714 230341 BRAD NURKIN 141265 8180 149445 CYNTHIA SALYER 63790 19891 153995 4206 18268 260150 FRINGE OR EXPENSE EXPLANATION SCHEDULE J, PAGE 1, PART I, LINE 1A BOARD MEMBERS AND TEAM MEMBERS OF MSHA ARE NOT PERMITTED TO TRAVEL FIRST-CLASS WITH THE EXCEPTION OF MSHA'S CEO. AS SANCTIONED BY MSHA'S BOARD OF DIRECTORS, MSHA'S CEO IS PERMITTED TO TRAVEL FIRST-CLASS WHEN THE FLIGHT'S DURATION IS GREATER THAN TWO HOURS. DUE TO THE LENGTH OF SUCH FLIGHTS, THE BOARD BELIEVES IT IS IN THE BEST INTEREST OF MSHA FOR THE CEO TO TRAVEL FIRST-CLASS. CHARTER TRAVEL IS LIMITED TO MSHA BUSINESS TRIPS THAT INCLUDE NUMEROUS TRAVELERS AND WHICH CAN BE JUSTIFIED BASED UPON FINANCIAL AND/OR ESSENTIAL TIME SAVINGS. CHARTER FLIGHTS MUST BE APPROVED BY THE CEO PRIOR TO BOOKING THE FLIGHT. SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SCHEDULE J, PAGE 1, PART I, LINE 4 CANDACE 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 INFORMATION SCHEDULE J, PART III PART 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. A HLTH & EDU FACIL BD 2011A&B&C&D OF THE CITY OF JOHNSON CITY TN 621464028 478271JS9 2011-10-19 195840000 CONSTRUCTION & EQUIP. false false false B HLTH & EDU FACILITIES BD 2010A&B 621464028 478271JH3 2010-04-29 205877528 PARTIAL REFUNDING false false false C HLTH & EDU FACILIT BD 2009AB&C 621464028 478271HT9 2009-03-31 124301533 CONSTRUCTION & EQUIP. false false false D HLTH & EDU FACILITIES BD 2008A&B 621464028 478271HL6 2008-02-20 127000000 ACQUIRE, CONSTRUCT false false false A 4975000 195840000 2353905 157897590 34166505 1422000 true false false true B 17070000 206132699 3474644 197461005 8297792 true false false true C 2435000 125642956 2481706 99702968 15096666 8361616 false false false true D 61790000 129700306 2719365 1953563 324975 77394022 47308380 2012 false false true true A false false true true false false false false true B false false true true false false false false true C false false true true false false false false true D false false true true false false false false true A false true false false true false false false true B false true false false false false false true true C false true false false false false false true true D false false false true true true MERRILL LYNCH CAPITAL SERVICES INC 30.4 false false false true true A true PURPOSE OF ISSUE DESCRIPTION SCHEDULE K HLTH 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 PERFORMED SCHEDULE K HLTH EDU FACILITIES BD 2008AB 022013 HLTH EDU FACILITIES BD 2006A 021710 ADDITIONAL INFORMATION SCHEDULE K HLTH 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 DENNIS VONDERFECHT SPLIT LIFE INSUR.LOAN,INCL.PR.YRS X 6444805 7367035 false true true MARVIN EICHORN SPLIT DOLLAR LIFE INSURANCE LOAN X 350000 360710 false true true MARVIN EICHORN SPLIT DOLLAR LIFE INSURANCE LOAN X 304332 304332 false true true MARVIN EICHORN SPLIT DOLLAR LIFE INSURANCE LOAN X 272483 272483 false true true MARVIN EICHORN SPLIT DOLLAR LIFE INSURANCE LOAN X 91682 93947 false true true MARVIN EICHORN SPLIT DOLLAR LIFE INSURANCE LOAN X 91682 93947 false true true 8492454 WATAUGA PATHOLOGY ASSOC PC M.D. SERVICES 340304 SEE PART V false MATTHEW MARTIN FAMILY MEMBER 18268 SEE PART V false MITCH HATHAWAY FAMILY MEMBER 98315 SEE PART V false SYCAMORE SHOALS ANESTHESIA ASSOC M.D. SERVICES 819996 SEE PART V false PAULA CLAYTORE FAMILY MEMBER 272107 SEE PART V false CLEM WILKES III FAMILY MEMBER 65040 SEE PART V false JAMES TEIXEIRA FAMILY MEMBER 76017 SEE PART V false WORKSPACE INTERIORS INC VENDOR 645484 SEE PART V false ADDITIONAL INFORMATION SCHEDULE L PART V 1 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 ARMSLENGTH DOING BUSINESS AS FORM 990, PAGE 1, ITEM C NISWONGER 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 MISSION FORM 990 - ORGANIZATION'S MISSION PART 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 DOCUMENTS FORM 990, PAGE 6, PART VI, LINE 4 BY 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 STOCKHOLDERS FORM 990, PAGE 6, PART VI, LINE 6 DURING 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 RIGHTS FORM 990, PAGE 6, PART VI, LINE 7A DURING 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 MEMBERS FORM 990, PAGE 6, PART VI, LINE 7B DURING 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 990 FORM 990, PAGE 6, PART VI, LINE 11B THE 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 POLICY FORM 990, PAGE 6, PART VI, LINE 12C ANNUALLY, THE CORPORATE AUDIT AND COMPLIANCE DEPARTMENT OF MSHA FORWARDS THE CONFLICT OF INTEREST POLICY AND DISCLOSURE FORM TO ALL MSHA MANAGEMENT TEAM MEMBERS AND BOARD MEMBERS. EMPLOYEES AND BOARD MEMBERS MUST NOTE ANY CONFLICTS OR ATTEST THEY HAVE "NONE", AND RETURN THE FORM TO THE AUDIT AND COMPLIANCE DEPARTMENT. ANY NOTED DISCLOSURES ARE FORWARDED TO THE APPROPRIATE MANAGEMENT OR BOARD PERSONNEL TO EVALUATE AND UTILIZE WHEN A TRANSACTION INVOLVING A CONFLICTED PERSON ARISES. ADDITIONALLY, PERSONNEL WHO HAVE A CONFLICT ARISE BETWEEN THE ANNUAL DISTRIBUTION OF THE POLICY AND FORMS ARE REQUIRED TO DISCLOSE THE CONFLICT AND WOULD BE DISCIPLINED IN ANY INSTANCE WHERE THEY HAVE NOT DISCLOSED AND ENGAGED IN A CONFLICTED TRANSACTION. COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A THE 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 OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B SIMILAR TO THE CEO'S COMPENSATION, THE CFO RECEIVES COMPENSATION AND BENEFITS THAT COMPLY WITH MSHA'S SALARY POLICY. HIS PAY IS SET AT A MARKET PERCENTILE SPECIFIC TO HIS POSITION. GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE UPON REQUEST TO APPROPRIATE PARTIES REQUESTING THEM. FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST TO APPROPRIATE PARTIES REQUESTING THEM, AND THEY ARE MADE AVAILABLE TO THOSE PARTIES WHO OWN INDEBTEDNESS OF THE COMPANY ON A QUARTERLY BASIS. GROUP RETURN EXPLANATION FORM 990, PAGE 7, PART VII OFFICER, 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 SERVICES FORM 990, PART IX, LINE 11G 84,136,191 7,818,901 229,313 OTHER CHANGES IN NET ASSETS EXPLANATION FORM 990, PART XI, LINE 9 PARTNERSHIP 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 DICKENSON COMMUNITY HOSPITAL ONE HOSPITAL DRIVE CLINTWOOD VA 24228 770599553 HOSPITAL VA 501C3 3 NCH false MOUNTAIN STATES FOUNDATION 2335 KNOB CREEK ROAD STE 101 JOHNSON CITY TN 37604 581418862 FUNDRAISER TN 501C3 11A NA false MSHA AUXILIARY 400 N STATE OF FRANKLIN ROAD JOHNSON CITY TN 37604 581418345 SUPPORT TN 501C3 11A NA false SMYTH COUNTY COMMUNITY HOSPITAL 245 MEDICAL PARK DRIVE MARION VA 24354 540794913 HOSPITAL VA 501C3 3 MSHA false NORTON COMMUNITY HOSPITAL 100 15TH STREET NW NORTON VA 24273 540566029 HOSPITAL VA 501C3 3 NA false JOHNSTON MEMORIAL HOSPITAL 16000 JOHNSTON MEMORIAL DRIVE ABINGDON VA 24211 540544705 HOSPITAL VA 501C3 3 NA false ABINGDON PHYSICIAN PARTNERS 16000 JOHNSTON MEMORIAL DRIVE ABINGDON VA 24211 205485346 MED. SERV. VA 501C3 11A JMH false APPALACHIAN EMERGENCY PHYSICIANS 1021 W OAKLAND AVENUE STE 207 JOHNSON CITY TN 37604 800592504 MED. SERV VA 501C3 11A NA false INTEGRATED SOLUTIONS HEALTH NETWORK 400 N STATE OF FRANKLIN ROAD JOHNSON CITY TN 37604 621711997 INVESTMENT TN NA EXCLUDED -17985 5942091 false false 0.99170 EMMAUS COMMUNITY HEALTHCARE LLC 6070 HWY 11E PINEY FLATS TN 37686 200577483 MED. SERV. TN NA false false MEDICAL SPECIALISTS OF JC LLC 2528 WESLEY STREET SUITE 2 JOHNSON CITY TN 37601 272199037 MED. SERV. TN NA EXCLUDED -234419 81508 false false 0.51000 INTEGRATED SOLUTIONS HEALTH NETWORK 400 N STATE OF FRANKLIN ROAD JOHNSON CITY TN 37604 621711997 INVESTMENT TN NA EXCLUDED -17985 5942091 false false 0.99170 EMMAUS COMMUNITY HEALTHCARE LLC 6070 HWY 11E PINEY FLATS TN 37686 200577483 MED. SERV. TN NA false false MEDICAL SPECIALISTS OF JC LLC 2528 WESLEY STREET SUITE 2 JOHNSON CITY TN 37601 272199037 MED. SERV. TN NA EXCLUDED -234419 81508 false false 0.51000 BLUE RIDGE MEDICAL MANAGEMENT CORP 1021 W OAKLAND AVENUE STE 207 JOHNSON CITY TN 37604 621490616 MED. SERV. TN NA C CORP 105058961 203141889 1.00000 false MEDISERVE MEDICAL EQUIPMENT 1021 W OAKLAND AVENUE SUITE 207 JOHNSON CITY TN 37604 621212286 DME TN BRMMC C CORP 5065565 4279186 1.00000 false MOUNTAIN STATES PROPERTIES 1021 W OAKLAND AVENUE SUITE 207 JOHNSON CITY TN 37604 621845895 PROP. MGMT TN BRMMC C CORP 14786575 149156249 1.00000 false MOUNTAIN STATES PHYSICIAN GROUP 1021 W OAKLAND AVENUE SUITE 207 JOHNSON CITY TN 37604 621700412 MED. SERV. TN BRMMC C CORP 59446917 6131411 1.00000 false COMMUNITY HOME CARE INC 1460 PARK AVENUE NORTON VA 24273 541453810 DME VA NCH C CORP 375002 382370 0.50100 false SOUTHWEST COMMUNITY HEALTH SERV PO BOX 880 MARION VA 24354 541460695 MED. SERV. VA SCCH C CORP 190852 1098214 0.80000 false WILSON PHARMACY INC PO BOX 5289 JOHNSON CITY TN 37604 620329587 PHARMACY TN BRMMC C CORP 4782181 2903651 1.00000 false CRESTPOINT HEALTH INSURANCE COMPANY 208 SUNSET DRIVE SUITE 101 JOHNSON CITY TN 37604 620381170 INSURANCE TN ISHN C CORP 0.99170 false BLUE RIDGE MEDICAL MANAGEMENT CORP 1021 W OAKLAND AVENUE STE 207 JOHNSON CITY TN 37604 621490616 MED. SERV. TN NA C CORP 105058961 203141889 1.00000 false MEDISERVE MEDICAL EQUIPMENT 1021 W OAKLAND AVENUE SUITE 207 JOHNSON CITY TN 37604 621212286 DME TN BRMMC C CORP 5065565 4279186 1.00000 false MOUNTAIN STATES PROPERTIES 1021 W OAKLAND AVENUE SUITE 207 JOHNSON CITY TN 37604 621845895 PROP. MGMT TN BRMMC C CORP 14786575 149156249 1.00000 false MOUNTAIN STATES PHYSICIAN GROUP 1021 W OAKLAND AVENUE SUITE 207 JOHNSON CITY TN 37604 621700412 MED. SERV. TN BRMMC C CORP 59446917 6131411 1.00000 false COMMUNITY HOME CARE INC 1460 PARK AVENUE NORTON VA 24273 541453810 DME VA NCH C CORP 375002 382370 0.50100 false SOUTHWEST COMMUNITY HEALTH SERV PO BOX 880 MARION VA 24354 541460695 MED. SERV. VA SCCH C CORP 190852 1098214 0.80000 false WILSON PHARMACY INC PO BOX 5289 JOHNSON CITY TN 37604 620329587 PHARMACY TN BRMMC C CORP 4782181 2903651 1.00000 false CRESTPOINT HEALTH INSURANCE COMPANY 208 SUNSET DRIVE SUITE 101 JOHNSON CITY TN 37604 620381170 INSURANCE TN ISHN C CORP 0.99170 false true true true true false false true true false true true true true true true true true true false MSHA AUXILIARY P 71464 MSHA AUXILIARY Q 279988 BLUE RIDGE MEDICAL MANAGMENT CORP L 10728044 BLUE RIDGE MEDICAL MANAGEMENT CORP M 37124494 BLUE RIDGE MEDICAL MANAGEMENT CORP O 1980659 BLUE RIDGE MEDICAL MANAGEMENT CORP Q 8844230 HEALTH PLUS J 57281 HEALTHPLUS L 408335 HEALTHPLUS M 332150 HEALTHPLUS O 103659 HEALTHPLUS P 68399 HEALTHPLUS Q 12333583 HEALTHPLUS R 621612 MEDISERVE K 179587 MEDISERVE L 169719 MEDISERVE O 53550 MEDISERVE P 193553 MEDISERVE Q 2441200 MOUNTAIN STATES PROPERTIES G 941514 MOUNTAIN STATES PROPERTIES K 2070952 MOUNTAIN STATES PROPERTIES L 249140 MOUNTAIN STATES PROPERTIES O 73430 MOUNTAIN STATES PROPERTIES Q 745635 MOUNTAIN STATES PROPERTIES R 736347 MOUNTAIN STATES FOUNDATION B 58000 MOUNTAIN STATES FOUNDATION C 1513427 NORTON COMMUNITY HOSPITAL D 21238380 NORTON COMMUNITY HOSPITAL L 5850147 NORTON COMMUNITY HOSPTIAL N 482656 NORTON COMMUNITY HOSPITAL P 6856647 NORTON COMMUNITY HOSPITAL Q 691339 DICKENSON COMMUNITY HOSPITAL P 982689 ISHN A 50000 ISHN B 6882150 ISHN L 232591 ISHN M 2158748 ISHN P 133333 ISHN Q 1351630 SMYTH COUNTY COMMUNITY HOSPITAL D 16208216 SMYTH COUNTY COMMUNITY HOSPITAL L 4757932 SMYTH COUNTY COMMUNITY HOSPITAL Q 67367 JOHNSTON MEMORIAL HOSPITAL L 10436254 JOHNSTON MEMORIAL HOSPTIAL O 887811 JOHNSTON MEMORIAL HOSPITAL P 72637 JOHNSTON MEMORIAL HOSPITAL R 216014 APP M 1078900 APP L 1927539 MSHA AUXILIARY P 71464 MSHA AUXILIARY Q 279988 BLUE RIDGE MEDICAL MANAGMENT CORP L 10728044 BLUE RIDGE MEDICAL MANAGEMENT CORP M 37124494 BLUE RIDGE MEDICAL MANAGEMENT CORP O 1980659 BLUE RIDGE MEDICAL MANAGEMENT CORP Q 8844230 HEALTH PLUS J 57281 HEALTHPLUS L 408335 HEALTHPLUS M 332150 HEALTHPLUS O 103659 HEALTHPLUS P 68399 HEALTHPLUS Q 12333583 HEALTHPLUS R 621612 MEDISERVE K 179587 MEDISERVE L 169719 MEDISERVE O 53550 MEDISERVE P 193553 MEDISERVE Q 2441200 MOUNTAIN STATES PROPERTIES G 941514 MOUNTAIN STATES PROPERTIES K 2070952 MOUNTAIN STATES PROPERTIES L 249140 MOUNTAIN STATES PROPERTIES O 73430 MOUNTAIN STATES PROPERTIES Q 745635 MOUNTAIN STATES PROPERTIES R 736347 MOUNTAIN STATES FOUNDATION B 58000 MOUNTAIN STATES FOUNDATION C 1513427 NORTON COMMUNITY HOSPITAL D 21238380 NORTON COMMUNITY HOSPITAL L 5850147 NORTON COMMUNITY HOSPTIAL N 482656 NORTON COMMUNITY HOSPITAL P 6856647 NORTON COMMUNITY HOSPITAL Q 691339 DICKENSON COMMUNITY HOSPITAL P 982689 ISHN A 50000 ISHN B 6882150 ISHN L 232591 ISHN M 2158748 ISHN P 133333 ISHN Q 1351630 SMYTH COUNTY COMMUNITY HOSPITAL D 16208216 SMYTH COUNTY COMMUNITY HOSPITAL L 4757932 SMYTH COUNTY COMMUNITY HOSPITAL Q 67367 JOHNSTON MEMORIAL HOSPITAL L 10436254 JOHNSTON MEMORIAL HOSPTIAL O 887811 JOHNSTON MEMORIAL HOSPITAL P 72637 JOHNSTON MEMORIAL HOSPITAL R 216014 APP M 1078900 APP L 1927539 MSHA AUXILIARY P 71464 MSHA AUXILIARY Q 279988 BLUE RIDGE MEDICAL MANAGMENT CORP L 10728044 BLUE RIDGE MEDICAL MANAGEMENT CORP M 37124494 BLUE RIDGE MEDICAL MANAGEMENT CORP O 1980659 BLUE RIDGE MEDICAL MANAGEMENT CORP Q 8844230 HEALTH PLUS J 57281 HEALTHPLUS L 408335 HEALTHPLUS M 332150 HEALTHPLUS O 103659 HEALTHPLUS P 68399 HEALTHPLUS Q 12333583 HEALTHPLUS R 621612 MEDISERVE K 179587 MEDISERVE L 169719 MEDISERVE O 53550 MEDISERVE P 193553 MEDISERVE Q 2441200 MOUNTAIN STATES PROPERTIES G 941514 MOUNTAIN STATES PROPERTIES K 2070952 MOUNTAIN STATES PROPERTIES L 249140 MOUNTAIN STATES PROPERTIES O 73430 MOUNTAIN STATES PROPERTIES Q 745635 MOUNTAIN STATES PROPERTIES R 736347 MOUNTAIN STATES FOUNDATION B 58000 MOUNTAIN STATES FOUNDATION C 1513427 NORTON COMMUNITY HOSPITAL D 21238380 NORTON COMMUNITY HOSPITAL L 5850147 NORTON COMMUNITY HOSPTIAL N 482656 NORTON COMMUNITY HOSPITAL P 6856647 NORTON COMMUNITY HOSPITAL Q 691339 DICKENSON COMMUNITY HOSPITAL P 982689 ISHN A 50000 ISHN B 6882150 ISHN L 232591 ISHN M 2158748 ISHN P 133333 ISHN Q 1351630 SMYTH COUNTY COMMUNITY HOSPITAL D 16208216 SMYTH COUNTY COMMUNITY HOSPITAL L 4757932 SMYTH COUNTY COMMUNITY HOSPITAL Q 67367 JOHNSTON MEMORIAL HOSPITAL L 10436254 JOHNSTON MEMORIAL HOSPTIAL O 887811 JOHNSTON MEMORIAL HOSPITAL P 72637 JOHNSTON MEMORIAL HOSPITAL R 216014 APP M 1078900 APP L 1927539 MSHA AUXILIARY P 71464 MSHA AUXILIARY Q 279988 BLUE RIDGE MEDICAL MANAGMENT CORP L 10728044 BLUE RIDGE MEDICAL MANAGEMENT CORP M 37124494 BLUE RIDGE MEDICAL MANAGEMENT CORP O 1980659 BLUE RIDGE MEDICAL MANAGEMENT CORP Q 8844230 HEALTH PLUS J 57281 HEALTHPLUS L 408335 HEALTHPLUS M 332150 HEALTHPLUS O 103659 HEALTHPLUS P 68399 HEALTHPLUS Q 12333583 HEALTHPLUS R 621612 MEDISERVE K 179587 MEDISERVE L 169719 MEDISERVE O 53550 MEDISERVE P 193553 MEDISERVE Q 2441200 MOUNTAIN STATES PROPERTIES G 941514 MOUNTAIN STATES PROPERTIES K 2070952 MOUNTAIN STATES PROPERTIES L 249140 MOUNTAIN STATES PROPERTIES O 73430 MOUNTAIN STATES PROPERTIES Q 745635 MOUNTAIN STATES PROPERTIES R 736347 MOUNTAIN STATES FOUNDATION B 58000 MOUNTAIN STATES FOUNDATION C 1513427 NORTON COMMUNITY HOSPITAL D 21238380 NORTON COMMUNITY HOSPITAL L 5850147 NORTON COMMUNITY HOSPTIAL N 482656 NORTON COMMUNITY HOSPITAL P 6856647 NORTON COMMUNITY HOSPITAL Q 691339 DICKENSON COMMUNITY HOSPITAL P 982689 ISHN A 50000 ISHN B 6882150 ISHN L 232591 ISHN M 2158748 ISHN P 133333 ISHN Q 1351630 SMYTH COUNTY COMMUNITY HOSPITAL D 16208216 SMYTH COUNTY COMMUNITY HOSPITAL L 4757932 SMYTH COUNTY COMMUNITY HOSPITAL Q 67367 JOHNSTON MEMORIAL HOSPITAL L 10436254 JOHNSTON MEMORIAL HOSPTIAL O 887811 JOHNSTON MEMORIAL HOSPITAL P 72637 JOHNSTON MEMORIAL HOSPITAL R 216014 APP M 1078900 APP L 1927539 MSHA AUXILIARY P 71464 MSHA AUXILIARY Q 279988 BLUE RIDGE MEDICAL MANAGMENT CORP L 10728044 BLUE RIDGE MEDICAL MANAGEMENT CORP M 37124494 BLUE RIDGE MEDICAL MANAGEMENT CORP O 1980659 BLUE RIDGE MEDICAL MANAGEMENT CORP Q 8844230 HEALTH PLUS J 57281 HEALTHPLUS L 408335 HEALTHPLUS M 332150 HEALTHPLUS O 103659 HEALTHPLUS P 68399 HEALTHPLUS Q 12333583 HEALTHPLUS R 621612 MEDISERVE K 179587 MEDISERVE L 169719 MEDISERVE O 53550 MEDISERVE P 193553 MEDISERVE Q 2441200 MOUNTAIN STATES PROPERTIES G 941514 MOUNTAIN STATES PROPERTIES K 2070952 MOUNTAIN STATES PROPERTIES L 249140 MOUNTAIN STATES PROPERTIES O 73430 MOUNTAIN STATES PROPERTIES Q 745635 MOUNTAIN STATES PROPERTIES R 736347 MOUNTAIN STATES FOUNDATION B 58000 MOUNTAIN STATES FOUNDATION C 1513427 NORTON COMMUNITY HOSPITAL D 21238380 NORTON COMMUNITY HOSPITAL L 5850147 NORTON COMMUNITY HOSPTIAL N 482656 NORTON COMMUNITY HOSPITAL P 6856647 NORTON COMMUNITY HOSPITAL Q 691339 DICKENSON COMMUNITY HOSPITAL P 982689 ISHN A 50000 ISHN B 6882150 ISHN L 232591 ISHN M 2158748 ISHN P 133333 ISHN Q 1351630 SMYTH COUNTY COMMUNITY HOSPITAL D 16208216 SMYTH COUNTY COMMUNITY HOSPITAL L 4757932 SMYTH COUNTY COMMUNITY HOSPITAL Q 67367 JOHNSTON MEMORIAL HOSPITAL L 10436254 JOHNSTON MEMORIAL HOSPTIAL O 887811 JOHNSTON MEMORIAL HOSPITAL P 72637 JOHNSTON MEMORIAL HOSPITAL R 216014 APP M 1078900 APP L 1927539 MSHA AUXILIARY P 71464 MSHA AUXILIARY Q 279988 BLUE RIDGE MEDICAL MANAGMENT CORP L 10728044 BLUE RIDGE MEDICAL MANAGEMENT CORP M 37124494 BLUE RIDGE MEDICAL MANAGEMENT CORP O 1980659 BLUE RIDGE MEDICAL MANAGEMENT CORP Q 8844230 HEALTH PLUS J 57281 HEALTHPLUS L 408335 HEALTHPLUS M 332150 HEALTHPLUS O 103659 HEALTHPLUS P 68399 HEALTHPLUS Q 12333583 HEALTHPLUS R 621612 MEDISERVE K 179587 MEDISERVE L 169719 MEDISERVE O 53550 MEDISERVE P 193553 MEDISERVE Q 2441200 MOUNTAIN STATES PROPERTIES G 941514 MOUNTAIN STATES PROPERTIES K 2070952 MOUNTAIN STATES PROPERTIES L 249140 MOUNTAIN STATES PROPERTIES O 73430 MOUNTAIN STATES PROPERTIES Q 745635 MOUNTAIN STATES PROPERTIES R 736347 MOUNTAIN STATES FOUNDATION B 58000 MOUNTAIN STATES FOUNDATION C 1513427 NORTON COMMUNITY HOSPITAL D 21238380 NORTON COMMUNITY HOSPITAL L 5850147 NORTON COMMUNITY HOSPTIAL N 482656 NORTON COMMUNITY HOSPITAL P 6856647 NORTON COMMUNITY HOSPITAL Q 691339 DICKENSON COMMUNITY HOSPITAL P 982689 ISHN A 50000 ISHN B 6882150 ISHN L 232591 ISHN M 2158748 ISHN P 133333 ISHN Q 1351630 SMYTH COUNTY COMMUNITY HOSPITAL D 16208216 SMYTH COUNTY COMMUNITY HOSPITAL L 4757932 SMYTH COUNTY COMMUNITY HOSPITAL Q 67367 JOHNSTON MEMORIAL HOSPITAL L 10436254 JOHNSTON MEMORIAL HOSPTIAL O 887811 JOHNSTON MEMORIAL HOSPITAL P 72637 JOHNSTON MEMORIAL HOSPITAL R 216014 APP M 1078900 APP L 1927539 MSHA AUXILIARY P 71464 MSHA AUXILIARY Q 279988 BLUE RIDGE MEDICAL MANAGMENT CORP L 10728044 BLUE RIDGE MEDICAL MANAGEMENT CORP M 37124494 BLUE RIDGE MEDICAL MANAGEMENT CORP O 1980659 BLUE RIDGE MEDICAL MANAGEMENT CORP Q 8844230 HEALTH PLUS J 57281 HEALTHPLUS L 408335 HEALTHPLUS M 332150 HEALTHPLUS O 103659 HEALTHPLUS P 68399 HEALTHPLUS Q 12333583 HEALTHPLUS R 621612 MEDISERVE K 179587 MEDISERVE L 169719 MEDISERVE O 53550 MEDISERVE P 193553 MEDISERVE Q 2441200 MOUNTAIN STATES PROPERTIES G 941514 MOUNTAIN STATES PROPERTIES K 2070952 MOUNTAIN STATES PROPERTIES L 249140 MOUNTAIN STATES PROPERTIES O 73430 MOUNTAIN STATES PROPERTIES Q 745635 MOUNTAIN STATES PROPERTIES R 736347 MOUNTAIN STATES FOUNDATION B 58000 MOUNTAIN STATES FOUNDATION C 1513427 NORTON COMMUNITY HOSPITAL D 21238380 NORTON COMMUNITY HOSPITAL L 5850147 NORTON COMMUNITY HOSPTIAL N 482656 NORTON COMMUNITY HOSPITAL P 6856647 NORTON COMMUNITY HOSPITAL Q 691339 DICKENSON COMMUNITY HOSPITAL P 982689 ISHN A 50000 ISHN B 6882150 ISHN L 232591 ISHN M 2158748 ISHN P 133333 ISHN Q 1351630 SMYTH COUNTY COMMUNITY HOSPITAL D 16208216 SMYTH COUNTY COMMUNITY HOSPITAL L 4757932 SMYTH COUNTY COMMUNITY HOSPITAL Q 67367 JOHNSTON MEMORIAL HOSPITAL L 10436254 JOHNSTON MEMORIAL HOSPTIAL O 887811 JOHNSTON MEMORIAL HOSPITAL P 72637 JOHNSTON MEMORIAL HOSPITAL R 216014 APP M 1078900 APP L 1927539 MSHA AUXILIARY P 71464 MSHA AUXILIARY Q 279988 BLUE RIDGE MEDICAL MANAGMENT CORP L 10728044 BLUE RIDGE MEDICAL MANAGEMENT CORP M 37124494 BLUE RIDGE MEDICAL MANAGEMENT CORP O 1980659 BLUE RIDGE MEDICAL MANAGEMENT CORP Q 8844230 HEALTH PLUS J 57281 HEALTHPLUS L 408335 HEALTHPLUS M 332150 HEALTHPLUS O 103659 HEALTHPLUS P 68399 HEALTHPLUS Q 12333583 HEALTHPLUS R 621612 MEDISERVE K 179587 MEDISERVE L 169719 MEDISERVE O 53550 MEDISERVE P 193553 MEDISERVE Q 2441200 MOUNTAIN STATES PROPERTIES G 941514 MOUNTAIN STATES PROPERTIES K 2070952 MOUNTAIN STATES PROPERTIES L 249140 MOUNTAIN STATES PROPERTIES O 73430 MOUNTAIN STATES PROPERTIES Q 745635 MOUNTAIN STATES PROPERTIES R 736347 MOUNTAIN STATES FOUNDATION B 58000 MOUNTAIN STATES FOUNDATION C 1513427 NORTON COMMUNITY HOSPITAL D 21238380 NORTON COMMUNITY HOSPITAL L 5850147 NORTON COMMUNITY HOSPTIAL N 482656 NORTON COMMUNITY HOSPITAL P 6856647 NORTON COMMUNITY HOSPITAL Q 691339 DICKENSON COMMUNITY HOSPITAL P 982689 ISHN A 50000 ISHN B 6882150 ISHN L 232591 ISHN M 2158748 ISHN P 133333 ISHN Q 1351630 SMYTH COUNTY COMMUNITY HOSPITAL D 16208216 SMYTH COUNTY COMMUNITY HOSPITAL L 4757932 SMYTH COUNTY COMMUNITY HOSPITAL Q 67367 JOHNSTON MEMORIAL HOSPITAL L 10436254 JOHNSTON MEMORIAL HOSPTIAL O 887811 JOHNSTON MEMORIAL HOSPITAL P 72637 JOHNSTON MEMORIAL HOSPITAL R 216014 APP M 1078900 APP L 1927539