SMYTH COUNTY COMMUNITY HOSPITAL: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: SMYTH COUNTY COMMUNITY HOSPITAL (EIN 54-0794913)
Tax period: 2011-07-01 to 2012-06-30
Filed: 2013-05-15
IRS object ID: 201311359349301896
Schema version: 2011v1.5
Source: Download XML · Original 990 at ProPublica

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

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-05-15T11:26:33-05:00	Timestamp
Tax Period End Date	2012-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	621517792	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	PERSHING YOAKLEY & ASSOCIATES PC	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	ONE CHEROKEE MILLS 2220 SUTHERLAND	AddressLine1
City	KNOXVILLE	City
State	TN	State
ZIP Code	379192363	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	540794913	EIN

Name Name

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

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

US Address USAddress

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

Officer Officer

Field	Value	IRS element (for citing)
Name	JEFFREY HUNDMAN	Name
Title	CFO	Title
Phone	2763781000	Phone
Date Signed	2013-05-15	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	DEBORAH O ERNSBERGER	Name
PTIN	P00364912	PTIN
Phone	8656730844	Phone

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

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

Address Principal Officer US AddressPrincipalOfficerUS

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

Field	Value	IRS element (for citing)
Gross Receipts	42953023	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.MSHA.COM	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1965	YearFormation
State Legal Domicile	VA	StateLegalDomicile
Activity Or Mission Description	SEE SCHEDULE OSMYTH COUNTY COMMUNITY HOSPITAL IS A NONSTOCK CORPORATION THAT OWNS AND OPERATES AN ACUTE CARE FACILITY, A HOME HEALTH AGENCY, AND FRANCIS MARION MANOR, A LONG TERM CARE FACILITY. THE FACILITIES ARE LOCATED IN SMYTH COUNTY, VIRGINIA. THEY PROVIDE INPATIENT, OUTPATIENT, EMERGENCY SERVICES, AND LONG-TERM MEDICAL CARE TO THE GENERAL PUBLIC. SERVICES INCLUDE, BUT ARE NOT LIMITED TO, RADIOLOGY, ELECTROCARDIOLOGY, LABORATORY, PHYSICAL THERAPY, SPEECH PATHOLOGY, HOME HEALTH, BLOOD BANK, LONG TERM CARE, AND NURSERY.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	15	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	9	NbrIndependentVotingMembers
Total Nbr Employees	0	TotalNbrEmployees
Total Nbr Volunteers	73	TotalNbrVolunteers
Total Gross UBI	30251	TotalGrossUBI
Net Unrelated Business Txbl Income	10560	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	79030	ContributionsGrantsPriorYear
Contributions Grants Current Year	38238	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	44879709	ProgramServiceRevenuePriorYear
Program Service Revenue CY	40449630	ProgramServiceRevenueCY
Investment Income Prior Year	2500195	InvestmentIncomePriorYear
Investment Income Current Year	1340112	InvestmentIncomeCurrentYear
Other Revenue Prior Year	817381	OtherRevenuePriorYear
Other Revenue Current Year	1125043	OtherRevenueCurrentYear
Total Revenue Prior Year	48276315	TotalRevenuePriorYear
Total Revenue Current Year	42953023	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	7421	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	12821	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	28759854	SalariesEtcPriorYear
Salaries Etc Current Year	23446103	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	32229	TotalFundrsngExpCurrentYear
Other Expense Prior Year	22117439	OtherExpensePriorYear
Other Expenses Current Year	22877592	OtherExpensesCurrentYear
Total Expenses Prior Year	50884714	TotalExpensesPriorYear
Total Expenses Current Year	46336516	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	-2608399	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	-3383493	RevenuesLessExpensesCY
Total Assets BOY	98026282	TotalAssetsBOY
Total Assets EOY	106754092	TotalAssetsEOY
Total Liabilities BOY	16754974	TotalLiabilitiesBOY
Total Liabilities EOY	24852213	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	81271308	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	81901879	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	SMYTH COUNTY COMMUNITY HOSPITAL IS COMMITTED TO BRINGING LOVING CARE TO HEALTHCARE. WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTHCARE NEEDS OF INDIVIDUALS AND COMMUNITIES IN OUR REGION AND TO ASSIST THEM IN ATTAINING THEIR HIGHEST POSSIBLE LEVEL OF HEALTH.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	38583338	Expense
Grants	12821	Grants
Revenue	40825294	Revenue
Description	SMYTH COUNTY COMMUNITY HOSPITAL ("SCCH") HAS A 40-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. ADDITIONALLY, SCCH HAS A 109-BED NURSING CARE FACILITY THAT OFFERS BOTH SKILLED NURSING CARE AND NURSING CARE, FRANCIS MARION MANOR. SCCH HAS A VARIETY OF OUTREACH PROGRAMS INCLUDING HOMECARE.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.PATIENT CARE SERVICES:AS A COMMUNITY FACILITY, SCCH IS DIRECTLY RESPONSIBLE FOR, AND RESPONSIVE TO, OUR FAMILIES, FRIENDS AND COMMUNITIES. HOW WILL IT IMPROVE PATIENT CARE? SHOULD WE MAKE AN INVESTMENT NOW, OR WAIT FOR AN IMMINENT BREAK-THROUGH? WHERE CAN WE BENEFIT THE MOST PEOPLE? THESE CONCERNS DIRECT OUR DOLLARS IN INTRODUCING NEW PROCEDURES, MORE IN-DEPTH SERVICES AND INNOVATION. CURRENTLY, SCCH SERVICES INCLUDE:24-HOUR EMERGENCY DEPARTMENTAUDIOLOGYBONE DENSITOMETRYCARDIAC REHABILITATIONCOMPUTERIZED TOMOGRAPHYHOMECAREINTENSIVE CARE UNIT (ICU)INTERMEDIATE CARE (FRANCIS MARION MANOR)LABORATORY SERVICESLIFELINE EMERGENCY RESPONSE SYSTEMLITHOTRIPSYMAGNETIC RESONANCE IMAGING (MRI)MAMMOGRAPHYMEDICAL AND SURGICAL SERVICESOCCUPATIONAL THERAPYPASTORAL CAREPEDIATRICSPHARMACYPHYSICAL THERAPYPRE-ADMISSION CENTERPULMONARY REHABILITATIONRADIOLOGY SERVICESRESPIRATORY THERAPYSAME DAY SURGERYSKILLED NURSING FACILITYSLEEPZONE DIAGNOSTIC CENTERSPEECH THERAPYTRANSRECTAL ULTRASOUNDULTRASONOGRAPHYHOMECARE SERVICES:SCCH UNDERSTANDS THE VALUE OF HOME HEALTHCARE AND THE RELIEF PATIENTS FEEL TO BE BACK IN FAMILIAR SURROUNDINGS WHILE CONTINUING TO RECEIVE EXPERT CARE. UNDER THE PHYSICIAN'S SUPERVISION, PATIENTS CONTINUE TO RECEIVE QUALITY MEDICAL TREATMENT FROM SKILLED NURSES, THERAPISTS AND HOME HEALTH AIDES WHO FOLLOW THE PATIENT'S INDIVIDUAL PLAN OF TREATMENT. HOMECARE SERVICES ALLOW PATIENTS THE CONVENIENCE OF:- TREATMENT IN THE COMFORT AND SECURITY OF HOME- CONTINUITY OF FAMILY RELATIONSHIPS- INDIVIDUAL PLAN OF TREATMENT- CONTINUING RELATIONSHIP WITH FAMILIAR PHYSICIAN- FREEDOM TO PARTICIPATE IN THE PLAN OF TREATMENT AT HOME- CARING, PERSONAL SERVICE BY EXPERIENCED, QUALIFIED HOME HEALTH PROFESSIONALS WORKING TOWARD THE SUCCESS OF THE PATIENT'S PLAN OF TREATMENT- AGENCY ACCEPTS ASSIGNMENT OF BENEFITS AND ASSISTS IN BILLING ISSUESFOR ELIGIBLE PATIENTS, CHARGES ARE 100 PERCENT REIMBURSABLE BY MEDICARE WHEN PRESCRIBED BY THE PHYSICIAN UNDER HOME HEALTH GUIDELINES.SCCH HOMECARE MEETS THE PHYSICIAN'S REQUIREMENTS THAT HIS OR HER PLAN OF TREATMENT IS CARRIED OUT BY QUALIFIED HOME HEALTH PROFESSIONALS. TRAINED HOME HEALTH NURSES CAREFULLY DOCUMENT PATIENTS' MEDICAL CHARTS AND PROVIDE THE PHYSICIAN WITH PROMPT AND ACCURATE INFORMATION ABOUT THE PATIENT'S CONDITION.OTHER HOME HEALTH BENEFITS WHICH SUPPORT THE PHYSICIAN IN QUALITY PATIENT CARE INCLUDE:- THOROUGH PRE-DISCHARGE ASSESSMENT BETWEEN THE PHYSICIAN, HOME HEALTH NURSE AND HOSPITAL DISCHARGE PLANNER TO EVALUATE THE PATIENT'S NEEDS BEFORE LEAVING THE HOSPITAL- ASSURED CONTINUITY OF THE PHYSICIAN'S PLAN OF TREATMENT- CONSISTENT, TIMELY COMMUNICATION ABOUT THE PATIENT'S CONDITION- LICENSED NURSES WHO MEET REGULATORY STANDARDS- DEDICATED TEAMWORK WITH THE PHYSICIAN AND RESPECT FOR THE PATIENT/PHYSICIAN RELATIONSHIP- CLEAR COMMUNICATION WITH THE PATIENT AND HIS OR HER FAMILY ABOUT REIMBURSEMENT AND COVERED HOME CARE SERVICESSCCH HOMECARE PROVIDES PROMPT ACCESS TO CARE FOR QUALIFIED PATIENTS. IT ASSISTS HOSPITAL DISCHARGE PLANNERS AND OTHER DECISION MAKERS IN DELIVERING ALTERNATIVES FOR PATIENTS AND THEIR FAMILIES OR CAREGIVERS, AS WELL AS THEIR PHYSICIAN - AN ALTERNATIVE THAT BRINGS FLEXIBILITY, SENSITIVITY, CONVENIENCE, AND DEPENDABILITY.OTHER BENEFITS OF HOME HEALTH CARE FOR THE HOSPITAL PROFESSIONAL STAFF INCLUDE: - PRE-DISCHARGE HOME CARE ASSESSMENT AND PLANNING BY OUR HOME CARE COORDINATOR- IMMEDIATE, RESPONSIVE ASSISTANCE WITH TRANSITION FROM HOSPITAL TO HOME- AN EXPANDED NETWORK OF SERVICES TO SERVE THE PATIENT- CONTINUOUS ASSESSMENT OF THE PLAN OF CARE WITH THE PHYSICIAN- COORDINATION OF COMMUNICATION AMONG PATIENTS AND THEIR FAMILIES/CAREGIVERS, THE PHYSICIAN AND THE REFERRAL SOURCE- COORDINATION AND EVALUATION OF REIMBURSEMENT WITH A MIX OF PAYERS, INCLUDING MEDICARE, MEDICAID AND PRIVATE/COMMERCIAL INSURANCE COMPANIESSKILLED NURSING:SCCH REGISTERED AND LICENSED NURSES ARE HIGHLY TRAINED AND EXPERIENCED IN PROVIDING NURSING SERVICES IN THE PATIENT'S HOME. THEY UNDERSTAND THE SPECIAL NEEDS OF HOMEBOUND PATIENTS AND MAINTAIN CONTINUOUS EDUCATION IN CLINICAL AND PSYCHOSOCIAL SKILLS DEVELOPMENT.THE POLICIES, PROCEDURES AND QUALITY ASSURANCE PROGRAMS SCCH NURSES FOLLOW MEET THE STANDARDS REQUIRED BY FEDERAL/STATE REGULATIONS; SCCH ROUTINELY SURVEYS PATIENTS AND PHYSICIANS TO ASSESS THE SATISFACTION LEVEL OF OUR NURSING SERVICES IN ORDER TO IMPROVE NURSING QUALITY.OUR NURSING SERVICES INCLUDE, BUT ARE NOT LIMITED TO:- COORDINATION AND IMPLEMENTATION OF PHYSICIAN'S PLAN OF TREATMENT- ROUTINE PATIENT EVALUATION AND COMMUNICATION WITH PHYSICIAN REGARDING PATIENT'S RESPONSES TO CARE AND CHANGES IN THE PATIENT'S CONDITION- INTERACTION WITH PATIENT'S FAMILY/CAREGIVER, CO-WORKERS AND OTHER DISCIPLINES TO PROVIDE OBSERVATION AND FEEDBACK REGARDING PATIENT'S CONDITION- REVIEW OF MEDICATION REGIMENT AND PATIENT TRAININGINFUSION THERAPY:OUR INFUSION THERAPY NURSES ARE SKILLED, REGISTERED NURSES WHO UNDERSTAND THE SPECIAL REQUIREMENTS OF INFUSION THERAPY.THE POLICIES, PROCEDURES AND QUALITY ASSURANCE PROGRAMS THEY FOLLOW MEET STANDARDS PUBLISHED BY THE INTRAVENOUS NURSES SOCIETY AND REGULARITY ORGANIZATIONS.OUR INFUSION THERAPY NURSING SERVICES INCLUDE, BUT ARE NOT LIMITED TO:- INITIAL AND ONGOING ASSESSMENT OF PATIENT AND FAMILY CAPABILITIES AND NEEDS- PATIENT AND FAMILY EDUCATION- PERIPHERAL INTRAVENOUS SITE ROTATION- CENTRAL VENOUS CATHETER CARE- BLOOD DRAWING- FOLLOW-UP REPORTS TO PHYSICIANS AND PHARMACY SERVICE PROVIDERS- PSYCHOSOCIAL SUPPORT FOR PATIENTS AND FAMILIES/CAREGIVERSHOME HEALTH AIDE:OUR HOME HEALTH AIDES ASSIST THE PROFESSIONAL NURSING STAFF BY PERFORMING ROUTINE DUTIES IN CARING FOR IN-HOME PATIENTS. THEY ARE QUALIFIED TO PROVIDE AN EXTENSION TO THERAPEUTIC SERVICES, PERSONAL CARE, AMBULATION, EXERCISE, AND HOUSEHOLD SERVICES ESSENTIAL TO HEALTH CARE AT HOME. HOME HEALTH AIDE SERVICES CAN ONLY BE OFFERED TO INDIVIDUALS QUALIFYING FOR SKILLED NURSING OR THERAPIST SERVICES.HOME HEALTH AIDE SERVICES INCLUDE, BUT ARE NOT LIMITED TO:- MAINTAINING ACCURATE CLINICAL RECORDS REGARDING ALL PATIENT OBSERVATIONS, CARE AND TREATMENT- ASSISTING PATIENT WITH AMBULATION AND/OR TRANSFER, USING PROPER BODY MECHANICS TO PROTECT PATIENT AND PERSONAL SAFETY- ASSISTING PATIENT IN MEETING PERSONAL HYGIENE NEEDS- PREPARING MEALS AND ASSISTING WITH EATING IF NECESSARY- PROVIDING SIMPLE HOUSEHOLD PROCEDURES ESSENTIAL TO HEALTH CARE AT HOMEPHYSICAL THERAPY:PHYSICAL THERAPISTS PROVIDED BY OUR HOME HEALTH AGENCY USE THE LATEST TECHNIQUES AND EQUIPMENT TO ASSIST PATIENTS IN ACHIEVING THE MOST COMPLETE RECOVERY POSSIBLE IN THE SHORTEST PERIOD OF TIME. PATIENTS WHO REQUIRE THESE SERVICES OFTEN BECOME FRUSTRATED IN THEIR ATTEMPTS AT RECOVERING SKILLS THAT WERE ONCE EASY FOR THEM. OUR PROFESSIONALS' ASSISTANCE CAN HELP OVERCOME THIS DOWNSIDE OF REHABILITATIVE THERAPY BY PROVIDING EXPERT AID WITH AN ENCOURAGING ATTITUDE THAT HELPS THE PATIENT ACHIEVE MORE IN LESS TIME.OUR PHYSICAL THERAPY SERVICES INCLUDE, BUT ARE NOT LIMITED TO:- ASSISTING THE PHYSICIAN WITH INITIAL AND ON-GOING PATIENT EVALUATION- DIRECTING AND AIDING PATIENTS IN VARIOUS EXERCISES AND ACTIVITIES- GAIT TRAINING- INSTRUCTING PATIENT AND CAREGIVER IN USE OF DURABLE MEDICAL EQUIPMENT AND PROSTHETIC AND ORTHOTIC DEVICES- THE APPLICATION OF VARIOUS DEVICES, SIMULATORS AND TRACTION- COORDINATING PHYSICAL THERAPY WITH OUR AGENCY'S NURSING SERVICESOCCUPATIONAL THERAPY:OUR OCCUPATIONAL THERAPIST IS HIGHLY TRAINED AND EXPERIENCED IN REHABILITATING PATIENTS. THE GOAL OF THERAPY IS TO IMPROVE AND RESTORE FUNCTION LOST OR IMPAIRED BY ILLNESS OR INJURY AND PROMOTE A RETURN TO INDEPENDENCE THROUGH TRAINING AND RE-EDUCATION IN SKILLS AND ACTIVITIES ASSOCIATED WITH DAILY LIVING.OUR OCCUPATIONAL THERAPY SERVICES INCLUDE, BUT ARE NOT LIMITED TO:- EVALUATION OF THE PATIENT'S LEVEL OF FUNCTION- GUIDING THE PATIENT IN THERAPEUTIC, CREATIVE AND SELF-CARE ACTIVITIES	Description
Total Program Service Expense	38583338	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	0	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	1	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	1	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	1	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	0	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	1	RelatedOrgControlledEntity
Transaction Related Entity	0	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	107	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	0	NumberOfEmployees
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	1	FundsToPayPremiums
Premiums Paid	1	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	15	NbrVotingGoverningBodyMembers
Number Independent Voting Members	9	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	1	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
States Where Copy Of Return Is Filed	VA	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	JEFFREY HUNDMAN	NamePerson
Telephone Number	2763781207	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	245 MEDICAL PARK DRIVE	AddressLine1
City	MARION	City
State	VA	State
ZIP Code	24354	ZIPCode

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

Form990 Part VII Section A Form990PartVIISectionA (23 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Highest Compensated EmployeeHighestCompensatedEmployee
ALLEN ABEL
DIRECTOR	3.00	X	0	0	0
JIM BEAR JR
TREASURER	3.00	X	0	0	0
RUTH COX
DIRECTOR	3.00	X	0	0	0
BOB FEATHERS
DIRECTOR	3.00	X	0	0	0
ANN FLEMING
CHAIR	3.00	X	0	501320	66728
JOANNE GROSECLOSE
SECRETARY	3.00	X	0	0	0
MARK GROSECLOSE
DIRECTOR	3.00	X	0	0	0
CHELSEA HAMMAN MD
DIRECTOR	3.00	X	21675	0	0
MAUREEN MACIVER
DIRECTOR	3.00	X	0	0	0
JIM MCDOWELL MD
DIRECTOR	3.00	X	3328	0	0
JIM PATTERSON MD
DIRECTOR	3.00	X	0	4639	0
CINDY SALYER
DIRECTOR	3.00	X	0	241894	42953
BOB SHULTS
VICE CHAIR	3.00	X	0	0	0
JOHN SCHARIO
DIRECTOR	3.00	X	0	181919	24892
CLEM WILKES JR
DIRECTOR	3.00	X	0	0	0
LINDA WHITE
VP/CEO	55.00		0	248644	39163	X
JOHN JETER
ASST ADMIN/CFO	50.00		0	141277	20972	X
JEFFREY HUNDMAN
CFO	50.00		0	105109	12765	X
MATTHEW JUSTUS
PHYSICIAN ASSISTANT	40.00		0	204637	5344		X
PAMELA DELOACH
CRNA	40.00		0	188787	15318		X
SAMUEL SMALL
CRNA	40.00		0	175100	12441		X
ANTONIO DE LA ROSA
CRNA	40.00		0	148377	21087		X
BELDON FLEMING
DIRECTOR OF PHARMACY	40.00		0	138356	23298		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	25003	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	2280059	TotalReportableCompFrmRltdOrgs
Total Other Compensation	284961	TotalOtherCompensation
Number Individuals GT100 K	0	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
SKANSKA USA BUILDING INC
1633 LITTLETON ROAD	PARSIPPANY	NJ	07054	CONSTRUCTION	32446192
MCKESSON TECHNOLOGIES INC
5995 WINDWARD PARKWAY	ALPHARETTA	GA	30005	SERVICE CONTRACTS	730037
SCYPHERS & AUSTIN PC
189 VALLEY STREET	ABINGDON	VA	24210	LEGAL SERVICES	462500
APPALACHIAN POWER COMPANY
13563 OWENS DRIVE	GLADE SPRING	VA	34340	UTILITIES	364448
TELEOPTICS COMMUNICATIONS
1041 TIDEWATER COURT	KINGSPORT	TN	37660	COMMUNICATIONS	352303

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	19	NumberOfContractorsGT100K
Government Grants	30674	GovernmentGrants
All Other Contributions	7564	AllOtherContributions
Total Contributions	38238	TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue
PATIENT SERVICES	621990	40383511	40383511
P/S INC RELATED TO PRO	561000	66119	64918	1201

Field	Value	IRS element (for citing)
Total Program Service Revenue	40449630	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	1297050	TotalRevenueColumn
Exclusion	$1,297,050	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	425192	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	0	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	425192	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	425192	TotalRevenueColumn
Exclusion	$425,192	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	36686	Securities
Other	6376	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	0	Securities
Other	0	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	36686	Securities
Other	6376	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	43062	TotalRevenueColumn
Exclusion	$43,062	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	1905	GrossIncomeFundraisingEvents
Fundraising Direct Expenses	0	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	1905	TotalRevenueColumn
Exclusion	$1,905	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue	ExclusionExclusionAmount
OTHER REVENUE	621500	354925	325875	29050
CAFETERIA SALES	722210	219517			$219,517
MANAGEMENT FEE REVENUE	900099	73715			$73,715

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	49789	TotalRevenueColumn
Related Or Exempt Function Income	49789	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Other Revenue	697946	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	42953023	TotalRevenueColumn
Related Or Exempt Function Income	40824093	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	30251	UnrelatedBusinessRevenue
Exclusion	$2,060,441	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	12821	Total
Program Services	12821	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	437895	Total
Program Services	20011	ProgramServices
Management And General	417884	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	19015551	Total
Program Services	16275073	ProgramServices
Management And General	2728456	ManagementAndGeneral
Fundraising	12022	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	573908	Total
Program Services	501553	ProgramServices
Management And General	71985	ManagementAndGeneral
Fundraising	370	Fundraising

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	2228428	Total
Program Services	2237769	ProgramServices
Management And General	-10751	ManagementAndGeneral
Fundraising	1410	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	1190321	Total
Program Services	1149288	ProgramServices
Management And General	41033	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	22283	Total
Management And General	22283	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	50499	Total
Management And General	50499	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	71227	Total
Management And General	71227	ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	72765	Total
Management And General	72765	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	7214799	Total
Program Services	7192004	ProgramServices
Management And General	22795	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	212961	Total
Program Services	169866	ProgramServices
Management And General	43095	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	524809	Total
Program Services	452560	ProgramServices
Management And General	54572	ManagementAndGeneral
Fundraising	17677	Fundraising

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	541825	Total
Program Services	530070	ProgramServices
Management And General	11755	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	1041974	Total
Program Services	936432	ProgramServices
Management And General	105542	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	162658	Total
Program Services	146734	ProgramServices
Management And General	15924	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	5919	Total
Program Services	5440	ProgramServices
Management And General	479	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	16311	Total
Management And General	16311	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	4791118	Total
Program Services	2493999	ProgramServices
Management And General	2297119	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
MEDICAL SUPPLIES & DRUG	4920974	5195003	-274029
MANAGEMENT FEES	1790645	150523	1640122
REPAIRS & MAINTENANCE	780101	769093	11008
UBI TAX	13125		13125

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	643599	Total
Program Services	345099	ProgramServices
Management And General	297750	ManagementAndGeneral
Fundraising	750	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	46336516	Total
Program Services	38583338	ProgramServices
Management And General	7720949	ManagementAndGeneral
Fundraising	32229	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	4743424	BOY
EOY	812382	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	588514	BOY
EOY	64910	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	6417679	BOY
EOY	8655192	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	975086	BOY
EOY	953670	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	332142	BOY
EOY	314696	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	122231744	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	49662316	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	37213493	BOY
EOY	72569428	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	26310961	BOY
EOY	18695346	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	202000	BOY
EOY	710615	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	21242983	BOY
EOY	3977853	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	98026282	BOY
EOY	106754092	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	12123566	BOY
EOY	4880379	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
EOY	16464093	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	4631408	BOY
EOY	3507741	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	16754974	BOY
EOY	24852213	EOY

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

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	81245506	BOY
EOY	81866036	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	25802	BOY
EOY	35843	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	81271308	BOY
EOY	81901879	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	98026282	BOY
EOY	106754092	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	-3383493	ReconcilationRevenueExpenses
Reconcilation Other Changes	4014064	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited
Audit Committee	1	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

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

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

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

Contributor Name Business ContributorNameBusiness

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

Contributor Address US ContributorAddressUS

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

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

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	1	GrantsOtherOrganizations
Grants Other Organizations	$3,090	GrantsOtherOrganizationsAmount
Direct Contact Legislators	0	DirectContactLegislators
Rallies Demonstrations	1	RalliesDemonstrations
Rallies Demonstrations	$1,403	RalliesDemonstrationsAmount
Other Activities	0	OtherActivities
Total Lobbying Expenditures IIB	4493	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Schedule D IRS990ScheduleD

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	3141729	OtherCostOrOtherBasis
Book Value	3141729	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	65407654	OtherCostOrOtherBasis
Depreciation	14748202	Depreciation
Book Value	50659452	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	65442	OtherCostOrOtherBasis
Depreciation	64433	Depreciation
Book Value	1009	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	40902611	OtherCostOrOtherBasis
Depreciation	34849681	Depreciation
Book Value	6052930	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	12714308	OtherCostOrOtherBasis
Book Value	12714308	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	72569428	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescription	AmountAmount
OTHER LONG-TERM LIABILITIES	$298,027
ASSET RETIREMENT OBLIGATION	$711,000
LEASE PAYABLE	$3,769
DUE TO THIRD-PARTY	$1,666,879
DUE TO AFFILIATES	$280,104
DUE TO MSHA, NET	$547,962

Field	Value	IRS element (for citing)
Total Of Amounts	3507741	TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

Field	Value	IRS element (for citing)
Identifier	DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:	Identifier
Return Reference	PART X:	ReturnReference
Explanation	THE HOSPITAL 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 HOSPITAL. SOUTHWEST COMMUNITY HEALTH SERVICES (SWCH) IS A TAXABLE ENTITY AND ACCOUNTS FOR INCOME TAXES IN ACCORDANCE WITH FASB ASC 740, INCOME TAXES. AT JUNE 30, 2012, TAX RETURNS FOR FISCAL YEARS 2009 THROUGH 2011 ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE HOSPITAL HAD NO UNCERTAIN TAX POSITIONS AT JUNE 30, 2012 AND 2011. AS SUCH, NO INTEREST OR PENALTIES WERE RECOGNIZED IN THE CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS RELATED TO UNRECOGNIZED TAX BENEFITS.	Explanation

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	1	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent400	X	Pcent400
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	1	ExpensesExceededBudget
Unable To Provide Care	0	UnableToProvideCare
Annual Community Benefit Report	0	AnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1154375	TotalCommunityBenefitExpense
Net Community Benefit Expense	1154375	NetCommunityBenefitExpense
Percent Of Total Expense	0.02490	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	5705552	TotalCommunityBenefitExpense
Direct Offsetting Revenue	4055399	DirectOffsettingRevenue
Net Community Benefit Expense	1650153	NetCommunityBenefitExpense
Percent Of Total Expense	0.03560	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	6859927	TotalCommunityBenefitExpense
Direct Offsetting Revenue	4055399	DirectOffsettingRevenue
Net Community Benefit Expense	2804528	NetCommunityBenefitExpense
Percent Of Total Expense	0.06050	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	121735	TotalCommunityBenefitExpense
Net Community Benefit Expense	121735	NetCommunityBenefitExpense
Percent Of Total Expense	0.00260	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	170588	TotalCommunityBenefitExpense
Net Community Benefit Expense	170588	NetCommunityBenefitExpense
Percent Of Total Expense	0.00370	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	11321	TotalCommunityBenefitExpense
Net Community Benefit Expense	11321	NetCommunityBenefitExpense
Percent Of Total Expense	0.00020	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	303644	TotalCommunityBenefitExpense
Net Community Benefit Expense	303644	NetCommunityBenefitExpense
Percent Of Total Expense	0.00650	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	7163571	TotalCommunityBenefitExpense
Direct Offsetting Revenue	4055399	DirectOffsettingRevenue
Net Community Benefit Expense	3108172	NetCommunityBenefitExpense
Percent Of Total Expense	0.06700	PercentOfTotalExpense

Other Other

Field	Value	IRS element (for citing)
Total Community Building Expense	1305	TotalCommunityBuildingExpense
Net Community Building Expense	1305	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Total Community Building Expense	1305	TotalCommunityBuildingExpense
Net Community Building Expense	1305	NetCommunityBuildingExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$1,557,693	BadDebtExpenseAmount
Amount Attributable To	1090385	AmountAttributableTo
Amount Reimbursed By Medicare	13740016	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	13537115	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	202901	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost To Charge Ratio	X	CostToChargeRatio

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare
Number Of Hospital Facilities	2	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)

Facility NumberFacilityNumber	Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Licensed HospitalLicensedHospital	General Medical And SurgicalGeneralMedicalAndSurgical	Er24 HoursEr24Hours	OtherOther
SMYTH COUNTY COMMUNITY HOSPITAL
1	PO BOX 880	MARION	VA	24354	X	X	X	44-BEDS
FRANCIS MARION MANOR
2	100 FRANCIS MARION LANE	MARION	VA	24354				NURSING HOME

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (2 entries)

Hospital Facility NumberHospitalFacilityNumber	CHNA ConductedCHNAConducted	Community DefinitionCommunityDefinition	Community DemographicsCommunityDemographics	Existing ResourcesExistingResources	How Data ObtainedHowDataObtained	Community Health NeedsCommunityHealthNeeds	Other Health IssuesOtherHealthIssues	Identifying ProcessIdentifyingProcess	Consulting ProcessConsultingProcess	Needs Assessment ConductedNeedsAssessmentConducted	Take Into AccountTakeIntoAccount	Other FacilitiesOtherFacilities	CHNA Widely AvailableCHNAWidelyAvailable	Own WebsiteOwnWebsite	On RequestOnRequest	Adopt Implement StrategyAdoptImplementStrategy	Execute Implement StrategyExecuteImplementStrategy	Develop Community PlanDevelopCommunityPlan	Include Operational PlansIncludeOperationalPlans	Prioritize Health NeedsPrioritizeHealthNeeds	Prioritize ServicesPrioritizeServices	All Needs AddressedAllNeedsAddressed	Eligibility Criteria ExplainedEligibilityCriteriaExplained	Uses FPG FreeUsesFPGFree	FPG Free PercentFPGFreePercent	Uses FPG DiscountedUsesFPGDiscounted	FPG Discount PercentFPGDiscountPercent	Explains BasisExplainsBasis	Income LevelIncomeLevel	Asset LevelAssetLevel	Medical IndigencyMedicalIndigency	Uninsured DiscountUninsuredDiscount	Explains Application MethodExplainsApplicationMethod	Includes Publicity MeasuresIncludesPublicityMeasures	Posted On WebsitePostedOnWebsite	Posted In Emergency RoomPostedInEmergencyRoom	Posted In Admission OfficePostedInAdmissionOffice	Available On RequestAvailableOnRequest	Other PublicityOtherPublicity	Actions On NonpaymentActionsOnNonpayment	Collection ActivitiesCollectionActivities	Nondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicy	Used Other MethodUsedOtherMethod	Amounts Generally BilledAmountsGenerallyBilled	Gross ChargesGrossCharges
SMYTH COUNTY COMMUNITY HOSPITAL
1	1	X	X	X	X	X	X	X	X	11	1	1	1	X	X	X	X	X	X	X	X	0	1	1	200.000000000000	1	400.000000000000	1	X	X	X	X	1	1	X	X	X	X	X	1	0	1	X	0	0
FRANCIS MARION MANOR
2	1	X	X	X	X	X	X	X	X	11	1	1	1	X	X	X	X	X	X	X	X	0	1	1	200.000000000000	1	400.000000000000	1	X	X	X	X	1	1	X	X	X	X	X	1	0	1	X	0	0

Form990 Schedule H Part VI Form990ScheduleHPartVI (22 entries)

ExplanationExplanation	IdentifierIdentifier	Return ReferenceReturnReference
PART I, LINE 6A: MOUNTAIN STATES HEALTH ALLIANCE (MSHA) HAS HISTORICALLY PREPARED AND MADE PUBLIC A COMMUNITY BENEFIT REPORT TO INCLUDE INFORMATION FOR ALL OF THE HOSPITALS WITHIN THE HEALTH SYSTEM. DURING FY12, MSHA DID NOT ISSUE A COMMUNITY BENEFIT REPORT. HOWEVER, MSHA INTENDS TO PREPARE A COMMUNITY BENEFIT REPORT DURING FY13. SCCH, AS A MEMBER OF MSHA, IS INCLUDED IN MSHA'S REPORT.
PART I, LINE 7: A COST TO CHARGE RATIO WAS DERIVED FROM THE SCHEDULE H APPLICABLE WORKSHEETS, INCLUDING WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGES.
PART II: THE ACTIVITIES REPORTED IN PART II SEEK TO ACHIEVE SPECIFIED OBJECTIVES, INCLUDING: IMPROVING ACCESS TO HEALTH SERVICES, ENHANCING PUBLIC HEALTH, AND RELIEF OF GOVERNMENT BURDEN. THE ACTIVITIES ARE AVAILABLE TO THE GENERAL PUBLIC, FOCUSING ON LOW-INCOME CONSUMERS.
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.THE VICE PRESIDENT OF PATIENT FINANCIAL SERVICES AND CFO ESTIMATE THAT 70% 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 SCCH'S BAD DEBT ASSOCIATED WITH THOSE PATIENTS WHO MAY HAVE MET THE CRITERIA SET FORTH IN OUR FINANCIAL ASSISTANCE POLICY WITHOUT HAVING A COMPLETE 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 SCCH'S FY12 AUDITED FINANCIAL STATEMENT READS "NEW ACCOUNTING PRONOUNCEMENTS: IN JULY 2011, THE FASB ISSUED ACCOUNTING STANDARD UPDATE (ASU) 2011-07, PRESENTATION AND DISCLOSURE OF PATIENT SERVICE REVENUE, PROVISION FOR BAD DEBTS, AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR CERTAIN HEALTH CARE ENTITIES. THE ASU REQUIRES THE CHANGE OF PRESENTATION OF THE ESTIMATED PROVISION FOR BAD DEBTS IN THE CONSOLIDATED STATEMENTS OF OPERATIONS FROM AN OPERATING EXPENSE TO A DEDUCTION FROM PATIENT SERVICE REVENUE, NET OF CONTRACTUAL DEDUCTIONS AND DISCOUNTS, ALONG WITH ADDITIONAL DISCLOSURES ABOUT THE POLICIES FOR RECOGNIZING REVENUE AND ASSESSING BAD DEBTS, AND QUALITATIVE INFORMATION ABOUT CHANGES IN THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE HOSPITAL RETROACTIVELY ADOPTED ASU 2011-07 IN FISCAL YEAR 2012. THE ADOPTION OF ASU 2011-07 DID NOT HAVE A MATERIAL IMPACT ON THE CONSOLIDATED FINANCIAL STATEMENTS."THE FOOTNOTES TO THE AUDITED FINANCIAL STATEMENT REPORT THE AMOUNT OF ESTIMATED UNCOLLECTIBLE SELF-PAY 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.
PART III, LINE 8: MEDICARE ALLOWABLE COSTS WERE REPORTED USING SCCH'S FILED MEDICARE COST REPORT (C/R). THE C/R USES A COST TO CHARGE RATIO BASED ON A STEP DOWN METHOD. IN CARING FOR THE PATIENT, THERE ARE SEVERAL SERVICES THAT ARE CONSIDERED NON-ALLOWABLE SUCH AS: TRANSPORTATION OF A PATIENT, COMFORT ITEMS TO INCLUDE A TELEVISION, MAGAZINES, OR A TELEPHONE. ADDITIONAL NON-ALLOWABLE 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 NON-ALLOWABLE COSTS, SHOULD BE COUNTED AS A COMMUNITY BENEFIT AS THIS IS THE COST OF CARE FOR SERVING THE AGING POPULATION. AS A NOT-FOR-PROFIT 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, 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 SCCH TO REPORT THESE UNCOMPENSATED SERVICES AS A COMMUNITY BENEFIT ON THIS DOCUMENT. BY MAKING THIS CHANGE, NON-PROFIT PROVIDERS WILL BE ENCOURAGED TO SUSTAIN IMPORTANT CARE DELIVERY MODELS FOR OUR AGING POPULATION IN SPITE OF THE FACT IT IS SOMETIMES ECONOMICALLY INJURIOUS.
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 PATIENT'S 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 NON-CHARITY. IN ROUTINE CIRCUMSTANCES WHEN IT IS DETERMINED THAT A PATIENT HAS NOT RESPONDED TO REQUESTS FOR PAYMENT, 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 COLLECTION AGENCY IT CAN BE RETRACTED IF IT IS 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.
PART V, SECTION B, LINE 3: MSHA MET WITH TEN FOCUS GROUPS, EACH REPRESENTING ONE OF THE TEN HOSPITAL FACILITIES, INCLUDING SCCH, LOCATED IN NINE COUNTIES WITHIN MSHA'S CORE SERVICE AREA. EACH GROUP CONSISTED OF PUBLIC HEALTH LEADERS, NURSES, NON-PROFIT 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 COUNTY'S 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
PART V, SECTION B, LINE 3: MSHA MET WITH TEN FOCUS GROUPS, EACH REPRESENTING ONE OF THE TEN HOSPITAL FACILITIES, INCLUDING JMH, LOCATED IN NINE COUNTIES WITHIN MSHA'S CORE SERVICE AREA. EACH GROUP CONSISTED OF PUBLIC HEALTH LEADERS, NURSES, NON-PROFIT 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 COUNTY'S 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.	FRANCIS MARION MANOR
PART V, SECTION B, LINE 4: EACH HOSPITAL WITHIN THE MSHA SYSTEM COMPLETED A CHNA. FOR THOSE HOSPITALS 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 COUNTY COMMUNITY HOSPITAL AND NORTON COMMUNITY HOSPITAL ALSO HAS ONE COMMUNITY GROUP SURVEYED. THESE TWO COUNTIES SERVE SIMILAR COMMUNITIES AND HAVE SIMILAR HEALTH RANKINGS ACCORDING TO AMERICA'S HEALTH RANKINGS. EVEN THOUGH ONLY TWO COMMUNITY GROUPS SERVED ON BEHALF OF THE FOUR HOSPITALS LISTED, STATISTICAL DATA WAS COLLECTED FOR EACH INDIVIDUALLY.SCCH'S 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, RUSSELL COUNTY MEDICAL CENTER, SMYTH COUNTY COMMUNITY HOSPITAL, DICKENSON COMMUNITY HOSPITAL, AND NORTON COMMUNITY HOSPITAL.	SMYTH COUNTY COMMUNITY HOSPITAL
PART V, SECTION B, LINE 4: EACH HOSPITAL WITHIN THE MSHA SYSTEM COMPLETED A CHNA. FOR THOSE HOSPITALS 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 COUNTY COMMUNITY HOSPITAL AND NORTON COMMUNITY HOSPITAL ALSO HAS ONE COMMUNITY GROUP SURVEYED. THESE TWO COUNTIES SERVE SIMILAR COMMUNITIES, AND HAVE SIMILAR HEALTH RANKINGS ACCORDING TO AMERICA'S HEALTH RANKINGS. EVEN THOUGH ONLY TWO COMMUNITY GROUPS SERVED ON BEHALF OF THE FOUR HOSPITALS LISTED, STATISTICAL DATA WAS COLLECTED FOR EACH INDIVIDUALLY.JMH'S 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, RUSSELL COUNTY MEDICAL CENTER, SMYTH COUNTY COMMUNITY HOSPITAL, DICKENSON COMMUNITY HOSPITAL, AND NORTON COMMUNITY HOSPITAL.	FRANCIS MARION MANOR
PART V, SECTION B, LINE 7: MSHA PUBLISHED ITS COMMUNITY HEALTH NEEDS ASSESSMENT ON JUNE 29 OF FY 12. THE DATA INCLUDED WAS COLLECTED OVER THE COURSE OF 2011 AND 2012. AN IMPLEMENTATION PLAN WAS CREATED FOR EACH HOSPITAL, AND EACH HOSPITAL'S 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 THE MSHA FACILITIES WERE UNABLE TO ADDRESS ISSUES THAT WERE IDENTIFIED.	SMYTH COUNTY COMMUNITY HOSPITAL
PART V, SECTION B, LINE 7: MSHA PUBLISHED ITS COMMUNITY HEALTH NEEDS ASSESSMENT ON JUNE 29 OF FY 12. THE DATA INCLUDED WAS COLLECTED OVER THE COURSE OF 2011 AND 2012. AN IMPLEMENTATION PLAN WAS CREATED FOR EACH HOSPITAL, AND EACH HOSPITAL'S 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.	FRANCIS MARION MANOR
PART V, SECTION B, LINE 13G: DURING THE ADMISSION PROCESS, PATIENTS ARE TOLD THAT THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY AND ADMISSION PAPERS ARE GIVEN TO EACH PATIENT ADVISING 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
PART V, SECTION B, LINE 13G: 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.	FRANCIS MARION MANOR
PART V, SECTION B, 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.	SMYTH COUNTY COMMUNITY HOSPITAL
PART V, SECTION B, LINE 19D: UNINSURED PATIENTS RECEIVE A 50% DISCOUNT; AND, BASED ON OTHER FACTORS SUCH AS INCOME OR MEDICAL INDIGENCY, MAY QUALIFY FOR AS ADDITIONAL DISCOUNT.	FRANCIS MARION MANOR
PART VI, LINE 2: MSHA INCLUDED AMERICA'S 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 MSHA FACILITIES ARE LOCATED) CLOSELY RESEMBLES THE HEALTH RANKINGS FOR TENNESSEE. AMERICA'S 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, NON-PROFIT 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 SMOKE-FREE AREAS, PARTNER WITH LOCAL FARMER'S MARKETS, SHARE HEALTH INFORMATION BETWEEN PHARMACIES, NETWORK WITH SMALL BUSINESSES AND NON-PROFITS IN ORDER TO AVOID DUPLICATING RESOURCES, AND PROVIDE EARLY SCREENINGS FOR THE UNINSURED OR UNDERINSURED. OVERALL, THE COMMUNITY MEMBERS GAVE MSHA'S CORE SERVICE AREA A HEALTH STATUS RANKING OF 4.24 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.
PART VI, LINE 3: SCCH PROVIDES COMMUNICATION OF FINANCIAL ASSISTANCE ON ITS WEB SITE AND ON POSTERS PLACED IN PROMINENT AREAS SUCH AS ADMITTING AREAS, EMERGENCY DEPARTMENTS AND PATIENT PAYMENT (CASHIER) LOCATIONS. PRINTED EDUCATIONAL MATERIALS INCLUDING FINANCIAL ASSISTANCE CONTACT INFORMATION ARE ALSO PROVIDED IN THE PATIENT'S ADMITTING PAPERWORK. POSTERS AND REFERENCE MATERIALS ARE WRITTEN IN BOTH ENGLISH AND SPANISH. ADMITTING STAFF ARE TRAINED TO EDUCATE PATIENTS ON SCCH'S FINANCIAL ASSISTANCE POLICY. SCCH ALSO HAS FINANCIAL COUNSELORS WHICH COMMUNICATE THE PATIENT'S FINANCIAL RESPONSIBILITY PRIOR TO SERVICE AS WELL AS PROVIDE EDUCATION ON SCCH'S 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 SELF-PAYING PATIENTS WHO HAVE LIMITED FINANCIAL RESOURCES. FIRSTSOURCE SOLUTIONS USA DETERMINES A PATIENT'S ELIGIBILITY IN MEDICAL COVERAGE OPTIONS AND ASSISTS WITH THEIR ENROLLMENT. SCCH BEARS THE COST FOR THE FIRSTSOURCE SOLUTIONS USA PROGRAM.
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 TENNSSEE 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 WAS 31,718 IN 2012 AND, ACCORDING TO THE U.S. CENSUS BUREAU, MARION HAS A POPULATION OF 5,936. THE MEDIAN AGE OF RESIDENTS OF SMYTH COUNTY IS 40, WHICH IS OLDER THAN THE MEDIAN AGE OF 36.8 IN THE UNITED STATES. SMYTH COUNTY HAS A MEDIAN HOUSEHOLD INCOME OF $34,533, WHICH IS WELL BELOW $52,762, THE MEDIAN HOUSEHOLD INCOME OF THE U.S. IT IS ESTIMATED THAT 20.3% OF SMYTH COUNTY'S RESIDENTS LIVE IN POVERTY COMPARED TO 10.7% STATEWIDE.
PART VI, LINE 5: THE MAJORITY OF SCCH'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA. PHYSICIANS THAT REQUEST PRIVILEGES WHO ARE QUALIFIED AND CREDENTIALED ARE EXTENDED PRIVILEGES BY SCCH.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.
PART VI, LINE 6: SCCH IS A 44-BED, ACUTE CARE FACILITY OPERATED UNDER THE DIRECTION OF A 13-MEMBER BOARD OF DIRECTORS PRIMARILY COMPRISED OF LOCAL COMMUNITY RESIDENTS. ADDITIONALLY, SCCH HAS A 109-BED 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 COUNTY'S PRIMARY HEALTH SERVICE PROVIDER. PATIENTS BENEFIT FROM SCCH'S 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 SYSTEM'S FLAGSHIP FACILITY, JOHNSON CITY MEDICAL CENTER, WHICH IS A TERTIARY CARE FACILITY PROVIDING ADVANCED TREATMENT OPTIONS.
VA	REPORTS FILED WITH STATES	PART VI, LINE 7

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	1	RecordsMaintained

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	PROCEDURE FOR MONITORING GRANTS IN THE U.S.:	Identifier
Return Reference	PART I, LINE 2:	ReturnReference
Explanation	SCHEDULE I, PART I, LINE 2: THE ORGANIZATION HAS GUIDELINES IN PLACE THAT ARE TO BE USED IN REVIEWING THE ELIGIBILITY OF GRANTEES. ALL GRANTS REQUIRE WRITTEN DOCUMENTATION AND APPROPRIATE LEVELS OF APPROVAL.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Club Dues Or Fees	X	ClubDuesOrFees
Written Policy Re T And E Expenses	1	WrittenPolicyReTAndEExpenses
Substantiation Required	1	SubstantiationRequired
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	1	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)

Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
ANN FLEMING
0	345309	0	116778	0	39233	0	47553	0	19175	0	568048	0	0
CINDY SALYER
0	179125	0	58693	0	4076	0	20647	0	22306	0	284847	0	0
JOHN SCHARIO
0	151737	0	0	0	30182	0	15358	0	9534	0	206811	0	0
LINDA WHITE
0	181225	0	54962	0	12457	0	20600	0	18563	0	287807	0	0
JOHN JETER
0	128011	0	7225	0	6041	0	3955	0	17017	0	162249	0	0
MATTHEW JUSTUS
0	204637	0	0	0	0	0	4822	0	522	0	209981	0	0
PAMELA DELOACH
0	188287	0	500	0	0	0	6324	0	8994	0	204105	0	0
SAMUEL SMALL
0	174850	0	250	0	0	0	5314	0	7127	0	187541	0	0
ANTONIO DE LA ROSA
0	126514	0	0	0	21863	0	7761	0	13326	0	169464	0	0
BELDON FLEMING
0	136781	0	1575	0	0	0	7010	0	16288	0	161654	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
PART I, LINE 1A	FIRST-CLASS OR CHARTER TRAVEL IS NOT A COVERED TRAVEL EXPENSE FOR EXECUTIVES; THEY ARE LIMITED TO BUSINESS OR COACH CLASS FARES ON COMMERCIAL FLIGHTS.
PART I, LINE 4B	PART I, LINE 4B: SEVERANCE NON-QUALIFIED EQUITY-BASED ANN FLEMING 0 35,303 0 CINDY SALYER 0 9,411 0 JOHN SCHARIO 0 15,358 0 LINDA WHITE 0 9,364 0 THE ABOVE INDIVIDUALS 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.
PART III	PART I, LINE 3 CEO 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.	SUPPLEMENTAL INFORMATION

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
BETTY KIRK
FAMILY MEMBER OF JIM BEAR	76057	JIM BEAR, SCCH BOARD TREASURER, IS A FAMILY MEMBER OF BETTY KIRK, AN EMPLOYEE OF SCCH.	0
REBECCA SPARGER
FAMILY MEMBER OF JAMES PATTERSON, M.D.	26495	JAMES PATTERSON, M.D., SCCH BOARD MEMBER, IS A FAMILY MEMBER OF REBECCA SPARGER, AN EMPLOYEE OF SCCH.	0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
FORM 990, PART VI, SECTION A, 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.
FORM 990, PART VI, SECTION A, LINE 7A	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.
FORM 990, PART VI, SECTION A, 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.
FORM 990, PART VI, SECTION B, LINE 11	THE FORM 990, WHICH WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM, WAS REVIEWED BY FINANCIAL MANAGEMENT PRIOR TO FILING. COPIES OF THE RETURN WERE MADE AVAILABLE TO THE BOARD TRUSTEES.
FORM 990, PART VI, SECTION B, LINE 12C	ANNUALLY, THE AUDIT AND COMPLIANCE DEPARTMENT PROVIDES THE POLICY AND 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 RETURN THE FORMS 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 THEY ENGAGE IN A CONFLICTED TRANSACTION.
FORM 990, PART VI, SECTION B, LINE 15	LINE 15A - COMPENSATION PROCESS FOR TOP OFFICIAL THE CEO COMPENSATION IS SUBJECT TO THE 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, JUST LIKE ANY OTHER MSHA EXECUTIVE BELOW THE MSHA CEO AND CFO LEVEL. LINE 15B - COMPENSATION PROCESS FOR OFFICERS 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.
FORM 990, PART VI, SECTION C, LINE 19	GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE 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.
FORM 990, PART VII, SECTION A,	HOSPITAL BOARD OF TRUSTEES MEMBERS ANN FLEMING, CHELSEA HAMANN, JOHN SCHARIO, CINDY SALYER, JIM PATTERSON, M.D., AND JIM MCDOWELL, M.D. HAVE FORM 990 REPORTABLE RELATED COMPENSATION DERIVED FROM SERVICES THEY PROVIDED TO RELATED ORGANIZATIONS. THEY DO NOT RECEIVE COMPENSATION FOR SERVICES AS HOSPITAL BOARD TRUSTEES.	TRUSTEE COMPENSATION:
FORM 990, PART XI, LINE 5:	WRITE-OFF OF INTERCOMPANY DEBT 5,086,979. CHANGE IN TEMP. RESTRICTED NET ASSETS 10,041. PARTNERSHIP INCOME NOT ON BOOKS -110,578. NET UNREALIZED LOSSES ON INVESTMENTS -1,012,082. PRIOR PERIOD ADJUSTMENTS 39,704. TOTAL TO FORM 990, PART XI, LINE 5: 4,014,064.	CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Direct Controlling Entity NADirectControllingEntityNA	Controlled OrgControlledOrg	Business Name Line1DirectControllingEntityName/BusinessNameLine1
MOUNTAIN STATES HEALTH ALLIANCE
400 N STATE OF FRANKLIN ROAD	JOHNSON CITY	TN	37604	620476282	HOSPITAL	TN	501(C)(3)	LINE 3	N/A	0
SMYTH COUNTY COMM FOUNDATION
1 HEALTH WAY	MARION	VA	24354	311650055	SUPPORTING ORGANIZATION TO SCCH	VA	501(C)(3)	LINE 11A, I	N/A	0
NORTON COMMUNITY HOSPITAL
100 15TH STREET NORTHWEST	NORTON	VA	24273	540566029	HOSPITAL	VA	501(C)(3)	LINE 3	N/A	0
DICKENSON COMMUNITY HOSPITAL
ONE HOSPITAL DRIVE	CLINTWOOD	VA	24228	770599553	HOSPITAL	VA	501(C)(3)	LINE 3		0	NORTON COMMUNITY HOSPITAL
JOHNSTON MEMORIAL HOSPITAL
16000 JOHNSTON MEMORIAL DRIVE	ABINGDON	VA	24211	540544705	HOSPITAL	VA	501(C)(3)	LINE 3	N/A	0
ABINGDON PHYSICIAN PARTNERS
16000 JOHNSTON MEMORIAL DRIVE	ABINGDON	VA	24211	205485346	MEDICAL SERVICES	VA	501(C)(3)	LINE 11A, I		0	JOHNSTON MEMORIAL HOSPITAL
MOUNTAIN STATES FOUNDATION
2335 KNOB CREEK ROAD STE 101	JOHNSON CITY	TN	37604	581418862	FUNDRAISING FOR MSHA HOSPITALS	TN	501(C)(3)	LINE 11A, I		0	MOUNTAIN STATES HEALTH ALLIANCE
MSHA AUXILIARY
400 N STATE OF FRANKLIN ROAD	JOHNSON CITY	TN	37604	581418345	SUPPORTING ORGANIZATION TO MSHA HOSPITALS	TN	501(C)(3)	LINE 11A, I	N/A	0

Form990 Schedule R Part III Form990ScheduleRPartIII (3 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Direct Controlling Entity NADirectControllingEntityNA	Predominant Income TypePredominantIncomeType	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Disproportionate AllocationsDisproportionateAllocations	General Or Managing PartnerGeneralOrManagingPartner	Percentage OwnershipPercentageOwnership
INTEGRATED SOLUTIONS HEALTH NETWORK LLC
400 N STATE OF FRANKLIN ROAD	JOHNSON CITY	TN	37604	621711997	INVESTMENT COMPANY	TN	N/A	(D)	-5125	3440	0	0	0.00050
EMMAUS COMMUNITY HEALTHCARE PLLC
6070 HWY 11E	PINEY FLATS	TN	37686	200577483	MEDICAL SERVICES	TN	N/A
MEDICAL SPECIALISTS OF JOHNSON CITY LLC
2528 WESLEY STREET STE 2	JOHNSON CITY	TN	37604	272199037	MEDICAL SERVICES	TN	N/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (9 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Direct Controlling Entity NADirectControllingEntityNA	Type Of EntityTypeOfEntity	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Percentage OwnershipPercentageOwnership
SOUTHWEST COMMUNITY HEALTH SERVICES
PO BOX 880	MARION	VA	24354	541460695	HEALTH SERVICES	VA	N/A	C	354538	1327420	1.00000
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
1021 W OAKLAND AVENUE STE 207	JOHNSON CITY	TN	37604	621490616	PHYSICIAN OFFICES	TN	N/A	C
MEDISERVE MEDICAL EQUIP OF KINGSPORT
1021 W OAKLAND AVENUE STE 207	JOHNSON CITY	TN	37604	621212286	DURABLE MEDICAL EQUIPMENT	TN	N/A	C
MOUNTAIN STATES PROPERTIES
1021 W OAKLAND AVENUE STE 207	JOHNSON CITY	TN	37604	621845895	PROPERTY MANAGEMENT	TN	N/A	C
MOUNTAIN STATES PHYSICIAN GROUP
1019 W OAKLAND AVENUE STE 207	JOHNSON CITY	TN	37604	621700412	HEALTHCARE SERVICES	TN	N/A	C
COMMUNITY HOME CARE INC
1460 PARK AVENUE	NORTON	VA	24273	541453810	MEDICAL PRODUCTS	VA	N/A	C
COMMUNITY PHYSICIANS SERV CORP
100 15TH STREET NW	NORTON	VA	24273	541641446	PHYSICIAN SERVICES	VA	N/A	C
WILSON PHARMACY INC
PO BOX 5289	JOHNSON CITY	TN	37602	620329587	PHARMACY	TN	N/A	C
CRESTPOINT HEALTH INSURANCE CO
208 SUNSET DRIVE SUITE 101	JOHNSON CITY	TN	37604	620381170	INSURANCE	TN		C

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	1	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	0	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	0	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	0	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	0	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	0	PerformOfServicesByOtherOrgs
Sharing Of Facilities	0	SharingOfFacilities
Sharing Of Paid Employees	1	SharingOfPaidEmployees
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	0	OtherTransferToOtherOrg
Other Transfer From Other Org	0	OtherTransferFromOtherOrg