SMYTH COUNTY COMMUNITY HOSPITAL: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: SMYTH COUNTY COMMUNITY HOSPITAL (EIN 54-0794913)
Tax period: 2012-07-01 to 2013-06-30
Filed: 2014-05-12
IRS object ID: 201421329349302877
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2014-05-12T14:40:20-05:00	Timestamp
Tax Period End Date	2013-06-30	TaxPeriodEndDate
Return Type	990	ReturnType
Tax Period Begin Date	2012-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	540794913	EIN

Name Name

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

Field	Value	IRS element (for citing)
Name Control	SMYT	NameControl
Phone	2763781000	Phone

US Address USAddress

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

Officer Officer

Field	Value	IRS element (for citing)
Name	LINDA WHITE	Name
Title	CEO	Title
Phone	2763781000	Phone
Date Signed	2014-05-12	DateSigned
Authorize Third Party	false	AuthorizeThirdParty

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2015-11-30 17:44:51Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	LINDA P WHITE	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

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

Field	Value	IRS element (for citing)
Gross Receipts	46051757	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.MSHA.COM	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1961	YearFormation
State Legal Domicile	VA	StateLegalDomicile
Activity Or Mission Description	PART I, LINE I - ORGANIZATION'S MISSION: SMYTH COUNTY COMMUNITY HOSPITAL (SCCH) IS COMMITTED TO BRINGING LOVING CARE TO HEALTH CARE. WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTH CARE NEEDS OF INDIVIDUALS AND COMMUNITIES IN OUR REGION AND TO ASSIST THEM IN ATTAINING THEIR HIGHEST POSSIBLE LEVEL OF HEALTH.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	13	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	8	NbrIndependentVotingMembers
Total Nbr Employees	1	TotalNbrEmployees
Total Nbr Volunteers	50	TotalNbrVolunteers
Total Gross UBI	159032	TotalGrossUBI
Net Unrelated Business Txbl Income	44809	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	38238	ContributionsGrantsPriorYear
Contributions Grants Current Year	106933	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	40449630	ProgramServiceRevenuePriorYear
Program Service Revenue CY	44574461	ProgramServiceRevenueCY
Investment Income Prior Year	1340112	InvestmentIncomePriorYear
Investment Income Current Year	565379	InvestmentIncomeCurrentYear
Other Revenue Prior Year	1125043	OtherRevenuePriorYear
Other Revenue Current Year	675303	OtherRevenueCurrentYear
Total Revenue Prior Year	42953023	TotalRevenuePriorYear
Total Revenue Current Year	45922076	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	12821	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	10732	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	23446103	SalariesEtcPriorYear
Salaries Etc Current Year	22759121	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	22877592	OtherExpensePriorYear
Other Expenses Current Year	24328438	OtherExpensesCurrentYear
Total Expenses Prior Year	46336516	TotalExpensesPriorYear
Total Expenses Current Year	47098291	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	-3383493	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	-1176215	RevenuesLessExpensesCY
Total Assets BOY	106754092	TotalAssetsBOY
Total Assets EOY	104424818	TotalAssetsEOY
Total Liabilities BOY	24852213	TotalLiabilitiesBOY
Total Liabilities EOY	22633834	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	81901879	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	81790984	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	PART I, LINE I - ORGANIZATION'S MISSION: SMYTH COUNTY COMMUNITY HOSPITAL (SCCH) IS COMMITTED TO BRINGING LOVING CARE TO HEALTH CARE. WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTH CARE NEEDS OF INDIVIDUALS AND COMMUNITIES IN OUR REGION AND TO ASSIST THEM IN ATTAINING THEIR HIGHEST POSSIBLE LEVEL OF HEALTH.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	36913040	Expense
Grants	10732	Grants
Revenue	44574461	Revenue
Description	SMYTH COUNTY COMMUNITY HOSPITAL (SCCH) HAS A 45-PLUS YEAR HISTORY OF PROVIDING HEALTHCARE SERVICES WITHIN THE COMMUNITY OF MARION, VIRGINIA. SCCH IS A 44-BED COMMUNITY-BASED HOSPITAL THAT OFFERS BOTH ACUTE CARE AND INPATIENT REHABILITATION CARE. THE HOSPITAL PROVIDES COMPREHENSIVE OUTPATIENT SERVICES AND A VARIETY OF OUTREACH PROGRAMS SUCH AS HOMECARE. ADDITIONALLY, SCCH HAS A 109-BED NURSING CARE FACILITY, FRANCIS MARION MANOR HEALTH AND REHABILITATION. (CONTINUED ON SCHEDULE O) AS A NOT-FOR-PROFIT HOSPITAL, ALL OF SCCH'S NET INCOME IS INVESTED IN IMPROVING HEALTHCARE IN THE COMMUNITY. WITH A STRONG COMMITMENT TO QUALITY PATIENT CARE AND A HERITAGE OF SERVICES, SCCH CONTINUES TO MEET THE HEALTHCARE NEEDS OF SMYTH AND THE ADJOINING COUNTIES. THROUGHOUT THE YEAR, SCCH PROVIDES A RANGE OF EVENTS AND PROGRAMS FOR THE COMMUNITY. A FEW EXAMPLES ARE: ADVANCED DIRECTIVES DAY: THIS WAS A DAY TO EDUCATE COMMUNITY MEMBERS ABOUT LEGAL DOCUMENTS THEY MAY WISH TO HAVE IN ORDER TO EXPRESS THE TYPE OF MEDICAL CARE WANTED WHEN ILL AND TO MAKE CLEAR THEIR DECISIONS FOR THEIR OWN END OF LIFE CARE. SINCE A MEDICAL CRISIS CAN OCCUR AT ANY AGE, THIS ADVANCED CARE PLANNING IS AN IMPORTANT STEP TOWARD ENSURING AN INDIVIDUAL'S WISHES ARE FOLLOWED IF HE/SHE IS TOO ILL TO MAKE HIS/HER OWN HEALTHCARE DECISIONS. TWELVE SCCH TEAM MEMBERS WERE INVOLVED WITH THIS EDUCATION DAY. MSHA FACILITIES, INCLUDING SCCH, SERVE AS CLINICAL TRAINING AREAS FOR HEALTH PROFESSIONAL EDUCATION STUDENTS. SCCH HAS DEDICATED STAFF TO WORK WITH REGIONAL COLLEGES AND UNIVERSITIES TO COORDINATE THE PLACEMENT OF HEALTHCARE PROFESSIONAL STUDENTS AS PART OF THEIR EDUCATIONAL CURRICULUM. IN ADDITION TO CLINICAL TRAINING, THE HEALTH CARE STUDENTS ENTERING OUR SYSTEM ARE REQUIRED TO HAVE ORIENTATION AND COMPUTER TRAINING. PARTICIPANTS RECEIVING CLINICAL EXPERIENCE AT SCCH DURING FY13 INCLUDED 50 NURSING STUDENTS FROM VARIOUS COLLEGES, UNIVERSITIES AND PROGRAMS. THIS NURSING CLINICAL EXPERIENCE REQUIRED EXTENSIVE SCCH NURSING STAFF INVOLVEMENT. THE CLINICAL SETTING AND HANDS-ON INSTRUCTION COST SCCH 100,328. SCCH PROVIDED A CLINICAL SETTING FOR ANOTHER 101 STUDENTS TRAINING IN HEALTH-RELATED PROGRAMS SUCH AS RADIOLOGY, PHARMACY, PHYSICAL THERAPY, EMT/PARAMEDIC AND OTHER ALLIED-HEALTH DISCIPLINES. THESE ADDITIONAL CLINICAL STUDENTS COST SCCH 88,368. SMYTH COUNTY LPN STUDENTS RECEIVE THEIR CLINICAL TRAINING AT SCCH. BECAUSE OF THE CLOSE TIE BETWEEN THE STUDENTS AND SCCH, THE STUDENTS ALWAYS ASK TO HAVE THEIR GRADUATION CEREMONY HELD AT THE HOSPITAL. THE HOSPITAL IS VERY PLEASED TO HOST THE CEREMONY FOR THE STUDENTS AND THEIR FAMILIES. REFRESHMENTS ARE PROVIDED AND SCCH'S CEO AND CNO ATTEND THE CEREMONY. SCCH OFFERS A SUPPORT GROUP FOR PEOPLE WITH DIABETES. TWO SCCH TEAM MEMBERS PROVIDE EDUCATION REGARDING SELF-CARE, INCLUDING NUTRITION COUNSELING. SCCH HAS PARTNERED WITH THE COMPANY, FIRSTSOURCE SOLUTIONS USA, TO WORK WITH SELF-PAYING PATIENTS WHO HAVE LIMITED FINANCIAL RESOURCES. FIRSTSOURCE REPRESENTATIVES WERE ABLE TO DETERMINE GOVERNMENTAL MEDICAL ASSISTANCE (MEDICAID) ELIGIBILITY, AND TO HELP WITH THE APPLICATION PROCESS AND FOLLOW-UP. ONCE A PERSON IS APPROVED FOR MEDICAID THROUGH THIS PROGRAM OFFERED THROUGH SCCH, THEY RETAIN COVERAGE FOR FUTURE MEDICAL CARE. FIRSTSOURCE IS COMPENSATED BY SCCH. DURING FY13, SCCH'S COST FOR THIS PROGRAM WAS 67,998. SCCH TEAM MEMBERS PARTICIPATE IN A LOCAL NUTRITION NETWORK, A COLLABORATION OF SPONSORS AND AGENCIES WHO GRAPPLE WITH THE ISSUES OF POVERTY, HUNGER, AND LACK OF KNOWLEDGE REGARDING HEALTH CONSEQUENCES OF POOR NUTRITION. THE NETWORK SERVES TO EDUCATE THE COMMUNITY ABOUT OBESITY RELATED HEALTH PROBLEMS SUCH AS DIABETES, HYPERTENSION, HIGH CHOLESTEROL, AND HEART DISEASE. THE NETWORK'S GOAL IS TO ADDRESS POVERTY AND THE WIDESPREAD USE OF INEXPENSIVE, PROCESSED FOODS WHICH CONTRIBUTE TO THE OBESITY RISK. SINCE THE SOLUTION TO OBESITY AND ITS RELATED DISEASES DOES NOT REQUIRE HIGH TECH TREATMENT OR CUTTING EDGE MEDICATIONS, REPRESENTATIVES FROM SCCH, VIRGINIA DEPARTMENT OF HEALTH, VIRGINIA TECH, FARMERS MARKETS AND GROCERY STORES, LOCAL SCHOOLS AND CHARITY ORGANIZATIONS ARE DEEMED TO BE THE BEST PLACE TO START THE PROCESS OF REDUCING OBESITY WITHIN THE COMMUNITY. A VARIETY OF SCREENINGS, SUPPORT GROUPS, HEALTH EDUCATION, AND HEALTH FAIRS WERE PROVIDED ON AN ONGOING BASIS THROUGHOUT THE YEAR. SOME OF THE SERVICES PROVIDED DURING THE YEAR INCLUDE: LAB SERVICES FOR A FREE PUBLIC CLINIC, CPR TRAINING TO THE PUBLIC, PHYSICALS FOR LOCAL SCHOOLS, AND FIRST AID CLASSES. THE COST OF PROVIDING THESE FREE SERVICES WAS MORE THAN 16,000. FOR MANY YEARS, SCCH HAS PROVIDED ASSISTANCE TO LOCAL LIFESAVING ORGANIZATIONS SUCH AS AMBULANCE SERVICES, FIRE DEPARTMENTS AND RESCUE SQUADS. SCCH DONATES FREE MEDICATIONS AND PHARMACEUTICAL SUPPLIES TO THESE NON-PROFIT ORGANIZATIONS. THE COST OF DONATED MEDICATIONS TO RESCUE ORGANIZATIONS DURING FY13 WAS 11,695. PLANS ARE UNDERWAY TO ESTABLISH AN AFTERHOURS URGENT CARE FOR COUNTY RESIDENTS SO THAT SCCH'S EMERGENCY DEPARTMENT IS NOT THE ONLY OPTION. THE SMYTH COUNTY HOSPITAL HEALTH TRUST WILL SOON BEGIN RAISING MONEY FOR THE MUCH NEEDED URGENT CARE CLINIC PROJECT. PATIENT CARE SERVICES INCLUDE, BUT ARE NOT LIMITED TO: 24-HOUR EMERGENCY DEPARTMENT: SCCH HAS A PHYSICIAN ON DUTY 24 HOURS A DAY, 7 DAYS A WEEK TO TAKE CARE OF MEDICAL NEEDS. IN ADDITION TO OUR PHYSICIANS, WE ALSO STAFF EITHER A FAMILY NURSE PRACTITIONER OR PHYSICIAN ASSISTANT 7 DAYS A WEEK FROM 11AM UNTIL 10PM TO EXPAND CARE BY TREATING EAR ACHES, SORE THROATS, BURNS, SIMPLE FRACTURES, AND MOST OTHER MINOR EMERGENCIES. TOTAL ER VISITS DURING THE YEAR EXCEEDED 18,000. SCCH HAS A HELIPAD FOR AIR EMERGENCY VEHICLES SUCH AS WINGS AIR RESCUE. INPATIENT CARE: THE MEDICAL/SURGICAL UNITS DELIVER COMPREHENSIVE CARE, INCLUDING TELEMETRY SERVICES. A CLINICAL NURSE SPECIALIST OVERSEES CLINICAL MANAGEMENT OF PATIENT CARE AND AN ENTEROSTOMAL NURSE ASSESSES PATIENTS FOR PREVENTION OF SKIN PROBLEMS AND COMPLICATED WOUNDS. SCCH ALSO PROVIDES INPATIENT REHABILITATION AND SKILLED NURSING CARE. INPATIENT ADMISSIONS WERE 1,712 DURING FY13, WHILE INPATIENT DAYS WERE 7,729. CARDIAC & PULMONARY: CARDIAC AND PULMONARY REHABILITATION IS A PROGRAM DESIGNED TO OFFER MORE REHABILITATIVE SERVICES AS WELL AS DIAGNOSTIC TESTING TO INDIVIDUALS SO THEY DO NOT HAVE TO TRAVEL TO LARGER MORE URBAN AREAS. UPON PHYSICIAN REFERRAL WITH HEART AND LUNG DISEASES THAT INCLUDE, BUT ARE NOT LIMITED TO, CORONARY ANGIOPLASTY, HEART ATTACK, CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) AND DYSPNEA (SHORTNESS OF BREATH). CARDIAC REHABILITATION, STRESS TESTING, AND RESPIRATORY THERAPY ARE FOR PATIENTS WHO HAVE EXPERIENCED CARDIAC ILLNESS. THE CARDIAC REHAB DEPARTMENT FOCUSES ON RISK FACTOR MODIFICATION AND LIFESTYLE CHANGES FOR THOSE WHO HAVE EXPERIENCED A HEART ATTACK, OR WHO HAVE HAD CARDIAC SURGERY, BALLOON ANGIOPLASTY OR CORONARY STENTS, KNOWN HEART DISEASE SUCH AS STABLE ANGINA OR CONGESTIVE HEART FAILURE. THIS YEAR, SCCH'S CARDIAC AND PULMONARY REHABILITATION PROGRAM RECEIVED CERTIFICATION FROM THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION (AACVPR) AFTER A TWO-YEAR DOCUMENTATION AND APPLICATION PROCESS. THE COVETED CERTIFICATION MEANS THAT THE OUPATIENT CARDIAC SERVICES OFFERED AT SCCH MEET AACVPR'S STRICT GUIDELINES FOR APPROPRIATE AND EFFECTIVE EARLY OUTPATIENT CARE OF CARDIAC PATIENTS. SINCE THE INCEPTION OF THIS PROGRAM 15 YEARS AGO, THE FACILITY'S SQUARE FOOTAGE HAS DOUBLED AND THE NUMBER OF REHABILITATION SESSIONS HAS GROWN MORE THAN 5 TIMES THE RATES SEEN IN EARLY YEARS. PHYSICIANS IN SEVERAL STATES NOW REFER PATIENTS TO SCCH'S CARDIAC REHABILITATION PROGRAM. LABORATORY SERVICES: LABORATORY SERVICES FOR SCCH ARE AVAILABLE TO MEET THE NEEDS OF OUR PATIENTS. LABORATORY SERVICES ARE INSPECTED AND ACCREDITED BY THE JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS AND THE VIRGINIA DEPARTMENT OF HEALTH. LABORATORY SERVICES ALSO PARTICIPATE IN THE COLLEGE OF AMERICAN PATHOLOGISTS' PROGRAMS FOR QUALITY CONTROL. TESTING IS PERFORMED AND SUPERVISED BY COLLEGE TRAINED AND DEGREED TECHNICIANS AND TECHNOLOGISTS CERTIFIED BY THE AMERICAN SOCIETY OF CLINICAL PATHOLOGISTS AND THE AMERICAN SOCIETY OF MEDICAL TECHNOLOGISTS. SATELLITE TESTING IS PROVIDED BY LICENSED NURSES TRAINED AND SUPERVISED BY LABORATORY STAFF. JUST UNDER 160,000 LAB TESTS WERE PERFORMED DURING THE YEAR. IN JANUARY 2013, AN UNANNOUNCED EXTERNAL INSPECTION OF THE LAB WAS CONDUCTED BY THE COLLEGE OF AMERICAN PATHOLOGISTS(CAP). THE INSPECTION WENT VERY WELL WITH SCCH'S LAB RECEIVING THE DESIGNATION OF EXCELLENCE. ONE OF THE INSPECTORS REMARKED THAT THE SCCH LAB INSPECTION WAS THE BEST HE HAS ENCOUNTERED OVER THE COURSE OF THE 12 YEARS HE HAS BEEN A LAB INSPECTOR. SURGICAL SERVICES: SURGICAL SERVICES PROVIDED BY SCCH INCLUDE: UROLOGY, SINUPLASTY AND OTHER ENT, OPTHALMOLOGY, ORTHOPEDICS, PLASTICS, GYN, PODIATRY, ORAL, AND GENERAL SURGERY, LASER OPTHALMOLOGY AND REFRACTORY PROCEDURES ARE PERFORMED IN THE OPERATING ROO	Description
Total Program Service Expense	36913040	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	true	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	true	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	true	ReportFin48Footnote
Independent Audit Financial Stmt	false	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	true	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	true	Hospital
Financial Stmt Attached	true	FinancialStmtAttached
Grants To Organizations	true	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	true	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	true	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	true	RelatedOrgControlledEntity
Transaction Related Entity	true	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	91	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	1	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	true	UnrelatedBusinessIncome
Form990-T Filed	true	Form990-TFiled
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	false	QuidProQuoContributions
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	13	NbrVotingGoverningBodyMembers
Number Independent Voting Members	8	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	true	MembersOrStockholders
Election Of Board Members	true	ElectionOfBoardMembers
Decisions Subject To Approval	true	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	true	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
States Where Copy Of Return Is Filed	VA	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	ERICA DILLARD	NamePerson
Telephone Number	2763781000	TelephoneNumber

Address US AddressUS

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

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

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Average Hours Per Week RelatedAverageHoursPerWeekRelated	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Highest Compensated EmployeeHighestCompensatedEmployee
ANN FLEMING
DIRECTOR	3.00	57.00	X	0	426280	66282
JOHN SCHARIO
DIRECTOR	3.00	57.00	X	0	401522	31188
CHELSEA HAMMAN MD
DIRECTOR	3.00		X	19019	0	0
ALLEN ABEL
DIRECTOR	3.00		X	0	0	0
JIM BEAR JR
TREASURER	3.00		X	0	0	0
RUTH COX
DIRECTOR	3.00		X	0	0	0
BOB FEATHERS
DIRECTOR	3.00	9.00	X	0	0	0
JOANNE GROSECLOSE
VICE CHAIR	3.00		X	0	0	0
ANDY BLEVINS
DIRECTOR	3.00		X	0	0	0
JIM MCDOWELL MD
DIRECTOR	3.00		X	0	0	0
JAMES PATTERSON MD
DIRECTOR	3.00		X	0	0	0
BOB SHULTS
CHAIRMAN	3.00		X	0	0	0
CLEM WILKES JR
DIRECTOR	3.00	11.00	X	0	0	0
LINDA WHITE
VP/CEO	3.00	52.00		0	217263	43482	X
JEFFREY HUNDMAN
CFO	3.00	47.00		0	114784	20164	X
MATTHEW JUSTUS
	40.00			0	174622	5929		X
SAMUEL SMALL
	40.00			0	160594	4816		X
STEPHANIE POLLARD
	40.00			0	136376	21876		X
BELDON FLEMING
	40.00			0	135501	28442		X
MARK MONTGOMERY
	40.00			0	107544	22765		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	19019	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	1874486	TotalReportableCompFrmRltdOrgs
Total Other Compensation	244944	TotalOtherCompensation
Number Individuals GT100 K	2	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
SKANSKA USA BUILDING INC
1633 LITTLETON ROAD	PARSIPPANY	NJ	07054	CONSTRUCTION	9126022
MORRISON MANAGEMENT SPECIALISTS
PO BOX 102289	ATLANTA	GA	30368	DIETARY SERVS.	1355166
INTERNETWORK ENGINEERING INC
PO BOX 636604	CINCINNATI	OH	45263	WEB MGMT/LICEN.	371017
CROTHALL SERVICES EAST TN
995 CHESTERBROOK BLVD SUITE 300	WAYNE	PA	19087	LINEN SERVICES	285499
MCKESSON TECHNOLOGIES INC
PO BOX 98347	CHICAGO	IL	60693	HLTH S/W MGMT.	195630

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	7	NumberOfContractorsGT100K
Related Organizations	82545	RelatedOrganizations
All Other Contributions	24388	AllOtherContributions
Total Contributions	106933	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue
PATIENT SERVICES	622110	42203917	42203917
WELLNESS PROGRAMS	622110	2098505	2098505
LABORATORY	622110	155640		155640
P/S INCOME PREMIER & ISHN	561000	113007	113007
PREMIER PURCHASING K-1	561000	3392		3392

Field	Value	IRS element (for citing)
Total Program Service Revenue	44574461	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	677241	TotalRevenueColumn
Exclusion	$677,241	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	276568	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	276568	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	276568	TotalRevenueColumn
Exclusion	$276,568	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Other	8636	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	120498	Securities

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	-120498	Securities
Other	8636	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	-111862	TotalRevenueColumn
Related Or Exempt Function Income	8630	RelatedOrExemptFunctionIncome
Exclusion	-$120,492	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	2819	GrossIncomeFundraisingEvents

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	2819	TotalRevenueColumn
Exclusion	$2,819	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	24782	GrossSalesOfInventory
Cost Of Goods Sold	9183	CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	15599	TotalRevenueColumn
Related Or Exempt Function Income	15599	RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount
CAFETERIA SALES	900099	259717	$259,717
MANAGEMENT FEES	900099	97867	$97,867
OTHER REVENUE	900099	11594	$11,594

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	11139	TotalRevenueColumn
Exclusion	$11,139	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	380317	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	45922076	TotalRevenueColumn
Related Or Exempt Function Income	44439658	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	159032	UnrelatedBusinessRevenue
Exclusion	$1,216,453	ExclusionAmount

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

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	10732	Total
Program Services	10732	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	414330	Total
Program Services	20644	ProgramServices
Management And General	393686	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	18541222	Total
Program Services	15357015	ProgramServices
Management And General	3184207	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	568963	Total
Program Services	483357	ProgramServices
Management And General	85606	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	2062690	Total
Program Services	1919173	ProgramServices
Management And General	143517	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	1171916	Total
Program Services	1129586	ProgramServices
Management And General	42330	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	34114	Total
Management And General	34114	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	51088	Total
Management And General	51088	ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	28018	Total
Management And General	28018	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	8172414	Total
Program Services	8153142	ProgramServices
Management And General	19272	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	82914	Total
Program Services	64643	ProgramServices
Management And General	18271	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	432536	Total
Program Services	374194	ProgramServices
Management And General	58342	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	228811	Total
Program Services	225028	ProgramServices
Management And General	3783	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	1141091	Total
Program Services	1035371	ProgramServices
Management And General	105720	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	172157	Total
Program Services	155849	ProgramServices
Management And General	16308	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	3557	Total
Program Services	3262	ProgramServices
Management And General	295	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	173767	Total
Management And General	173767	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	4932945	Total
Program Services	1870477	ProgramServices
Management And General	3062468	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	149572	Total
Management And General	149572	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
MEDICAL SUPPLIES & DRUGS	5036215	5036215
MANAGEMENT FEES	2658267	189358	2468909
REPAIRS & MAINTENANCE	676687	658585	18102
UBI TAXES	8500		8500

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	345785	Total
Program Services	226409	ProgramServices
Management And General	119376	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	47098291	Total
Program Services	36913040	ProgramServices
Management And General	10185251	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	812382	BOY
EOY	2388481	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	64910	BOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	8655192	BOY
EOY	7640675	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	953670	BOY
EOY	915788	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	314696	BOY
EOY	351420	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	127433476	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	54087105	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	72569428	BOY
EOY	73346371	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	18695346	BOY
EOY	18545937	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	710615	BOY
EOY	710615	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	3977853	BOY
EOY	525531	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	106754092	BOY
EOY	104424818	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	4880379	BOY
EOY	4596331	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	16464093	BOY
EOY	16208215	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	3507741	BOY
EOY	1829288	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	24852213	BOY
EOY	22633834	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	81866036	BOY
EOY	81755141	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	35843	BOY
EOY	35843	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	81901879	BOY
EOY	81790984	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	106754092	BOY
EOY	104424818	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	-1176215	ReconcilationRevenueExpenses
Reconcilation Other Changes	1065320	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Consolidated	X	FinancialStatementConsolidated

Field	Value	IRS element (for citing)
Audit Committee	true	AuditCommittee
Federal Grant Audit Required	false	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

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

Contributor Address US ContributorAddressUS

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

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	false	Volunteers
Paid Staff Or Management	false	PaidStaffOrManagement
Media Advertisements	false	MediaAdvertisements
Mailings Members	false	MailingsMembers
Publications Or Broadcast	false	PublicationsOrBroadcast
Grants Other Organizations	true	GrantsOtherOrganizations
Grants Other Organizations	$2,105	GrantsOtherOrganizationsAmount
Direct Contact Legislators	false	DirectContactLegislators
Rallies Demonstrations	false	RalliesDemonstrations
Other Activities	false	OtherActivities
Total Lobbying Expenditures IIB	2105	TotalLobbyingExpendituresIIB
Not Described In501c3	false	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Return Reference	SCHEDULE C, PART II-B, LINE 1	ReturnReference
Explanation	PORTION OF DUES PAID TO VIRGINIA HOSPITAL AND HEALTHCARE ASSOCIATION THAT ARE ATTRIBUTABLE TO DIRECT LOBBYING.	Explanation

Schedule D IRS990ScheduleD

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1842711	OtherCostOrOtherBasis
Book Value	1842711	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	65964188	OtherCostOrOtherBasis
Depreciation	14912807	Depreciation
Book Value	51051381	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	65442	OtherCostOrOtherBasis
Depreciation	64850	Depreciation
Book Value	592	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	56586390	OtherCostOrOtherBasis
Depreciation	37823784	Depreciation
Book Value	18762606	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	2974745	OtherCostOrOtherBasis
Depreciation	1285664	Depreciation
Book Value	1689081	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	73346371	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescription	AmountAmount
ASSET RETIREMENT OBLIGATION	$752,000
DUE TO AFFILIATES	$441,720
OTHER LONG-TERM LIABILITIES	$360,275
DUE TO THIRD-PARTY	$275,293

Field	Value	IRS element (for citing)
Total Of Amounts	1829288	TotalOfAmounts
Footnote In Part XIII	X	FootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

Field	Value	IRS element (for citing)
Identifier	LIABILITY UNDER FIN 48 FOOTNOTE	Identifier
Return Reference	SCHEDULE D, PAGE 3, PART X	ReturnReference
Explanation	"THE HOSPITAL 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 HOSPITAL. SOUTHWEST COMMUNITY HEALTH SERVICES (SWCH) IS A TAXABLE ENTITY AND ACCOUNTS FOR INCOME TAXES IN ACCORDANCE WITH FASB ASC 740, INCOME TAXES (NOTE K). AT JUNE 30, 2013, TAX RETURNS FOR FISCAL YEARS 2010 THROUGH 2012 ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE HOSPITAL HAS NO UNCERTAIN TAX POSITIONS AT JUNE 30, 2013 AND 2012. AS SUCH, NO INTEREST OR PENALTIES WERE RECOGNIZED IN THE CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS RELATED TO UNRECOGNIZED BENEFITS".	Explanation

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	true	CharityCarePolicy
Written Policy	true	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	true	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	true	FPGReferenceDiscountedCare
Pcent400	X	Pcent400
Free Disc Care Medically Indigent	true	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	true	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	false	ExpensesExceededBudget
Annual Community Benefit Report	true	AnnualCommunityBenefitReport
Report Publically Available	true	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	797530	TotalCommunityBenefitExpense
Net Community Benefit Expense	797530	NetCommunityBenefitExpense
Percent Of Total Expense	0.01690	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	7009144	TotalCommunityBenefitExpense
Direct Offsetting Revenue	5704341	DirectOffsettingRevenue
Net Community Benefit Expense	1304803	NetCommunityBenefitExpense
Percent Of Total Expense	0.02770	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	7806674	TotalCommunityBenefitExpense
Direct Offsetting Revenue	5704341	DirectOffsettingRevenue
Net Community Benefit Expense	2102333	NetCommunityBenefitExpense
Percent Of Total Expense	0.04460	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	164999	TotalCommunityBenefitExpense
Net Community Benefit Expense	164999	NetCommunityBenefitExpense
Percent Of Total Expense	0.00350	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	188696	TotalCommunityBenefitExpense
Net Community Benefit Expense	188696	NetCommunityBenefitExpense
Percent Of Total Expense	0.00400	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	14486	TotalCommunityBenefitExpense
Net Community Benefit Expense	14486	NetCommunityBenefitExpense
Percent Of Total Expense	0.00030	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	12742	TotalCommunityBenefitExpense
Net Community Benefit Expense	12742	NetCommunityBenefitExpense
Percent Of Total Expense	0.00030	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	380923	TotalCommunityBenefitExpense
Net Community Benefit Expense	380923	NetCommunityBenefitExpense
Percent Of Total Expense	0.00810	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	8187597	TotalCommunityBenefitExpense
Direct Offsetting Revenue	5704341	DirectOffsettingRevenue
Net Community Benefit Expense	2483256	NetCommunityBenefitExpense
Percent Of Total Expense	0.05270	PercentOfTotalExpense

Other Other

Field	Value	IRS element (for citing)
Total Community Building Expense	500	TotalCommunityBuildingExpense
Net Community Building Expense	500	NetCommunityBuildingExpense

Total Total

Field	Value	IRS element (for citing)
Total Community Building Expense	500	TotalCommunityBuildingExpense
Net Community Building Expense	500	NetCommunityBuildingExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	true	BadDebtExpenseReported
Bad Debt Expense	$5,015,379	BadDebtExpenseAmount
Amount Attributable To	3410458	AmountAttributableTo
Amount Reimbursed By Medicare	15707620	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	15928487	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-220867	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Other	X	Other

Field	Value	IRS element (for citing)
Written Debt Collection Policy	true	WrittenDebtCollectionPolicy
Provision For Charity Care	true	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

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

Address Address

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

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Er24 Hours	X	Er24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

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

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
CHNA Conducted	true	CHNAConducted
Community Definition	X	CommunityDefinition
Community Demographics	X	CommunityDemographics
Existing Resources	X	ExistingResources
How Data Obtained	X	HowDataObtained
Community Health Needs	X	CommunityHealthNeeds
Other Health Issues	X	OtherHealthIssues
Identifying Process	X	IdentifyingProcess
Consulting Process	X	ConsultingProcess
Needs Assessment Conducted	11	NeedsAssessmentConducted
Take Into Account	true	TakeIntoAccount
Other Facilities	true	OtherFacilities
CHNA Widely Available	true	CHNAWidelyAvailable
Own Website	X	OwnWebsite
On Request	X	OnRequest
Adopt Implement Strategy	X	AdoptImplementStrategy
Execute Implement Strategy	X	ExecuteImplementStrategy
Develop Community Plan	X	DevelopCommunityPlan
Include Operational Plans	X	IncludeOperationalPlans
Prioritize Health Needs	X	PrioritizeHealthNeeds
Prioritize Services	X	PrioritizeServices
All Needs Addressed	false	AllNeedsAddressed
Organization Incur Excise Tax	false	OrganizationIncurExciseTax
Eligibility Criteria Explained	true	EligibilityCriteriaExplained
Uses FPG Free	true	UsesFPGFree
FPG Free Percent	200.0	FPGFreePercent
Uses FPG Discounted	true	UsesFPGDiscounted
FPG Discount Percent	400.0	FPGDiscountPercent
Explains Basis	true	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Medical Indigency	X	MedicalIndigency
Insurance Status	X	InsuranceStatus
Uninsured Discount	X	UninsuredDiscount
Explains Application Method	true	ExplainsApplicationMethod
Includes Publicity Measures	true	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Posted In Emergency Room	X	PostedInEmergencyRoom
Posted In Admission Office	X	PostedInAdmissionOffice
Available On Request	X	AvailableOnRequest
Other Publicity	X	OtherPublicity
Actions On Nonpayment	true	ActionsOnNonpayment
Collection Activities	false	CollectionActivities
Nondiscrim Emergency Care Policy	true	NondiscrimEmergencyCarePolicy
Used Other Method	X	UsedOtherMethod
Amounts Generally Billed	false	AmountsGenerallyBilled
Gross Charges	false	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	1	NumberOfOtherFacilities

Other Facilities OtherFacilities

Name Name

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

Address Address

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

Field	Value	IRS element (for citing)
Facility Type	NURSING HOME	FacilityType

Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
RELATED ORGANIZATION INFORMATION	PART I LINE 6A	MOUNTAIN STATES HEALTH ALLIANCE PREPARED AND MADE PUBLIC A COMMUNITY BENEFIT REPORT TO INCLUDE INFORMATION FOR ALL OF THE HOSPITALS WITHIN THE HEALTH SYSTEM INCLUDING SCCH
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 RATIO OF PATIENT CARE COST TO CHARGES LINES 7E F AND G USED THE DIRECT COST OF SPECIFIC PROGRAMS LINE 7I REFLECTS CHARITABLE CONTRIBUTIONS AT COST WE SUBTRACTED LINES 7EI COLUMNC EXPENSE FROM WORKSHEET 2 LINE 4 SO THAT THE EXPENSE WOULD NOT BE DUPLICATED
BAD DEBT EXPENSE EXPLANATION	PART III LINE 4	OUR VICE PRESIDENT OF PATIENT FINANCIAL SERVICES AND OUR CFO ESTIMATE THAT 68 OF TOTAL 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 SCCHS 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 SCCHS FY13 AUDITED FINANCIAL STATEMENTS CURRENT OPERATIONS ARE CHARGED WITH AN ESTIMATED PROVISION FOR BAD DEBTS BASED UPON HISTORICAL EXPERIENCE KNOWN COLLECTION RISKS AND OTHER ENVIRONMENTAL FACTORS INCLUDING THE AGE OF THE RECEIVABLES ADDITIONS TO THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS RESULT FROM THE PROVISION FOR BAD DEBTS PATIENT ACCOUNTS WRITTEN OFF AS UNCOLLECTIBLE ARE DEDUCTED FROM THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS THE FOOTNOTES TO THE AUDITED FINANCIAL STATEMENTS REPORT THE AMOUNT OF ESTIMATED UNCOLLECTIBLE SELFPAY AND EXPLAINS 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 SCCHS 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 PARTICIPATING PROVIDER IN THE MEDICARE PROGRAM SCCH IS REQUIRED TO PROVIDE THE FULL REGIMEN OF CARE FOR OUR MEDICARE POPULATION THERE ARE A NUMBER OF CARE REGIMENS THAT ARE COMPENSATED BY THE MEDICARE PROGRAM AT LEVELS BELOW OUR COST THEREFORE IT IS ONLY LOGICAL TO ALLOW JMH 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	SCCH PROVIDES A PATIENT FRIENDLY BILLING FLOW CHART ON ITS WEBSITE THAT GUIDES A PATIENT THROUGH THE PROCESS BEGINNING WITH ADMISSION AND ENDING WITH THE PATIENTS ACCOUNT BEING SUCCESSFULLY RESOLVED SCCH 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 SCCH 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 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 DEATHS 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 SCCH PROVIDES COMMUNICATION OF FINANCIAL ASSISTANCE ON ITS WEBSITE AND ON POSTERS LOCATED IN PROMINENT AREAS OF THE HOSPITAL SUCH AS ADMITTING AND THE EMERGENCY DEPARTMENT PRINTED EDUCATIONAL MATERIALS INCLUDING FINANCIAL ASSISTANCE CONTACT INFORMATION ARE ALSO PROVIDED IN EACH PATIENTS PAPERWORK POSTERS AND REFERENCE MATERIALS ARE WRITTEN IN BOTH ENGLISH AND SPANISH ADMITTING STAFF ARE TRAINED TO EDUCATE PATIENTS ON SCCHS FINANCIAL ASSISTANCE POLICY SCCH ALSO HAS FINANCIAL COUNSELORS TO PROVIDE FURTHER INFORMATION AND ASSISTANCE TO SCCH PATIENTS REGARDING SCCHS FINANCIAL ASSISTANCE POLICY THESE COUNSELORS ALSO HELP UNINSURED PATIENTS DETERMINE SOURCES OF PAYMENT FOR MEDICAL BILLS AND HELP PATIENTS DETERMINE ELIGIBILITY FOR PROGRAMS SUCH AS MEDICAID IN ADDITION SCCH CONTRACTS WITH THE COMPANY FIRSTSOURCE SOLUTIONS USA TO WORK WITH SELFPAYING PATIENTS WHO HAVE LIMITED FINANCIAL RESOURCES FIRSTSOURCE SOLUTIONS USA DETERMINES A PATIENTS ELIGIBILITY IN MEDICAL COVERAGE OPTIONS AND ASSISTS WITH THEIR ENROLLMENT SCCH BEARS THE COST FOR THE FIRSTSOURCE SOLUTIONS PROGRAM
COMMUNITY INFORMATION	PART VI	PART VI LINE 4 SCCH IS LOCATED IN MARION SMYTH COUNTY WHICH IS IN RURAL SOUTHWEST VIRGINIA BOTH NORTHEAST TENNESSEE AND SOUTHWEST VIRGINIA SWVA ARE LOCATED WITHIN THE APPALACHIAN MOUNTAINS SPECIFICALLY THE BLUE RIDGE MOUNTAIN REGION AND TENNESSEE VALLEY SWVA IS CONSIDERED RURAL AND MUCH DIFFERENT THAN THE REST OF THE STATE SWVA HAS BEEN AND REMAINS A MAJOR COAL MINING REGION SMYTH COUNTY IS A FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREA AND HAS A HIGH RATE OF INDIVIDUALS WHO ARE UNINSURED THE POPULATION OF SMYTH COUNTY IS JUST OVER 31100 AND ACCORDING TO THE US CENSUS BUREAU THE TOWN OF MARION HAS A POPULATION OF 5869 THE LATEST CENSUS BUREAU DATA ESTIMATES THE MEDIAN AGE OF RESIDENTS OF SMYTH COUNTY IS 431 WHICH IS OLDER THAN THE MEDIAN AFE OF 375 IN VIRGINIA THE BUREAU ESTIMATES SMYTH COUNTY MEDIAN HOUSEHOLD INCOME AT 34394 COMPARED TO 61741 FOR THE STATE OF VIRGINIA 28 OF SMYTH COUNTYS CHILDREN LIVE IN POVERTY COMPARED TO 16 STATEWIDE
HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE	PART VI	PART VI LINE 5 SCCH IS DEDICATED TO OPERATING EFFICIENTLY SO THAT WASTE IS MINIMIZED AND SURPLUSES MAY BE APPLIED TO MAINTAINING ADEQUATE FACILITIES AND EQUIPMENT FOR THE CARE OF OUR PATIENTS VARIOUS CHECKS AND BALANCES ARE ESTABLISHED TO ENSURE THAT EXPENDITURES FOR OPERATING EXPENSES AND CAPITAL COSTS ARE REASONABLE AND NECESSARY THE MAJORITY OF SCCHS GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATIONS PRIMARY SERVICE AREAS PHYSICIANS THAT REQUEST PRIVILEGES WHO ARE QUALIFIED AND CREDENTIALED ARE EXTENDED PRIVILEGES BY SCCH
AFFILIATED HEALTH CARE INFORMATION	PART VI	PART VI LINE 6 SCCH IS A 44BED ACUTECARE FACILITY OPERATED UNDER THE DIRECTION OF A 13MEMBER BOARD OF DIRECTORS PRIMARILY COMPRISED OF LOCAL COMMUNITY RESIDENTS ADDITIONALLY SCCH HAS A 109BED NURSING CARE FACILITY THAT OFFERS BOTH SKILLED NURSING CARE AND NURSING CARE SCCH IS MAJORITY OWNED BY MOUNTAIN STATES HEALTH ALLIANCE MSHA BASED IN JOHNSON CITY TENNESSEE MSHA IS INTEGRATED BOTH VERTICALLY AND HORIZONTALLY AND IS THE LARGEST REGIONAL HEALTHCARE SYSTEM WITH 13 HOSPITALS MSHA PROVIDES CARE TO PEOPLE IN 29 COUNTIES IN TENNESSEE VIRGINIA KENTUCKY AND NORTH CAROLINA SCCH SERVES AS THE COUNTYS PRIMARY HEALTH SERVICE PROVIDER PATIENTS BENEFIT FROM SCCHS AFFILIATION WITH A HEALTHCARE SYSTEM WHERE THEY CAN BE EFFICIENTLY MOVED ALONG AN INTEGRATED COMPREHENSIVE CONTINUUM OF CARE AS THEIR HEALTH STATUS DICTATES PATIENTS CAN BE MOVED TO THE SYSTEMS FLAGSHIP FACILITY JOHNSON CITY MEDICAL CENTER WHICH IS A TERTIARY CARE FACILITY PROVIDING ADVANCED TREATMENT OPTIONS
LIST OF STATES WHERE COMMUNITY BENEFIT REPORT IS FILED	PART VI	VIRGINIA
SMYTH COUNTY COMMUNITY HOSPITAL 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 SCCH 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
SMYTH COUNTY COMMUNITY HOSPITAL 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 DICKENSON COMMUNITY HOSPITAL AND NORTON COMMUNITY HOSPITAL ALSO HAD ONE COMMUNITY GROUP SURVEYED THESE TWO COUNTIES SERVE SIMILAR COMMUNITIES AND HAVE SIMILAR HEALTH RANKINGS ACCORDING TO AMERICAS HEALTH RANKINGS EVEN THOUGH ONLY TWO COMMUNITY GROUPS SERVED ON BEHALF OF THE FOUR HOSPITALS LISTED STATISTICAL DATA WAS COLLECTED FOR EACH INDIVIDUALLY SCCHS CHNA WAS CONDUCTED WITH ALL MSHA HOSPITALS TO INCLUDE JOHNSON CITY MEDICAL CENTER FRANKLIN WOODS COMMUNITY HOSPITAL INDIAN PATH MEDICAL CENTER SYCAMORE SHOALS HOSPITAL JOHNSON COUNTY COMMUNITY HOSPITAL RUSSELL COUNTY MEDICAL CENTER JOHNSTON MEMORIAL HOSPITAL NORTON COMMUNITY HOSPITAL AND DICKENSON COMMUNITY HOSPITAL
SMYTH COUNTY COMMUNITY HOSPITAL 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
SMYTH COUNTY COMMUNITY HOSPITAL LINE NUMBER 1 PART V LINE 14G	PART V LINE 14G	THE MOUNTAIN STATES HEALTH ALLIANCE FINANCIAL ASSISTANCE POLICY HS 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 ADVISE 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
SMYTH COUNTY COMMUNITY HOSPITAL 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

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	true	RecordsMaintained

Form990 Schedule I Part IV Form990ScheduleIPartIV (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INSIDE THE UNITED STATES	SCHEDULE I, PAGE 1, PART I, LINE 2	FUNDING MAY BE PROVIDED TO LOCAL 501(C)(3)ORGANIZATIONS WHOSE FOCUS IS ON HEALTH AND EDUCATION. FOR MANY YEARS, SCCH HAS MADE DONATIONS OF MEDICATIONS TO AREA NON-PROFIT EMERGENCY MEDICAL SERVICE COMPANIES. THESE MEDICATION DONATIONS COMPRISE THE SIGNIFICANT MAJORITY OF OUR DONATIONS. ON OCCASION, WE MAKE A VERY SMALL NUMBER OF MODEST CASH DONATIONS TO AREA SCHOOLS AND OTHER NON-PROFIT HEALTH CARE ORGANIZATIONS. DURING FY13, WE MADE ONE DONATION TO A SCHOOL AND ONE DONATION TO A HEALTH CARE ORGANIZATION. DONATION REQUESTS ARE EVALUATED BASED ON COMMUNITY NEED AND HEALTH CARE BENEFIT (OTHER THAN THE OCCASIONAL SCHOOL DONATION).
ADDITIONAL INFORMATION	SCHEDULE I, PAGE 4, PART IV	PART III, LINE 1 DURING FY13, SCCH DID NOT CONTRIBUTE 5,000 TO ANY ONE ORGANIZATION.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	false	SeverancePayment
Supplemental Nonqual Retire Plan	true	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	false	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	false	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	false	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	false	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	false	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	false	AnyNonFixedPayments
Initial Contract Exception	false	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)

TitleTitle	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Related OrgsTotalCompensationRelatedOrgs
ANN FLEMING
DIRECTOR	351697	51836	22747	48425	17857	492562
JOHN SCHARIO
DIRECTOR	326339	68681	6502	6630	24558	432710
LINDA WHITE
VPCEO	184990	23278	8995	20963	22519	260745
MATTHEW JUSTUS
	174442		180	5428	501	180551
SAMUEL SMALL
	157956		2638	4739	77	165410
STEPHANIE POLLARD
	130643		5733	4062	17814	158252
BELDON FLEMING
	135321		180	7658	20784	163943

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
RELATED ORG METHODS USED FOR COMPENSATION EXPLANATION	SCHEDULE J, PAGE 1, PART I, LINE 3	SCCH'S CEO'S SALARY AND BENEFITS ARE SUBJECT TO THE MOUNTAIN STATES HEALTH ALLIANCE (MSHA) COMPENSATION COMMITTEE PROCESS, WHEREBY THE MSHA CEO RECOMMENDS THE SALARY AND IT IS REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE, BASED UPON MARKET DATA, MADE AVAILABLE BY THIRD PARTY CONSULTANTS. THE COMPENSATION COMMITTEE HAS FINAL APPROVAL OF MSHA'S CEO RECOMMENDATIONS FOR PAY AND BENEFITS FOR THE SCCH CEO AND ALL OTHER EXECUTIVES WITHIN MSHA. WE USE AN OUTSIDE, INDEPENDENT CONSULTING FIRM TO PROVIDE CONSULTATION ON EXECUTIVE PAY AS WELL AS OUR EXECUTIVE PAY AT RISK PLAN.
SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS	SCHEDULE J, PAGE 1, PART I, LINE 4	ANN FLEMING 0 35,925 0 LINDA WHITE 0 9,529 0
OTHER ADDITIONAL INFORMATION	SCHEDULE J, PART III	PART I, LINE 4B ANN FLEMING AND LINDA WHITE PARTICIPATED IN A 457(F) RETIREMENT PLAN PROVIDED BY MOUNTAIN STATES HEALTH ALLIANCE (MSHA). THE 457(F)PLAN IS A NONQUALIFIED TAX-DEFERRED COMPENSATION PLAN AVAILABLE TO A SELECT GROUP OF KEY EXECUTIVES FOR THE INTENT OF SUPPORTING RETENTION AND TO OFFER A COMPETITIVE TOTAL RETIREMENT PROGRAM. ACCOUNT BALANCES HAVE A "SUBSTANTIAL RISK OF FORFEITURE". IN ADDITION TO CREDITOR RISK, SUBSTANTIAL RISK OF FORFEITURE IS CREATED THROUGH DEFAULT RISK IF THE PARTICIPANT'S EMPLOYMENT WITH MSHA IS TERMINATED PRIOR TO AGE 65. HOWEVER, THE 457(F) PLAN CONTAINS A NON-COMPETE PROVISION THAT PROVIDES THE ACCOUNT BALANCE TO BE PAID IN A LUMP SUM AFTER THE EXECUTIVE SATISFIES THE TWO-YEAR NON-COMPETE PERIOD. THIS PROVISION APPLIES TO EMPLOYER CONTRIBUTIONS IF THE EXECUTIVE HAS PROVIDED ELIGIBLE SERVICE FOR SIX OR MORE YEARS. (ELIGIBLE SERVICE IS OFFICER SERVICE THAT PERMITTED THE EXECUTIVE TO PARTICIPATE IN THE PLAN.) THE EXECUTIVE WILL RECEIVE THE ENTIRE ACCOUNT BALANCE IF HE/SHE BECOMES DISABLED, DIES OR IF THE EXECUTIVE TERMINATES FOR "GOOD REASON" OR IS INVOLUNTARILY TERMINATED WITHOUT "GOOD CAUSE" WITHIN A 24 MONTH PERIOD AFTER A CHANGE-OF-CONTROL OCCURS. DISTRIBUTIONS FROM THIS PLAN ARE SUBJECT TO FEDERAL, STATE, AND LOCAL TAXES ON THE ENTIRE ACCOUNT BALANCE UPON DISTRIBUTION.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
BETTY KIRK
FAMILY MEMBER	75192	SEE PART V	false
REBECCA SPARGER
FAMILY MEMBER	9124	SEE PART V	false

Form990 Schedule L Part V Form990ScheduleLPartV

Field	Value	IRS element (for citing)
Identifier	ADDITIONAL INFORMATION	Identifier
Return Reference	SCHEDULE L PART V	ReturnReference
Explanation	1A NAME OF PERSON BETTY KIRK 1B RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION FAMILY MEMBER OF JIM BEAR 1D DESCRIPTION OF TRANSACTION JIM BEAR SCCH BOARD TREASURER IS A FAMILY MEMBER OF BETTY KIRK AN EMPLOYEE OF SMYTH COUNTY COMMUNITY HOSPITAL 2A NAME OF PERSON REBECCA SPARGER 2B RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION FAMILY MEMBER OF JAMES PATTERSON MD 2D DESCRIPTION OF TRANSACTION JAMES PATTERSON MD SCCH BOARD MEMBER IS A FAMILY MEMBER OF REBECCA SPARGER AN EMPLOYEE OF SMYTH COUNTY COMMUNITY HOSPITAL	Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (13 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
ORGANIZATION'S MISSION	FORM 990 - ORGANIZATION'S MISSION	PART I, LINE I - ORGANIZATION'S MISSION: SMYTH COUNTY COMMUNITY HOSPITAL (SCCH) IS COMMITTED TO BRINGING LOVING CARE TO HEALTH CARE. WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTH CARE NEEDS OF INDIVIDUALS AND COMMUNITIES IN OUR REGION AND TO ASSIST THEM IN ATTAINING THEIR HIGHEST POSSIBLE LEVEL OF HEALTH.
FIRST ACCOMPLISHMENT DESCRIPTION	FORM 990, PAGE 2, PART III, LINE 4A	AS A NOT-FOR-PROFIT HOSPITAL, ALL OF SCCH'S NET INCOME IS INVESTED IN IMPROVING HEALTHCARE IN THE COMMUNITY. WITH A STRONG COMMITMENT TO QUALITY PATIENT CARE AND A HERITAGE OF SERVICES, SCCH CONTINUES TO MEET THE HEALTHCARE NEEDS OF SMYTH AND THE ADJOINING COUNTIES. THROUGHOUT THE YEAR, SCCH PROVIDES A RANGE OF EVENTS AND PROGRAMS FOR THE COMMUNITY. A FEW EXAMPLES ARE: ADVANCED DIRECTIVES DAY: THIS WAS A DAY TO EDUCATE COMMUNITY MEMBERS ABOUT LEGAL DOCUMENTS THEY MAY WISH TO HAVE IN ORDER TO EXPRESS THE TYPE OF MEDICAL CARE WANTED WHEN ILL AND TO MAKE CLEAR THEIR DECISIONS FOR THEIR OWN END OF LIFE CARE. SINCE A MEDICAL CRISIS CAN OCCUR AT ANY AGE, THIS ADVANCED CARE PLANNING IS AN IMPORTANT STEP TOWARD ENSURING AN INDIVIDUAL'S WISHES ARE FOLLOWED IF HE/SHE IS TOO ILL TO MAKE HIS/HER OWN HEALTHCARE DECISIONS. TWELVE SCCH TEAM MEMBERS WERE INVOLVED WITH THIS EDUCATION DAY. MSHA FACILITIES, INCLUDING SCCH, SERVE AS CLINICAL TRAINING AREAS FOR HEALTH PROFESSIONAL EDUCATION STUDENTS. SCCH HAS DEDICATED STAFF TO WORK WITH REGIONAL COLLEGES AND UNIVERSITIES TO COORDINATE THE PLACEMENT OF HEALTHCARE PROFESSIONAL STUDENTS AS PART OF THEIR EDUCATIONAL CURRICULUM. IN ADDITION TO CLINICAL TRAINING, THE HEALTH CARE STUDENTS ENTERING OUR SYSTEM ARE REQUIRED TO HAVE ORIENTATION AND COMPUTER TRAINING. PARTICIPANTS RECEIVING CLINICAL EXPERIENCE AT SCCH DURING FY13 INCLUDED 50 NURSING STUDENTS FROM VARIOUS COLLEGES, UNIVERSITIES AND PROGRAMS. THIS NURSING CLINICAL EXPERIENCE REQUIRED EXTENSIVE SCCH NURSING STAFF INVOLVEMENT. THE CLINICAL SETTING AND HANDS-ON INSTRUCTION COST SCCH 100,328. SCCH PROVIDED A CLINICAL SETTING FOR ANOTHER 101 STUDENTS TRAINING IN HEALTH-RELATED PROGRAMS SUCH AS RADIOLOGY, PHARMACY, PHYSICAL THERAPY, EMT/PARAMEDIC AND OTHER ALLIED-HEALTH DISCIPLINES. THESE ADDITIONAL CLINICAL STUDENTS COST SCCH 88,368. SMYTH COUNTY LPN STUDENTS RECEIVE THEIR CLINICAL TRAINING AT SCCH. BECAUSE OF THE CLOSE TIE BETWEEN THE STUDENTS AND SCCH, THE STUDENTS ALWAYS ASK TO HAVE THEIR GRADUATION CEREMONY HELD AT THE HOSPITAL. THE HOSPITAL IS VERY PLEASED TO HOST THE CEREMONY FOR THE STUDENTS AND THEIR FAMILIES. REFRESHMENTS ARE PROVIDED AND SCCH'S CEO AND CNO ATTEND THE CEREMONY. SCCH OFFERS A SUPPORT GROUP FOR PEOPLE WITH DIABETES. TWO SCCH TEAM MEMBERS PROVIDE EDUCATION REGARDING SELF-CARE, INCLUDING NUTRITION COUNSELING. SCCH HAS PARTNERED WITH THE COMPANY, FIRSTSOURCE SOLUTIONS USA, TO WORK WITH SELF-PAYING PATIENTS WHO HAVE LIMITED FINANCIAL RESOURCES. FIRSTSOURCE REPRESENTATIVES WERE ABLE TO DETERMINE GOVERNMENTAL MEDICAL ASSISTANCE (MEDICAID) ELIGIBILITY, AND TO HELP WITH THE APPLICATION PROCESS AND FOLLOW-UP. ONCE A PERSON IS APPROVED FOR MEDICAID THROUGH THIS PROGRAM OFFERED THROUGH SCCH, THEY RETAIN COVERAGE FOR FUTURE MEDICAL CARE. FIRSTSOURCE IS COMPENSATED BY SCCH. DURING FY13, SCCH'S COST FOR THIS PROGRAM WAS 67,998. SCCH TEAM MEMBERS PARTICIPATE IN A LOCAL NUTRITION NETWORK, A COLLABORATION OF SPONSORS AND AGENCIES WHO GRAPPLE WITH THE ISSUES OF POVERTY, HUNGER, AND LACK OF KNOWLEDGE REGARDING HEALTH CONSEQUENCES OF POOR NUTRITION. THE NETWORK SERVES TO EDUCATE THE COMMUNITY ABOUT OBESITY RELATED HEALTH PROBLEMS SUCH AS DIABETES, HYPERTENSION, HIGH CHOLESTEROL, AND HEART DISEASE. THE NETWORK'S GOAL IS TO ADDRESS POVERTY AND THE WIDESPREAD USE OF INEXPENSIVE, PROCESSED FOODS WHICH CONTRIBUTE TO THE OBESITY RISK. SINCE THE SOLUTION TO OBESITY AND ITS RELATED DISEASES DOES NOT REQUIRE HIGH TECH TREATMENT OR CUTTING EDGE MEDICATIONS, REPRESENTATIVES FROM SCCH, VIRGINIA DEPARTMENT OF HEALTH, VIRGINIA TECH, FARMERS MARKETS AND GROCERY STORES, LOCAL SCHOOLS AND CHARITY ORGANIZATIONS ARE DEEMED TO BE THE BEST PLACE TO START THE PROCESS OF REDUCING OBESITY WITHIN THE COMMUNITY. A VARIETY OF SCREENINGS, SUPPORT GROUPS, HEALTH EDUCATION, AND HEALTH FAIRS WERE PROVIDED ON AN ONGOING BASIS THROUGHOUT THE YEAR. SOME OF THE SERVICES PROVIDED DURING THE YEAR INCLUDE: LAB SERVICES FOR A FREE PUBLIC CLINIC, CPR TRAINING TO THE PUBLIC, PHYSICALS FOR LOCAL SCHOOLS, AND FIRST AID CLASSES. THE COST OF PROVIDING THESE FREE SERVICES WAS MORE THAN 16,000. FOR MANY YEARS, SCCH HAS PROVIDED ASSISTANCE TO LOCAL LIFESAVING ORGANIZATIONS SUCH AS AMBULANCE SERVICES, FIRE DEPARTMENTS AND RESCUE SQUADS. SCCH DONATES FREE MEDICATIONS AND PHARMACEUTICAL SUPPLIES TO THESE NON-PROFIT ORGANIZATIONS. THE COST OF DONATED MEDICATIONS TO RESCUE ORGANIZATIONS DURING FY13 WAS 11,695. PLANS ARE UNDERWAY TO ESTABLISH AN AFTERHOURS URGENT CARE FOR COUNTY RESIDENTS SO THAT SCCH'S EMERGENCY DEPARTMENT IS NOT THE ONLY OPTION. THE SMYTH COUNTY HOSPITAL HEALTH TRUST WILL SOON BEGIN RAISING MONEY FOR THE MUCH NEEDED URGENT CARE CLINIC PROJECT. PATIENT CARE SERVICES INCLUDE, BUT ARE NOT LIMITED TO: 24-HOUR EMERGENCY DEPARTMENT: SCCH HAS A PHYSICIAN ON DUTY 24 HOURS A DAY, 7 DAYS A WEEK TO TAKE CARE OF MEDICAL NEEDS. IN ADDITION TO OUR PHYSICIANS, WE ALSO STAFF EITHER A FAMILY NURSE PRACTITIONER OR PHYSICIAN ASSISTANT 7 DAYS A WEEK FROM 11AM UNTIL 10PM TO EXPAND CARE BY TREATING EAR ACHES, SORE THROATS, BURNS, SIMPLE FRACTURES, AND MOST OTHER MINOR EMERGENCIES. TOTAL ER VISITS DURING THE YEAR EXCEEDED 18,000. SCCH HAS A HELIPAD FOR AIR EMERGENCY VEHICLES SUCH AS WINGS AIR RESCUE. INPATIENT CARE: THE MEDICAL/SURGICAL UNITS DELIVER COMPREHENSIVE CARE, INCLUDING TELEMETRY SERVICES. A CLINICAL NURSE SPECIALIST OVERSEES CLINICAL MANAGEMENT OF PATIENT CARE AND AN ENTEROSTOMAL NURSE ASSESSES PATIENTS FOR PREVENTION OF SKIN PROBLEMS AND COMPLICATED WOUNDS. SCCH ALSO PROVIDES INPATIENT REHABILITATION AND SKILLED NURSING CARE. INPATIENT ADMISSIONS WERE 1,712 DURING FY13, WHILE INPATIENT DAYS WERE 7,729. CARDIAC & PULMONARY: CARDIAC AND PULMONARY REHABILITATION IS A PROGRAM DESIGNED TO OFFER MORE REHABILITATIVE SERVICES AS WELL AS DIAGNOSTIC TESTING TO INDIVIDUALS SO THEY DO NOT HAVE TO TRAVEL TO LARGER MORE URBAN AREAS. UPON PHYSICIAN REFERRAL WITH HEART AND LUNG DISEASES THAT INCLUDE, BUT ARE NOT LIMITED TO, CORONARY ANGIOPLASTY, HEART ATTACK, CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) AND DYSPNEA (SHORTNESS OF BREATH). CARDIAC REHABILITATION, STRESS TESTING, AND RESPIRATORY THERAPY ARE FOR PATIENTS WHO HAVE EXPERIENCED CARDIAC ILLNESS. THE CARDIAC REHAB DEPARTMENT FOCUSES ON RISK FACTOR MODIFICATION AND LIFESTYLE CHANGES FOR THOSE WHO HAVE EXPERIENCED A HEART ATTACK, OR WHO HAVE HAD CARDIAC SURGERY, BALLOON ANGIOPLASTY OR CORONARY STENTS, KNOWN HEART DISEASE SUCH AS STABLE ANGINA OR CONGESTIVE HEART FAILURE. THIS YEAR, SCCH'S CARDIAC AND PULMONARY REHABILITATION PROGRAM RECEIVED CERTIFICATION FROM THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION (AACVPR) AFTER A TWO-YEAR DOCUMENTATION AND APPLICATION PROCESS. THE COVETED CERTIFICATION MEANS THAT THE OUPATIENT CARDIAC SERVICES OFFERED AT SCCH MEET AACVPR'S STRICT GUIDELINES FOR APPROPRIATE AND EFFECTIVE EARLY OUTPATIENT CARE OF CARDIAC PATIENTS. SINCE THE INCEPTION OF THIS PROGRAM 15 YEARS AGO, THE FACILITY'S SQUARE FOOTAGE HAS DOUBLED AND THE NUMBER OF REHABILITATION SESSIONS HAS GROWN MORE THAN 5 TIMES THE RATES SEEN IN EARLY YEARS. PHYSICIANS IN SEVERAL STATES NOW REFER PATIENTS TO SCCH'S CARDIAC REHABILITATION PROGRAM. LABORATORY SERVICES: LABORATORY SERVICES FOR SCCH ARE AVAILABLE TO MEET THE NEEDS OF OUR PATIENTS. LABORATORY SERVICES ARE INSPECTED AND ACCREDITED BY THE JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS AND THE VIRGINIA DEPARTMENT OF HEALTH. LABORATORY SERVICES ALSO PARTICIPATE IN THE COLLEGE OF AMERICAN PATHOLOGISTS' PROGRAMS FOR QUALITY CONTROL. TESTING IS PERFORMED AND SUPERVISED BY COLLEGE TRAINED AND DEGREED TECHNICIANS AND TECHNOLOGISTS CERTIFIED BY THE AMERICAN SOCIETY OF CLINICAL PATHOLOGISTS AND THE AMERICAN SOCIETY OF MEDICAL TECHNOLOGISTS. SATELLITE TESTING IS PROVIDED BY LICENSED NURSES TRAINED AND SUPERVISED BY LABORATORY STAFF. JUST UNDER 160,000 LAB TESTS WERE PERFORMED DURING THE YEAR. IN JANUARY 2013, AN UNANNOUNCED EXTERNAL INSPECTION OF THE LAB WAS CONDUCTED BY THE COLLEGE OF AMERICAN PATHOLOGISTS(CAP). THE INSPECTION WENT VERY WELL WITH SCCH'S LAB RECEIVING THE DESIGNATION OF EXCELLENCE. ONE OF THE INSPECTORS REMARKED THAT THE SCCH LAB INSPECTION WAS THE BEST HE HAS ENCOUNTERED OVER THE COURSE OF THE 12 YEARS HE HAS BEEN A LAB INSPECTOR. SURGICAL SERVICES: SURGICAL SERVICES PROVIDED BY SCCH INCLUDE: UROLOGY, SINUPLASTY AND OTHER ENT, OPTHALMOLOGY, ORTHOPEDICS, PLASTICS, GYN, PODIATRY, ORAL, AND GENERAL SURGERY, LASER OPTHALMOLOGY AND REFRACTORY PROCEDURES ARE PERFORMED IN THE OPERATING ROOM. 422 INPATIENT SURGERY CASES WERE PERFORMED DURING THE YEAR. SCCH HAS A 11-BED OUTPATIENT SURGERY DEPARTMENT DEVELOPED FOR PATIENTS WHO ARE HAVING A SHORT STAY SURGERY OR PROCEDURE AND ARE ABLE TO BE SENT HOME FOLLOWING A RECOVERY PERIOD AT THE HOSPITAL. 1,358 OUTPATIENT SURGERY CASES WERE PERFORMED DURING FY13. SPIRITUAL AND PASTORAL CARE: SCCH HAS A VOLUNTEER CHAPLAIN PROGRAM THAT IS ENHANCED BY A SPIRITUAL SUPPORT TEAM MADE UP OF SCCH TEAM MEMBERS. THEIR WORK CROSSES INSTITUT
CLASSES OF MEMBERS OR STOCKHOLDERS	FORM 990, PAGE 6, PART VI, LINE 6	MOUNTAIN STATES HEALTH ALLIANCE IS THE 80% MEMBER OF SMYTH COUNTY COMMUNITY HOSPITAL. SMYTH COUNTY COMMUNITY HOSPITAL FOUNDATION IS THE 20% MEMBER OF SMYTH COUNTY COMMUNITY HOSPITAL.
ELECTION OF MEMBERS AND THEIR RIGHTS	FORM 990, PAGE 6, PART VI, LINE 7A	THERE ARE TWO CLASSES OF MEMBERS, AND EACH CLASS IS ENTITLED TO ELECT A SPECIFIED NUMBER OF DIRECTORS TO THE BOARD. THE MOUNTAIN STATES HEALTH ALLIANCE (MSHA) CLASS IS ELECTED BY THE MSHA BOARD OF DIRECTORS AND THE SMYTH COUNTY COMMUNITY HOSPITAL CLASS IS ELECTED BY THE SMYTH COUNTY COMMUNITY HOSPITAL FOUNDATION BOARD OF DIRECTORS. NEITHER SIDE CAN VETO AN APPOINTMENT.
DECISIONS SUBJECT TO APPROVAL OF MEMBERS	FORM 990, PAGE 6, PART VI, LINE 7B	CERTAIN DECISIONS OF THE BOARD ARE, PURSUANT TO CHARTER AND VIRGINIA STATUTE, SUBJECT TO APPROVAL OF THE MEMBERS. THESE DECISIONS INCLUDE: DISSOLUTION OF THE CORPORATION; MERGER OF THE CORPORATION; NON-ORDINARY COURSE OF BUSINESS SALE OF ASSETS; ETC. NO ORDINARY, DAY TO DAY DECISIONS ARE SUBJECT TO MEMBER APPROVAL.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990	FORM 990, PAGE 6, PART VI, LINE 11B	THE CONTROLLER, ALLONG WITH THE CEO, REVIEWED THE FORM 990 WITH THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS AND THE RETURN WAS MADE AVAILABLE TO EACH BOARD MEMBER IN AN ELECTRONIC FORMAT PRIOR TO THE REVIEW.
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, INCLUDING SMYTH COUNTY COMMUNITY HOSPITAL'S CEO, LINDA WHITE. 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 TO THOSE PARTIES WHO OWN INDEBTEDNESS OF THE COMPANY ON A QUARTERLY BASIS.
RELATED ORGANIZATIONS	FORM 990, PAGE 7, PART VII	FORM 990, PART VII, SECTION A: TRUSTEE COMPENSATION: HOSPITAL BOARD OF TRUSTEES MEMBERS ANN FLEMING AND JOHN SCHARIO HAVE FORM 990 REPORTABLE COMPENSATION DERIVED FROM SERVICES THEY PROVIDED TO RELATED ORGANIZATIONS. THEY DO NOT RECEIVE COMPENSATION FOR SERVICES AS HOSPITAL BOARD TRUSTEES.
OTHER FEES FOR SERVICES	FORM 990, PART IX, LINE 11G	HOSPITAL SUPPORTED CLINIC 3,464,549 0 0 PHYSICIAN FEES 2,695,862 0 0 DIETARY FEES 1,360,071 0 0 OTHER FEES 632,660 19,272 0
OTHER CHANGES IN NET ASSETS EXPLANATION	FORM 990, PART XI, LINE 9	NET UNREALIZED GAIN ON INVESTMENTS 1,535,593 PARTNERSHIP INCOME NOT ON BOOKS -116,399 PARTNERSHIP INTEREST INCOME NOT ON BOOKS -517 PARTNERSHIP CAPITAL GAINS NOT ON BOOKS -6 PARTNERSHIP CHARITABLE CONTRIBUTIONS NOT ON BOOKS 30 ELIMINATION OF INTERCOMPANY REC/PAY -353,381 TOTAL TO FORM 990, PART XI, LINE 5 1,065,320

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (9 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg	Direct Controlling Entity NADirectControllingEntityNA
MOUNTAIN STATES HEALTH ALLIANCE
400 N STATE OF FRANKLIN ROAD	JOHNSON CITY	TN	37604	620476282	HOSPITAL	TN	501C3	3	NA	false
SMYTH COUNTY COMM FOUNDATION
1 HEALTH WAY	MARION	VA	24354	311650055	SUPPORT	VA	501C3	11A	NA	false
NORTON COMMUNITY HOSPITAL
100 15TH STREET NORTHWEST	NORTON	VA	24273	540566029	HOSPITAL	VA	501C3	3	NA	false
DICKENSON COMMUNITY HOSPITAL
ONE HOSPITAL DRIVE	CLINTWOOD	VA	24238	770599553	HOSPITAL	VA	501C3	3	NCH	false
JOHNSTON MEMORIAL HOSPITAL
16000 JOHNSTON MEMORIAL DRIVE	ABINGDON	VA	24211	540544705	HOSPITAL	VA	501C3	3	NA	false
ABINGDON PHYSICIAN PARTNERS
16000 JOHNSTON MEMORIAL DRIVE	ABINGDON	VA	24211	205485346	MED. SERV.	VA	501C3	11A	JMH	false
MOUNTAIN STATES FOUNDATION
2335 KNOB CREEK ROAD STE 101	JOHNSON CITY	TN	37604	581418862	FUNDRAISER	TN	501C3	11A	MSHA	false
MSHA AUXILIARY
400 N STATE OF FRANKLIN ROAD	JOHNSON CITY	TN	37604	581418345	SUPPORT	TN	501C3	11A	NA	false
APPALACHIAN EMERGENCY PHYSICIANS
1021 W OAKLAND AVENUE STE 207	JOHNSON CITY	TN	37604	800592504	MED. SERV	VA	501C3	11A		false	N/A

Form990 Schedule R Part III Form990ScheduleRPartIII (8 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Predominant Income TypePredominantIncomeType	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Disproportionate AllocationsDisproportionateAllocations	General Or Managing PartnerGeneralOrManagingPartner	Percentage OwnershipPercentageOwnership
INTEGRATED SOLUTIONS HLTH NTWK LLC
400 N STATE OF FRANKLIN ROAD	JOHNSON CITY	TN	37604	621711997	INVESTMENT	TN	NA	EXCLUDED	-10	-352	false	false	0.00040
EMMAUS COMMUNITY HEALTHCARE PLLC
6070 HWY 11E	PINEY FLATS	TN	37686	200577483	MED. SERV.	TN	NA				false	false
MEDICAL SPECIALISTS OF J C LLC
2528 WESLEY STREET SUITE 2	JOHNSON CITY	TN	37604	272199037	MED. SERV.	TN	NA				false	false
ANEWCARE COLLABORATIVE LLC
208 SUNSET DRIVE SUITE 403	JOHNSON CITY	TN	37604	453232366	ACO	TN	NA				false	false
INTEGRATED SOLUTIONS HLTH NTWK LLC
400 N STATE OF FRANKLIN ROAD	JOHNSON CITY	TN	37604	621711997	INVESTMENT	TN	NA	EXCLUDED	-10	-352	false	false	0.00040
EMMAUS COMMUNITY HEALTHCARE PLLC
6070 HWY 11E	PINEY FLATS	TN	37686	200577483	MED. SERV.	TN	NA				false	false
MEDICAL SPECIALISTS OF J C LLC
2528 WESLEY STREET SUITE 2	JOHNSON CITY	TN	37604	272199037	MED. SERV.	TN	NA				false	false
ANEWCARE COLLABORATIVE LLC
208 SUNSET DRIVE SUITE 403	JOHNSON CITY	TN	37604	453232366	ACO	TN	NA				false	false

Form990 Schedule R Part IV Form990ScheduleRPartIV (16 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Type Of EntityTypeOfEntity	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Percentage OwnershipPercentageOwnership	Controlled OrgControlledOrg
SOUTHWEST COMMUNITY HEALTH SERVICES
P O BOX 880	MARION	VA	24354	541460695	MED. SERV.	VA	NA	C CORP	238565	1372768	1.00000	false
BLUE RIDGE MEDICAL MANAGEMENT CORP
1021 W OAKLAND AVENUE SUITE 207	JOHNSON CITY	TN	37604	621490616	MED. SERV.	TN	NA	C CORP				false
MEDISERVE MED EQUIP OF KINGSPORT
1021 W OAKLAND AVENUE SUITE 207	JOHNSON CITY	TN	37604	621212286	DME	TN	NA	C CORP				false
MOUNTAIN STATES PROPERTIES
1021 W OAKLAND AVENUE SUITE 207	JOHNSON CITY	TN	37604	621845895	PROP MGMT	TN	NA	C CORP				false
MOUNTAIN STATES PHYSICIANS GRP INC
1021 W OAKLAND AVENUE SUITE 207	JOHNSON CITY	TN	37604	621700412	HEALTHCARE	TN	NA	C CORP				false
COMMUNITY HOME CARE INC
1460 PARK AVENUE	NORTON	VA	24273	541453810	MED. EQUIP	TN	NA	C CORP				false
WILSON PHARMACY INC
PO BOX 5289	JOHNSON CITY	TN	37602	620329587	PHARMACY	TN	NA	C CORP				false
CRESTPOINT HEALTH INSURANCE CO INC
208 SUNSET DRIVE SUITE 101	JOHNSON CITY	TN	37604	620381170	INSURANCE	TN	NA	C CORP				false
SOUTHWEST COMMUNITY HEALTH SERVICES
P O BOX 880	MARION	VA	24354	541460695	MED. SERV.	VA	NA	C CORP	238565	1372768	1.00000	false
BLUE RIDGE MEDICAL MANAGEMENT CORP
1021 W OAKLAND AVENUE SUITE 207	JOHNSON CITY	TN	37604	621490616	MED. SERV.	TN	NA	C CORP				false
MEDISERVE MED EQUIP OF KINGSPORT
1021 W OAKLAND AVENUE SUITE 207	JOHNSON CITY	TN	37604	621212286	DME	TN	NA	C CORP				false
MOUNTAIN STATES PROPERTIES
1021 W OAKLAND AVENUE SUITE 207	JOHNSON CITY	TN	37604	621845895	PROP MGMT	TN	NA	C CORP				false
MOUNTAIN STATES PHYSICIANS GRP INC
1021 W OAKLAND AVENUE SUITE 207	JOHNSON CITY	TN	37604	621700412	HEALTHCARE	TN	NA	C CORP				false
COMMUNITY HOME CARE INC
1460 PARK AVENUE	NORTON	VA	24273	541453810	MED. EQUIP	TN	NA	C CORP				false
WILSON PHARMACY INC
PO BOX 5289	JOHNSON CITY	TN	37602	620329587	PHARMACY	TN	NA	C CORP				false
CRESTPOINT HEALTH INSURANCE CO INC
208 SUNSET DRIVE SUITE 101	JOHNSON CITY	TN	37604	620381170	INSURANCE	TN	NA	C CORP				false

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	true	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	true	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	false	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	true	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	false	DividendsRelatedOrganization
Sale Of Assets To Other Org	false	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	false	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	false	ExchangeOfAssets
Rental Of Facilities To Other Orgs	true	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	false	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	false	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	true	PerformOfServicesByOtherOrgs
Sharing Of Facilities	false	SharingOfFacilities
Sharing Of Paid Employees	true	SharingOfPaidEmployees
Reimbursement Paid To Other Org	true	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	false	OtherTransferToOtherOrg
Other Transfer From Other Org	true	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved
SOUTHWEST COMMUNITY HEALTH SERVICES
A	25177
SOUTHWEST COMMUNITY HEALTH SERVICES
B	358645