2014-05-12T14:40:20-05:00 2013-06-30 990 2012-07-01 540794913 SMYTH COUNTY COMMUNITY HOSPITAL SMYT 2763781000 PO BOX 880 MARION VA 24354 LINDA WHITE 2763781000 2014-05-12 false 2012 2015-11-30 17:44:51Z LINDA P WHITE PO BOX 880 MARION VA 24354 46051757 false X WWW.MSHA.COM X 1961 VA 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. 13 8 1 50 159032 44809 38238 106933 40449630 44574461 1340112 565379 1125043 675303 42953023 45922076 12821 10732 0 23446103 22759121 0 0 22877592 24328438 46336516 47098291 -3383493 -1176215 106754092 104424818 24852213 22633834 81901879 81790984 X 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. false false 36913040 10732 44574461 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 36913040 true true false true false false false false false false true false false false true true false true false false false false false false false false true true true false true false false false false false false true false false false false false false true true true false false true 91 0 true 1 true true true false false false false false false false false false X 13 8 false false false false true true true true true false false true true true true true true true true false VA X ERICA DILLARD 2763781000 PO BOX 880 MARION VA 24354 X ANN FLEMING 3.00 57.00 X 0 426280 66282 JOHN SCHARIO 3.00 57.00 X 0 401522 31188 CHELSEA HAMMAN MD 3.00 X 19019 0 0 ALLEN ABEL 3.00 X 0 0 0 JIM BEAR JR 3.00 X 0 0 0 RUTH COX 3.00 X 0 0 0 BOB FEATHERS 3.00 9.00 X 0 0 0 JOANNE GROSECLOSE 3.00 X 0 0 0 ANDY BLEVINS 3.00 X 0 0 0 JIM MCDOWELL MD 3.00 X 0 0 0 JAMES PATTERSON MD 3.00 X 0 0 0 BOB SHULTS 3.00 X 0 0 0 CLEM WILKES JR 3.00 11.00 X 0 0 0 LINDA WHITE 3.00 52.00 X 0 217263 43482 JEFFREY HUNDMAN 3.00 47.00 X 0 114784 20164 MATTHEW JUSTUS 40.00 X 0 174622 5929 SAMUEL SMALL 40.00 X 0 160594 4816 STEPHANIE POLLARD 40.00 X 0 136376 21876 BELDON FLEMING 40.00 X 0 135501 28442 MARK MONTGOMERY 40.00 X 0 107544 22765 19019 1874486 244944 2 false true false 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 7 82545 24388 106933 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 44574461 677241 677241 276568 276568 276568 276568 8636 120498 -120498 8636 -111862 8630 -120492 2819 2819 2819 24782 9183 15599 15599 CAFETERIA SALES 900099 259717 259717 MANAGEMENT FEES 900099 97867 97867 OTHER REVENUE 900099 11594 11594 11139 11139 380317 45922076 44439658 159032 1216453 X 10732 10732 414330 20644 393686 18541222 15357015 3184207 568963 483357 85606 2062690 1919173 143517 1171916 1129586 42330 34114 34114 51088 51088 28018 28018 8172414 8153142 19272 82914 64643 18271 432536 374194 58342 228811 225028 3783 1141091 1035371 105720 172157 155849 16308 3557 3262 295 173767 173767 4932945 1870477 3062468 149572 149572 MEDICAL SUPPLIES & DRUGS 5036215 5036215 MANAGEMENT FEES 2658267 189358 2468909 REPAIRS & MAINTENANCE 676687 658585 18102 UBI TAXES 8500 8500 345785 226409 119376 47098291 36913040 10185251 0 812382 2388481 64910 8655192 7640675 953670 915788 314696 351420 127433476 54087105 72569428 73346371 18695346 18545937 710615 710615 3977853 525531 106754092 104424818 4880379 4596331 16464093 16208215 3507741 1829288 24852213 22633834 X 81866036 81755141 35843 35843 81901879 81790984 106754092 104424818 X -1176215 1065320 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 2105 false false false 2105 false SCHEDULE C, PART II-B, LINE 1 PORTION OF DUES PAID TO VIRGINIA HOSPITAL AND HEALTHCARE ASSOCIATION THAT ARE ATTRIBUTABLE TO DIRECT LOBBYING. 1842711 1842711 65964188 14912807 51051381 65442 64850 592 56586390 37823784 18762606 2974745 1285664 1689081 73346371 ASSET RETIREMENT OBLIGATION 752000 DUE TO AFFILIATES 441720 OTHER LONG-TERM LIABILITIES 360275 DUE TO THIRD-PARTY 275293 1829288 X LIABILITY UNDER FIN 48 FOOTNOTE SCHEDULE D, PAGE 3, PART X "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". true true X true X true X true true false true true 797530 797530 0.01690 7009144 5704341 1304803 0.02770 7806674 5704341 2102333 0.04460 164999 164999 0.00350 188696 188696 0.00400 14486 14486 0.00030 12742 12742 0.00030 380923 380923 0.00810 8187597 5704341 2483256 0.05270 500 500 500 500 true 5015379 3410458 15707620 15928487 -220867 X true true 1 1 SMYTH COUNTY COMMUNITY HOSPITAL

PO BOX 880 MARIN VA 24354

X X X SMYTH COUNTY COMMUNITY HOSPITAL 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 true true X X X X X true false true X false false 1 FRANCIS MARION MANOR HEALTH &

REHABILITATION 100 FRANCIS MARION LANE MARION VA 24354

NURSING HOME 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 true 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. X X X X X false true false false false false false false false ANN FLEMING 351697 51836 22747 48425 17857 492562 JOHN SCHARIO 326339 68681 6502 6630 24558 432710 LINDA WHITE 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 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. BETTY KIRK FAMILY MEMBER 75192 SEE PART V false REBECCA SPARGER FAMILY MEMBER 9124 SEE PART V false ADDITIONAL INFORMATION SCHEDULE L PART V 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 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 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. 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