2013-05-06T12:44:07-05:00 2012-06-30 990 2011-07-01 620476282 MOUNTAIN STATES HEALTH ALLIANCE MOUN 4233023372 400 N STATE OF FRANKLIN ROAD JOHNSON CITY TN 37604 MARVIN EICHORN 4233023372 2013-05-01 2011 2016-03-07 17:11:31Z JOHNSON CITY MEDICAL CENTER DENNIS VONDERFECHT 303 MED TECH PARKWAY STE 300 JOHNSON CITY TN 37604 735073921 false X WWW.MSHA.COM X 1945 TN PART I, LINE 1: MOUNTAIN STATES HEALTH ALLIANCE (MSHA) IS COMMITTED TO OUR MISSION OF BRINGING LOVING CARE TO HEALTH CARE. WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTHCARE NEEDS OF INDIVIDUALS AND COMMUNITIES IN THE 29-COUNTY AREA WE SERVE, HELPING THEM ATTAIN THEIR HIGHEST LEVEL OF HEALTH. MSHA DELIVERS THIS CARE THROUGH THE PHILOSOPHY OF PATIENT-CENTERED CARE, AND THE DEVELOPMENT OF COMPREHENSIVE STRATEGIC PLANNING AND IMPLEMENTATION. MSHA OPENED A NEW REPLACEMENT HOSPITAL IN 2012, SMYTH COUNTY COMMUNITY HOSPITAL (SCCH) WHICH IS LOCATED IN VIRGINIA AND MAJORITY-OWNED BY MSHA. 13 6 9147 2409 3141566 221368 3143661 2745426 703882320 697705296 15682301 24259649 6648445 10171526 729356727 734881897 357333 990095 0 301399812 309796341 0 1619946 377644976 372114544 679402121 682900980 49954606 51980917 1573869411 1517954041 1268238796 1169345060 305630615 348608981 X PART I, LINE 1: MOUNTAIN STATES HEALTH ALLIANCE (MSHA) IS COMMITTED TO OUR MISSION OF BRINGING LOVING CARE TO HEALTH CARE. WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTHCARE NEEDS OF INDIVIDUALS AND COMMUNITIES IN THE 29-COUNTY AREA WE SERVE, HELPING THEM ATTAIN THEIR HIGHEST LEVEL OF HEALTH. MSHA DELIVERS THIS CARE THROUGH THE PHILOSOPHY OF PATIENT-CENTERED CARE, AND THE DEVELOPMENT OF COMPREHENSIVE STRATEGIC PLANNING AND IMPLEMENTATION. MSHA OPENED A NEW REPLACEMENT HOSPITAL IN 2012, SMYTH COUNTY COMMUNITY HOSPITAL (SCCH) WHICH IS LOCATED IN VIRGINIA AND MAJORITY-OWNED BY MSHA. false false 576044872 990095 699506098 SEE ATTACHED DOCUMENT: MSHA - PROGRAM SERVICE ACCOMPLISHMENTS 576044872 true true false true false false false false false false true false true true true true false true false false false false false false false false true true true false true true true false false false false true false true true true false false false false false true true true false false true 666 0 true 9147 true true true false false false false false false false false false false false X 13 6 false false false false true true true true true false true true true true true true true true true true true true VA X X MARVIN EICHORN 4233023372 303 MED TECH PARKWAY SUITE 300 JOHNSON CITY TN 37604 X DENNIS VONDERFECHT 60.00 X X 1099588 0 167285 JEFF FARROW MD 3.00 X 39813 0 0 CLEM WILKES JR 4.10 X 0 0 0 GARY PEACOCK 3.60 X 0 0 0 SANDRA BROOKS MD 3.40 X 0 0 0 RICK STOREY 2.90 X 0 0 0 THOMAS FOWLKES 3.00 X 0 0 0 LINDA GARCEAU 3.50 X 0 0 0 DONALD JEANES 4.10 X 0 0 0 JOANNE GILMER 4.50 X 0 0 0 DAVID MAY MD 3.30 X 0 0 0 ROBERT FEATHERS 3.70 X 0 0 0 MICHAEL CHRISTIAN 4.10 X 0 0 0 MARVIN EICHORN 60.00 X 672484 0 35543 CANDACE JENNINGS 60.00 X 553717 0 73519 ANN FLEMING 60.00 X 501320 0 66728 BRAD NURKIN 55.00 X 394647 0 21243 MONTY MCLAURIN 55.00 X 348701 0 55842 LYNN KRUTAK 55.00 X 271648 0 30747 DAVID NICELY 55.00 X 262306 0 26990 SHANE HILTON 55.00 X 253872 0 35521 CYNTHIA SALYER 55.00 X 241894 0 42953 DALE CLAYTORE 55.00 X 227871 0 12784 PAT NIDAY 55.00 X 193264 0 30352 MORRIS SELIGMAN MD 50.00 X 597687 0 79845 FRANK LAURO MD 50.00 X 450006 0 29327 JAMES PASKERT MD 60.00 X 426742 0 37947 DOUGLAS EDEMA 50.00 X 397868 0 37897 CARL KILGORE 50.00 X 393219 0 50572 7326647 835095 196 false true false MORRISON MANAGEMENT SPECIALISTS PO BOX 102289 ATLANTA GA 30368 DIETARY SVC. 8951589 ETSU COLLEGE OF MEDICINE BOX 70415 JOHNSON CITY TN 37614 PHYSICIAN SVC. 6388241 ANESTHESIA PAIN CONSULTANTS STE 4 1113 SUNSET DRIVE JOHNSON CITY TN 37605 PHYSICIAN SVC. 4401130 HOSPITAL HOUSEKEEPING SYSTEMS LTD P O BOX 826 SAN ANTONIO TX 78293 HOUSEKPNG SVC. 3719557 CROTHALL LAUNDRY SERVICES INC 13028 COLLECTIONS CENTER DR CHICAGO IL 60693 LAUNDRY SVC. 3293657 125 1692349 893978 159099 2745426 PATIENT REVENUE-OTHER 683614493 683614493 WELLNESS PROGRAMS 15921471 15921471 LAB UBI REVENUE 621500 1524216 1524216 PREMIER PURCHASING K-1 (UBI) 541610 28428 28428 P/S PROG. SERV. INCOME -1417217 -1417217 -1966095 -1966095 697705296 17200885 17200885 6669 6669 299873 169391 130482 130482 69979 60503 6840192 234536 22633 6840192 211903 7052095 211880 6840215 CAFE' SALES 4006850 4006850 DIETARY,SECURITY,ENGIN., ETC. 3462020 3462020 DAY CARE 1002231 1002231 1569943 1518943 51000 10041044 734881897 696364532 3141566 32630373 990095 990095 5468957 5468957 241272312 231707399 8724394 840519 10089414 9725390 328745 35279 34130913 30429032 3636805 65076 18834745 16813372 1978810 42563 1977334 7764 1969570 282707 5100 256771 20836 43468 43468 1391642 1391642 86176772 79284416 6726297 166059 2951800 2317069 613471 21260 9686133 9407004 44685 234444 14644324 12718745 1925579 14759554 11571695 3123421 64438 2448538 1772022 644172 32344 276813 229790 46335 688 42918548 -816 42919364 46483192 26942801 19534953 5438 2364804 5727 2359077 MEDICAL SUPPLIES & DRUGS 124004766 123838671 165092 1003 REPAIRS & MAINTENANCE 14349584 13702930 603502 43152 DUES & SUBSCRIPTIONS 3768837 1068939 2696271 3627 ALL OTHER EXPENSES 3519503 3464259 12024 43220 66225 66225 682900980 576044872 105236162 1619946 94236272 39216743 196903 248258 96082434 103299284 5517265 6806393 94585775 15373693 15564585 15480550 3217335 3139089 926605812 432580246 469613025 494025566 257416902 271118030 282266093 307033212 143276118 143276118 111896704 118937105 1573869411 1517954041 66520793 85554685 19167490 2928666 620629456 813947753 382866923 177320621 4437945 179054134 85155390 1268238796 1169345060 X 305570637 348411488 59978 197493 305630615 348608981 1573869411 1517954041 X 51980917 -9002551 X X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true false false false false true 299578 false false 299578 false false false false false SCHEDULE C, PART II-B, LINE 1 THE COMMUNITY & GOVERNMENT RELATIONS ASSISTANT VICE PRESIDENT AND/OR THE COMMUNITY & GOVERNMENT RELATIONS MANAGER AND/OR DIRECTOR ATTENDED THE FOLLOWING LEGISLATIVE CONFERENCES: - PREMIER FEDERAL AFFAIRS NETWORK MEETINGS - AMERICAN HOSPITAL ASSOCIATION ANNUAL MEETING - TENNESSEE HOSPITAL ASSOCIATION LEGISLATIVE ADVOCACY DAY - TENNESSEE HOSPITAL ASSOCIATION ANNUAL MEETING - HOSPITAL ALLIANCE OF TENNESSEE ANNUAL MEETING - NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS AND RELATED INSTITUTIONS VIP ADVOCACY DAY - TENNESSEE PUBLIC & TEACHING HOSPITALS ASSOCIATION ANNUAL MEETING - VIRGINIA HOSPITAL & HEALTHCARE ASSOCIATION LEGISLATIVE ISSUES CONFERENCE, SPRING CONFERENCE ANNUAL MEETING - ASSOCIATION OF AMERICAN MEDICAL COLLEGES GOVERNMENT RELATIONS MEETING THE COMMUNITY & GOVERNMENT RELATIONS ASSISTANT VICE PRESIDENT AND/OR DEPARTMENTAL STAFF ALSO CONTACTED CONGRESSIONAL OFFICES CONCERNING THE FOLLOWING ISSUES: - SUPPORT FOR PROVISIONS TO EXPAND INSURANCE COVERAGE (HEALTH INSURANCE EXCHANGES AND MEDICAID EXPANSION). - SUPPORT FOR INITIATIVES TO IMPROVE PAYMENT DELIVERY REDESIGN; SUCH AS ACCOUNTABLE CARE ORGANIZATION DEVELOPMENT. - SUPPORT FOR CONTINUATION OF TENNESSEE MEDICAID DISPROPORTIONATE SHARE HOSPITAL PAYMENTS. - SUPPORT IMPROVEMENTS IN MEDICARE SHARED SAVINGS PAYMENT RULE. - OPPOSITION TO ADDITIONAL CUTS IN MEDICARE/MEDICAID. - SUPPORT FOR REAUTHORIZATIONAL AND FUNDING OF CHILDREN'S HOSPITAL GRADUATE MEDICAL EDUCATION. - SUPPORT FEDERAL FUNDING FOR TRAUMA CARE. - SUPPORT CONTINUATION OF GRADUATE MEDICAL EDUCATIONAL FUNDING. - SUPPORT OF STATE MEDICAID PROVIDER TAX PROVISIONS. - SUPPORT OF MEDICARE DEPENDENT HOSPITAL AND LOW-VOLUME DESIGNATIONS. THE COMMUNITY & GOVERNMENT RELATIONS ASSISTANT VICE PRESIDENT AND/OR DEPARTMENTAL DIRECTORS RESPONDED VIA LETTER, PHONE, OR IN PERSON TO THE FOLLOWING TENNESSEE AND VIRGINIA LEGISLATIVE ISSUES: - SUPPORT OF STRONG CERTIFICATE OF NEED PROGRAMS IN TENNESSEE AND VIRGINIA. - SUPPORT FOR CONTINUATION OF HOSPITAL ASSESSMENT FEE IN TENNESSEE. - SUPPORT INCREASE OF TENNESSEE'S APPROPRIATION FOR CARE OF UNINSURED MENTALLY ILL PATIENTS. - SUPPORT OF FUNDING FOR PERINATAL CENTERS IN TENNESSEE. - SUPPORT OF SAFETY NET FUNDING FOR PROJECT ACCESS. - OPPOSE GUNS IN WORKPLACE LEGISLATION. - SUPPORT OF IMPROVEMENTS IN TENNESSEE'S CONTROLLED SUBSTANCE DATABASE. - SUPPORT OF STABLE MEDICAID RATES IN VIRGINIA. - SUPPORT REGULATIONS TO CONTINUE SUPPLEMENTAL PAYMENTS TO JCMC'S NICU FOR ITS HIGH VIRGINIA MEDICAID VOLUME. false false false false false false false false false false 37347384 37347384 471102737 143764013 327338724 958973 431346 527627 417196718 288384887 128811831 494025566 INVESTMENT IN JMH 132000000 C INVESTMENT IN BRMMC 100273634 C INVESTMENT IN SCCH 67400494 C INVESTMENT IN ISHN 7505747 C INVESTMENT IN OTHER -146663 F 307033212 AWUL - UNDER BOND INDENTURE AGREE. 64391147 AWUL - CURRENT 22744639 DEFERRED CHARGES AND OTHER 19588106 LONG TERM COMPENSATION INVESTMENT 12213213 118937105 ACCRUED SALARIES, ABSENCES & W/H 35776926 ACCRUED INTEREST 18362502 DUE TO THIRD-PARTY PAYERS 14363582 EST. FAIR VALUE OF INT. RATE SWAP 8533957 OTHER LONG-TERM LIABILITIES 8118423 85155390 LIABILITY UNDER FIN 48 FOOTNOTE SCHEDULE D, PAGE 3, PART X "MOUNTAIN STATES HEALTH ALLIANCE IS CLASSIFIED AS AN ORGANIZATION EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3 OF THE INTERNAL REVENUE CODE. AS SUCH, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS FOR THE ALLIANCE AND ITS TAX-EXEMPT SUBSIDIARIES. TAXABLE ENTITIES ACCOUNT FOR INCOME TAXES IN ACCORDANCE WITH FASB ASC740, "INCOME TAXES". THE ALLIANCE HAS NO SIGNIFICANT UNCERTAIN TAX POSITIONS AT JUNE 30, 2012 AND 2011." true true X true X true X true true true false false 17797660 17797660 0.02610 21369903 15863216 5506687 0.00810 85083534 61855886 23227648 0.03400 124251097 77719102 46531995 0.06810 6146288 409962 5736326 0.00840 10108023 3585484 6522539 0.00960 24886625 13342547 11544078 0.01690 490139 490139 0.00070 205542 205542 0.00030 41836617 17337993 24498624 0.03590 166087714 95057095 71030619 0.10400 20000 20000 1969962 1969962 0.00290 784554 784554 0.00110 2774516 2774516 0.00410 true 18684338 13079036 186939141 206482868 -19543727 true true MED'L SPEC OF JC LLC MEDICAL SERVICES 0.51000 0.49000 EMMAUS COMM HLTHCR MEDICAL SERVICES 0.75000 0.25000 6 1 JOHNSON CITY MEDICAL CENTER

400 N STATE OF FRANKLIN ROAD JOHNSON CITY TN 37604

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2000 BROOKSIDE DRIVE KINGSPORT TN 37660

X X X X 3 FRANKLIN WOODS COMMUNITY HOSPITAL

300 MED TECH PARKWAY JOHNSON CITY TN 37604

X X X 4 SYCAMORE SHOALS HOSPITAL

1501 W ELK AVENUE ELIZABETHTON TN 37643

X X X 5 RUSSELL COUNTY MEDICAL CENTER

58 CARROLL STREET LEBANON VA 24266

X X X 6 JOHNSON COUNTY COMMUNITY HOSPITAL

16901 S SHADY STREET MOUNTAIN CITY TN 37683

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

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LICENSED OUTPATIENT DIAGNOSTIC CENTER FRANKLIN TRANSITIONAL CARE

400 N STATE OF FRANKLIN ROAD JOHNSON CITY TN 37604

LICENSED SKILLED NURSING FACILITY INDIAN PATH TRANSITIONAL CARE

2000 BROOKSIDE DRIVE KINGSPORT TN 37660

LICENSED SKILLED NURSING FACILITY MEDICAL CNTR HOME CARE-JOHNSON CITY

101 MED TECH PARKWAY SUITE 100 JOHNSON CITY TN 37604

LICENSED HOME HEALTH AGENCY MEDICAL CNTR HOME CARE-KINGSPORT

2020 BROOKSIDE DRIVE 28 KINGSPORT TN 37660

LICENSED HOME HEALTH AGENCY RUSSELL CO MEDICAL CNTR HOME HLTH

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LICENSED HOME HEALTH AGENCY MEDICAL CENTER HOSPICE

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LICENSED HOSPICE AGENCY JOHNSON COUNTY HOME HEALTH

1987 SOUTH SHADY STREET MOUNTAIN CITY TN 37683

LICENSED HOME HEALTH AGENCY RUSSELL COUNTY MEDICAL CNTR HOSPICE

116 FLANNAGAN AVENUE LABANON VA 24266

LICENSED HOSPICE AGENCY RELATED ORGANIZATION INFORMATION PART I LINE 6A MOUNTAIN STATES HEALTH ALLIANCE HAS HISTORICALLY PREPARED AND MADE PUBLIC A COMMUNITY BENEFIT REPORT TO INCLUDE INFORMATION FOR ALL OF THE HOSPITALS WITHIN THE HEALTH SYSTEM DURING FY12 WE DID NOT ISSUE A COMMUNITY BENEFIT REPORT HOWEVER WE INTEND TO PREPARE A COMMUNITY BENEFIT REPORT DURING FY13 COSTING METHODOLOGY EXPLANATION PART I LINE 7 A COST TO CHARGE RATIO WAS USED WHEN APPROPRIATE TO CALCULATE LINE 7 UTILIZING THE SCHEDULE H APPLICABLE WORKSHEETS INCLUDING WORKSHEET 2 A RATIO OF PATIENT CARE COST TO CHARGES PART I LINE 7G JOHNSON COUNTY COMMUNITY HOSPITAL A FEDERALLY DESIGNATED CRITICAL ACCESS HOSPITAL OPERATES A PHYSICIAN SPECIALTY CLINIC WHICH INCURRED AN OPERATING LOSS OF 50869 FOR THE TWELVE MONTHS ENDING JUNE 30 2012 THE SPECIALTY CLINIC INCLUDES CARDIOLOGY GENERAL SURGERY PODIATRY AND OTHER SPECIALTY SERVICES THIS CONTINUES TO BE A VALUABLE RESOURCE TO THE RESIDENTS OF THE AREA BY AIDING WITH TRANSPORTATION ISSUES OTHER PHYSICIAN OFFICES ARE MORE THAN AN HOUR AWAY RESOLVING ACCESS LIMITATIONS FOR SPECIALTY SERVICES AND PROVIDING RELIEF TO THE SPECIAL HEALTH PROBLEMS OF A LARGELY ELDERLY POPULATION RUSSELL COUNTY MEDICAL CENTER OPERATES A RURAL HEALTH CLINIC LOCATED IN ST PAUL VA ON THE BORDER OF WISE AND RUSSELL COUNTIES RIVERSIDE CLINIC FIRST OPENED IN 1991 TO PROVIDE PRIMARY CARE SERVICES TO THIS ELDERLY UNDERSERVED POPULATION THE CLINICS LARGEST PAYOR IS MEDICARE WHICH ACCOUNTS FOR MORE THAN 45 OF THEIR PATIENTS DURING THE 12MONTH REPORTING PERIOD THE CLINIC INCURRED UNREIMBURSED EXPENSES OF 492682 SOME OTHER SUBSIDIZED AREAS WITHIN MSHA INCLUDE SKILLED NURSING FACILITIES WITHIN TWO HOSPITALS OUR AIR TRANSPORT SERVICE WINGS BABYCHILD GROUND TRANSPORT AND MENTAL HEALTH COMMUNITY BUILDING ACTIVITIES PART II MSHA LEADERS SUPPORT AND ENCOURAGE ALL TEAM MEMBERS TO VOLUNTEER TIME MONEY AND SKILLS TO COMMUNITY SERVICE PROJECTS AND CHARITABLE ORGANIZATIONS SENIOR LEADERS AND BOARD MEMBERS SET A POSITIVE EXAMPLE FOR MSHA TEAM MEMBERS SERVING VOLUNTARILY ON COMMITTEES AND MANAGING BOARDS OF LOCAL SERVICE AND NONPROFIT ORGANIZATIONS MANY ALSO SERVE AS MEMBERS AND CONSULTANTS ON PROFESSIONAL COMMITTEES AND TASK FORCES THAT AFFECT REGIONAL DEVELOPMENT IN HEALTHCARE AND EDUCATION SOME OF THESE TEAM MEMBERS DEVOTED TWO WEEKS OF NORMAL WORK TIME TO OUTSIDE CHARITABLE ACTIVITIES MSHA IN COLLABORATION WITH AREA HEALTH AGENCIES AND PROVIDERS MAY OFFER ASSISTANCE WITH COORDINATION ADVOCACY AND PUBLICITY PROVIDE SPACE OR CONTRIBUTE SUPPLIES TO SUPPORT GROUPS FOR THEIR PROGRAM ACTIVITIES PHYSICIAN RECRUITMENT IS REPORTED IN COMMUNITY BUILDING AND INCLUDES EXPENSE TO REPLACE PHYSICIANS RETIRING OR LEAVING OUR SERVICE AREAS INCLUDING RECRUITMENT TO ONE OF OUR FEDERALLY DESIGNATED UNDERSERVED COMMUNITIES WITHOUT MSHAS DEDICATION TO RURAL HEALTH THERE WOULD NOT BE AN ADEQUATE NUMBER OF PHYSICIANS TO SERVE THIS PATIENT POPULATION MSHA SUPPORTS THE ECONOMIC DEVELOPMENT OF THE REGION BY PROVIDING FINANCIAL SUPPORT AS WELL AS PAID TEAM MEMBERS TIME TO SERVE ON ECONOMIC DEVELOPMENT BOARDS EVIDENCE SHOWS THAT A HEALTHY ECONOMY RELATES TO A HEALTHIER POPULATION BAD DEBT EXPENSE EXPLANATION PART III LINE 4 THE CALCULATED COST TO CHARGE RATIO WORKSHEET 2 WAS APPLIED TO BAD DEBT CONTRA REVENUE AND PROVISION FOR BAD DEBT IN DETERMINING LINE 2 OUR VICE PRESIDENT OF PATIENT FINANCIAL SERVICES AND OUR CFO ESTIMATE THAT 70 OF BAD DEBT EXPENSE WAS ASSUMED ATTRIBUTABLE TO PATIENTS LIKELY ELIGIBLE FOR FINANCIAL ASSISTANCE WE HAVE MANY INSTANCES DURING THE YEAR OF PATIENTS WITH LARGE ACCOUNT BALANCES AND NO HEALTH INSURANCE COVERAGE THAT WE ARE SURE WOULD QUALIFY FOR CHARITY CARE ALTHOUGH HOSPITAL TEAM MEMBERS ENCOURAGE THESE INDIVIDUALS TO COMPLETE OUR FINANCIAL ASSISTANCE APPLICATION MANY WILL NOT DO SO EVEN WHEN THESE INDIVIDUALS ARE TOLD WE FEEL SURE THEY DO QUALIFY FOR FULL OR PARTIAL ASSISTANCE THEY STILL REFUSE TO COMPLETE OUR FINANCIAL ASSISTANCE APPLICATION REGARDING LINE 3 IT IS IMPLAUSIBLE TO DETERMINE THE AMOUNT OF MSHAS BAD DEBT ASSOCIATED WITH THOSE PATIENTS WHO MAY HAVE MET THE CRITERIA SET FORTH IN OUR FINANCIAL ASSISTANCE POLICY WITHOUT HAVING A COMPLETED FINANCIAL ASSESSMENT WE ARE UNABLE TO DETERMINE OUR PATIENTS FINANCIAL CIRCUMSTANCES UNLESS A COMPLETED FINANCIAL ASSESSMENT FORM IS VOLUNTARILY PROVIDED TO US WE CAN ASSERT THAT MORE THAN 90 OF OUR PATIENTS WHO HAVE PROVIDED COMPLETED FINANCIAL ASSESSMENT FORMS HAVE BEEN APPROVED FOR AT LEAST PARTIAL FINANCIAL ASSISTANCE FOOTNOTE DISCLOSURE FROM MSHAS FY12 AUDITED FINANCIAL STATEMENT READS NEW ACCOUNTING PRONOUNCEMENTS IN JULY 2011 THE FASB ISSUED ASU 201107 HEALTHCARE ENTITIES TOPIC 954 PRESENTATION AND DISCLOSURE OF PATIENT SERVICE REVENUE PROVISION FOR BAD DEBTS AND ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR CERTAIN HEALTHCARE ENTITIES WHICH REQUIRES CERTAIN HEALTHCARE ENTITIES TO RECLASSIFY THE PROVISION FOR BAD DEBTS ASSOCIATED WITH PROVIDING PATIENT CARE FROM AN OPERATING EXPENSE TO A DEDUCTION FROM NET PATIENT SERVICE REVENUE IN THE CONSOLIDATED STATEMENTS OF OPERATIONS ADDITIONALLY ASU 201107 REQUIRES ENHANCED DISCLOSURES ABOUT AN ENTITYS POLICIES FOR RECOGNIZING REVENUE AND ASSESSING BAD DEBTS AND QUALITATIVE AND QUANTITATIVE INFORMATION ABOUT CHANGES IN THE ALLOWANCE FOR DOUBTFUL ACCOUNTS THE ALLIANCE RETROACTIVELY ADOPTED ASU 201107 IN FISCAL YEAR 2012 THE ADOPTION OF ASU 201107 DID NOT HAVE A MATERIAL IMPACT ON THE 2012 OR 2011 CONSOLIDATED FINANCIAL STATEMENTS THE FOOTNOTES TO THE AUDITED FINANCIAL STATEMENT REPORT THE AMOUNT OF ESTIMATED UNCOLLECTIBLE SELFPAY AND EXPLAIN THAT UNCOLLECTIBLE PATIENT ACCOUNTS RECEIVABLE ESTIMATED RESERVES ARE BASED UPON PRIOR COLLECTION HISTORY FOR GROUPS OF RECEIVABLES KNOWN COLLECTION RISKS AND OTHER ENVIRONMENTAL FACTORS INCLUDING THE AGE OF THE RECEIVABLES MEDICARE EXPLANATION PART III LINE 8 MEDICARE ALLOWABLE COSTS WERE REPORTED USING MSHAS FILED MEDICARE COST REPORT CR THE CR USES A COST TO CHARGE RATIO BASED ON A STEPDOWN ALLOCATION METHODOLOGY IN CARING FOR THE PATIENT THERE ARE SEVERAL SERVICES THAT ARE CONSIDERED NONALLOWABLE SUCH AS TRANSPORTATION OF A PATIENT COMFORT ITEMS TO INCLUDE A TELEVISION MAGAZINES OR A TELEPHONE ADDITIONAL NONALLOWABLE COSTS INCLUDE THE RECRUITMENT OF PHYSICIANS PHYSICIAN GUARANTEES AND A PORTION OF THE BAD DEBT 30 ASSOCIATED WITH THE CARE OF THE PATIENT MEDICARE LOSSES INCLUDING SOME NONALLOWABLE COSTS SHOULD BE COUNTED AS A COMMUNITY BENEFIT AS THIS IS THE COST OF CARE FOR SERVING THE AGING POPULATION AS A NOTFORPROFIT ORGANIZATION WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTH CARE NEEDS OF THE COMMUNITY AND THE INDIVIDUAL WHILE MAINTAINING A HIGH LEVEL OF HEALTH CARE SERVICES WITHOUT LOSSES SINCE LOSSES DO OCCUR THROUGH THE CMS SYSTEM OF REIMBURSEMENT THESE LOSSES ARE A COST OF DOING BUSINESS FOR OUR COMMUNITY AND SHOULD BE CONSIDERED A COMMUNITY BENEFIT AS A PARTICIPATING PROVIDER IN THE MEDICARE PROGRAM MSHA IS REQUIRED TO PROVIDE THE FULL REGIMEN OF CARE FOR OUR MEDICARE POPULATION THERE ARE A NUMBER OF CARE REGIMENS THAT ARE COMPENSATED BY THE MEDICARE PROGRAM AT LEVELS BELOW OUR COST THEREFORE IT IS ONLY LOGICAL TO ALLOW MSHA TO REPORT THESE UNCOMPENSATED SERVICES AS A COMMUNITY BENEFIT ON THIS DOCUMENT BY MAKING THIS CHANGE NONPROFIT PROVIDERS WILL BE ENCOURAGED TO SUSTAIN IMPORTANT CARE DELIVERY MODELS FOR OUR AGING POPULATION IN SPITE OF THE FACT IT IS SOMETIMES ECONOMICALLY INJURIOUS COLLECTION PRACTICES EXPLANATION PART III LINE 9B MSHA FOLLOWS A STRONG COLLECTION PROGRAM THAT COMMUNICATES FINANCIAL RESPONSIBILITY TO THE PATIENT COLLECTION PRACTICES APPLY TO ALL PATIENTS CHARITY AND NONCHARITY CARE IN ROUTINE CIRCUMSTANCES WHEN IT IS DETERMINED THAT A PATIENT HAS NOT RESPONDED TO REQUESTS FOR PAYMENT AND HAS NOT PROVIDED INFORMATION TO ASCERTAIN ABILITY TO PAY AN ACCOUNT CAN BE REFERRED TO AN OUTSIDE COLLECTION AGENCY FOR COLLECTION ASSISTANCE MSHA ENSURES THAT OUTSIDE COLLECTION AGENCIES FOLLOW HOSPITAL BILLING AND COLLECTION GUIDELINES ONCE A DELINQUENT PATIENT ACCOUNT HAS BEEN SUBMITTED TO AN OUTSIDE AGENCY IT CAN BE RETRACTED IF IT IS LATER DETERMINED 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 RANKED 39TH AND VIRGINIA RANKED 20TH HOWEVER IT SHOULD BE NOTED THAT SOUTHWEST VIRGINIA WHERE SOME OF MSHA FACILITIES ARE LOCATED CLOSELY RESEMBLES THE HEALTH RANKINGS FOR TENNESSEE AMERICAS HEALTH RANKINGS ARE BASED ON A SERIES OF MEASURES INCLUDING SEVERAL HEALTH OUTCOMES AND HEALTH FACTORS A SURVEY WAS GIVEN TO 67 INDIVIDUALS REPRESENTING THE NINE COUNTIES IN WHICH MSHA OWNS A FACILITY THESE INDIVIDUALS INCLUDED PHYSICIANS PUBLIC HEALTH LEADERS NONPROFIT DIRECTORS SCHOOL NURSES AND OFFICIALS AND BUSINESS LEADERS A SURVEY WAS GIVEN TO EACH INDIVIDUAL SEEKING FEEDBACK REGARDING AVAILABLE RESOURCES IN EACH AREA THE HEALTH STATUS HEALTH PRIORITIES AND SUGGESTIONS FOR IMPROVEMENT THE MAJORITY OF RESPONSES SUGGESTED FOCUSING ON EDUCATION IN ORDER TO PROMOTE HEALTHY HABITS OTHER RESPONSES INCLUDED MAKE PHYSICAL EDUCATION A REQUIREMENT AS PART OF SCHOOL CURRICULUM IMPROVE NATURAL TRAILS AND WALKWAYS INCREASE COMMUNITY SUPPORT FOR SMOKEFREE AREAS PARTNER WITH LOCAL FARMERS MARKETS SHARE HEALTH INFORMATION BETWEEN PHARMACIES NETWORK WITH SMALL BUSINESSES AND NONPROFITS IN ORDER TO AVOID DUPLICATING RESOURCES AND PROVIDE EARLY SCREENINGS FOR THE UNINSURED OR UNDERINSURED OVERALL THE COMMUNITY MEMBERS GAVE MSHAS CORE SERVICE AREA A HEALTH STATUS RANKING OF 424 OUT OF 10 1 BEING THE LOWEST 10 BEING THE HIGHEST ALSO ALL 67 PARTICIPANTS AGREED THAT OBESITY CANCER HEART DISEASE AND DIABETES WERE THE TOP HEALTH PRIORITIES IN EACH COUNTY AHR REPORTS THAT TENNESSEE AND VIRGINIA BOTH SAW AN INCREASE IN DIABETES AND OBESITY WITHIN THE PAST TEN YEARS TENNESSEE ALSO RANKED 44TH FOR CARDIOVASCULAR DISEASE AND 46TH FOR CANCER DEATHS VIRGINIA OVERALL HAD A BETTER RANKING IN THESE TWO CATEGORIES BUT AS STATED EARLIER SOUTHWEST VIRGINIA CLOSELY RESEMBLES TENNESSEE MSHA PLANS TO USE THE AVAILABLE RESOURCES TO START IMPROVING THE HEALTH STATUS OF NORTHEAST TENNESSEE AND SOUTHWEST VIRGINIA PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI PART VI LINE 3 MSHA PROVIDES COMMUNICATION OF FINANCIAL ASSISTANCE ON ITS WEBSITE AND ON POSTERS LOCATED IN PROMINENT AREAS OF THE HOSPITALS SUCH AS ADMITTING AND THE EMERGENCY DEPARTMENTS PRINTED EDUCATIONAL MATERIALS INCLUDING FINANCIAL ASSISTANCE CONTACT INFORMATION ARE ALSO PROVIDED IN EACH PATIENTS PAPERWORK POSTERS AND REFERENCE MATERIALS ARE WRITTEN IN BOTH ENGLISH AND SPANISH ADMITTING STAFF ARE TRAINED TO EDUCATE PATIENTS ON MSHAS FINANCIAL ASSISTANCE POLICY MSHA ALSO HAS FINANCIAL COUNSELORS TO PROVIDE FURTHER INFORMATION AND ASSISTANCE TO MSHA PATIENTS REGARDING MSHAS FINANCIAL ASSISTANCE POLICY THESE COUNSELORS ALSO HELP UNINSURED PATIENTS DETERMINE SOURCES OF PAYMENT FOR MEDICAL BILLS AND HELP PATIENTS DETERMINE ELIGIBILITY FOR PROGRAMS SUCH AS TNCAREMEDICAID IN ADDITION MSHA CONTRACTS WITH THE COMPANY FIRSTSOURCE SOLUTIONS USA TO WORK WITH SELFPAYING PATIENTS WHO HAVE LIMITED FINANCIAL RESOURCES FIRSTSOURCE SOLUTIONS DETERMINES A PATIENTS ELIGIBILITY IN MEDICAL COVERAGE OPTIONS AND ASSISTS WITH THEIR ENROLLMENT MSHA BEARS THE COST FOR THE FIRSTSOURCE SOLUTIONS PROGRAM COMMUNITY INFORMATION PART VI MSHA SERVES THE HEALTHCARE NEEDS OF 29 APPALACHIAN COUNTIES IN TENNESSEE SOUTHWEST VIRGINIA KENTUCKY AND NORTH CAROLINA SOME OF THE COUNTIES MSHA SERVES ARE FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREAS MSHA OPERATES 2 CRITICAL ACCESS HOSPITALS DICKENSON COMMUNITY HOSPITAL IN VIRGINIA AND JOHNSON COUNTY COMMUNITY HOSPITAL IN TENNESSEE THESE TWO FACILITIES OPERATE IN FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREAS THE HEALTH STATUS OF THE POPULATION IN MSHAS SERVICE AREA IS GENERALY POOR THE SERVICE AREA EXTENDS TO SOME OF THE POOREST RURAL COUNTIES IN THE REGION WITH A POVERTY RATE OF ALMOST 30 SOME OF THE MOST WELL OFF COUNTIES IN MSHAS SERVICE AREA STILL HAVE A MEDIAN HOUSEHOLD INCOME LOWER THAN STATE AND NATIONAL AVERAGES RURAL SERVICE AREA COUNTIES SHARE COMMON CHALLENGES OF 1 HIGH RATES OF UNINSURED 2 HIGH PREVALENCE OF OBESITY 3 HIGH PREVALENCE OF DIABETES HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE PART VI PART VI LINE 5 MSHA IS DEDICATED TO OPERATING EFFICIENTLY SO THAT WASTE IS MINIMIZED MSHAS LEADERSHIP REMAINS MINDFUL OF MANAGING THE ALLIANCES LIMITED RESOURCES SO THAT ADEQUATE FACILITIES AND EQUIPMENT ARE AVAILABLE FOR THE CARE OF OUR PATIENTS VARIOUS CHECKS AND BALANCES ARE ESTABLISHED TO ENSURE THAT EXPENDITURES FOR OPERATING EXPENSES AND CAPITAL COSTS ARE REASONABLE AND NECESSARY THE MAJORITY OF MSHAS GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATIONS PRIMARY SERVICE AREA PHYSICIANS THAT REQUEST PRIVILEGES WHO ARE QUALIFIED AND CREDENTIALED ARE EXTENDED PRIVILEGES BY MSHA AFFILIATED HEALTH CARE INFORMATION PART VI MSHA PROVIDES CARE TO PEOPLE IN 29 COUNTIES IN TENNESSEE VIRGINIA KENTUCKY AND NORTH CAROLINA EACH HOSPITAL IS FULLY ACCREDITED MOST BY THE JOINT COMMISSION MSHA IS INTEGRATED BOTH VERTICALLY AND HORIZONTALLY AND IS THE LARGEST REGIONAL HEALTHCARE SYSTEM WITH 13 HOSPITALS NINE FACILITIES ARE WHOLLYOWNED FACILITIES 8 FACILITIES IN TENNESSEE AND 1 IN VIRGINIA EACH FACILITY IN THIS FORM 990 IS ACCREDITED BY THE JOINT COMMISSION WITH THE EXCEPTION OF JCCH JCCH RECEIVES CERTIFICATION THROUGH THE STATE OF TENNESSEE SINCE IT IS A CRITICAL ACCESS HOSPITAL IN ADDITION TO THE WHOLLYOWNED HOSPITALS WITHIN THIS FORM 990 MSHA ALSO HAS MAJORITY OWNERSHIP IN 4 HOSPITALS IN SOUTHWEST VIRGINIA IN ADDITION TO OUR ACUTE CARE HOSPITALS OUR SYSTEM ALSO INCLUDES SUCH SERVICES AS PRIMARYSPECIALTY PHYSICIAN PRACTICES URGENT CARE CENTERS EMERGENCY DEPARTMENTS OCCUPATIONAL MEDICINE REHABILITATION OUTREACH LABORATORY MENTAL HEALTH NEONATAL INTENSIVE CARE A NACHRIAFFILIATED CHILDRENS HOSPITAL RENAL DIALYSIS ST JUDES ONCOLOGY INPATIENTOUTPATIENT SURGERY SKILLED NURISNG HOME HEALTH AIR AMBULANCE TRANSPORT AND MORE WITH THESE ADDITIONAL FACILITIES AND SERVICES MSHA EXTENDS A HIGHLY EFFECTIVE HEALTH CARE DELIVERY SYSTEM SINCE OUR SYSTEM IS BOTH HORIZONTALLY AND VERTICALLY INTEGRATED PATIENTS CAN BE EFFICIENTLY MOVED ALONG AN INTEGRATED COMPREHENSIVE CONTINUUM OF CARE AS THEIR HEALTH STATUS DICTATES OUR FLAGSHIP FACILITY JOHNSON CITY MEDICAL CENTER IS AT THE CORE OF OUR SYSTEM OFFERING FULL SERVICE TERTIARY CARE IN ADDITION TO OUR HOSPITALS MSHA IS THE SOLE MEMBER OF BLUE RIDGE MEDICAL MANAGEMENT CORPORATION BRMMC MSHA EXTENDS AN INTEGRATED HEALTHCARE DELIVERY SYSTEM THROUGH BRMMC TO INCLUDE MULTIPLE PRIMARY AND SPECIALTY CARE PATIENT ACCESS CENTERS AND NUMEROUS OUTPATIENT CARE SITES INCLUDING URGENT CARE CENTERS OCCUPATIONAL MEDICINE SERVICES A SAME DAY SURGERY CENTER AND OUTPATIENT REHABILITATION MSHA COUNTYSPECIFIC OPERATIONS ARE GOVERNED BY A COMMUNITY BOARD OF DIRECTORS COUNTY BOARDS REPORT TO A SYSTEM LEVEL BOARD OF DIRECTORS ALL BOARDS ARE PRIMARILY COMPOSED OF LOCAL COMMUNITY RESIDENTS PART VI LINE 8 MSHA SUBMITS COMMUNITY BENEFIT DATA TO THE VIRGINIA HEALTH AND HOSPITAL ASSOCIATION VHHA AND THE HOSPITAL ALLIANCE OF TENNESSEE HAT VHHA COMBINES DATA FROM ALL SOURCES TO DEMONSTRATE THE COMMUNITY BENEFITS PROVIDED BY BOTH FORPROFIT AND NOTFORPROFIT HOSPITALS AND HEALTH SYSTEMS TO THE STATE OF VIRGINIA HAT PROVIDES ITS MEMBERS AND TENNESSEE LEGISLATORS WITH COMMUNITY BENEFIT DATA IN AN EFFORT TO PROVIDE A CLEAR PICTURE OF NOTFORPROFIT HEALTH SYSTEMS INVESTMENT IN THE COMMUNITIES THEY SERVE LIST OF STATES WHERE COMMUNITY BENEFIT REPORT IS FILED PART VI TENNESSEE VIRGINIA JOHNSON CITY MEDICAL CENTER LINE NUMBER 1 PART V LINE 3 PART V LINE 3 MSHA MET WITH TEN FOCUS GROUPS EACH REPRESENTING ONE OF THE TEN HOSPITAL FACILITIES INCLUDING ALL OF THE HOSPITALS INCLUDED IN THIS 990 LOCATED IN NINE COUNTIES WITHIN MSHAS CORE SERVICE AREA 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 APPRORIATE FACILITY IMPLEMENTATION PLAN JOHNSON CITY MEDICAL CENTER LINE NUMBER 1 PART V LINE 4 PART V LINE 4 EACH HOSPITAL WITHIN THE MSHA SYSTEM COMPLETED A CHNA FOR THOSE HOSPITALS THAT ARE LOCATED IN THE SAME COUNTY ONLY ONE COMMUNITY GROUP WAS SURVEYED FOR INSTANCE JOHNSON CITY MEDICAL CENTER AND FRANKLIN WOODS COMMUNITY HOSPITAL ARE BOTH LOCATED IN WASHINGTON COUNTY TENNESSEE WE SURVEYED 21 INDIVIDUALS FROM WASHINGTON COUNTY IN ORDER TO DETERMINE HEALTH PRIORITIES JCMCS CHNA WAS CONDUCTED WITH ALL MSHA HOSPITALS TO INCLUDE FRANKLIN WOODS COMMUNITY HOSPITAL WOODRIDGE PSYCHIATRIC HOSPITAL JAMES H CECILE C QUILLEN REHABILITATION HOSPITAL INDIAN PATH MEDICAL CENTER SYCAMORE SHOALS HOSPITAL JOHNSON COUNTY COMMUNITY HOSPITAL RUSSELL COUNTY MEDICAL CENTER JOHNSTON MEMORIAL HOSPITAL SMYTH COUNTY COMMUNITY HOSPITAL NORTON COMMUNITY HOSPITAL AND DICKENSON COMMUNITY HOSPITAL JOHNSON CITY MEDICAL CENTER LINE NUMBER 1 PART V LINE 7 PART V LINE 7 MSHA PUBLISHED ITS COMMUNITY HEALTH NEEDS ASSESSMENT ON JUNE 29 OF FY12 THE DATA INCLUDED WAS COLLECTED OVER THE COURSE OF 2011 AND 2012 AN IMPLEMENTATION PLAN WAS CREATED FOR EACH HOSPITAL AND EACH HOSPITALS BOARD APPROVED THE IMPLEMENTATION PLAN DURING THE MONTHS OF MAY AND JUNE 2012 NOW THAT THE IMPLEMENTATION PLANS HAVE BEEN ADOPTED MSHA WILL BE ABLE TO BEGIN TAKING ACTION TO IMPROVE THE HEALTH PRIORITIES IN EACH COUNTY THOUGH AT THIS POINT NOT ALL OF THE PRIORITIES HAVE BEEN ADDRESSED DUE TO LACK OF RESOURCES SOME OF MSHA FACILITIES WERE UNABLE TO ADDRESS ISSUES THAT WERE IDENTIFIED JOHNSON CITY MEDICAL CENTER LINE NUMBER 1 PART V LINE 13G PART V LINE 13G DURING THE ADMISSION PROCESS PATIENTS ARE TOLD THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY AND ADMISSION PAPERS GIVEN TO EACH PATIENT ADVISES THEM OF THE POLICY BILLING CORRESPONDENCE ALSO ADVISES THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE A COMMUNITY RESOURCE GUIDE REPORTS THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY JOHNSON CITY MEDICAL CENTER LINE NUMBER 1 PART V LINE 19D PART V LINE 19D UNINSURED PATIENTS RECEIVE A 50 DISCOUNT AND BASED ON OTHER FACTORS SUCH AS INCOME OR MEDICAL INDIGENCY MAY QUALIFY FOR AN ADDITIONAL DISCOUNT INDIAN PATH MEDICAL CENTER LINE NUMBER 2 PART V LINE 3 PART V LINE 3 MSHA MET WITH TEN FOCUS GROUPS EACH REPRESENTING ONE OF THE TEN HOSPITAL FACILITIES INCLUDING ALL OF THE HOSPITALS INCLUDED IN THIS 990 LOCATED IN NINE COUNTIES WITHIN MSHAS CORE SERVICE AREA 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 APPRORIATE FACILITY IMPLEMENTATION PLAN INDIAN PATH MEDICAL CENTER LINE NUMBER 2 PART V LINE 4 PART V LINE 4 EACH HOSPITAL WITHIN THE MSHA SYSTEM COMPLETED A CHNA FOR THOSE HOSPITALS THAT ARE LOCATED IN THE SAME COUNTY ONLY ONE COMMUNITY GROUP WAS SURVEYED FOR INSTANCE JOHNSON CITY MEDICAL CENTER AND FRANKLIN WOODS COMMUNITY HOSPITAL ARE BOTH LOCATED IN WASHINGTON COUNTY TENNESSEE WE SURVEYED 21 INDIVIDUALS FROM WASHINGTON COUNTY IN ORDER TO DETERMINE HEALTH PRIORITIES IPMCS CHNA WAS CONDUCTED WITH ALL MSHA HOSPITALS TO INCLUDE JOHNSON CITY MEDICAL CENTER FRANKLIN WOODS COMMUNITY HOSPITAL WOODRIDGE PSYCHIATRIC HOSPITAL JAMES H CECILE C QUILLEN REHABILITATION HOSPITAL SYCAMORE SHOALS HOSPITAL JOHNSON COUNTY COMMUNITY HOSPITAL RUSSELL COUNTY MEDICAL CENTER JOHNSTON MEMORIAL HOSPITAL SMYTH COUNTY COMMUNITY HOSPITAL NORTON COMMUNITY HOSPITAL AND DICKENSON COMMUNITY HOSPITAL INDIAN PATH MEDICAL CENTER LINE NUMBER 2 PART V LINE 7 PART V LINE 7 MSHA PUBLISHED ITS COMMUNITY HEALTH NEEDS ASSESSMENT ON JUNE 29 OF FY12 THE DATA INCLUDED WAS COLLECTED OVER THE COURSE OF 2011 AND 2012 AN IMPLEMENTATION PLAN WAS CREATED FOR EACH HOSPITAL AND EACH HOSPITALS BOARD APPROVED THE IMPLEMENTATION PLAN DURING THE MONTHS OF MAY AND JUNE 2012 NOW THAT THE IMPLEMENTATION PLANS HAVE BEEN ADOPTED MSHA WILL BE ABLE TO BEGIN TAKING ACTION TO IMPROVE THE HEALTH PRIORITIES IN EACH COUNTY THOUGH AT THIS POINT NOT ALL OF THE PRIORITIES HAVE BEEN ADDRESSED DUE TO LACK OF RESOURCES SOME OF MSHA FACILITIES WERE UNABLE TO ADDRESS ISSUES THAT WERE IDENTIFIED INDIAN PATH MEDICAL CENTER LINE NUMBER 2 PART V LINE 13G PART V LINE 13G DURING THE ADMISSION PROCESS PATIENTS ARE TOLD THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY AND ADMISSION PAPERS GIVEN TO EACH PATIENT ADVISES THEM OF THE POLICY BILLING CORRESPONDENCE ALSO ADVISES THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE A COMMUNITY RESOURCE GUIDE REPORTS THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY INDIAN PATH MEDICAL CENTER LINE NUMBER 2 PART V LINE 19D PART V LINE 19D UNINSURED PATIENTS RECEIVE A 50 DISCOUNT AND BASED ON OTHER FACTORS SUCH AS INCOME OR MEDICAL INDIGENCY MAY QUALIFY FOR AN ADDITIONAL DISCOUNT FRANKLIN WOODS COMMUNITY HOSPITAL LINE NUMBER 3 PART V LINE 3 PART V LINE 3 MSHA MET WITH TEN FOCUS GROUPS EACH REPRESENTING ONE OF THE TEN HOSPITAL FACILITIES INCLUDING ALL OF THE HOSPITALS INCLUDED IN THIS 990 LOCATED IN NINE COUNTIES WITHIN MSHAS CORE SERVICE AREA 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 APPRORIATE FACILITY IMPLEMENTATION PLAN FRANKLIN WOODS COMMUNITY HOSPITAL LINE NUMBER 3 PART V LINE 4 PART V LINE 4 EACH HOSPITAL WITHIN THE MSHA SYSTEM COMPLETED A CHNA FOR THOSE HOSPITALS THAT ARE LOCATED IN THE SAME COUNTY ONLY ONE COMMUNITY GROUP WAS SURVEYED FOR INSTANCE JOHNSON CITY MEDICAL CENTER AND FRANKLIN WOODS COMMUNITY HOSPITAL ARE BOTH LOCATED IN WASHINGTON COUNTY TENNESSEE WE SURVEYED 21 INDIVIDUALS FROM WASHINGTON COUNTY IN ORDER TO DETERMINE HEALTH PRIORITIES FWCHS CHNA WAS CONDUCTED WITH ALL MSHA HOSPITALS TO INCLUDE JOHNSON CITY MEDICAL CENTER WOODRIDGE PSYCHIATRIC HOSPITAL JAMES H CECILE C QUILLEN REHABILITATION HOSPITAL INDIAN PATH MEDICAL CENTER SYCAMORE SHOALS HOSPITAL JOHNSON COUNTY COMMUNITY HOSPITAL RUSSELL COUNTY MEDICAL CENTER JOHNSTON MEMORIAL HOSPITAL SMYTH COUNTY COMMUNITY HOSPITAL NORTON COMMUNITY HOSPITAL AND DICKENSON COMMUNITY HOSPITAL FRANKLIN WOODS COMMUNITY HOSPITAL LINE NUMBER 3 PART V LINE 7 PART V LINE 7 MSHA PUBLISHED ITS COMMUNITY HEALTH NEEDS ASSESSMENT ON JUNE 29 OF FY12 THE DATA INCLUDED WAS COLLECTED OVER THE COURSE OF 2011 AND 2012 AN IMPLEMENTATION PLAN WAS CREATED FOR EACH HOSPITAL AND EACH HOSPITALS BOARD APPROVED THE IMPLEMENTATION PLAN DURING THE MONTHS OF MAY AND JUNE 2012 NOW THAT THE IMPLEMENTATION PLANS HAVE BEEN ADOPTED MSHA WILL BE ABLE TO BEGIN TAKING ACTION TO IMPROVE THE HEALTH PRIORITIES IN EACH COUNTY THOUGH AT THIS POINT NOT ALL OF THE PRIORITIES HAVE BEEN ADDRESSED DUE TO LACK OF RESOURCES SOME OF MSHA FACILITIES WERE UNABLE TO ADDRESS ISSUES THAT WERE IDENTIFIED FRANKLIN WOODS COMMUNITY HOSPITAL LINE NUMBER 3 PART V LINE 13G PART V LINE 13G DURING THE ADMISSION PROCESS PATIENTS ARE TOLD THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY AND ADMISSION PAPERS GIVEN TO EACH PATIENT ADVISES THEM OF THE POLICY BILLING CORRESPONDENCE ALSO ADVISES THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE A COMMUNITY RESOURCE GUIDE REPORTS THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY FRANKLIN WOODS COMMUNITY HOSPITAL LINE NUMBER 3 PART V LINE 19D PART V LINE 19D UNINSURED PATIENTS RECEIVE A 50 DISCOUNT AND BASED ON OTHER FACTORS SUCH AS INCOME OR MEDICAL INDIGENCY MAY QUALIFY FOR AN ADDITIONAL DISCOUNT SYCAMORE SHOALS HOSPITAL LINE NUMBER 4 PART V LINE 3 PART V LINE 3 MSHA MET WITH TEN FOCUS GROUPS EACH REPRESENTING ONE OF THE TEN HOSPITAL FACILITIES INCLUDING ALL OF THE HOSPITALS INCLUDED IN THIS 990 LOCATED IN NINE COUNTIES WITHIN MSHAS CORE SERVICE AREA 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 APPRORIATE FACILITY IMPLEMENTATION PLAN SYCAMORE SHOALS HOSPITAL LINE NUMBER 4 PART V LINE 4 PART V LINE 4 EACH HOSPITAL WITHIN THE MSHA SYSTEM COMPLETED A CHNA FOR THOSE HOSPITALS THAT ARE LOCATED IN THE SAME COUNTY ONLY ONE COMMUNITY GROUP WAS SURVEYED FOR INSTANCE JOHNSON CITY MEDICAL CENTER AND FRANKLIN WOODS COMMUNITY HOSPITAL ARE BOTH LOCATED IN WASHINGTON COUNTY TENNESSEE WE SURVEYED 21 INDIVIDUALS FROM WASHINGTON COUNTY IN ORDER TO DETERMINE HEALTH PRIORITIES SSHS CHNA WAS CONDUCTED WITH ALL MSHA HOSPITALS TO INCLUDE JOHNSON CITY MEDICAL CENTER FRANKLIN WOODS COMMUNITY HOSPITAL WOODRIDGE PSYCHIATRIC HOSPITAL JAMES H CECILE C QUILLEN REHABILITATION HOSPITAL INDIAN PATH MEDICAL CENTER JOHNSON COUNTY COMMUNITY HOSPITAL RUSSELL COUNTY MEDICAL CENTER JOHNSTON MEMORIAL HOSPITAL SMYTH COUNTY COMMUNITY HOSPITAL NORTON COMMUNITY HOSPITAL AND DICKENSON COMMUNITY HOSPITAL SYCAMORE SHOALS HOSPITAL LINE NUMBER 4 PART V LINE 7 PART V LINE 7 MSHA PUBLISHED ITS COMMUNITY HEALTH NEEDS ASSESSMENT ON JUNE 29 OF FY12 THE DATA INCLUDED WAS COLLECTED OVER THE COURSE OF 2011 AND 2012 AN IMPLEMENTATION PLAN WAS CREATED FOR EACH HOSPITAL AND EACH HOSPITALS BOARD APPROVED THE IMPLEMENTATION PLAN DURING THE MONTHS OF MAY AND JUNE 2012 NOW THAT THE IMPLEMENTATION PLANS HAVE BEEN ADOPTED MSHA WILL BE ABLE TO BEGIN TAKING ACTION TO IMPROVE THE HEALTH PRIORITIES IN EACH COUNTY THOUGH AT THIS POINT NOT ALL OF THE PRIORITIES HAVE BEEN ADDRESSED DUE TO LACK OF RESOURCES SOME OF MSHA FACILITIES WERE UNABLE TO ADDRESS ISSUES THAT WERE IDENTIFIED SYCAMORE SHOALS HOSPITAL LINE NUMBER 4 PART V LINE 13G PART V LINE 13G DURING THE ADMISSION PROCESS PATIENTS ARE TOLD THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY AND ADMISSION PAPERS GIVEN TO EACH PATIENT ADVISES THEM OF THE POLICY BILLING CORRESPONDENCE ALSO ADVISES THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE A COMMUNITY RESOURCE GUIDE REPORTS THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY SYCAMORE SHOALS HOSPITAL LINE NUMBER 4 PART V LINE 19D PART V LINE 19D UNINSURED PATIENTS RECEIVE A 50 DISCOUNT AND BASED ON OTHER FACTORS SUCH AS INCOME OR MEDICAL INDIGENCY MAY QUALIFY FOR AN ADDITIONAL DISCOUNT RUSSELL COUNTY MEDICAL CENTER LINE NUMBER 5 PART V LINE 3 PART V LINE 3 MSHA MET WITH TEN FOCUS GROUPS EACH REPRESENTING ONE OF THE TEN HOSPITAL FACILITIES INCLUDING ALL OF THE HOSPITALS INCLUDED IN THIS 990 LOCATED IN NINE COUNTIES WITHIN MSHAS CORE SERVICE AREA 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 APPRORIATE FACILITY IMPLEMENTATION PLAN RUSSELL COUNTY MEDICAL CENTER LINE NUMBER 5 PART V LINE 4 PART V LINE 4 EACH HOSPITAL WITHIN THE MSHA SYSTEM COMPLETED A CHNA FOR THOSE HOSPITALS THAT ARE LOCATED IN THE SAME COUNTY ONLY ONE COMMUNITY GROUP WAS SURVEYED FOR INSTANCE JOHNSON CITY MEDICAL CENTER AND FRANKLIN WOODS COMMUNITY HOSPITAL ARE BOTH LOCATED IN WASHINGTON COUNTY TENNESSEE WE SURVEYED 21 INDIVIDUALS FROM WASHINGTON COUNTY IN ORDER TO DETERMINE HEALTH PRIORITIES RCMCS CHNA WAS CONDUCTED WITH ALL MSHA HOSPITALS TO INCLUDE JOHNSON CITY MEDICAL CENTER FRANKLIN WOODS COMMUNITY HOSPITAL WOODRIDGE PSYCHIATRIC HOSPITAL JAMES H CECILE C QUILLEN REHABILITATION HOSPITAL INDIAN PATH MEDICAL CENTER SYCAMORE SHOALS HOSPITAL JOHNSON COUNTY COMMUNITY HOSPITAL JOHNSTON MEMORIAL HOSPITAL SMYTH COUNTY COMMUNITY HOSPITAL NORTON COMMUNITY HOSPITAL AND DICKENSON COMMUNITY HOSPITAL RUSSELL COUNTY MEDICAL CENTER LINE NUMBER 5 PART V LINE 7 PART V LINE 7 MSHA PUBLISHED ITS COMMUNITY HEALTH NEEDS ASSESSMENT ON JUNE 29 OF FY12 THE DATA INCLUDED WAS COLLECTED OVER THE COURSE OF 2011 AND 2012 AN IMPLEMENTATION PLAN WAS CREATED FOR EACH HOSPITAL AND EACH HOSPITALS BOARD APPROVED THE IMPLEMENTATION PLAN DURING THE MONTHS OF MAY AND JUNE 2012 NOW THAT THE IMPLEMENTATION PLANS HAVE BEEN ADOPTED MSHA WILL BE ABLE TO BEGIN TAKING ACTION TO IMPROVE THE HEALTH PRIORITIES IN EACH COUNTY THOUGH AT THIS POINT NOT ALL OF THE PRIORITIES HAVE BEEN ADDRESSED DUE TO LACK OF RESOURCES SOME OF MSHA FACILITIES WERE UNABLE TO ADDRESS ISSUES THAT WERE IDENTIFIED RUSSELL COUNTY MEDICAL CENTER LINE NUMBER 5 PART V LINE 13G PART V LINE 13G DURING THE ADMISSION PROCESS PATIENTS ARE TOLD THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY AND ADMISSION PAPERS GIVEN TO EACH PATIENT ADVISES THEM OF THE POLICY BILLING CORRESPONDENCE ALSO ADVISES THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE A COMMUNITY RESOURCE GUIDE REPORTS THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY RUSSELL COUNTY MEDICAL CENTER LINE NUMBER 5 PART V LINE 19D PART V LINE 19D UNINSURED PATIENTS RECEIVE A 50 DISCOUNT AND BASED ON OTHER FACTORS SUCH AS INCOME OR MEDICAL INDIGENCY MAY QUALIFY FOR AN ADDITIONAL DISCOUNT JOHNSON COUNTY COMMUNITY HOSPITAL LINE NUMBER 6 PART V LINE 3 PART V LINE 3 MSHA MET WITH TEN FOCUS GROUPS EACH REPRESENTING ONE OF THE TEN HOSPITAL FACILITIES INCLUDING ALL OF THE HOSPITALS INCLUDED IN THIS 990 LOCATED IN NINE COUNTIES WITHIN MSHAS CORE SERVICE AREA 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 APPRORIATE FACILITY IMPLEMENTATION PLAN JOHNSON COUNTY COMMUNITY HOSPITAL LINE NUMBER 6 PART V LINE 4 PART V LINE 4 EACH HOSPITAL WITHIN THE MSHA SYSTEM COMPLETED A CHNA FOR THOSE HOSPITALS THAT ARE LOCATED IN THE SAME COUNTY ONLY ONE COMMUNITY GROUP WAS SURVEYED FOR INSTANCE JOHNSON CITY MEDICAL CENTER AND FRANKLIN WOODS COMMUNITY HOSPITAL ARE BOTH LOCATED IN WASHINGTON COUNTY TENNESSEE WE SURVEYED 21 INDIVIDUALS FROM WASHINGTON COUNTY IN ORDER TO DETERMINE HEALTH PRIORITIES JCCHS CHNA WAS CONDUCTED WITH ALL MSHA HOSPITALS TO INCLUDE JOHNSON CITY MEDICAL CENTER FRANKLIN WOODS COMMUNITY HOSPITAL WOODRIDGE PSYCHIATRIC HOSPITAL JAMES H CECILE C QUILLEN REHABILITATION HOSPITAL INDIAN PATH MEDICAL CENTER SYCAMORE SHOALS HOSPITAL RUSSELL COUNTY MEDICAL CENTER JOHNSTON MEMORIAL HOSPITAL SMYTH COUNTY COMMUNITY HOSPITAL NORTON COMMUNITY HOSPITAL AND DICKENSON COMMUNITY HOSPITAL JOHNSON COUNTY COMMUNITY HOSPITAL LINE NUMBER 6 PART V LINE 7 PART V LINE 7 MSHA PUBLISHED ITS COMMUNITY HEALTH NEEDS ASSESSMENT ON JUNE 29 OF FY12 THE DATA INCLUDED WAS COLLECTED OVER THE COURSE OF 2011 AND 2012 AN IMPLEMENTATION PLAN WAS CREATED FOR EACH HOSPITAL AND EACH HOSPITALS BOARD APPROVED THE IMPLEMENTATION PLAN DURING THE MONTHS OF MAY AND JUNE 2012 NOW THAT THE IMPLEMENTATION PLANS HAVE BEEN ADOPTED MSHA WILL BE ABLE TO BEGIN TAKING ACTION TO IMPROVE THE HEALTH PRIORITIES IN EACH COUNTY THOUGH AT THIS POINT NOT ALL OF THE PRIORITIES HAVE BEEN ADDRESSED DUE TO LACK OF RESOURCES SOME OF MSHA FACILITIES WERE UNABLE TO ADDRESS ISSUES THAT WERE IDENTIFIED JOHNSON COUNTY COMMUNITY HOSPITAL LINE NUMBER 6 PART V LINE 13G PART V LINE 13G DURING THE ADMISSION PROCESS PATIENTS ARE TOLD THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY AND ADMISSION PAPERS GIVEN TO EACH PATIENT ADVISES THEM OF THE POLICY BILLING CORRESPONDENCE ALSO ADVISES THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE A COMMUNITY RESOURCE GUIDE REPORTS THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY JOHNSON COUNTY COMMUNITY HOSPITAL LINE NUMBER 6 PART V LINE 19D PART V LINE 19D UNINSURED PATIENTS RECEIVE A 50 DISCOUNT AND BASED ON OTHER FACTORS SUCH AS INCOME OR MEDICAL INDIGENCY MAY QUALIFY FOR AN ADDITIONAL DISCOUNT true SUSAN KOMEN BREAST CANCER FOUND PO BOX 5835 KINGSPORT TN 37663 841689067 501 9000 1122 PRINTING SPONSORSHIP ETSU FOUNDATION P O BOX 70721 JOHNSON CITY TN 37614 237092731 501 10000 SUPPORT BUSINESS COL EAST TENNESSEE STATE UNIVERSITY PO BOX 70732 JOHNSON CITY TN 37614 626021046 501 24500 SUPPORT FIT KIDS COALITION FOR KIDS PO BOX 3156 JOHNSON CITY TN 37602 621765487 501 10795 FIGHT CHILD OBESITY JC PARKS & RECREATION FOUNDATION 4137 BRISTOL HIGHWAY JOHNSON CITY TN 37601 383731893 501 15000 SPONSORSHIP AMERICAN DIABETES ASSOCIATION PO BOX 930850 ATLANTA GA 311930850 131623888 501 10000 BOYS & GIRLS CLUB OF KINGSPORT PO BOX 784 213 LEE STREET KINGSPORT TN 37662 620481370 501 10000 PROGRAM SUPPORT MOUNTAIN STATES FOUNDATION 2335 KNOB CREEK ROAD SUITE 101 JOHNSON CITY TN 37604 581418862 501 672450 95 PRINTING PROGRAM SUPPORT RUSSELL COUNTY PUBLIC SCHOOLS P O BOX 8 LEBANON VA 24266 546001591 501 6500 PROGRAM SUPPORT UNITED WAY WASHINGTON CO P O BOX 4039 JOHNSON CITY TN 37602 626001105 501 10000 1675 PRINT & POSTAGE PROGRAM SUPPORT LEBANON LIFESAVING CREW INC P O BOX 791 LEBANON VA 24266 541382140 501 25694 811 DRUG BOX REFILL HEART MONITORS FOUNDATION OF THE NSNA 45 MAIN STREET 606 BROOKLYN NY 11201 135123125 501 5370 NURSING SCHOLARSHIP AMERICAN HEART ASSOCIATION 3101 BROWNS MILL RD SUITE 6-321 JOHNSON CITY TN 37604 135613797 501 35000 PROGRAM SUPPORT MARCH OF DIMES PO BOX 799 2700 S ROAN ST 430 JOHNSON CITY TN 37605 131846366 17500 567 PRINTING PROGRAM SUPPORT 14 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INSIDE THE UNITED STATES SCHEDULE I, PAGE 1, PART I, LINE 2 PART I, LINE 2: MSHA ADHERED TO THE FOLLOWING CRITERIA FOR OUR CONTRIBUTIONS TO ORGANIZATIONS IN THE REGION: HEALTHCARE: THE ORGANIZATION ENHANCED OR IMPROVED ACCESS FOR THE UNINSURED OR UNDERINSURED POPULATION OR SUPPORTED A PROGRAM TO IMPROVE THE HEALTH OF OUR CHILDREN (I.E., CHILDHOOD OBESITY PREVENTION). EDUCATION: THE ORGANIZATION PROVIDED A PROGRAM TO IMPROVE EDUCATION OF THE CHILDREN IN OUR REGION ALL THE WAY TO COLLEGE AGE STUDENTS (RN NURSING PROGRAMS). QUALITY OF LIFE: THE ORGANIZATION OFFERED PROGRAMS TO ENHANCE THE QUALITY OF LIFE WHICH IS IMPORTANT IN THE RECRUITMENT EFFORTS OF BUSINESSES IN THE REGION AS WE WORK TO ATTRACT AND RETAIN THE BEST TALENT. FOR THE SUPPORTED PROGRAMS, METRICS WERE ESTABLISHED TO DETERMINE THE SUCCESS (OR FAILURE) OF EACH PROGRAM TO WHICH MSHA CONTRIBUTES. AS THE DEPRESSED ECONOMIC SITUATION CONTINUED DURING FY12. THE CRITERIA USED IN THE DECISION MAKING PROCESS FOR MAJOR DONATIONS WAS REVISED TO SUPPORT THOSE PROGRAMS WHICH FOCUSED ON HEALTH AND WELLNESS INITIATIVES, PARTICULARLY THOSE FIGHTING CHILDHOOD OBESITY. X true true X X X X X false true false false false false false false false DENNIS VONDERFECHT 764230 252675 82683 144600 22685 1266873 MARVIN EICHORN 440258 157892 74334 14700 20843 708027 CANDACE JENNINGS 396230 140783 16704 52596 20923 627236 ANN FLEMING 345309 116778 39233 47553 19175 568048 BRAD NURKIN 201273 88769 104605 2192 19051 415890 MONTY MCLAURIN 255744 78002 14955 27874 27968 404543 LYNN KRUTAK 209522 59811 2315 14824 15923 302395 DAVID NICELY 200047 49739 12520 8529 18461 289296 SHANE HILTON 193442 46928 13502 12104 23417 289393 CYNTHIA SALYER 179125 58693 4076 20647 22306 284847 DALE CLAYTORE 172480 40007 15384 9428 3356 240655 PAT NIDAY 145691 35094 12479 6854 23498 223616 MORRIS SELIGMAN MD 413000 155691 28996 50582 29263 677532 FRANK LAURO MD 414898 35016 92 9970 19357 479333 JAMES PASKERT MD 338025 75998 12719 17123 20824 464689 DOUGLAS EDEMA 327315 52449 18104 16675 21222 435765 CARL KILGORE 298394 82632 12193 31500 19072 443791 FRINGE OR EXPENSE EXPLANATION SCHEDULE J, PAGE 1, PART I, LINE 1A BOARD MEMBERS AND TEAM MEMBERS OF MSHA ARE NOT PERMITTED TO TRAVEL FIRST-CLASS WITH THE EXCEPTION OF MSHA'S CEO. AS SANCTIONED BY MSHA'S BOARD OF DIRECTORS, MSHA'S CEO IS PERMITTED TO TRAVEL FIRST-CLASS WHEN THE FLIGHT'S DURATION IS GREATER THAN TWO HOURS. DUE TO THE LENGTH OF SUCH FLIGHTS, THE BOARD BELIEVES IT IS IN THE BEST INTEREST OF MSHA FOR THE CEO TO TRAVEL FIRST-CLASS. CHARTER TRAVEL IS LIMITED TO MSHA BUSINESS TRIPS THAT INCLUDE NUMEROUS TRAVELERS AND WHICH CAN BE JUSTIFIED BASED UPON FINANCIAL AND/OR ESSENTIAL TIME SAVINGS. CHARTER FLIGHTS MUST BE APPROVED BY THE CEO PRIOR TO BOOKING THE FLIGHT. SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SCHEDULE J, PAGE 1, PART I, LINE 4 DENNIS VONDERFECHT 0 125,000 0 CANDACE JENNINGS 0 40,346 0 ANN FLEMING 0 35,303 0 MONTY MCLAURIN 0 13,352 0 DAVID NICELY 0 269 0 CYNTHIA SALYER 0 9,411 0 MORRIS SELIGMAN, M.D. 0 42,363 0 FRANK LAURO, M.D. 0 3,173 0 JAMES PASKERT, M.D. 0 17,123 0 DOUGLAS EDEMA 0 16,675 0 CARL KILGORE 0 15,208 0 OTHER ADDITIONAL INFORMATION SCHEDULE J, PART III PART I, LINE 4B: THE FOLLOWING EXECUTIVES LISTED IN SCHEDULE J, PART II PARTICIPATED IN A 457(F) RETIREMENT PLAN PROVIDED BY MOUNTAIN STATES HEALTH ALLIANCE (MSHA): DENNIS VONDERFECHT, ANN FLEMING, CANDACE JENNINGS, MONTY MCLAURIN, CINDY SALYER, MORRIS SELIGMAN, FRANK LAURO, DAVID NICELY, JAMES PASKERT, DOUGLAS EDEMA, AND CARL KILGORE. THE 457(F)PLAN IS A NONQUALIFIED TAX-DEFERRED COMPENSATION PLAN AVAILABLE TO A SELECT GROUP OF KEY EXECUTIVES FOR THE INTENT OF SUPPORTING RETENTION AND TO OFFER A COMPETITIVE TOTAL RETIREMENT PROGRAM. ACCOUNT BALANCES HAVE A "SUBSTANTIAL RISK OF FORFEITURE." IN ADDITON 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 OCCCURS. DISTRIBUTIONS FROM THIS PLAN ARE SUBJECT TO FEDERAL, STATE, AND LOCAL TAXES ON THE ENTIRE ACCOUNT BALANCE UPON DISTRIBUTION. HLTH & EDU FACILITIES BD 2011A&B OF THE CITY OF JOHNSON CITY TN 621464028 478271JS9 2011-10-19 195840000 CONSTRUCT AND EQUIP false false false HLTH & EDU FACILITIES BD 2010A&B 621464028 478271JH3 2010-04-29 205877528 PARTIAL REFUNDING OF false false false HLTH & EDU FACILITIES BD2009ABC 621464028 478271HT9 2009-03-31 124301533 CONSTRUCT AND EQUIP false false false HLTH & EDU FACILITIES BD 2008A&B 621464028 478271HL6 2008-02-20 127000000 ACQUIRE, CONSTRUCT false false false 195840000 2328425 154142550 34166505 5202520 true false false true 9620000 206072386 18402779 3474644 184194962 16988109 true false false true 125179916 12200052 2481706 94192104 9870809 6435244 false false false true 60825000 129698430 2719365 1953563 324975 75648290 47306504 926984 false false false true false false true true false false true false false true true false false true false false true true false false true false false true true false false true false true false false false false false false false false false false false false false false true false false true true MERRILL LYNCH CAPITAL SERVICES INC 30.4 false false false true false PURPOSE OF ISSUE DESCRIPTION SCHEDULE K HLTH EDU FACILITIES BD 2011AB LINE A CONSTRUCT AND EQUIP HOSPITAL FACILITIESINCLUDING REFINANCING TAXABLE DEBT RELATING THERETO REFUND BONDS ISSUED 12012001 REFINANCING LOANS AND EQUIPMENT LEASES HLTH EDU FACILITIES BD 2010AB LINE B PARTIAL REFUNDING OF BONDS ISSUED 12142007 2007A AND 2007C AND 2202008 2008A HLTH EDU FACILITIES BD2009ABC LINE C CONSTRUCT AND EQUIP HOSPITAL FACILITIESINCLUDING REFINANCING OF TAXABLE INDEBTEDNESS RELATING THERETO HLTH EDU FACILITIES BD 2008AB LINE D ACQUIRE CONSTRUCT AND EQUIP HOSPITAL FACILITIES INCLUDING REFINANCING OF TAXABLE INDEBTEDNESS RELATING THERETO AND WORKING CAPITAL EXPENDITURES RELATING TO CAPITAL EXPENDITURES HLTH EDU FACILITIES BD 2006A LINE E CONSTRUCT AND EQUIP HOSPITAL FACILITIESINCLUDING REFINANCING TAXABLE DEBT RELATING THERETO AND COST OF INTEREST RATE HEDGE REFUND BONDS ISSUED 32801 70103 70804 112304 9705 AND 112305 HLTH & EDU FACILITIES BD 2011A&B OF THE CITY OF JOHNSON CITY TN 621464028 478271JS9 2011-10-19 195840000 CONSTRUCT AND EQUIP false false false HLTH & EDU FACILITIES BD 2010A&B 621464028 478271JH3 2010-04-29 205877528 PARTIAL REFUNDING OF false false false HLTH & EDU FACILITIES BD2009ABC 621464028 478271HT9 2009-03-31 124301533 CONSTRUCT AND EQUIP false false false HLTH & EDU FACILITIES BD 2008A&B 621464028 478271HL6 2008-02-20 127000000 ACQUIRE, CONSTRUCT false false false 195840000 2328425 154142550 34166505 5202520 true false false true 9620000 206072386 18402779 3474644 184194962 16988109 true false false true 125179916 12200052 2481706 94192104 9870809 6435244 false false false true 60825000 129698430 2719365 1953563 324975 75648290 47306504 926984 false false false true false false true true false false true false false true true false false true false false true true false false true false false true true false false true false true false false false false false false false false false false false false false false true false false true true MERRILL LYNCH CAPITAL SERVICES INC 30.4 false false false true false PURPOSE OF ISSUE DESCRIPTION SCHEDULE K HLTH EDU FACILITIES BD 2011AB LINE A CONSTRUCT AND EQUIP HOSPITAL FACILITIESINCLUDING REFINANCING TAXABLE DEBT RELATING THERETO REFUND BONDS ISSUED 12012001 REFINANCING LOANS AND EQUIPMENT LEASES HLTH EDU FACILITIES BD 2010AB LINE B PARTIAL REFUNDING OF BONDS ISSUED 12142007 2007A AND 2007C AND 2202008 2008A HLTH EDU FACILITIES BD2009ABC LINE C CONSTRUCT AND EQUIP HOSPITAL FACILITIESINCLUDING REFINANCING OF TAXABLE INDEBTEDNESS RELATING THERETO HLTH EDU FACILITIES BD 2008AB LINE D ACQUIRE CONSTRUCT AND EQUIP HOSPITAL FACILITIES INCLUDING REFINANCING OF TAXABLE INDEBTEDNESS RELATING THERETO AND WORKING CAPITAL EXPENDITURES RELATING TO CAPITAL EXPENDITURES HLTH EDU FACILITIES BD 2006A LINE E CONSTRUCT AND EQUIP HOSPITAL FACILITIESINCLUDING REFINANCING TAXABLE DEBT RELATING THERETO AND COST OF INTEREST RATE HEDGE REFUND BONDS ISSUED 32801 70103 70804 112304 9705 AND 112305 DENNIS VONDERFECHT SPLIT DOLLAR LIFE INSURANCE LOAN X 2705125 2705125 false true true DENNIS VONDERFECHT SPLIT DOLLAR LIFE INSURANCE LOAN X 900000 938520 false true true DENNIS VONDERFECHT SPLIT DOLLAR LIFE INSURANCE LOAN X 900000 937530 false true true DENNIS VONDERFECHT SPLIT DOLLAR LIFE INSURANCE LOAN X 900000 936090 false true true DENNIS VONDERFECHT SPLIT DOLLAR LIFE INSURANCE LOAN X 900000 927540 false true true MARVIN EICHORN SPLIT DOLLAR LIFE INSURANCE LOAN X 350000 361588 false true true 6806393 WATAUGA PATHOLOGY ASSOC PC M.D. SERVICES 317520 SEE PART V false PULMONARY ASSOC OF EAST TN PC M.D. SERVICES 129033 SEE PART V false WORKSPACE INTERIORS INC VENDOR 352578 SEE PART V false MATTHEW MARTIN FAMILY MEMBER 28276 SEE PART V false MITCH HATHAWAY FAMILY MEMBER 94307 SEE PART V false SYCAMORE SHOALS ANESTHESIA ASSOC M.D. SERVICES 1046064 SEE PART V false PAULA CLAYTORE FAMILY MEMBER 289749 SEE PART V false CLEM WILKES III FAMILY MEMBER 59551 SEE PART V false JAMES TEIXEIRA FAMILY MEMBER 33282 SEE PART V false ADDITIONAL INFORMATION SCHEDULE L PART V 1 SANDRA BROOKS MD MSHA BOARD MEMBER IS A PARTNER WITH OWNERSHIP INTEREST IN WATAUGA PATHOLOGY ASSOCIATES PC WATAUGA PATHOLOGY ASSOCIATES PC PROVIDES MEDICAL SERVICES TO MSHA 2 JEFF FARROW MD MSHA BOARD MEMBER IS A KEY EMPLOYEE OF PULMONARY ASSOC OF EAST TN PC AND HAS AN OWNERSHIP INTEREST IN THE PC PULMONARY ASSOC OF EAST TN PC PROVIDES MEDICAL SERVICES TO MSHA 3 ROBERT FEATHERS MSHA BOARD MEMBER IS OWNER OF WORKSPACE INTERIORS INC WHICH PROVIDES COMMERCIAL FURNISHINGS AND DESIGN SERVICES TO MSHA TRANSACTIONS ARE CONDUCTED AT ARMSLENGTH 4 JOANNE GILMER MSHA BOARD MEMBER IS A FAMILY MEMBER OF MATTHEW MARTIN AN EMPLOYEE OF MSHA 5 JOANNE GILMER MSHA BOARD MEMBER IS A FAMILY MEMBER OF MITCH HATHAWAY AN EMPLOYEE OF MSHA 6 DAVID MAY MD MSHA BOARD MEMBER SERVES AS BOARD CHAIR FOR SYCAMORE SHOALS ANESTHESIA ASSOCIATES PC AND HAS AN OWNERSHIP SHARE IN THE PROFESSIONAL CORPORATION SYCAMORE SHOALS ANESTHESIA ASSOCIATES PC PROVIDES MEDICAL SERVICES TO MSHA 7 DALE CLAYTORE KEY EMPLOYEE OF MSHA IS A FAMILY MEMBER OF PAULA CLAYTORE AN EMPLOYEE OF MSHA 8 CLEM WILKES JR MSHA BOARD MEMBER IS A FAMILY MEMBER OF CLEM WILKES III AN EMPLOYEE OF MSHA 9 PAT NIDAY KEY EMPLOYEE OF MSHA IS A FAMILY MEMBER OF JAMES TEIXEIRA AN EMPLOYEE OF MSHA DOING BUSINESS AS FORM 990, PAGE 1, ITEM C NISWONGER CHILDREN'S HOSPITAL; QUILLEN REHABILITATION HOSPITAL; FRANKLIN WOODS COMMUNITY HOSPITAL; INDIAN PATH MEDICAL CENTER; SYCAMORE SHOALS HOSPITAL; WOODRIDGE HOSPITAL FOR BEHAVIORAL HEALTH SERVICES; JOHNSON COUNTY COMMUNITY HOSPITAL; RUSSELL COUNTY MEDICAL CENTER ORGANIZATION'S MISSION FORM 990 - ORGANIZATION'S MISSION PART I, LINE 1: MOUNTAIN STATES HEALTH ALLIANCE (MSHA) IS COMMITTED TO OUR MISSION OF BRINGING LOVING CARE TO HEALTH CARE. WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTHCARE NEEDS OF INDIVIDUALS AND COMMUNITIES IN THE 29-COUNTY AREA WE SERVE, HELPING THEM ATTAIN THEIR HIGHEST LEVEL OF HEALTH. MSHA DELIVERS THIS CARE THROUGH THE PHILOSOPHY OF PATIENT-CENTERED CARE, AND THE DEVELOPMENT OF COMPREHENSIVE STRATEGIC PLANNING AND IMPLEMENTATION. MSHA OPENED A NEW REPLACEMENT HOSPITAL IN 2012, SMYTH COUNTY COMMUNITY HOSPITAL (SCCH) WHICH IS LOCATED IN VIRGINIA AND MAJORITY-OWNED BY MSHA. CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PAGE 6, PART VI, LINE 6 MSHA CORPORATION HAS TWO CLASSES OF MEMBERS, A & B. THE CLASS A MEMBERS ARE WHAT IS TRADITIONALLY CONSIDERED MEMBERS, HAVING THE ABILITY TO ELECT OFFICERS AND VOTE ON CERTAIN ACTIONS OF THE CORPORATION. CLASS A MEMBERS WILL REMAIN CLASS A MEMBERS SO LONG AS THEY PARTICIPATE IN TWO EDUCATIONAL SESSIONS ANNUALLY OFFERED BY THE CORPORATION. PERSONS DESIRING TO BECOME NEW CLASS A MEMBERS MUST CONTRIBUTE 500 UPON APPLICATION, CONTRIBUTE 100 ANNUALLY THEREAFTER, AND PARTICIPATE IN THE TWO ANNUAL EDUCATION SESSIONS. CLASS B MEMBERS ARE ANY FORMER CLASS A MEMBERS WHO FAILED TO MAINTAIN THE REQUIREMENTS OF CLASS A MEMBERSHIP, OR ANYONE APPLYING TO BECOME A CLASS B MEMBER AND CONTRIBUTE 100 AT APPLICATION. CLASS B MEMBERS HAVE NO VOTE, BUT CAN ATTEND AND PARTICIPATE IN THE MEETINGS AND EDUCATION SESSIONS OF THE CLASS A MEMBERSHIP, BUT ARE NOT REQUIRED TO. ELECTION OF MEMBERS AND THEIR RIGHTS FORM 990, PAGE 6, PART VI, LINE 7A THE CLASS A MEMBERS ANNUALLY ELECT MEMBERS TO THE BOARD OF DIRECTORS. DECISIONS SUBJECT TO APPROVAL OF MEMBERS FORM 990, PAGE 6, PART VI, LINE 7B CERTAIN DECISIONS OF THE BOARD ARE, PURSUANT TO TENNESSEE STATUTE, SUBJECT TO APPROVAL BY THE CLASS A MEMBERS. THESE DECISIONS INCLUDE: DISSOLUTION OF THE CORPORATION; MERGER OF THE CORPORATION; NON-ORDINARY COURSE OF BUSINESS SALE OF ASSETS, ETC. NO ORDINARY DAY-TO-DAY DECISIONS ARE SUBJECT TO MEMBER APPROVAL. ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11B THE CFO REVIEWED THE FORM 990 WITH THE BOARD OF DIRECTORS PRIOR TO FILING AND THE RETURN WAS MADE AVAILABLE TO EACH BOARD MEMBER IN AN ELECTRONIC FORMAT PRIOR TO THE REVIEW. ENFORCEMENT OF CONFLICTS POLICY FORM 990, PAGE 6, PART VI, LINE 12C ANNUALLY, THE AUDIT AND COMPLIANCE DEPARTMENT OF THE CORPORATION FORWARDS THE POLICY AND THE CONFLICT OF INTEREST DISCLOSURE FORMS TO ALL COVERED PERSONS. EACH PERSON IS REQUIRED TO PROVIDE A COMPLETED DISCLOSURE FORM, NOTING ANY CONFLICTS OR ATTESTING THEY HAVE "NONE", AND THEN FORWARD THOSE BACK TO THE AUDIT AND COMPLIANCE DEPARTMENT. ANY 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 COMPENSATION COMMITTEE, WHICH IS THE EXECUTIVE COMMITTEE OF THE MSHA BOARD, OBTAINS THE SERVICES OF AN OUTSIDE AND INDEPENDENT COMPENSATION CONSULTANT TO PROVIDE THE COMMITTEE WITH RELEVANT MARKET DATA FROM COMPENSATION SURVEYS AND WITH ADVICE WHEN THE COMMITTEE MAKES RECOMMENDATIONS ON PAY AND BENEFITS FOR THE CEO OF MSHA. COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B THE BOARD ALSO APPROVES PAY AND BENEFITS FOR THE CFO. THE COMPENSATION COMMITTEE REVIEWS AND HAS FINAL APPROVAL OF CEO RECOMMENDATIONS FOR PAY AND BENEFITS FOR ALL OTHER EXECUTIVES. GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 GOVERNING DOCUMENTS AND CONFILICT OF INTEREST POLICY ARE MADE AVAILABLE UPON REQUEST TO APPROPRIATE PARTIES REQUESTING THEM. FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST TO APPROPRIATE PARTIES REQUESTING THEM, AND THEY ARE MADE AVAILABLE TO THOSE PARTIES WHO OWN INDEBTEDNESS OF THE COMPANY ON A QUARTERLY BASIS. GROUP RETURN EXPLANATION FORM 990, PAGE 7, PART VII OFFICER, KEY EMPLOYEE & HIGHEST PAID COMPENSATION: LYNN KRUTAK, CFO AND MSHA KEY EMPLOYEE, IS PAID BY MSHA. BLUE RIDGE MEDICAL MANAGEMENT CORPORATION (BRMMC) REIMBURSES MSHA FOR 50% OF KRUTAK'S SALARY AND BENEFITS. MSHA IS THE SOLE MEMBER OF BRMMC. KRUTAK DEVOTES AN EQUAL AMOUNT OF TIME BETWEEN MSHA AND BRMMC. CARL KILGORE, REPORTABLE AS A HIGHEST COMPENSATED EMPLOYEE, IS PAID BY MSHA AND HIS SALARY AND BENEFITS ARE FULLY RIEMBURSED TO MSHA BY BRMMC. DR. FRANK LAURO, REPORTABLE AS A HIGHEST COMPENSATED EMPLOYEE, IS PAID BY MSHA AND 50% OF HIS SALARY AND BENEFITS ARE REIMBURSED TO MSHA BY BRMMC. DR. LAURO DEVOTES AN EQUAL AMOUNT OF TIME BETWEEN MSHA AND BRMMC. DR. DOUGLAS EDEMA, REPORTABLE AS A HIGHEST COMPENSATED EMPLOYEE, IS PAID BY MSHA AND HIS SALARY AND BENEFITS ARE FULLY REIMBURSED TO MSHA BY BRMMC. CERTAIN EXECUTIVES OF THE ORGANIZATION, SUCH AS THE CEO AND SR VP/CFO, PROVIDE SERVICES TO SOME OR ALL OF THE ORGANIZATIONS RELATED TO MSHA. OTHER CHANGES IN NET ASSETS EXPLANATION FORM 990, PART XI, LINE 5 PARTNERSHIP CHARITABLE CONTRIBUTIONS NOT ON BOOKS 17,654 PARTNERSHIP PORTFOLIO EXPENSES NOT ON BOOKS 252,901 TEMPORARILY RESTRICTED GRANTS 41,832 CHANGE IN FAIR VALUE OF DERIVATIVES -6,085,740 NET UNREALIZED (LOSS) ON INVESTMENT -3,807,518 PARTNERSHIP INCOME NOT ON BOOKS 1,193,604 PARTNERSHIP INTEREST INCOME NOT ON BOOKS -16,657 PARTNERSHIP CAPITAL LOSSES NOT ON BOOKS -23 PARTNERSHIP DIVIDEND INCOME NOT ON BOOKS -598,604 TOTAL TO FORM 990, PART XI, LINE 5 -9,002,551 ADDITIONAL INFORMATION FORM 990, PART XII RESPONSE TO PART VI TO SCHEDULE K (FORM 990) 1. COMMENT ON SCHEDULE K, PART L, LINES A, B, C AND D. MOUNTAIN STATES HEALTH ALLIANCE (MSHA) OWNS AND/OR OPERATES HOSPITALS IN A NUMBER OF DIFFERENT LOCATIONS BOTH IN TENNESSEE AND IN VIRGINIA. AS A RESULT, MSHA MUST UTILIZE CONDUIT GOVERNMENTAL BOND ISSUERS IN A NUMBER OF JURISDICTIONS IN ORDER TO FINANCE IMPROVEMENTS TO ITS HOSPITAL FACILITIES. IN 2008,2009,2010 AND 2011, MSHA WAS THE CONDUIT BORROWER OF TAX-EXEMPT BONDS ISSUED BY MULTIPLE ISSUERS IN TENNESSEE AND VIRGINIA. FOR FEDERAL TAX PURPOSES, EVEN THOUGH DIFFERENT GOVERNMENTAL ISSUERS WERE INVOLVED, THESE MULTIPLE ISSUES IN EACH YEAR WERE REQUIRED TO BE TREATED, AND WERE TREATED, AS A SINGLE "ISSUE" BECAUSE THEY MET THE SINGLE "ISSUE" TEST UNDER THE APPLICABLE FEDERAL TAX REGULATIONS. THEREFORE, MULTIPLE ISSUERS ARE LISTED UNDER LINES A,B,C AND D BECAUSE THE BONDS THAT WERE ISSUED WERE PART OF A SINGLE "ISSUE" FOR FEDERAL TAX PURPOSES. 2. COMMENT ON SCHEDULE K, PART LL, LINE 3. LINE 3 FOR THE BOND ISSUES LISTED IN LINES B, C, D AND E DOES NOT MATCH THE APPLICABLE ISSUE PRICE FOR EACH SUCH BOND ISSUE BECAUSE OF INTEREST EARNINGS EARNED ON THE SALE PROCEEDS OF EACH SERIES OF BONDS. PLEASE ALSO NOTE THAT THE AMOUNTS SHOWN ON LINE 3 FOR THE SAME BOND ISSUES LISTED ON LINES B, C, D AND E ARE DIFFERENT THAN THE AMOUNTS THAT WERE LISTED FOR THE SAME BOND ISSUES SHOWN ON THIS SAME FILING FOR FY2011. THE INSTRUCTIONS PROVIDE THAT THE AMOUNT OF PROCEEDS TO BE SHOWN ON THIS LINE FOR EACH ISSUE IS THE PROCEEDS "AS OF THE END OF THE 12-MONTH PERIOD." THIS LANGUAGE RESULTED IN OUR LISTING THE AMOUNT OF PROCEEDS EXISTING AS OF THE END OF THE FISCAL YEAR, NOT THE AGGREGATE PROCEEDS. AFTER REVIEWING 990 FILING BY A NUMBER OF OTHER ENTITIES, IT APPEARS THAT A MAJORITY OF SUCH ENTITIES LISTED THE AGGREGATE AMOUNT OF PROCEEDS, NOT THE AMOUNT EXISTING AS OF THE END OF THE FISCAL YEAR. FOR THIS 990, MSHA HAS TAKEN THAT SAME APPROACH. A CLARIFICATION IN THE INSTRUCTIONS AS TO THIS ISSUE WOULD BE HELPFUL. 3. COMMENT ON SCHEDULE K, PART II, LINE 4 CERTAIN PROCEEDS OF THE BOND ISSUES LISTED IN LINES B, C, AND E ARE DEPOSITED IN REASONABLY REQUIRED RESERVE FUNDS, THE SIZE OF EACH OF WHICH COMPLIES WITH FEDERAL TAX REGULATIONS. THE AMOUNTS SHOWN ON LINE 2 OF PART II OF SCHEDULE K INCLUDE PROCEEDS HELD IN THOSE FUNDS. THESE LINES (OTHER THAN LINE E) ALSO INCLUDE A SMALL AMOUNT OF INVESTMENT EARNINGS RELATIVE TO THESE FUNDS THAT HAD NOT YET BEEN MOVED AS OF THE END OF THE APPLICABLE REPORTING PERIOD TO ANOTHER FUND TO BE USED TO PAY DEBT SERVICE, AS IS PERMITTED UNDER THE APPLICABLE BOND DOCUMENTS. 4. COMMENTS ON SCHEDULE K, PART II, LINES 9 THROUGH 11. THE INSTRUCTIONS ARE UNCLEAR AS TO WHETHER AMOUNTS USED TO REFINANCE SHORT- TERM TAXABLE LOANS INCURRED TO TEMPORARILY FINANCE ELIGIBLE COSTS SHOULD BE SHOWN AS CAPITAL EXPENDITURES AND WORKING CAPITAL (LINES 9 AND 10) OR AS OTHER SPENT PROCEEDS(LINE 11). BASED UPON A REVIEW OF OTHER 990 FILINGS, IT APPEARS THAT MOST REPORTING ENTITIES HAVE LISTED THE APPLICATION OF PROCEEDS FOR SUCH PURPOSE UNDER OTHER SPENT PROCEEDS (LINE 11). THIS FILING TAKES THAT APPROACH, AND THEREFORE THE REPORTING ON LINES 9 THROUGH 11 FOR PART IV IS INCONSISTENT WITH REPORTING ON THE SAME LINES FOR THE PRIOR FISCAL YEAR. 5. COMMENT ON SCHEDULE K, PART IV, LINE 12 IT IS UNCLEAR UNDER THE INSTRUCTIONS WHETHER TRANSFERRED PROCEEDS SHOULD BE TREATED AS OTHER UNSPENT PROCEDS FOR REPORTING PURPOSES ON LINE 12. AS AN ABUNDANCE OF CAUTION. TRANSFERRED PROCEEDS HAVE BEEN INCLUDED ON LINE 12 FOR EACH ISSUE TO THE EXTENT APPLICABLE. 6. COMMENT ON SCHEDULE K, PART IV, LINE 1 AS OF THE REPORTING DATE OF THE 990, THE ONLY ARBITRAGE REBATE CALCULATION THAT WAS REQUIRED RELATED TO THE BONDS DESCRIBED IN LINE E OF PART I (THE SERIES 2006 BONDS). MSHA RETAINED A REBATE CALCULATION AGENT TO CALCULATE WHETHER ANY ARBITRAGE REBATE WAS DUE WITH RESPECT TO THOSE BONDS, AND THERE WAS NEGATIVE ARBITRAGE REBATE LIABILITY IN A SIGNIFICANT AMOUNT. THEREFORE, NO FORM 8038-T WAS REQUIRED TO BE FILED WITH RESPECT TO THAT BOND ISSUE. 7. COMMENT ON SCHEDULE K, PART IV, LINE 4D. PART IV, LINE 4D RELATIVE TO THE BOND ISSUE DESCRIBED ON LINE E SHOWS THAT THE REGULATORY SAFE HARBOR FOR ESTABLISHING FAIR MARKET VALUE OF THE GIC DESCRIBED IN LINE 4A WAS NOT SATISFIED. DUE TO MARKET CONDITIONS AT THE TIME, MSHA DID NOT RECEIVE THREE BIDS FOR THIS GIC. HOWEVER, THE YIELD ON THE GIC WAS SO SUBSTANTIALLY BELOW THE YIELD ON THE RELEVANT BONDS THAT THERE WAS NO DOUBT THAT THE YIELD ON THE GIC DID NOT EXCEED THE APPROPRIATE YIELD ON THE RELEVANT BONDS. 8. COMMENT ON SCHEDULE K, PART IV, LINE 5. THE BOND ISSUES DESCRIBED IN LINES B, C AND D OF PART I FINANCED SIGNIFICANT CAPITAL IMPROVEMENTS TO HOSPITAL FACILITIES. THERE HAVE BEEN UNEXPECTED DELAYS IN THE CONSTRUCTION AND EQUIPPING OF CERTAIN OF THESE HOSPITAL FACILITIES, AND THEREFORE NOT ALL OF THE BOND PROCEEDS WERE SPENT WITHIN THE THREE-YEAR TEMPORARY PERIOD RELATIVE TO CONSTRUCTION PROJECTS. HOWEVER, MSHA HAS YIELD RESTRICTED THESE PROCEEDS AFTER THE END OF THE APPLICABLE TEMPORARY PERIOD AND/OR WILL BE MAKING A YIELD REDUCTION PAYMENT WITH RESPECT TO THOSE PROCEEDS, IF REQUIRED. 9. COMMENT ON SCHEDULE K, PART V. MSHA HAS EXECUTED DETAILED TAX CERTIFICATES REQUIRING TAX COMPLIANCE THAT ARE INTENDED TO ENSURE THAT VIOLATIONS OF FEDERAL TAX REQUIREMENTS ARE TIMELY IDENTIFIED. MSHA HAS ALSO ADOPTED SEPARATE PROCEDURES FOR SUCH PURPOSES THAT WERE APPLICABLE DURING THE REPORTING PERIOD. 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TN BRMMC C CORP 49444275 6131411 1.00000 COMMUNITY HOME CARE INC 1460 PARK AVENUE NORTON VA 24273 541453810 DME VA NCH C CORP 364522 353609 0.50100 COMMUNITY PHYSICIAN SERVICES CORP 100 15TH STREET NW NORTON VA 24273 541641446 MED. SERV. VA NCH C CORP 516 0.50100 SOUTHWEST COMMUNITY HEALTH SERV 565 RADIO HILL RD PO BOX 880 MARION VA 24354 541460695 MED. SERV. VA SCCH C CORP 283630 1061936 0.80000 WILSON PHARMACY INC PO BOX 5289 JOHNSON CITY TN 37604 620329587 PHARMACY TN BRMMC C CORP 3257657 2903651 1.00000 CRESTPOINT HEALTH INSURANCE COMPANY 208 SUNSET DRIVE SUITE 101 JOHNSON CITY TN 37604 620381170 INSURANCE TN ISHN C CORP 0.99170 true true true false false false true false true true true true true true true true true true MSHA AUXILIARY O 178832 MSHA AUXILIARY P 197250 BLUE RIDGE MEDICAL MANAGEMENT CORP I 105998 BLUE RIDGE MEDICAL MANAGMENT CORP K 9910706 BLUE RIDGE MEDICAL MANAGEMENT CORP L 31167999 BLUE RIDGE MEDICAL MANAGEMENT CORP N 531062 BLUE RIDGE MEDICAL MANAGEMENT CORP P 4628746 WILSON PHARMACY N 76462 WILSON PHARMACY P 1841888 MEDISERVE G 56623 MEDISERVE J 138688 MEDISERVE K 174373 MEDISERVE P 1101681 MOUNTAIN STATES PROPERTIES J 2050216 MOUNTAIN STATES PROPERTIES K 247351 MOUNTAIN STATES PROPERTIES N 86339 MOUNTAIN STATES PROPERTIES Q 523559 MOUNTAIN STATES FOUNDATION B 672450 MOUNTAIN STATES FOUNDATION C 1647435 MOUNTAIN STATES FOUNDATION K 1023012 NORTON COMMUNITY HOSPTIAL K 10161993 NORTON COMMUNITY HOSPITAL N 531171 NORTON COMMUNITY HOSPITAL P 796930 DICKENSON COMMUNITY HOSPITAL K 785766 ISHN B 5661810 ISHN D 1000000 ISHN L 1989315 ISHN P 691062 SMYTH COUNTY COMMUNITY HOSPITAL B 19300494 SMYTH COUNTY COMMUNITY HOSPITAL D 16464093 SMYTH COUNTY COMMUNITY HOSPITAL K 4127318 SMYTH COUNTY COMMUNITY HOSPITAL P 72934 SMYTH COUNTY COMMUNITY HOSPITAL Q 310435 JOHNSTON MEMORIAL HOSPITAL K 9554598 JOHNSTON MEMORIAL HOSPTIAL L 253600 JOHNSTON MEMORIAL HOSPITAL O 114068 APP K 850322 MSHA AUXILIARY O 178832 MSHA AUXILIARY P 197250 BLUE RIDGE MEDICAL MANAGEMENT CORP I 105998 BLUE RIDGE MEDICAL MANAGMENT CORP K 9910706 BLUE RIDGE MEDICAL MANAGEMENT CORP L 31167999 BLUE RIDGE MEDICAL MANAGEMENT CORP N 531062 BLUE RIDGE MEDICAL MANAGEMENT CORP P 4628746 WILSON PHARMACY N 76462 WILSON PHARMACY P 1841888 MEDISERVE G 56623 MEDISERVE J 138688 MEDISERVE K 174373 MEDISERVE P 1101681 MOUNTAIN STATES PROPERTIES J 2050216 MOUNTAIN STATES PROPERTIES K 247351 MOUNTAIN STATES PROPERTIES N 86339 MOUNTAIN STATES PROPERTIES Q 523559 MOUNTAIN STATES FOUNDATION B 672450 MOUNTAIN STATES FOUNDATION C 1647435 MOUNTAIN STATES FOUNDATION K 1023012 NORTON COMMUNITY HOSPTIAL K 10161993 NORTON COMMUNITY HOSPITAL N 531171 NORTON COMMUNITY HOSPITAL P 796930 DICKENSON COMMUNITY HOSPITAL K 785766 ISHN B 5661810 ISHN D 1000000 ISHN L 1989315 ISHN P 691062 SMYTH COUNTY COMMUNITY HOSPITAL B 19300494 SMYTH COUNTY COMMUNITY HOSPITAL D 16464093 SMYTH COUNTY COMMUNITY HOSPITAL K 4127318 SMYTH COUNTY COMMUNITY HOSPITAL P 72934 SMYTH COUNTY COMMUNITY HOSPITAL Q 310435 JOHNSTON MEMORIAL HOSPITAL K 9554598 JOHNSTON MEMORIAL HOSPTIAL L 253600 JOHNSTON MEMORIAL HOSPITAL O 114068 APP K 850322 MSHA AUXILIARY O 178832 MSHA AUXILIARY P 197250 BLUE RIDGE MEDICAL MANAGEMENT CORP I 105998 BLUE RIDGE MEDICAL MANAGMENT CORP K 9910706 BLUE RIDGE MEDICAL MANAGEMENT CORP L 31167999 BLUE RIDGE MEDICAL MANAGEMENT CORP N 531062 BLUE RIDGE MEDICAL MANAGEMENT CORP P 4628746 WILSON PHARMACY N 76462 WILSON PHARMACY P 1841888 MEDISERVE G 56623 MEDISERVE J 138688 MEDISERVE K 174373 MEDISERVE P 1101681 MOUNTAIN STATES PROPERTIES J 2050216 MOUNTAIN STATES PROPERTIES K 247351 MOUNTAIN STATES PROPERTIES N 86339 MOUNTAIN STATES PROPERTIES Q 523559 MOUNTAIN STATES FOUNDATION B 672450 MOUNTAIN STATES FOUNDATION C 1647435 MOUNTAIN STATES FOUNDATION K 1023012 NORTON COMMUNITY HOSPTIAL K 10161993 NORTON COMMUNITY HOSPITAL N 531171 NORTON COMMUNITY HOSPITAL P 796930 DICKENSON COMMUNITY HOSPITAL K 785766 ISHN B 5661810 ISHN D 1000000 ISHN L 1989315 ISHN P 691062 SMYTH COUNTY COMMUNITY HOSPITAL B 19300494 SMYTH COUNTY COMMUNITY HOSPITAL D 16464093 SMYTH COUNTY COMMUNITY HOSPITAL K 4127318 SMYTH COUNTY COMMUNITY HOSPITAL P 72934 SMYTH COUNTY COMMUNITY HOSPITAL Q 310435 JOHNSTON MEMORIAL HOSPITAL K 9554598 JOHNSTON MEMORIAL HOSPTIAL L 253600 JOHNSTON MEMORIAL HOSPITAL O 114068 APP K 850322 MSHA AUXILIARY O 178832 MSHA AUXILIARY P 197250 BLUE RIDGE MEDICAL MANAGEMENT CORP I 105998 BLUE RIDGE MEDICAL MANAGMENT CORP K 9910706 BLUE RIDGE MEDICAL MANAGEMENT CORP L 31167999 BLUE RIDGE MEDICAL MANAGEMENT CORP N 531062 BLUE RIDGE MEDICAL MANAGEMENT CORP P 4628746 WILSON PHARMACY N 76462 WILSON PHARMACY P 1841888 MEDISERVE G 56623 MEDISERVE J 138688 MEDISERVE K 174373 MEDISERVE P 1101681 MOUNTAIN STATES PROPERTIES J 2050216 MOUNTAIN STATES PROPERTIES K 247351 MOUNTAIN STATES PROPERTIES N 86339 MOUNTAIN STATES PROPERTIES Q 523559 MOUNTAIN STATES FOUNDATION B 672450 MOUNTAIN STATES FOUNDATION C 1647435 MOUNTAIN STATES FOUNDATION K 1023012 NORTON COMMUNITY HOSPTIAL K 10161993 NORTON COMMUNITY HOSPITAL N 531171 NORTON COMMUNITY HOSPITAL P 796930 DICKENSON COMMUNITY HOSPITAL K 785766 ISHN B 5661810 ISHN D 1000000 ISHN L 1989315 ISHN P 691062 SMYTH COUNTY COMMUNITY HOSPITAL B 19300494 SMYTH COUNTY COMMUNITY HOSPITAL D 16464093 SMYTH COUNTY COMMUNITY HOSPITAL K 4127318 SMYTH COUNTY COMMUNITY HOSPITAL P 72934 SMYTH COUNTY COMMUNITY HOSPITAL Q 310435 JOHNSTON MEMORIAL HOSPITAL K 9554598 JOHNSTON MEMORIAL HOSPTIAL L 253600 JOHNSTON MEMORIAL HOSPITAL O 114068 APP K 850322 MSHA AUXILIARY O 178832 MSHA AUXILIARY P 197250 BLUE RIDGE MEDICAL MANAGEMENT CORP I 105998 BLUE RIDGE MEDICAL MANAGMENT CORP K 9910706 BLUE RIDGE MEDICAL MANAGEMENT CORP L 31167999 BLUE RIDGE MEDICAL MANAGEMENT CORP N 531062 BLUE RIDGE MEDICAL MANAGEMENT CORP P 4628746 WILSON PHARMACY N 76462 WILSON PHARMACY P 1841888 MEDISERVE G 56623 MEDISERVE J 138688 MEDISERVE K 174373 MEDISERVE P 1101681 MOUNTAIN STATES PROPERTIES J 2050216 MOUNTAIN STATES PROPERTIES K 247351 MOUNTAIN STATES PROPERTIES N 86339 MOUNTAIN STATES PROPERTIES Q 523559 MOUNTAIN STATES FOUNDATION B 672450 MOUNTAIN STATES FOUNDATION C 1647435 MOUNTAIN STATES FOUNDATION K 1023012 NORTON COMMUNITY HOSPTIAL K 10161993 NORTON COMMUNITY HOSPITAL N 531171 NORTON COMMUNITY HOSPITAL P 796930 DICKENSON COMMUNITY HOSPITAL K 785766 ISHN B 5661810 ISHN D 1000000 ISHN L 1989315 ISHN P 691062 SMYTH COUNTY COMMUNITY HOSPITAL B 19300494 SMYTH COUNTY COMMUNITY HOSPITAL D 16464093 SMYTH COUNTY COMMUNITY HOSPITAL K 4127318 SMYTH COUNTY COMMUNITY HOSPITAL P 72934 SMYTH COUNTY COMMUNITY HOSPITAL Q 310435 JOHNSTON MEMORIAL HOSPITAL K 9554598 JOHNSTON MEMORIAL HOSPTIAL L 253600 JOHNSTON MEMORIAL HOSPITAL O 114068 APP K 850322 MSHA AUXILIARY O 178832 MSHA AUXILIARY P 197250 BLUE RIDGE MEDICAL MANAGEMENT CORP I 105998 BLUE RIDGE MEDICAL MANAGMENT CORP K 9910706 BLUE RIDGE MEDICAL MANAGEMENT CORP L 31167999 BLUE RIDGE MEDICAL MANAGEMENT CORP N 531062 BLUE RIDGE MEDICAL MANAGEMENT CORP P 4628746 WILSON PHARMACY N 76462 WILSON PHARMACY P 1841888 MEDISERVE G 56623 MEDISERVE J 138688 MEDISERVE K 174373 MEDISERVE P 1101681 MOUNTAIN STATES PROPERTIES J 2050216 MOUNTAIN STATES PROPERTIES K 247351 MOUNTAIN STATES PROPERTIES N 86339 MOUNTAIN STATES PROPERTIES Q 523559 MOUNTAIN STATES FOUNDATION B 672450 MOUNTAIN STATES FOUNDATION C 1647435 MOUNTAIN STATES FOUNDATION K 1023012 NORTON COMMUNITY HOSPTIAL K 10161993 NORTON COMMUNITY HOSPITAL N 531171 NORTON COMMUNITY HOSPITAL P 796930 DICKENSON COMMUNITY HOSPITAL K 785766 ISHN B 5661810 ISHN D 1000000 ISHN L 1989315 ISHN P 691062 SMYTH COUNTY COMMUNITY HOSPITAL B 19300494 SMYTH COUNTY COMMUNITY HOSPITAL D 16464093 SMYTH COUNTY COMMUNITY HOSPITAL K 4127318 SMYTH COUNTY COMMUNITY HOSPITAL P 72934 SMYTH COUNTY COMMUNITY HOSPITAL Q 310435 JOHNSTON MEMORIAL HOSPITAL K 9554598 JOHNSTON MEMORIAL HOSPTIAL L 253600 JOHNSTON MEMORIAL HOSPITAL O 114068 APP K 850322 MSHA AUXILIARY O 178832 MSHA AUXILIARY P 197250 BLUE RIDGE MEDICAL MANAGEMENT CORP I 105998 BLUE RIDGE MEDICAL MANAGMENT CORP K 9910706 BLUE RIDGE MEDICAL MANAGEMENT CORP L 31167999 BLUE RIDGE MEDICAL MANAGEMENT CORP N 531062 BLUE RIDGE MEDICAL MANAGEMENT CORP P 4628746 WILSON PHARMACY N 76462 WILSON PHARMACY P 1841888 MEDISERVE G 56623 MEDISERVE J 138688 MEDISERVE K 174373 MEDISERVE P 1101681 MOUNTAIN STATES PROPERTIES J 2050216 MOUNTAIN STATES PROPERTIES K 247351 MOUNTAIN STATES PROPERTIES N 86339 MOUNTAIN STATES PROPERTIES Q 523559 MOUNTAIN STATES FOUNDATION B 672450 MOUNTAIN STATES FOUNDATION C 1647435 MOUNTAIN STATES FOUNDATION K 1023012 NORTON COMMUNITY HOSPTIAL K 10161993 NORTON COMMUNITY HOSPITAL N 531171 NORTON COMMUNITY HOSPITAL P 796930 DICKENSON COMMUNITY HOSPITAL K 785766 ISHN B 5661810 ISHN D 1000000 ISHN L 1989315 ISHN P 691062 SMYTH COUNTY COMMUNITY HOSPITAL B 19300494 SMYTH COUNTY COMMUNITY HOSPITAL D 16464093 SMYTH COUNTY COMMUNITY HOSPITAL K 4127318 SMYTH COUNTY COMMUNITY HOSPITAL P 72934 SMYTH COUNTY COMMUNITY HOSPITAL Q 310435 JOHNSTON MEMORIAL HOSPITAL K 9554598 JOHNSTON MEMORIAL HOSPTIAL L 253600 JOHNSTON MEMORIAL HOSPITAL O 114068 APP K 850322