MOUNTAIN STATES HEALTH ALLIANCE: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization: MOUNTAIN STATES HEALTH ALLIANCE (EIN 62-0476282)
Tax period: 2010-07-01 to 2011-06-30
Filed: 2012-05-08
IRS object ID: 201221299349300512
Schema version: 2010v3.4
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 K
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2012-05-08T08:11:19-05:00	Timestamp
Tax Period End Date	2011-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	PERSHING YOAKLEY & ASSOCIATES P C	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	2010-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	620476282	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	MOUNTAIN STATES HEALTH ALLIANCE	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	MOUN	NameControl
Phone	4233023372	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	400 NORTH STATE OF FRANKLIN ROAD	AddressLine1
City	JOHNSON CITY	City
State	TN	State
ZIP Code	37604	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	MARVIN EICHORN	Name
Title	SR VP/CFO	Title
Phone	4233023372	Phone
Date Signed	2012-04-30	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

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

Field	Value	IRS element (for citing)
Tax Year	2010	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

Field	Value	IRS element (for citing)
Business Name Line1	JOHNSON CITY MEDICAL CENTER	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	DENNIS VONDERFECHT	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	701 NSTATE OF FRANKLIN RD STE 1	AddressLine1
City	JOHNSON CITY	City
State	TN	State
ZIP Code	37604	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	729709747	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.MSHA.COM	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1945	YearFormation
State Legal Domicile	TN	StateLegalDomicile
Activity Or Mission Description	PLEASE SEE SCHEDULE O - PART I, LINE 1, MISSION AND SIGNIFICANT ACTIVITIES.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	13	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	7	NbrIndependentVotingMembers
Total Nbr Employees	8870	TotalNbrEmployees
Total Nbr Volunteers	1759	TotalNbrVolunteers
Total Gross UBI	3543768	TotalGrossUBI
Net Unrelated Business Txbl Income	174903	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	3938777	ContributionsGrantsPriorYear
Contributions Grants Current Year	3143661	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	674850480	ProgramServiceRevenuePriorYear
Program Service Revenue CY	703882320	ProgramServiceRevenueCY
Investment Income Prior Year	16043398	InvestmentIncomePriorYear
Investment Income Current Year	15682301	InvestmentIncomeCurrentYear
Other Revenue Prior Year	6999981	OtherRevenuePriorYear
Other Revenue Current Year	6648445	OtherRevenueCurrentYear
Total Revenue Prior Year	701832636	TotalRevenuePriorYear
Total Revenue Current Year	729356727	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	301136	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	357333	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	287264466	SalariesEtcPriorYear
Salaries Etc Current Year	301399812	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	1534772	TotalFundrsngExpCurrentYear
Other Expense Prior Year	370493266	OtherExpensePriorYear
Other Expenses Current Year	377644976	OtherExpensesCurrentYear
Total Expenses Prior Year	658058868	TotalExpensesPriorYear
Total Expenses Current Year	679402121	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	43773768	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	49954606	RevenuesLessExpensesCY
Total Assets BOY	1530090739	TotalAssetsBOY
Total Assets EOY	1573869411	TotalAssetsEOY
Total Liabilities BOY	1311074327	TotalLiabilitiesBOY
Total Liabilities EOY	1268238796	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	219016412	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	305630615	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	MOUNTAIN STATES HEALTH ALLIANCE IS COMMITTED TO BRINGING LOVING CARE TO HEALTH CARE. WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTH CARE NEEDS OF INDIVIDUALS AND COMMUNITIES IN OUR REGION AND TO ASSIST THEM IN ATTAINING THEIR HIGHEST POSSIBLE LEVEL OF HEALTH.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	548973782	Expense
Grants	357333	Grants
Revenue	704105247	Revenue
Description	MOUNTAIN STATES HEALTH ALLIANCE (MSHA) WAS CREATED IN SEPTEMBER 1998 AS A PRIVATE, LOCALLY OWNED, TAX-EXEMPT, REGIONAL HEALTHCARE SYSTEM. MSHA IS A 1,200 BED TERTIARY-CARE AND REFERRAL HOSPITAL SYSTEM, THE REGION'S LARGEST BY BED COUNT AND VOLUMES. FOR THE YEAR ENDING JUNE 30, 2011, MSHA RECORDED 48,180 INPATIENT ADMISSIONS, AND PROVIDED FOR 720,772 OUTPATIENT VISITS, INCLUDING 145,390 EMERGENCY VISITS AND 94,251 HOME HEALTH VISITS. THE ALLIANCE IS COMPOSED OF 8 HOSPITALS, AN OUTPATIENT SURGERY CENTER, AN OUTPATIENT RADIATION ONCOLOGY CENTER, TWO OUTPATIENT DIAGNOSTIC CENTERS AND TWO OUTPATIENT REHABILITATION THERAPY CENTERS. IT ALSO HAS SERVICES FOR HOME HEALTH, DURABLE MEDICAL EQUIPMENT, INFUSION THERAPY, HOSPICE AND PARISH NURSING. FRANKLIN WOODS COMMUNITY HOSPITAL (FWCH) LICENSED FOR 80 BEDS, OPENED IN JULY 2010, REPLACING OPERATIONS AT NORTH SIDE HOSPITAL (NSH) AND JOHNSON CITY SPECIALTY HOSPITAL (JCSH). NSH AND JCSH WERE LICENSED FOR 91 BEDS AND 23 BEDS, RESPECTIVELY, PRIOR TO THE OPENING OF FWCH AND A TOTAL OF 64 BEDS WERE TRANSFERRED WITHIN THE ALLIANCE.MSHA ENTITIES, IN CONCERT WITH THE MOUNTAIN STATES HEALTHCARE NETWORK OF 54 AFFILIATED HOSPITALS AND NURSING HOMES, PROVIDE AN INTEGRATED, COMPREHENSIVE CONTINUUM OF CARE TO RESIDENTS ACROSS A WIDESPREAD, PREDOMINANTLY RURAL 29-COUNTY AREA OF APPALACHIA. THE SERVICE AREA INCLUDES PARTS OF NORTHEAST TENNESSEE, SOUTHWEST VIRGINIA, SOUTHEAST KENTUCKY AND WESTERN NORTH CAROLINA. ALL 8 MSHA HOSPITALS ARE LOCATED IN NORTHEAST TENNESSEE AND SOUTHWEST VIRGINIA. JOHNSON CITY MEDICAL CENTER, THE COMPANY'S FLAGSHIP FACILITY, IS HOME TO MANY OF THE REGION'S CRITICALLY NEEDED PROGRAMS. MSHA ALSO HAS A MAJORITY OWNERSHIP IN SMYTH COUNTY COMMUNITY HOSPITAL (SCCH) LOCATED IN MARION, VA, NORTON COMMUNITY HOSPITAL (NCH), LOCATED IN NORTON, VA, DICKENSON COMMUNITY HOSPITAL (DCH), LOCATED IN CLINTWOOD, VA, AND JOHNSTON MEMORIAL HOSPITAL (JMH), LOCATED IN ABINGDON, VA. BECAUSE SCCH, NCH, DCH AND JMH ARE PARTIALLY OWNED ENTITIES, THEIR DATA ARE EXCLUDED FROM THIS DOCUMENT AND EACH OF THESE HOSPITALS FILE A SEPARATE FORM 990. WASHINGTON COUNTY, TN: JOHNSON CITY MEDICAL CENTER (JCMC) FLAGSHIP FACILITY: - TEACHING HOSPITAL AFFILIATED WITH QUILLEN COLLEGE OF MEDICINE AT EAST TENNESSEE STATE UNIVERSITY (ETSU)- LEVEL I TRAUMA CENTER - ONE OF ONLY SIX IN TENNESSEE - HOME OF THE REGIONAL CANCER CENTER- HOME OF THE REGION'S ONLY ORGAN TRANSPLANT PROGRAM - ONE OF ONLY SIX IN TENNESSEE- HOME TO NISWONGER CHILDREN'S HOSPITAL, WHICH ALSO OFFERS THE ST. JUDE TRI-CITIES AFFILIATE CLINIC, ONE OF ONLY SIX SUCH CLINICS IN THE COUNTRY, WORKING WITH THE MEMPHIS FACILITY TO TREAT PEDIATRIC PATIENTS IN OUR REGION. AND, THE REGION'S ONLY NACHRI-AFFILIATED CHILDREN'S HOSPITAL- HOME OF THE REGION'S ONLY STATE-DESIGNATED PERINATAL CENTER - ONE OF ONLY FIVE IN TENNESSEE- HOME OF THE REGION'S FIRST AND LARGEST AIR AMBULANCE FLEET, WINGS AIR RESCUE- FIRST HOSPITAL IN TENNESSEE AWARDED MAGNET STATUS FOR NURSING EXCELLENCE BY AMERICAN NURSES CREDENTIALING CENTER- 2001-2011 CONSUMER'S CHOICE AWARD FOR THE REGION THROUGH AN INDEPENDENT SURVEY CONDUCTED BY THE NATIONAL RESEARCH COUNCIL: BEST OVERALL QUALITY, BEST DOCTORS, BEST NURSES, MOST PERSONALIZED CARE AND HAVING THE BEST REPUTATIONOTHER JCMC HOSPITALS; JAMES H. & CECILE C. QUILLEN REHABILITATION HOSPITAL (CARF-ACCREDITED) AND WOODRIDGE HOSPITAL FOR BEHAVIORAL HEALTH SERVICES.FRANKLIN WOODS COMMUNITY HOSPITAL (FWCH) OPENED ITS DOORS IN THE SUMMER OF 2010 AS A REPLACEMENT HOSPITAL FOR 2 AGING WASHINGTON COUNTY FACILITIES. FWCH WAS THE FIRST "LEED" CERTIFIED HOSPITAL IN TENNESSEE AND HAS SET THE PRECEDENT FOR ENVIRONMENTALLY FRIENDLY DESIGNS. SULLIVAN COUNTY, TN: INDIAN PATH MEDICAL CENTERCARTER COUNTY, TN: SYCAMORE SHOALS HOSPITALJOHNSON COUNTY, TN: JOHNSON COUNTY COMMUNITY HOSPITAL, A FEDERALLY DESIGNATED CRITICAL ACCESS HOSPITAL LOCATED IN ONE OF TENNESSEE'S POOREST COUNTIES, A MEDICALLY UNDERSERVED AREARUSSELL COUNTY, VA: RUSSELL COUNTY MEDICAL CENTER MSHA WAS AWARDED THE GOVERNOR'S EXCELLENCE AWARD BY THE TENNESSEE CENTER FOR PERFORMANCE EXCELLENCE (TNCPE) IN 2009. MSHA WAS ALSO THE RECIPIENT OF THIS ESTEEMED AWARD IN 2005 AND IS THE FIRST HEALTHCARE RECIPIENT TO BE RECOGNIZED TWICE, AND ONLY THE SECOND ORGANIZATION IN THE HISTORY OF TNCPE TO BE RECOGNIZED AT THIS TOP LEVEL MORE THAN ONCE. THREE MSHA HOSPITALS WERE RECOGNIZED AS TOP PERFORMERS ON KEY QUALITY MEASURES AS DEFINED BY THE JOINT COMMISSION, THE LEADING ACCREDITOR OF HEALTH CARE ORGANIZATIONS IN THE UNITED STATES. FRANKLIN WOODS COMMUNITY HOSPITAL, INDIAN PATH MEDICAL CENTER AND RUSSELL COUNTY MEDICAL CENTER WERE RECOGNIZED BY THE JOINT COMMISION BASED ON DATA REPORTED ABOUT EVIDENCE-BASED CLINICAL PROCESSES THAT ARE SHOWN TO IMPROVE CARE FOR CERTAIN CONDITIONS, INCLUDING HEART ATTACK, HEART FAILURE, PNEUMONIA, SURGICAL CARE AND CHILDREN'S ASTHMA. THESE THREE HOSPITALS ARE AMONG ONLY 405 U.S. HOSPITALS EARNING THE DISTINCTION OF "TOP PERFORMER ON KEY QUALITY MEASURES". JOHNSON CITY MEDICAL CENTER (JCMC) WAS RECOGNIZED BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES AND THE SOCIETY OF CRITICAL CARE MEDICINE WITH AN OUTSTANDING LEADERSHIP AWARD FOR THE HOSPITAL'S ACHIEVEMENT IN PREVENTING VENTILATOR-ASSOCIATED PNEUMONIA. JCMC WAS ONE OF ONLY SIX HOSPITALS IN THE NATION RECOGNIZED FOR OUTSTANDING LEADERSHIP IN PREVENTING VENTILATOR-ASSOCIATED PNEUMONIA (VAP). THE VAP RATE AT JCMC IS NOW ONE-THIRD OF WHAT IS TYPICALLY FOUND IN HOSPITALS OF A SIMILAR SIZE AND PATIENT POPULATION. ICU TEAMS AT JCMC BEGAN A PROJECT IN 2006 DESIGNED TO TARGET VAP INFECTIONS. THE OUTSTANDING LEADERSHIP AWARD REQUIRES A HOSPITAL TO REACH THEIR INFECTION TARGETS FOR 25 MONTHS OR MORE. FOR THE SECOND YEAR IN A ROW, JOHNSON CITY MEDICAL CENTER HAS BEEN AWARDED TWO GOLD MEDALS BY THE AMERICAN HEART ASSOCIATION, WHILE TWO OTHER MSHA FACILITIES EACH RECEIVED THEIR FIRST AHA GOLD AWARDS. THESE AHA AWARDS WERE SPOTLIGHTED IN THE JULY 2010 EDITION OF U.S. NEWS AND WORLD REPORT. JCMC RECEIVED ITS SECOND GOLD IN TREATMENT OF BOTH HEART FAILURE AND CORONARY ARTERY DISEARSE IN AS MANY YEARS. JCMC WAS THE ONLY HOSPITAL IN TENNESSEE TO ACHIEVE THE HONOR OF TWO GOLDS OVER A TWO-YEAR PERIOD IN THESE CATEGORIES. IPMC AND SSH EACH RECEIVED THEIR FIRST GOLD AWARDS IN THE TREATMENT OF HEART FAILURE. TO ACHIEVE A GOLD AWARD, A HOSPITAL MUST MEET OR EXCEED BEST PRACTICE GUIDELINES WITH A MINIMUM 85% COMPLIANCE FOR AT LEAST 24 MONTHS. MSHA FACILITIES HAVE STEADILY IMPROVED IN THE AHA'S RANKINGS OVER THE YEARS AND WERE THE ONLY HOSPITALS IN THE REGION TO RECEIVE THIS RECOGNITION. A DOCUMENTARY ON THE HISTORY OF JOHNSON CITY MEDICAL CENTER WON GOLD IN THE MARCOM AWARDS, AN INTERNATIONAL COMPETITION FOR INDIVIDUALS AND COMPANIES INVOLVED IN THE CONCEPT, WRITING AND DESIGN OF PRINT, VISUAL, AUDIO AND WEB MATERIALS. THERE WERE MORE THAN 6,000 ENTRIES THROUGHOUT THE UNITED STATES, CANADA AND OTHER COUNTRIES IN THE 2011 COMPETITION. THE DOCUMENTARY FOCUSED ON 100 YEARS OF HEALTH CARE AT JCMC. AUDIT AND COMPLIANCE PRACTICES: MSHA IS GOVERNED BY A BOARD OF DIRECTORS, WHOSE MEMBERS ARE FROM THE COMMUNITIES MSHA SERVES. THE CORPORATE BOARD INCLUDES A LONGSTANDING AUDIT AND COMPLIANCE COMMITTEE. ALL AUDITORS AND COMPLIANCE SPECIALISTS, INTERNAL AND EXTERNAL, REPORT DIRECTLY TO THE AUDIT AND COMPLIANCE COMMITTEE AS A WAY TO ENSURE THE AUDIT AND COMPLIANCE PROCESS IS INDEPENDENT. - MSHA'S COMPLIANCE PLAN ENSURES THE ORGANIZATION CONDUCTS BUSINESS IN AN APPROPRIATE MANNER AND IN ACCORDANCE WITH LOCAL, STATE AND FEDERAL LAWS AND REGULATIONS. THE PLAN ADDRESSES FISCAL ACCOUNTABILITY AND TRANSPARENCY OF OPERATIONS THROUGH THE REVIEW AND USE OF INDEPENDENT AUDITS BY EXTERNAL AUDITORS AND RATING AGENCIES. - UPON EMPLOYMENT, MSHA TEAM MEMBERS RECEIVE A COPY OF THE BOOKLET "CODE OF ETHICS AND BUSINESS CONDUCT", DETAILING REQUIRED STANDARDS OF BEHAVIOR. YEARLY, TEAM MEMBERS RECEIVE REFRESHER EDUCATION ON THEIR OBLIGATIONS UNDER THE CODE OF ETHICS AND BUSINESS CONDUCT. - ANNUALLY, DEPARTMENT DIRECTORS, EXECUTIVE OFFICERS AND BOARD MEMBERS ARE REQUIRED TO SIGN MSHA'S CONFLICT OF INTEREST POLICY. BY SIGNING THIS POLICY, THEY AFFIRM THEIR KNOWLEDGE AND UNDERSTANDING OF THE POLICY AND ALSO HAVE THE OPPORTUNITY TO DISCLOSE ANY CONFLICT OF INTEREST THEY MAY HAVE. ALL TEAM MEMBERS ARE REQUIRED BY POLICY TO IMMEDIATELY DISCLOSE SITUATIONS THAT MAY CONSTITUTE CONFLICTS OF INTEREST WHEN THEY ARISE. - MSHA IS FULLY COMPLIANT WITH REGULATORY AND LEGAL REQUIREMENTS, AND ITS HOSPITALS ARE ACCREDITED BY THE JOINT COMMISSION.	Description
Total Program Service Expense	548973782	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
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	1	ReportProgRelInvest
Report Other Assets	1	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	1	TaxExemptBonds
Invest Tax Exempt Bonds	1	InvestTaxExemptBonds
Escrow Account	0	EscrowAccount
On Behalf Of Issuer	0	OnBehalfOfIssuer
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	1	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	1	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	1	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	1	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	719	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	8870	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
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	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	13	NbrVotingGoverningBodyMembers
Number Independent Voting Members	7	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	1	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	1	LocalChapters
Policies Reference Chapters	1	PoliciesReferenceChapters
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	1	InvestmentInJointVenture
Written Policy Or Procedure	1	WrittenPolicyOrProcedure
States Where Copy Of Return Is Filed	VA	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

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

Field	Value	IRS element (for citing)
Telephone Number	4233023372	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	400 N STATE OF FRANKLIN RD	AddressLine1
City	JOHNSON CITY	City
State	TN	State
ZIP Code	37604	ZIPCode

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

Form990 Part VII Section A Form990PartVIISectionA (28 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee
DENNIS VONDERFECHT
PRESIDENT/CEO	60.00	X	X	855625	0	42464
WILLIAM WALKER MD
DIRECTOR	0.80	X		0	612004	1615
BARBARA ALLEN
VICE CHAIR	2.10	X		0	0	0
JOHN CAMPBELL
DIRECTOR	0.60	X		0	0	0
SANDRA BROOKS MD
DIRECTOR	1.30	X		0	0	0
MAUREEN MACIVER
PAST CHAIR	2.20	X		0	0	0
GARY PEACOCK
DIRECTOR	1.10	X		0	0	0
CLEM WILKES JR
TREASURER	1.60	X		0	0	0
ROBERT FEATHERS
CHAIRMAN	1.60	X		0	0	0
BILL HAWKINS
DIRECTOR	1.10	X		0	0	0
MIKE CHRISTIAN
DIRECTOR	1.30	X		0	0	0
JOANNE GILMER
SECRETARY	1.50	X		0	0	0
DAVID MAY
DIRECTOR	1.30	X		0	0	0
MARVIN EICHORN
SR VP/CFO	60.00		X	597053	0	209233
DALE CLAYTORE
VP	55.00			216997	0	11406	X
ANN FLEMING
SR VP	55.00			442795	0	65589	X
CANDACE JENNINGS
SR VP/CEO WASHINGTON CO.	55.00			458976	0	71955	X
LYNN KRUTAK
VP/CFO	55.00			242859	0	30312	X
MONTY MCLAURIN
VP/CEO IPMC	55.00			324458	0	54124	X
CINDY SALYER
VP CARDIO/PULMONARY	55.00			232182	0	41464	X
SHANE HILTON
VP/CFO-TN	55.00			193587	0	31422	X
PAT NIDAY
CNO - WASHINGTON COUNTY	55.00			156116	0	27602	X
BRAD NURKIN
CEO - JCMC	55.00			244706	0	20237	X
STEVE KILGORE
PRESIDENT/CEO BRMMC	55.00			339311	0	52799		X
JAMIE PARSONS
VP H/R	50.00			253987	0	30442		X
CHAO LEE MD
PHYSICIAN	50.00			309360	0	25655		X
TONY BENTON JR
VP	50.00			238984	0	28792		X
MORRIS SELIGMAN
CMO	50.00			485251	0	69030		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	5592247	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	612004	TotalReportableCompFrmRltdOrgs
Total Other Compensation	814141	TotalOtherCompensation
Number Individuals GT100 K	164	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
HOSPITAL HOUSEKEEPING SYSTEMS
322 CONGRESS AVENUE	AUSTIN	TX	78701	HOUSEKEEPING SERVICES/MGMT	3899360
CREDIT BUREAU COLLECTIONS
PO BOX 5187	KINGSPORT	TN	37663	COLLECTION SERVICES	1053429
MILLIGAN COLLEGE
PO BOX 750	MILLIGAN COLLEGE	TN	37682	EDUCATIONAL	801069
HANCOCK DANIEL JOHNSON & NAGLE
PO BOX 72050	RICHMOND	VA	232552050	LEGAL SERVICES	724381
AVANTAS WORK STRATEGIES
1128 JOHN GALT BLVD STE 400	OMAHA	NE	68134	SCHEDULING SYSTEM	688140

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	36	NumberOfContractorsGT100K
Related Organizations	1957949	RelatedOrganizations
Government Grants	947756	GovernmentGrants
All Other Contributions	237956	AllOtherContributions
Total Contributions	3143661	TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue
PATIENT SERVICES	621500	700421164	698661352	1759812
WELLNESS PROGRAMS	621990	3231669	3231669
P/S PROG. SERV. INCOME	561000	229487	225554	3933

Field	Value	IRS element (for citing)
Total Program Service Revenue	703882320	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	14059273	TotalRevenueColumn
Unrelated Business Revenue	7768	UnrelatedBusinessRevenue
Exclusion	$14,051,505	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	13232	TotalRevenueColumn
Exclusion	$13,232	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	302737	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	289918	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	12819	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	12819	TotalRevenueColumn
Unrelated Business Revenue	13871	UnrelatedBusinessRevenue
Exclusion	-$1,052	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	1403969	Securities
Other	268929	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Other	63102	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	1403969	Securities
Other	205827	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	1609796	TotalRevenueColumn
Related Or Exempt Function Income	222929	RelatedOrExemptFunctionIncome
Exclusion	$1,386,867	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount	Unrelated Business RevenueUnrelatedBusinessRevenue
CAFETERIA SALES	722210	3932816	$3,932,816
JCMC DAYCARE	624410	970799	$970,799
DIET/SECUR/ENGIN/OTHER	541900	953931	-$26,373	980304

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	778080	TotalRevenueColumn
Unrelated Business Revenue	778080	UnrelatedBusinessRevenue

Field	Value	IRS element (for citing)
Total Other Revenue	6635626	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	729356727	TotalRevenueColumn
Related Or Exempt Function Income	702341504	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	3543768	UnrelatedBusinessRevenue
Exclusion	$20,327,794	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	357333	Total
Program Services	357333	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	4701600	Total
Management And General	4701600	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	233797106	Total
Program Services	223583109	ProgramServices
Management And General	9528935	ManagementAndGeneral
Fundraising	685062	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	9763324	Total
Program Services	9582668	ProgramServices
Management And General	151295	ManagementAndGeneral
Fundraising	29361	Fundraising

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	35048014	Total
Program Services	30903153	ProgramServices
Management And General	4064436	ManagementAndGeneral
Fundraising	80425	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	18089768	Total
Program Services	16140576	ProgramServices
Management And General	1911865	ManagementAndGeneral
Fundraising	37327	Fundraising

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	1481288	Total
Program Services	70	ProgramServices
Management And General	1481218	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	252600	Total
Program Services	5441	ProgramServices
Management And General	227519	ManagementAndGeneral
Fundraising	19640	Fundraising

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	15666	Total
Program Services	15666	ProgramServices

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	909566	Total
Management And General	909566	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	78751295	Total
Program Services	60834645	ProgramServices
Management And General	17708514	ManagementAndGeneral
Fundraising	208136	Fundraising

Advertising Advertising

Field	Value	IRS element (for citing)
Total	3065167	Total
Program Services	2407402	ProgramServices
Management And General	645067	ManagementAndGeneral
Fundraising	12698	Fundraising

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	8682390	Total
Program Services	6842387	ProgramServices
Management And General	1703754	ManagementAndGeneral
Fundraising	136249	Fundraising

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	11401755	Total
Program Services	10286180	ProgramServices
Management And General	1115575	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	14429955	Total
Program Services	11969854	ProgramServices
Management And General	2395897	ManagementAndGeneral
Fundraising	64204	Fundraising

Travel Travel

Field	Value	IRS element (for citing)
Total	2291207	Total
Program Services	1637251	ProgramServices
Management And General	615980	ManagementAndGeneral
Fundraising	37976	Fundraising

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	359432	Total
Program Services	297108	ProgramServices
Management And General	61719	ManagementAndGeneral
Fundraising	605	Fundraising

Interest Interest

Field	Value	IRS element (for citing)
Total	42206499	Total
Program Services	8154	ProgramServices
Management And General	42198345	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	61675549	Total
Program Services	30249046	ProgramServices
Management And General	31418807	ManagementAndGeneral
Fundraising	7696	Fundraising

Insurance Insurance

Field	Value	IRS element (for citing)
Total	627063	Total
Program Services	15885	ProgramServices
Management And General	611178	ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral	FundraisingFundraising
MEDICAL SUPPLIES & DRUG	126183544	126032884	146030	4630
TAXES - UBIT	7800		7800
REPAIRS & MAINTENANCE	14046240	13466849	529169	50222
OTHER	5377696	2923554	2293658	160484
BAD DEBTS	4097305	18145	4079160

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	1782959	Total
Program Services	1396422	ProgramServices
Management And General	386480	ManagementAndGeneral
Fundraising	57	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	679402121	Total
Program Services	548973782	ProgramServices
Management And General	128893567	ManagementAndGeneral
Fundraising	1534772	Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	208449573	BOY
EOY	94236272	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	189220	BOY
EOY	196903	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	84415992	BOY
EOY	96082434	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
BOY	4579735	BOY
EOY	5517265	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	20219171	BOY
EOY	94585775	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	14609053	BOY
EOY	15564585	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	4368028	BOY
EOY	3217335	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	887338436	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	417725411	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	463651654	BOY
EOY	469613025	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	152089704	BOY
EOY	257416902	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	282350254	BOY
EOY	282266093	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	143276118	BOY
EOY	143276118	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	151892237	BOY
EOY	111896704	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	1530090739	BOY
EOY	1573869411	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	76082572	BOY
EOY	66520793	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	20092072	BOY
EOY	19167490	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	626569957	BOY
EOY	620629456	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	400096949	BOY
EOY	382866923	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	3114607	BOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	185118170	BOY
EOY	179054134	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	1311074327	BOY
EOY	1268238796	EOY

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

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	218490539	BOY
EOY	305570637	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	525873	BOY
EOY	59978	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	219016412	BOY
EOY	305630615	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	1530090739	BOY
EOY	1573869411	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	49954606	ReconcilationRevenueExpenses
Reconcilation Other Changes	36659597	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	1	FederalGrantAuditRequired
Federal Grant Audit Performed	1	FederalGrantAuditPerformed

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	1	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	0	GrantsOtherOrganizations
Direct Contact Legislators	1	DirectContactLegislators
Direct Contact Legislators	$248,878	DirectContactLegislatorsAmount
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	0	OtherActivities
Total Lobbying Expenditures IIB	248878	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	EXPLANATION OF OTHER LOBBYING ACTIVITIES:	Identifier
Return Reference	PART II-B, LINE 1I:	ReturnReference
Explanation	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 - NACHRI VIP ADVOCACY DAY - TNPATH ANNUAL MEETING - VHHA 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 EXTENSION OF ENHANCED FEDERAL MATCH ASSISTANCE PROGRAM - SUPPORT AFFORDABLE CARE ACT PROVISIONS TO EXPAND INSURANCE COVERAGE TO THE UNINSURED - SUPPORT FOR INITIATIVES TO IMPROVE PAYMENT DELIVERY REDESIGN SUCH AS ACO REGULATIONS - SUPPORT FOR CONTINUATION OF TENNESSEE MEDICAID DSH - CONTRIBUTED TO MSHA'S COMMENTS REGARDING PROPOSED ACO REGULATIONS - OPPOSITION TO HOSPITAL CUTS IN PROPOSED IPPS RULE (CODING OFFSET) - OPPOSITION TO ADDITIONAL CUTS IN MEDICARE/MEDICAID - SUPPORT FOR REAUTHORIZATION OF CHILDREN'S HOSPITAL GRADUATE MEDICAL EDUCATION - CONTINUED WORK WITH THE NATIONAL FOUNDATION FOR TRAUMA CARE TO SECURE FEDERAL FUNDING - SUPPORT FOR AN INCREMENTAL AND REALISTIC TIMETABLE THAT RECOGNIZES FLEXIBLE CRITERIA FOR THE MEDICARE EHR INCENTIVE PROGRAM - SUPPORT FOR GRADUATE MEDICAL EDUCATION THE COMMUNITY AND GOVERNMENT RELATIONS ASSISTANT VICE PRESIDENT AND/OR DEPARTMENTAL STAFF RESPONDED VIA LETTER, PHONE, OR IN PERSON TO THE FOLLOWING TENNESSEE AND VIRGINIA LEGISLATIVE ISSUES: - SUPPORT FOR CONTINUATION OF HOSPITAL ASSESSMENT FEE IN TENNESSEE - SUPPORT FOR CONTINUATION OF TENNESSEE'S APPROPRIATION FOR CARE OF UNINSURED MENTALLY ILL PATIENTS - SUPPORT FOR RESTORATION OF FUNDING FOR PERINATAL CENTERS IN TENNESSEE - SUPPORT FOR CONTINUATION OF SAFETY NET FUNDING FOR PROJECT ACCESS - SUPPORT FOR LEGISLATION TO ENSURE THAT MEDICAID RATES REMAIN UNCHANGED IN VIRGINIA - SUPPORT FOR A BUDGET AMENDMENT THAT REINSTATED SUPPLEMENTAL PAYMENTS TO JCMC'S NICU FOR ITS HIGH VIRGINIA MEDICAID VOLUME - OPPOSED A CERTIFICATE OF NEED BILL IN TENNESSEE THAT WOULD HAVE SEVERELY WEAKENED THE CON PROCESS - SUPPORTED TORT REFORM LEGISLATION IN TENNESSEE	Explanation

Schedule D IRS990ScheduleD

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	34838122	OtherCostOrOtherBasis
Book Value	34838122	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	443078534	OtherCostOrOtherBasis
Depreciation	127384695	Depreciation
Book Value	315693839	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	856198	OtherCostOrOtherBasis
Depreciation	379181	Depreciation
Book Value	477017	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	408565582	OtherCostOrOtherBasis
Depreciation	289961535	Depreciation
Book Value	118604047	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	469613025	TotalOfBookValueLandBuildings

Investments Program Related InvestmentsProgramRelated (5 entries)

DescriptionDescription	Book ValueBookValue	Method Of ValuationMethodOfValuation
INVESTMENT IN BRMMC	100273634	C
INVESTMENT IN ISHN	1843937	C
INVESTMENT IN OTHER	48522	C
INVESTMENT IN SCCH	48100000	C
INVESTMENT IN JMH	132000000	C

Field	Value	IRS element (for citing)
Total Of Book Value Program Related	282266093	TotalOfBookValueProgramRelated

Other Assets OtherAssets (4 entries)

DescriptionDescription	Book ValueBookValue
AWUL - CURRENT	7628257
AWUL - UNDER BOND INDENTURE AGREEMENTS	71689876
DEFERRED CHARGES AND OTHER	22473469
LONG TERM COMPENSATION INVESTMENT	10105102

Field	Value	IRS element (for citing)
Total Book Value Other Assets	111896704	TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescription	AmountAmount
ACCRUED INTEREST	$19,607,249
OTHER LONG-TERM LIABILITIES	$6,895,891
ACCRUED SALARIES, ABSENCES, & W/H	$40,176,880
CALL OPTION LIABILITY	$92,044,033
EST. FAIR VALUE OF INT. RATE SWAP	$7,782,969
DUE TO THIRD PARTY PAYORS	$12,547,112

Field	Value	IRS element (for citing)
Total Of Amounts	179054134	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	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 ASC 740, "INCOME TAXES". THE ALLIANCE HAS NO SIGNIFICANT UNCERTAIN TAX POSITIONS AT JUNE 30, 2011 AND 2010.	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

Discounted Other DiscountedOther

Field	Value	IRS element (for citing)
Other	X	Other
Discounted Other Percentage	380.000000000000	DiscountedOtherPercentage

Field	Value	IRS element (for citing)
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	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	13141846	TotalCommunityBenefitExpense
Net Community Benefit Expense	13141846	NetCommunityBenefitExpense
Percent Of Total Expense	0.01950	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	15382326	TotalCommunityBenefitExpense
Direct Offsetting Revenue	11993765	DirectOffsettingRevenue
Net Community Benefit Expense	3388561	NetCommunityBenefitExpense
Percent Of Total Expense	0.00500	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Total Community Benefit Expense	73485181	TotalCommunityBenefitExpense
Direct Offsetting Revenue	50198122	DirectOffsettingRevenue
Net Community Benefit Expense	23287059	NetCommunityBenefitExpense
Percent Of Total Expense	0.03450	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	102009353	TotalCommunityBenefitExpense
Direct Offsetting Revenue	62191887	DirectOffsettingRevenue
Net Community Benefit Expense	39817466	NetCommunityBenefitExpense
Percent Of Total Expense	0.05900	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	6281105	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1021002	DirectOffsettingRevenue
Net Community Benefit Expense	5260103	NetCommunityBenefitExpense
Percent Of Total Expense	0.00780	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	9860820	TotalCommunityBenefitExpense
Direct Offsetting Revenue	2652458	DirectOffsettingRevenue
Net Community Benefit Expense	7208362	NetCommunityBenefitExpense
Percent Of Total Expense	0.01070	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	17494050	TotalCommunityBenefitExpense
Direct Offsetting Revenue	5593591	DirectOffsettingRevenue
Net Community Benefit Expense	11900459	NetCommunityBenefitExpense
Percent Of Total Expense	0.01760	PercentOfTotalExpense

Research Research

Field	Value	IRS element (for citing)
Total Community Benefit Expense	472920	TotalCommunityBenefitExpense
Net Community Benefit Expense	472920	NetCommunityBenefitExpense
Percent Of Total Expense	0.00070	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	248259	TotalCommunityBenefitExpense
Net Community Benefit Expense	248259	NetCommunityBenefitExpense
Percent Of Total Expense	0.00040	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	34357154	TotalCommunityBenefitExpense
Direct Offsetting Revenue	9267051	DirectOffsettingRevenue
Net Community Benefit Expense	25090103	NetCommunityBenefitExpense
Percent Of Total Expense	0.03720	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	136366507	TotalCommunityBenefitExpense
Direct Offsetting Revenue	71458938	DirectOffsettingRevenue
Net Community Benefit Expense	64907569	NetCommunityBenefitExpense
Percent Of Total Expense	0.09620	PercentOfTotalExpense

Economic Development EconomicDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	26206	TotalCommunityBuildingExpense
Net Community Building Expense	26206	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Total Community Building Expense	359	TotalCommunityBuildingExpense
Net Community Building Expense	359	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	2139245	TotalCommunityBuildingExpense
Net Community Building Expense	2139245	NetCommunityBuildingExpense
Percent Of Total Expense	0.00320	PercentOfTotalExpense

Other Other

Field	Value	IRS element (for citing)
Total Community Building Expense	82635	TotalCommunityBuildingExpense
Net Community Building Expense	82635	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Total Community Building Expense	2248445	TotalCommunityBuildingExpense
Net Community Building Expense	2248445	NetCommunityBuildingExpense
Percent Of Total Expense	0.00330	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$19,031,222	BadDebtExpenseAmount
Amount Attributable To	11418733	AmountAttributableTo
Amount Reimbursed By Medicare	201775707	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	207565036	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-5789329	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

Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivity	Organization Profit Or OwnershipOrganizationProfitOrOwnership	Physicans Profit Or OwnershipPhysicansProfitOrOwnership
1 MEDICAL SPECIALISTS OF JOHNSON CITY LLC
MEDICAL SERVICES	0.51000	0.49000
2 EMMAUS COMMUNITY HEALTHCARE PLLC
MEDICAL SERVICES	0.75000	0.25000

Field	Value	IRS element (for citing)
Number Of Hospital Facilities	6	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (6 entries)

Facility NumberFacilityNumber	Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Licensed HospitalLicensedHospital	General Medical And SurgicalGeneralMedicalAndSurgical	Childrens HospitalChildrensHospital	Teaching HospitalTeachingHospital	Research FacilityResearchFacility	Er24 HoursEr24Hours	OtherOther	Critical Access HospitalCriticalAccessHospital
JOHNSON CITY MEDICAL CENTER
1	400 N STATE OF FRANKLIN ROAD	JOHNSON CITY	TN	37604	X	X	X	X	X	X	REHABILITATION & MENTAL HEALTH HOSPITALS
INDIAN PATH MEDICAL CENTER
2	2000 BROOKSIDE DRIVE	KINGSPORT	TN	37660	X	X		X		X
FRANKLIN WOODS COMMUNITY HOSPITAL
3	300 MED TECH PARKWAY	JOHNSON CITY	TN	37604	X	X				X
SYCAMORE SHOALS HOSPITAL
4	1501 W ELK AVENUE	ELIZABETHTON	TN	37643	X	X				X
RUSSELL COUNTY MEDICAL CENTER
5	58 CARROLL STREET	LEBANON	VA	24266	X	X				X
JOHNSON COUNTY COMMUNITY HOSPITAL
6	1901 S SHADY STREET	MOUNTAIN CITY	TN	37683	X					X		X

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (6 entries)

Hospital Facility NumberHospitalFacilityNumber
JOHNSON CITY MEDICAL CENTER
1
INDIAN PATH MEDICAL CENTER
2
FRANKLIN WOODS COMMUNITY HOSPITAL
3
SYCAMORE SHOALS HOSPITAL
4
RUSSELL COUNTY MEDICAL CENTER
5
JOHNSON COUNTY COMMUNITY HOSPITAL
6

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	11	NumberOfOtherFacilities

Other Facilities OtherFacilities (11 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
JCMC AMBULATORY SURGERY CENTER
400 N STATE OF FRANKLIN ROAD	JOHNSON CITY	TN	37604	LICENSED AMBULATORY SURGERY CENTER
MOUNTAIN STATES IMAGING CENTER
301 MED TECH PARKWAY STE 100	JOHNSON CITY	TN	37604	LICENSED OUTPATIENT DIAGNOSTIC CENTER
FRANKLIN TRANSITIONAL CARE
400 N STATE OF FRANKLIN ROAD	JOHNSON CITY	TN	37604	LICENSED SKILLED NURSING FACILITY
MOUNTAIN STATES DIAGNOSTIC CENTER
1 PROFESSIONAL PARK DRIVE 16	JOHNSON CITY	TN	37604	LICENSED OUTPATIENT DIAGNOSTIC CENTER
INDIAN PATH TRANSITIONAL CARE
2000 BROOKSIDE DRIVE	KINGSPORT	TN	37660	LICENSED SKILLED NURSING FACILITY
MED CENTER HOME CARE - JOHNSON CITY
101 MED TECH PARKWAY STE 100	JOHNSON CITY	TN	37604	LICENSED HOME HEALTH AGENCY
MEDICAL CENTER HOME CARE - KINGSPORT
2020 BROOKSIDE DRIVE 28	KINGSPORT	TN	37660	LICENSED HOME HEALTH AGENCY
RUSSELL CO MED CENTER HOME HEALTH
116 FLANNAGAN AVE	LEBANON	VA	24266	LICENSED HOME HEALTH AGENCY
MEDICAL CENTER HOSPICE
10101 MED TECH PARKWAY STE 100	JOHNSON CITY	TN	37604	LICENSED HOSPICE AGENCY
JOHNSON COUNTY HOME HEALTH
1987 S SHADY STREET	MOUNTAIN CITY	TN	37683	LICENSED HOME HEALTH AGENCY
RUSSELL COUNTY MEDICAL CENTER HOSPICE
116 FLANNAGAN AVE	LEBANON	VA	24266	LICENSED HOSPICE AGENCY

Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)

ExplanationExplanation	IdentifierIdentifier	Return ReferenceReturnReference
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 I, LINE 7G: JOHNSON COUNTY COMMUNITY HOSPITAL, A FEDERALLY DESIGNATED CRITICAL ACCESS HOSPITAL, OPERATES A PHYSICIAN SPECIALTY CLINIC, WHICH INCURRED AN OPERATING LOSS OF $59,254 FOR THE TWELVE MONTHS ENDING JUNE, 2011. THE SPECIALTY CLINIC INCLUDES CARDIOLOGY, ORTHOPEDICS, GENERAL SURGERY, VASCULAR SURGERY, NEPHROLOGY, ONCOLOGY, PODIATRY AND OTHER SPECIALTY SERVICES. THIS CONTINUES TO BE A VALUABLE RESOURCE TO THE RESIDENTS OF THE AREA BY AIDING WITH TRANSPORTATION ISSUES (OTHER 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. THE SPECIALTY CLINIC REPORTED 2,227 VISITS DURING THE YEAR.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 CLINIC'S LARGEST PAYOR IS MEDICARE, WHICH ACCOUNTS FOR MORE THAN 40% OF THEIR PATIENTS. DURING THE 12-MONTH REPORTING PERIOD, THE CLINIC HAD 10,101 OUTPATIENT VISITS AND INCURRED UNREIMBURSED EXPENSES OF $399,460.
PART I, L7 COL(F): BAD DEBT EXPENSE OF $4,097,305 IS INCLUDED IN THE STATEMENT OF FUNCTIONAL EXPENSES ON FORM 990, PART IX, LINE 25, BUT HAS BEEN SUBTRACTED FOR PURPOSES OF CALCULATING PERCENTAGES ON PART 1, LINE 7, COLUMN F.
PART II: MSHA LEADERS SUPPORT AND ENCOURAGE ALL EMPLOYEES TO VOLUNTEER TIME, MONEY, AND SKILLS TO COMMUNITY SERVICE PROJECTS AND CHARITABLE ORGANIZATIONS. SENIOR LEADERS AND BOARD MEMBERS SET A POSITIVE EXAMPLE FOR MSHA EMPLOYEES BY 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 HEALTH CARE, AND EDUCATION. EMPLOYEES SERVED THE BOYS & GIRLS CLUB, KIWANIS CLUBS, SUSAN G. KOMEN BREAST CANCER FOUNDATION, ECONOMIC DEVELOPMENT STEERING COMMITTEE FOR WASHINGTON COUNTY, THE TENNESSEE VALLEY CORRIDOR, JUNIOR ACHIEVEMENT, SALVATION ARMY, AMERICAN HEART ASSOCIATION, HANDS ON! MUSEUM, KINGSPORT TOMORROW INC., CARTER COUNTY TOMORROW, APPALACHIAN MOUNTAIN PROJECT ACCESS, WASHINGTON COUNTY EMERGENCY MEDICAL SERVICES, APPALACHIAN REGIONAL COALITION ON HOMELESSNESS, WASHINGTON COUNTY VETERAN'S MEMORIAL COMMITTEE OF THE JOHNSON CITY PARKS AND RECREATION FOUNDATION, EATING DISORDERS COALITION OF TENNESSEE, JOHNSON CITY SYMPHONY ORCHESTRA, DAWN OF HOPE, UNITED WAY, CHAMBER OF COMMERCE BOARDS, AND MANY OTHERS. SOME OF THESE EMPLOYEES DEVOTED TWO WEEKS OF NORMAL WORK TIME TO OUTSIDE CHARITABLE ACTIVITIES. MSHA PROVIDES SPONSORSHIPS AND OFFERS ASSISTANCE WITH COORDINATION, ADVOCACY, AND PUBLICITY; PROVIDES SPACE; OR CONTRIBUTES SUPPLIES TO SUPPORT COMMUNITY ORGANIZATIONS FOR THEIR PROGRAM ACTIVITIES. MSHA PROVIDES STAFF AT ITS EXPENSE TO LOCAL AGENCIES, COMMUNITY ADVISORY BOARDS, COUNCILS, AND OTHER ORGANIZATIONS TO ASSIST WITH LEADERSHIP PROGRAMS, PLANNING, COMMITTEE PARTICIPATION, AND ASSISTANCE WITH SPECIAL EVENTS. EXAMPLES INCLUDE AMERICAN RED CROSS BLOOD DRIVES, IMAGINATION LIBRARY STEERING COMMITTEE, RONALD MCDONALD HOUSE BOARD, UNITED WAY BOARD, AND OTHERS. 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 MSHA'S 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 EMPLOYEE'S TIME TO SERVE ON ECONOMIC DEVELOPMENT BOARDS. EVIDENCE SHOWS THAT A HEALTHY ECONOMY RELATES TO A HEALTHIER POPULATION.
PART III, LINE 4: WORKSHEET A WAS USED FOR PART III, LINES 2 AND 3 IN DETERMINING BAD DEBT AT COST. MSHA FOLLOWS THE HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION'S PRINCIPLES AND PRACTICES BOARD ISSUED STATEMENT 15: VALUATION AND FINANCIAL STATEMENT PRESENTATION OF CHARITY CARE AND BAD DEBTS BY INSTITUTIONAL HEALTHCARE PROVIDERS ("THE STATEMENT"). THE STATEMENT PROVIDES GUIDANCE ON COLLECTABILITY CRITERIA AND EMPHASIZES REVENUE RECOGNITION ONLY WHEN COLLECTIONS ARE REASONABLY ASSURED. TO FURTHER EXPLAIN MSHA'S REPORTING OF BAD DEBT EXPENSE, MSHA'S FINANCIAL STATEMENTS ACCOUNT FOR BAD DEBT IN TWO LOCATIONS. FIRST, A DEDUCTION FROM REVENUE LINE ITEM CALLED "CONTRA-REVENUE" CONTAINS THE MAJORITY OF MSHA'S SELF-PAY ESTIMATED BAD DEBT. FOR FISCAL YEAR 2011, 95% OF TOTAL BAD DEBT WAS MOVED TO THIS LINE. THIS PERCENTAGE IS SIMPLY AN ESTIMATE OF WHAT PATIENT FINANCIAL SERVICES ANTICIPATES WILL NOT BE COLLECTED AFTER ALL DEBT COLLECTION EFFORTS HAVE BEEN EXHAUSTED. THIS ESTIMATE IS BASED ON HISTORICAL INFORMATION. THE REMAINING 5% OF BAD DEBT IS RECORDED IN THE EXPENSE SECTION APPROPRIATELY CALLED "BAD DEBT."THE FOOTNOTES TO THE AUDITED FINANCIAL STATEMENTS STATES "CURRENT OPERATIONS INCLUDE A PROVISION FOR BAD DEBTS IN THE CONSOLIDATED STATEMENTS OF OPERATIONS ESTIMATED BASED UPON THE AGE OF THE PATIENT ACCOUNTS RECEIVABLE, PRIOR EXPERIENCE AND ANY UNUSUAL CIRCUMSTANCES (SUCH AS LOCAL, REGIONAL OR NATIONAL ECONOMIC CONDITIONS) WHICH AFFECT THE COLLECTABILITY OF RECEIVABLES, INCLUDING MANAGEMENT'S ASSUMPTIONS ABOUT CONDITIONS IT EXPECTS TO EXIST AND COURSES OF ACTION IT EXPECTS TO TAKE."REGARDING LINE 3, IT IS IMPLAUSIBLE TO DETERMINE THE AMOUNT OF MSHA'S BAD DEBT EXPENSE ASSOCIATED WITH THOSE CLIENTS 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 PATIENT'S 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. OUR VICE PRESIDENT OF PATIENT FINANCIAL SERVICES CONSERVATIVELY ESTIMATES THAT 60% OF TOTAL BAD DEBT EXPENSE WAS ASSUMED ATTRIBUTABLE TO CLIENTS POTENTIALLY ELIGIBLE FOR FINANCIAL ASSISTANCE.
PART III, LINE 8: MEDICARE ALLOWABLE COSTS WERE REPORTED USING MSHA'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, 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, 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: MSHA FOLLOWS A STRONG COLLECTION PROGRAM THAT COMMUNICATES FINANCIAL RESPONSIBILITY TO THE PATIENT PRIOR TO SERVICE. 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. MSHA 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 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 FOR-PROFIT AND NOT-FOR-PROFIT 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 NOT-FOR-PROFIT HEALTH SYSTEM'S INVESTMENT IN THE COMMUNITIES THEY SERVE.
PART VI, LINE 2: DURING FISCAL YEAR 2008 AND FISCAL YEAR 2009, MSHA CONDUCTED THE LARGEST COMMUNITY HEALTH NEEDS ASSESSMENT IN ITS HISTORY IN AN EFFORT TO PROFILE THE HEALTH OF THE RESIDENTS WITHIN THE LOCAL REGION. THE ASSESSMENT FOCUSED ON STATE, REGIONAL, AND COUNTY SPECIFIC DATA COLLECTION. THIS ASSESSMENT ALSO INCLUDED PRIMARY DATA COLLECTED THROUGH APPROXIMATELY 50 ONE-ON-ONE INTERVIEWS. THOSE INTERVIEWED WERE INDIVIDUALS FROM AROUND THE REGION WHICH INCLUDED LOCAL AND STATE GOVERNMENT OFFICIALS, HEALTH DEPARTMENT REPRESENTATIVES, PHYSICIANS, GENERAL PUBLIC, LOCAL INDUSTRY, CIVIC ORGANIZATIONS, EDUCATION OFFICIALS, AND COMMUNITY RESOURCE GROUPS. THIS INFORMATION WAS COLLECTED, AND THEN ANALYZED, AND A SUMMARY OF THE FINDINGS WAS LISTED IN AN EFFORT TO OBTAIN A MORE DETAILED SNAPSHOT SPECIFIC TO EACH COUNTY LOCATED THROUGHOUT THE MSHA SERVICE AREA. THIS INFORMATION WAS REVIEWED BY MSHA'S STRATEGIC PLANNING TEAM ALONG WITH GOVERNMENT RELATIONS AND QUALITY DEPARTMENTS. THE MSHA STEERING COMMITTEE IDENTIFIED CHILDHOOD OBESITY AS THE HEALTH DISPARITY TARGETED FOR IMPROVEMENT. DURING FISCAL YEAR 2009, MSHA BEGAN COLLABORATIVE EFFORTS WITH EAST TENNESSEE STATE UNIVERSITY'S COLLEGE OF PUBLIC HEALTH TO DEVELOP THE MSHA-ETSU OBESITY COLLABORATIVE COMMITTEE. THE FOCUS OF THIS COMMITTEE IS TO PULL TOGETHER MANY PARTNERS AND ORGANIZATIONS IN COLLABORATION TO REDUCE THE LEVEL OF CHILDHOOD OBESITY THROUGHOUT NORTHEAST TENNESSEE AND SOUTHWEST VIRGINIA. DURING FISCAL YEAR 2011, THE COMMITTEE OFFERED 25 SEED GRANTS OF $2,000 EACH TO LOCAL COMMUNITY ORGANIZATIONS SUCH AS CHURCHES, COMMUNITY GROUPS, SCHOOLS, AND EMPLOYERS THAT WANT TO EXPLORE OBESITY REDUCTION EFFORTS.IN ADDITION TO THE GRANTS PROGRAM, AN ANNUAL SYMPOSIUM IS PROVIDED FREE TO THE REGION AND AVAILABLE TO RESIDENTS AND COMMUNITY GROUPS. NATIONAL, REGIONAL, AND LOCAL EXPERTS SHARE INFORMATION ON TRENDS REGARDING CHILDHOOD OBESITY AND PROVEN COMMUNITY-BASED STRATEGIES TO REDUCE THE PREVALENCE.MOUNTAIN STATES HEALTH ALLIANCE DOCUMENTED ITS CORPORATE RESPONSIBILITY PROGRAMS, PARTNERSHIPS, AND ACTIVITIES FOR COMMUNITY BENEFIT AND SOCIAL RESPONSIBILITY IN THE 2011 SOCIAL RESPONSIBILITY PLAN (THE PLAN). THE PLAN PROVIDES THE STRATEGIC DIRECTION OF SOCIAL RESPONSIBILITY FOR THE ORGANIZATION. MSHA CREATED A SOCIAL RESPONSIBILITY COMMITTEE TO ENSURE A STRATEGIC COMMITMENT TO THE ORGANIZATION'S SOCIAL RESPONSIBILITY THROUGH NEEDS PRIORITIZED FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE CHNA IDENTIFIES SEVERAL PRIORITIES TO FOCUS THE ORGANIZATION'S COMMUNITY BENEFIT, COMMUNITY BUILDING AND OTHER INITIATIVES TO IMPACT THE HEALTH OF INDIVIDUALS AND COMMUNITIES WITHIN THE DEFINED SERVICE AREA. THE COMMITTEE MEETS ON A QUARTERLY BASIS AND INCLUDES MSHA BOARD MEMBERS; THE DEAN OF PUBLIC HEALTH AT EAST TENNESSEE STATE UNIVERSITY; THE PRESIDENT AND CEO OF UNITED WAY OF WASHINGTON COUNTY, TENNESSEE; MSHA'S CEO AND OTHER EXECUTIVES AS WELL AS OTHER COMMUNITY LEADERS. THE FOUNDATION OF MSHA'S SOCIAL RESPONSIBILITY IS THE CHNA TO PRIORITIZE FUTURE HEALTH IMPROVEMENT INITIATIVES TO BE COMPLETED IN COLLABORATION WITH LOCAL RESOURCES. THE PROJECT FULLY SUPPORTS THE MSHA MISSION TO "IDENTIFY AND RESPOND TO THE HEALTH CARE NEEDS OF INDIVIDUALS AND COMMUNITIES IN OUR REGION AND TO ASSIST THEM IN ATTAINING THEIR HIGHEST POSSIBLE LEVEL OF HEALTH". THE ASSESSMENT FOCUSES ON MSHA'S THIRTEEN CORE COUNTIES. ACTIVITIES ASSOCIATED WITH THE DEVELOPMENT OF THIS ASSESSMENT INCLUDE STATE, REGIONAL AND COUNTY-SPECIFIC SECONDARY DATA COLLECTION AND PRIMARY DATA OBTAINED THROUGH OVER 56 SURVEYS WITH INDIVIDUALS FROM THE LOCAL COMMUNITIES.
PART VI, LINE 3: MSHA 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 MSHA'S FINANCIAL ASSISTANCE POLICY. MSHA ALSO HAS FINANCIAL COUNSELORS WHICH COMMUNICATE THE PATIENT'S FINANCIAL RESPONSIBILITY PRIOR TO SERVICE AS WELL AS PROVIDE EDUCATION ON MSHA'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 TENNCARE OR MEDICAID. IN ADDITION, MSHA 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. MSHA BEARS THE COST FOR THE FIRSTSOURCE SOLUTIONS USA PROGRAM.
PART VI, LINE 4: MSHA SERVES THE HEALTHCARE NEEDS OF 29 APPALACHIAN COUNTIES IN TENNESSEE, SOUTHWEST VIRGINIA, KENTUCKY AND NORTH CAROLINA. SOME OF THE COUNTIES MSHA SERVES ARE FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREAS. MSHA OPERATES 2 CRITICAL ACCESS HOSPITALS, DICKENSON COMMUNITY HOSPITAL IN VIRGINIA AND JOHNSON COUNTY COMMUNITY HOSPITAL IN TENNESSEE. THESE TWO FACILITIES OPERATE IN FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREAS. THE HEALTH STATUS OF THE POPULATION IN MSHA'S SERVICE AREA IS GENERALLY POOR. THE SERVICE AREA EXTENDS TO SOME OF THE POOREST RURAL COUNTIES IN THE REGION WITH A POVERTY RATE OF ALMOST 30%. SOME OF THE MOST WELL OFF COUNTIES IN MSHA'S 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 UNINSURED2. HIGH PREVALENCE OF OBESITY3. HIGH PREVALENCE OF DIABETES
PART VI, LINE 6: THE MAJORITY OF MSHA'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA. ONLY TWO EMPLOYEES ARE ON THE MSHA BOARD OF DIRECTORS: THE CEO PAID BY MSHA AND A PHYSICIAN WHO IS PAID BY A RELATED ORGANIZATION. PHYSICIANS THAT REQUEST PRIVILEGES WHO ARE QUALIFIED AND CREDENTIALED ARE EXTENDED PRIVILEGES BY MSHA.MSHA IS DEDICATED TO OPERATING OUR FACILITIES EFFICIENTLY SO THAT WASTE IS MINIMIZED AND SURPLUSES MAY BE APPLIED TO MAINTAINING ADEQUATE FACILITIES AND EQUIPMENT FOR THE CARE FOR 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 7: MOUNTAIN STATES HEALTH ALLIANCE (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. 9 FACILITIES ARE WHOLLY-OWNED AND 4 ARE MAJORITY OWNED. THIS FORM 990 ENCOMPASSES 9 WHOLLY-OWNED 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 WHOLLY-OWNED HOSPITALS WITHIN THIS REPORTING FEDERAL EMPLOYER IDENTIFICATION NUMBER, MSHA ALSO HAS MAJORITY OWNERSHIP IN 4 HOSPITALS IN SOUTHWEST VIRGINA. IN ADDITION TO OUR ACUTE CARE HOSPITALS, OUR SYSTEM ALSO INCLUDES SUCH SERVICES AS: PRIMARY / SPECIALTY PHYSICIAN PRACTICES, URGENT CARE CENTERS, EMERGENCY DEPARTMENTS, OCCUPATIONAL MEDICINE, REHABILITATION, TRANSPLANT, OUTREACH LABORATORY, MENTAL HEALTH, NEONATAL INTENSIVE CARE, A NACHRI AFFILIATED CHILDREN'S HOSPITAL, RENAL DIALYSIS, ST. JUDE'S ONCOLOGY, INPATIENT / OUTPATIENT SURGERY, SKILLED NURSING, HOME HEALTH, AIR AMBULANCE TRANSPORT, AN ORGAN TRANSPLANT DEPARTMENT, 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 COUNTY-SPECIFIC 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.
VA	REPORTS FILED WITH STATES	PART VI, LINE 7

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (11 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Amount Of Non Cash AssistanceAmountOfNonCashAssistance	Method Of ValuationMethodOfValuation	Description Of Non Cash AssistanceDescriptionOfNonCashAssistance	Purpose Of GrantPurposeOfGrant
ETSU
807 UNIVERSITY PKWY	JOHNSON CITY	TN	37614	626021046	501(C)(3)	20450	214	COST	PRINT SUPPLIES FOR MEDICAL SYMPOSIUM	SUPPORT FIT KIDS PROGRAM
CARESPARK
PO BOX 657 125 BROAD STREET	KINGSPORT	TN	37662	202694144	501(C)(3)	53027				SUPPORT DEVELOPMENT OF SHARED HEALTH INFORMATION TO IMPROVE PATIENT CARE
SUSAN KOMEN BREAST CANCER FOUNDATION
POBOX 5835	KINGSPORT	TN	37663	841689067	501(C)(3)	25164	196	COST	PRINT SUPPLIES FOR FUNDRAISING BROCHURE	BREAST CANCER RESEARCH
HANDS ON REGIONAL MUSEUM
315 E MAIN STREET	JOHNSON CITY	TN	37601	621282542	501(C)(3)	7500				SUPPORT LOCAL INTERACTIVE CHILDREN'S MUSEUM
CITY OF JOHNSON CITY
601 E MAIN STREET	JOHNSON CITY	TN	37601	626000320	115	9500	2290	COST	PRINT SUPPLIES	SPONSOR ECONOMIC DEVELOPMENT AND OTHER PROGRAMS/EVENTS
COALITION FOR KIDS
PO BOX 3156	JOHNSON CITY	TN	37602	621765487	501(C)(3)	2000	6560	COST	PRINT SERVICES AND POSTAGE	GRANT TO COMBAT CHILDHOOD OBESITY
BOYS AND GIRLS CLUB OF KINGSPORT
PO BOX 784 213 LEE STREET	KINGSPORT	TN	37662	620481370	501(C)(3)	20000				GENERAL SUPPORT
CROSSROADS MEDICAL MISSION
PO BOX 16852	BRISTOL	VA	24209	542038877	501(C)(3)	12500				SUPPORT REMOTE AREA MEDICAL CARE
LINCOLN THEATRE
117 E MAIN STREET PO BOX 664	MARION	VA	24354	541477479	501(C)(3)	12500				SUPPORT PERFORMING ARTS
ETSU FOUNDATION
PO BOX 70721	JOHNSON CITY	TN	37614	237092731	501(C)(3)	51500	81	COST	PRINT MEDICAL SYMPOSIUM BROCHURE	SUPPORT INDIGENT CLINIC AND FIT KIDS PROGRAM
RUSSELL COUNTY CAREER & TECHNOLOGY
PO BOX 849 304 CAREER TECH DRIVE	LEBANON	VA	24266	546001591	501(C)(3)		17474	COST	MEDICAL SUPPLIES	SUPPORT HEALTH PROFESSIONS EDUCATION

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	11	TotalNbrOf501C3AndGovtGrants

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: 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 FY11, 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.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
First Class Or Charter Travel	X	FirstClassOrCharterTravel
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 (17 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
DENNIS VONDERFECHT
639736	0	141752	0	74137	0	19600	0	22864	0	898089	0	0	0
WILLIAM WALKER MD
0	512691	0	98124	0	1189	0	0	0	1615	0	613619	0	0
MARVIN EICHORN
422229	0	115646	0	59178	0	188316	0	20917	0	806286	0	0	0
DALE CLAYTORE
171000	0	28881	0	17116	0	8550	0	2856	0	228403	0	0	0
ANN FLEMING
328461	0	72944	0	41390	0	48481	0	17108	0	508384	0	0	0
CANDACE JENNINGS
354039	0	91919	0	13018	0	51539	0	20416	0	530931	0	0	0
LYNN KRUTAK
200939	0	39904	0	2016	0	13403	0	16909	0	273171	0	0	0
MONTY MCLAURIN
253584	0	60997	0	9877	0	26340	0	27784	0	378582	0	0	0
CINDY SALYER
179548	0	35558	0	17076	0	20422	0	21042	0	273646	0	0	0
SHANE HILTON
179001	0	9129	0	5457	0	11090	0	20332	0	225009	0	0	0
PAT NIDAY
143084	0	8820	0	4212	0	6000	0	21602	0	183718	0	0	0
BRAD NURKIN
193067	0	0	0	51639	0	9808	0	10429	0	264943	0	0	0
STEVE KILGORE
270098	0	62796	0	6417	0	30631	0	22168	0	392110	0	0	0
JAMIE PARSONS
198788	0	46144	0	9055	0	20134	0	10308	0	284429	0	0	0
CHAO LEE MD
308922	0	0	0	438	0	9692	0	15963	0	335015	0	0	0
TONY BENTON JR
179605	0	47651	0	11728	0	11100	0	17692	0	267776	0	0	0
MORRIS SELIGMAN
392982	0	53556	0	38713	0	40385	0	28645	0	554281	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReference

ExplanationExplanation

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.

PART I, LINE 4B

THE FOLLOWING EXECUTIVES LISTED IN SCHEDULE J, PART II PARTICIPATED IN A 457(F) RETIREMENT PLAN PROVIDED BY MSHA: ANN FLEMING, CANDACE JENNINGS, MONTY MCLAURIN, CINDY SALYER, BRAD NURKIN, MORRIS SELIGMAN,STEVE KILGORE, AND JAMIE PARSONS. THE 457(F) PLAN IS A NONQUALIFIED TAX-DEFERRED COMPENSATION PLAN AVAILABLE TO A SELECT GROUP OF KEY EXECUTIVES FOR THE INTENT OF SUPPORTING RETENTION AND TO OFFER A COMPETITIVE TOTAL RETIREMENT PROGRAM. ACCOUNT BALANCES HAVE A "SUBSTANTIAL RISK OF FORFEITURE." IN ADDITION TO CREDITOR RISK, SUBSTANTIAL RISK OF FORFEITURE IS CREATED THROUGH DEFAULT RISK IF THE PARTICIPANT'S EMPLOYMENT WITH MSHA IS TERMINATED PRIOR TO AGE 65. HOWEVER, THE 457(F) PLAN CONTAINS A NON-COMPETE PROVISION THAT PROVIDES THE ACCOUNT BALANCE TO BE PAID IN A LUMP SUM AFTER THE EXECUTIVE SATISFIES THE TWO-YEAR NON-COMPETE PERIOD. THIS PROVISION APPLIES TO EMPLOYER CONTRIBUTIONS IF THE EXECUTIVE HAS PROVIDED ELIGIBLE SERVICE FOR SIX OR MORE YEARS. (ELIGIBLE SERVICE IS OFFICER SERVICE THAT PERMITTED THE EXECUTIVE TO PARTICIPATE IN THE PLAN.) THE EXECUTIVE WILL RECEIVE THE ENTIRE ACCOUNT BALANCE IF HE/SHE BECOMES DISABLED, DIES OR IF THE EXECUTIVE TERMINATES FOR "GOOD REASON" OR IS INVOLUNTARILY TERMINATED WITHOUT "GOOD CAUSE" WITHIN A 24 MONTH PERIOD AFTER A CHANGE-OF-CONTROL OCCURS. DISTRIBUTIONS FROM THIS PLAN ARE SUBJECT TO FEDERAL, STATE, AND LOCAL TAXES ON THE ENTIRE ACCOUNT BALANCE UPON DISTRIBUTION.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Issuer EINIssuerEIN	Date IssuedDateIssued	Issue PriceIssuePrice	Description Of PurposeDescriptionOfPurpose	DefeasedDefeased	On Behalf Of IssuerOnBehalfOfIssuer	Pool FinancingPoolFinancing	CUSIP NumberCUSIPNumber
HEALTH AND EDUCATIONAL FACILITIES BOARD OF THE CITY OF JOHNSON CITY TN
621464028	2010-05-27	16000000	ACQUIRE HOSPITAL EQUIPMENT	0	0	0
HEALTH AND EDUCATIONAL FACILITIES BOARD OF THE CITY OF JOHNSON CITY TN
621464028	2010-04-29	205877528	PARTIAL REFUNDING OF BONDS ISSUED 12/14/07 AND 2/20/2008	0	0	0	478271JH3
INDUSTRIAL DEVELOPMENT AUTHORITY OF WASHINGTON COUNTY VA
521324605	2009-03-31	124301533	CONSTRUCT & EQUIP HOSPITAL FACILITIES, INCLUD'G REFINANCING OF TAXABLE DEBT	0	0	0	938740CF2
HEALTH AND EDUCATIONAL FACILITIES BOARD OF THE CITY OF JOHNSON CITY TN
621464028	2008-02-20	127000000	ACQUIRE,CONSTRUCT & EQUIP HOSP FACILITIES,INCLUD'G REFINANCING TAXABLE DEBT	0	0	0	478271HL6

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Amount RetiredAmountRetired	Total ProceedsTotalProceeds	Issuance Costs From ProceedsIssuanceCostsFromProceeds	Capital ExpendituresCapitalExpenditures	Amount UnspentAmountUnspent	Current RefundingCurrentRefunding	Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind	Amount In Reserve FundAmountInReserveFund	Capitalized InterestCapitalizedInterest	Credit EnhancementCreditEnhancement	Working Capital ExpendituresWorkingCapitalExpenditures
1989299	7121143	45000	8835764	7121143	0	1
	18340116	3476394		21469689	1	1	18340116
	18570379	2481706	94192104	6438617	0	1	12131763
59900000	1745703	1953563	105490018	926968	0	1		2719265	324975	4473649

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty	Bond Counsel Routinely EngagedBondCounselRoutinelyEngaged	Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
1	1	1
1	1	1
1	1	1
1	1	1

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Variable Rate IssueVariableRateIssue	Gross Proceeds InvestedGrossProceedsInvested	Exception To RebateExceptionToRebate
0	0	1
0	0	0
0	0	0
1	1	0

Form990 Schedule K Part V Form990ScheduleKPartV

Field	Value	IRS element (for citing)
Identifier	SCHEDULE K SUPPLENTAL INFORMATION	Identifier
Explanation	1. COMMENT ON SCHEDULE K, PART I, LINES B, C, D, AND E. MOUNTAIN STATES HEALTH ALLIANCE OWNS AND/OR OPERATES HOSPITALS IN A NUMBER OF DIFFERENT LOCATIONS BOTH IN TENNESSEE AND IN VIRGINIA. AS A RESULT, MOUNTAIN STATES HEALTH ALLIANCE MUST UTILIZE CONDUIT GOVERNMENTAL BOND ISSUERS IN A NUMBER OF JURISDICTIONS IN ORDER TO FINANCE IMPROVEMENTS TO ITS HOSPITAL FACILITIES. IN 2007, 2008, 2009 AND 2010, MOUNTAIN STATES HEALTH ALLIANCE WAS THE CONDUIT BORROWER OF TAX-EXEMPT BONDS ISSUED BY MULTIPLE ISSUERS IN TENNESSEE AND VIRGINIA. FOR FEDERAL TAX PURPOSES, EVEN THOUGH DIFFERENT GOVERNMENT ISSUERS WERE INVOLVED, THESE MULTIPLE ISSUES IN EACH YEAR WERE REQUIRED TO BE TREATED, AND WERE TREATED, AS A SINGLE "ISSUE" BECAUSE THEY MET THE SINGLE "ISSUE" TEST UNDER THE APPLICABLE FEDERAL TAX REGULATIONS. THEREFORE, MULTIPLE ISSUERS ARE LISTED UNDER LINES B, C, D AND E BECAUSE THE BONDS THAT WERE ISSUED WERE PART OF A SINGLE "ISSUE" FOR FEDERAL TAX PURPOSES. 2. COMMENT ON SCHEDULE K, PART II, LINE 3. THE INSTRUCTIONS REQUEST THE TOTAL AMOUNT OF BOND PROCEEDS "AS OF THE END OF THE 12-MONTH PERIOD". BECAUSE A SUBSTANTIAL AMOUNT OF THE PROCEEDS OF EACH ISSUE WAS SPENT AS OF THE END OF THE REPORTING PERIOD, THE TOTAL PROCEEDS AS OF THE END OF SUCH PERIOD WILL NECESSARILY BE LESS THAN THE ISSUE PRICE. 3. COMMENT ON SCHEDULE K, PART II, LINE 4. CERTAIN PROCEEDS OF THE BOND ISSUES LISTED IN LINES B, C, AND F 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 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. LINE 2 OF PART II OF SCHEDULE K FOR THE BOND ISSUE DESCRIBED IN LINE F ALSO INCLUDES CERTAIN MONIES HELD IN A BONA FIDE DEBT SERVICE FUND. 4. COMMENT ON SCHEDULE K, PART II, LINE 9. THE BOND ISSUE DESCRIBED IN LINE D OF PART I FINANCED A SMALL AMOUNT OF WORKING CAPITAL EXPENDITURES. THESE WORKING CAPITAL EXPENDITURES DIRECTLY RELATED TO THE CAPITAL EXPENDITURES THAT WERE FINANCED WITH THE PROCEEDS OF THE BONDS. THEREFORE THE PROCEEDS OF THESE BONDS COULD BE ALLOCATED TO SUCH WORKING CAPITAL EXPENDITURES PURSUANT TO SECTION 1.148-6(D)(3)(V) OF THE TREASURY REGULATIONS. 5. COMMENTS 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 F OF PART I (THE SERIES 2006 BONDS). MOUNTAIN STATES HEALTH ALLIANCE RETAINED A REBATE CALCULATION AGENT TO CALCULATE WHETHER ANY ARBITRAGE REBATE WAS DUE WITH RESPECT TO THOSE BONDS, AND THERE WAS NEGATIVE ARBITRAGE REBATE LIABILITY IN A SIGNIFICANT AMOUNT. THEREFORE, NO FORM 8038-T WAS REQUIRED TO BE FILED WITH RESPECT TO THAT BOND ISSUE. 6. COMMENT ON SCHEDULE K, PART IV, LINE 4D. PART IV, LINE 4D RELATIVE TO THE BOND ISSUE DESCRIBED ON LINE F SHOWS THAT THE REGULATORY SAFE HARBOR FOR ESTABLISHING FAIR MARKET VALUE OF THE GIC DESCRIBED IN LINE 4A WAS NOT SATISFIED. DUE TO MARKET CONDITIONS AT THE TIME, MOUNTAIN STATES HEALTH ALLIANCE DID NOT RECEIVE THREE BIDS FOR THIS GIC. HOWEVER, THE YIELD ON THE GIC WAS SO SUBSTANTIALLY BELOW THE YIELD ON THE RELEVANT BONDS THAT THERE WAS NO DOUBT THAT THE YIELD ON THE GIC DID NOT EXCEED THE APPROPRIATE YIELD ON THE RELEVANT BONDS. 7. COMMENT ON SCHEDULE K, PART IV, LINE 5. THE BOND ISSUES DESCRIBED IN LINES 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, MOUNTAIN STATES HEALTH ALLIANCE 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. PORTIONS OF THE BOND ISSUES DESCRIBED IN LINE D AS WELL AS BOND ISSUES ISSUED IN 2007 WERE PARTIALLY REFUNDED BY THE BONDS DESCRIBED IN LINE B (THE SERIES 2010 BONDS), SO SOME OF THE PROCEEDS OF THE BONDS DESCRIBED IN LINE C HAVE BECOME TRANSFERRED PROCEEDS OF THE SERIES 2010 BONDS (AND ARE REPORTED UNDER THE APPROPRIATE LINES FOR THE SERIES 2010 BONDS). 8. COMMENT ON PART V. MOUNTAIN STATES HEALTH ALLIANCE HAS EXECUTED DETAILED TAX CERTIFICATES REQUIRING TAX COMPLIANCE THAT ARE INTENDED TO ENSURE THAT VIOLATIONS OF FEDERAL TAX REQUIREMENTS ARE TIMELY IDENTIFIED. MOUNTAIN STATES HEALTH ALLIANCE HAS ALSO RECENTLY ADOPTED SEPARATE PROCEDURES FOR SUCH PURPOSES.	Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	HEALTH AND EDUCATIONAL FACILITIES BOARD OF THE CITY OF JOHNSON CITY TN	BusinessNameLine1

Field	Value	IRS element (for citing)
Issuer EIN	621464028	IssuerEIN
CUSIP Number	478271GX1	CUSIPNumber
Date Issued	2006-02-14	DateIssued
Issue Price	178614171	IssuePrice
Description Of Purpose	CONSTRUCT & EQUIP HOSPITAL FACILITIES, INCLUDING REFINANCING TAXABLE DEBT	DescriptionOfPurpose
Defeased	0	Defeased
On Behalf Of Issuer	0	OnBehalfOfIssuer
Pool Financing	0	PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

Field	Value	IRS element (for citing)
Amount Retired	3395000	AmountRetired
Total Proceeds	17303000	TotalProceeds
Amount In Reserve Fund	17463000	AmountInReserveFund
Issuance Costs From Proceeds	2383533	IssuanceCostsFromProceeds
Capital Expenditures	127559187	CapitalExpenditures
Year Of Subst Completion	2011	YearOfSubstCompletion
Current Refunding	1	CurrentRefunding
Advance Refunding	1	AdvanceRefunding
Final Allocation Made	1	FinalAllocationMade
Adequate Books And Recds Maintaind	1	AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

Field	Value	IRS element (for citing)
Owning Bond Financed Property	0	OwningBondFinancedProperty
Any Lease Arrangements	0	AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty	1	MngmentCntrctBondFinancdPrprty
Any Research Agreements	0	AnyResearchAgreements
Bond Counsel Routinely Engaged	1	BondCounselRoutinelyEngaged
Prcntge Prvt Business Use By Others	0.00000	PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI	0.00000	PercentageOfPrvtBusinessReUBI
Total Private Business Use	0.00000	TotalPrivateBusinessUse
Post Issuance Compliance Procdrs	1	PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

Field	Value	IRS element (for citing)
Form8038 T Filed	0	Form8038TFiled
Variable Rate Issue	0	VariableRateIssue
Hedge Identified In Books And Recds	0	HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC	1	GrossProceedsInvestedInGIC

Name Of GIC Provider NameOfGICProvider

Field	Value	IRS element (for citing)
Business Name Line1	JP MORGAN CHASE	BusinessNameLine1
Business Name Line2	BANK NA	BusinessNameLine2

Field	Value	IRS element (for citing)
Regulatory Safe Harbor Satisfied	0	RegulatorySafeHarborSatisfied
Gross Proceeds Invested	1	GrossProceedsInvested
Exception To Rebate	0	ExceptionToRebate

Schedule L IRS990ScheduleL

Loan Table LoanTable (4 entries)

Purpose Of LoanPurposeOfLoan	Loan From OrganizationLoanFromOrganization	Original PrincipalOriginalPrincipalAmount	Balance DueBalanceDue	DefaultDefault	Approved By BoardApprovedByBoard	Written AgreementWrittenAgreement
DENNIS VONDERFECHT
SPLIT DOLLAR LIFE INSUR. LOAN	X	$2,705,125	2705125	0	1	1
DENNIS VONDERFECHT
SPLIT DOLLAR LIFE INSUR. LOAN	X	$900,000	938520	0	1	1
DENNIS VONDERFECHT
SPLIT DOLLAR LIFE INSUR. LOAN	X	$900,000	936090	0	1	1
DENNIS VONDERFECHT
SPLIT DOLLAR LIFE INSUR. LOAN	X	$900,000	937530	0	1	1

Field	Value	IRS element (for citing)
Total Balance Due	5517265	TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (8 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
CLEM WILKES III
FAMILY MEMBER OF CLEM WILKES, JR., MSHA BOARD TREASURER	49200	CLEM WILKES, JR., TREASURER OF THE MSHA BOARD OF DIRECTORS, IS A FAMILY MEMBER OF CLEM WILKES, III, AN EMPLOYEE OF MSHA.	0
WATAUGA PATHOLOGY ASSOCIATES PC
PROVIDER OF MEDICAL SERVICES TO MSHA	320674	DR. SANDRA BROOKS, MEMBER OF THE MSHA BOARD OF DIRECTORS, SERVES AS VICE PRESIDENT OF WATAUGA PATHOLOGY ASSOCIATES, P.C. AND HAS AN OWNERSHIP IN THE PROFESSIONAL CORPORATION. WATAUGA PATHOLOGY ASSOCIATES, P.C. PROVIDES MEDICAL SERVICES TO MSHA.	0
PAULA CLAYTORE
FAMILY MEMBER OF DALE CLAYTORE, MSHA KEY EMPLOYEE	245953	DALE CLAYTORE, A KEY EMPLOYEE OF MSHA, IS A FAMILY MEMBER OF PAULA CLAYTORE, AN EMPLOYEE OF MSHA.	0
WORKSPACE INTERIORS INC
PROVIDER OF COMMERCIAL FURNISHINGS TO MSHA	267026	ROBERT FEATHERS, CHAIRMAN OF THE MSHA BOARD OF DIRECTORS, IS OWNER OF WORKSPACE INTERIORS, INC., WHICH PROVIDES COMMERCIAL FURNISHING PRODUCTS TO MSHA. TRANSACTIONS ARE CONDUCTED AT ARMS-LENGTH.	0
REBEKAH HILTON
FAMILY MEMBER OF SHANE HILTON, MSHA KEY EMPLOYEE	33447	SHANE HILTON, A KEY EMPLOYEE OF MSHA, IS A FAMILY MEMBER OF REBEKAH HILTON, AN EMPLOYEE OF MSHA.	0
JAMES TEIXEIRA
FAMILY MEMBER OF PAT NIDAY, MSHA KEY EMPLOYEE	49611	PAT NIDAY, A KEY EMPLOYEE OF MSHA, IS A FAMILY MEMBER OF JAMES TEIXEIRA, AN EMPLOYEE OF MSHA.	0
MITCHELL HATHAWAY
FAMILY MEMBER OF JOANNE GILMER, MSHA BOARD MEMBER	94743	JOANNE GILMER, MSHA BOARD SECRETARY, IS A FAMILY MEMBER OF MITCHELL HATHAWAY, AN EMPLOYEE OF MSHA.	0
SYCAMORE SHOALS ANESTHESIA ASSOCIATES PC
PROVIDER OF MEDICAL SERVICES TO MSHA	845445	DR. DAVID MAY, MSHA BOARD MEMBER, SERVES AS BOARD CHAIR OF SYCAMORE SHOALS ANESTHESIA ASSOCIATES, P.C. AND HAS AN OWNERSHIP IN THE PROFESSIONAL CORPORATION. SYCAMORE SHOALS ANESTHESIA ASSOCIATES, P.C. PROVIDES MEDICAL SERVICES TO MSHA.	0

Form990 Schedule L Part V Form990ScheduleLPartV

Field	Value	IRS element (for citing)
Identifier	SCHEDULE L, PART II, LOANS TO AND FROM INTERESTED PERSONS:	Identifier
Explanation	THE FIRST LINE ON PART II IS THE ORIGINAL LOAN AMOUNT FOR A SPLIT DOLLAR LIFE INSURANCE PLAN, WHILE THE ADDITIONAL LINES ARE ANNUAL PREMIUM FUNDINGS AND INTEREST.	Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (17 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
DOING BUSINESS AS	FORM 990, PART I, ITEM C	SYCAMORE SHOALS HOSPITAL INDIAN PATH MEDICAL CENTER WOODRIDGE HOSPITAL FOR BEHAVIORAL HEALTH SERVICES FRANKLIN WOODS COMMUNITY HOSPITAL JOHNSON COUNTY COMMUNITY HOSPITAL NISWONGER CHILDREN'S HOSPITAL RUSSELL COUNTY MEDICAL CENTER
FORM 990, PART VI, SECTION A, LINE 4		THE MEMBERSHIP OF THE MSHA CORPORATION VOTED TO AMEND THE CHARTER OF THE CORPORATION TO CREATE 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. ALL EXISTING MEMBERS AUTOMATICALLY BECOME CLASS A MEMBERS, AND 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 CONTRIBUTING $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.
FORM 990, PART VI, SECTION A, LINE 6		THE CORPORATION HAS MEMBERS AS FULLY DESCRIBED IN RESPONSE TO NUMBER 4 ABOVE.
FORM 990, PART VI, SECTION A, LINE 7A		THE CLASS A MEMBERS ANNUALLY ELECT MEMBERS TO THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, 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.
FORM 990, PART VI, SECTION B, LINE 11		MSHA'S FORM 990 WAS REVIEWED BY MSHA'S BOARD OF DIRECTORS PRIOR TO SUBMITTING THE RETURN TO THE IRS. MSHA'S CFO AND SENIOR VICE-PRESIDENT PRESIDED OVER THE BOARD REVIEW. THE BOARD MEMBERS WERE PROVIDED ELECTRONIC ACCESS TO THE FORM 990 AND SCHEDULES PRIOR TO THE IN-PERSON REVIEW TO ALLOW MEMBERS ADEQUATE TIME TO LOOK OVER THE RETURN.
	FORM 990, PART VI, SECTION B, 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.
	FORM 990, PART VI, SECTION B, LINE 15	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. 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 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 AND ANNUAL BASIS.
OFFICER, KEY EMPLOYEE & HIGHEST PAID COMPENSATION:	FORM 990, PART VII, SECTION A	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. STEVE KILGORE, REPORTABLE AS A HIGHEST COMPENSATED EMPLOYEE, IS PAID BY MSHA AND HIS SALARY AND BENEFITS ARE FULLY REIMBURSED TO MSHA BY BRMMC. DR. WILLIAM WALKER, MSHA BOARD MEMBER, HAS REPORTABLE COMPENSATION AND BENEFITS PAID BY BRMMC. DR. WALKER IS A CARDIOVASCULAR THORACIC SURGEON IN A MEDICAL PRACTICE OWNED BY BRMMC. HE DOES NOT RECEIVE COMPENSATION FOR HIS MSHA BOARD SERVICE. 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.
CHANGES IN NET ASSETS OR FUND BALANCES:	FORM 990, PART XI, LINE 5:	PSHP CHARITABLE CONTRIBUTIONS NOT ON BOOKS 19,300. PSHP PORTFOLIO EXPENSES NOT ON BOOKS 3. TEMPORARILY RESTRICTED GRANTS 59,978. CHANGE IN FAIR VALUE OF DERIVATIVES 36,801,826. PARTNERSHIP INCOME NOT ON BOOKS -229,487. PSHP INTEREST INCOME NOT ON BOOKS -9,125. PSHP CAPITAL LOSSES NOT ON BOOKS 17,102. TOTAL TO FORM 990, PART XI, LINE 5: 36,659,597.
MISSION & SIGNIFICANT ACTIVITIES:	FORM 990, PART I, LINE 1	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 EARLY FY11, FRANKLIN WOODS COMMUNITY HOSPITAL (FWCH), A CERTIFIED "GREEN" FACILITY AND THE FIRST "GREEN" HOSPITAL IN THE STATE OF TENNESSEE. FWCH REPLACED NORTH SIDE AND SPECIALTY HOSPITALS IN JOHNSON CITY. CONSTRUCTION ON A REPLACEMENT HOSPITAL FOR JOHNSTON MEMORIAL HOSPITAL (JMH) WAS COMPLETED DURING FY11 AND THE HOSPITAL OPENED DURING THE YEAR. CONSTRUCTION WAS STARTED ON A REPLACEMENT FACILITY FOR SMYTH COUNTY COMMUNITY HOSPITAL (SCCH) AS WELL, WHICH WILL OPEN DURING FY12. BOTH JMH AND SCCH ARE LOCATED IN VIRGINIA AND MAJORITY OWNED BY MSHA. MSHA OFFERS UNIQUE SERVICES TO THE BROAD COMMUNITY WITH OUR NISWONGER CHILDREN'S HOSPITAL. THROUGH NISWONGER CHILDREN'S HOSPITAL, THE ST. JUDE CHILDREN'S HOSPITAL AFFILIATE CLINIC, WE PROVIDE THE REGION'S ONLY CHILDREN'S EMERGENCY DEPARTMENT. NISWONGER CHILDREN'S ALSO PROVIDES AN N.I.C.U., WHICH IS THE STATE DESIGNATED PERINATAL CENTER FOR THIS REGION. MSHA OFFERS THE LARGEST AIR AMBULANCE SERVICE IN THE REGION WITH WINGS AIR RESCUE COVERING THE ENTIRE 29-COUNTY SERVICE AREA. TO MEET ITS MISSION CLINICALLY, MSHA IS INVOLVED IN NUMEROUS QUALITY INITIATIVES AROUND THE UNITED STATES, BENCHMARKING AND IMPROVING PATIENT OUTCOMES AT OUR ACUTE CARE FACILITIES. THESE EFFORTS HAVE GENERATED NATIONAL, STATE AND REGIONAL RECOGNITIONS AS MSHA CONTINUES TO IMPROVE ITS PROCESSES AND OUTCOMES. MORE NARRATIVE INFORMATION IS PROVIDED ABOUT OUR HEALTH SYSTEM IN PART III AND SCHEDULE H. OUR MISSION DIRECTS THE SYSTEM TO IDENTIFY AND RESPOND TO THE HEALTHCARE NEEDS OF INDIVIDUALS AND COMMUNITIES IN OUR REGION. AS A RESULT, MSHA FINANCIALLY SUPPORTS MANY NON-PROFIT ORGANIZATIONS COMMITTED TO MEDICAL ASSISTANCE TO THE UNINSURED/UNDERINSURED AS WELL AS PROGRAMS TO IMPROVE THE OVERALL HEALTH AND WELLNESS OF OUR REGION.
VOLUNTEERS:	FORM 990, PART I, LINE 6	MOUNTAIN STATES HEALTH ALLIANCE AUXILIARY (AUXILIARY) SUPPORTS THE NUMEROUS HOSPITALS WITHIN THE MSHA SYSTEM. THE AUXILIARY IS AN ACTIVE ORGANIZATION THAT CONSTANTLY LOOKS FOR AND SOLICITS RECOMMENDATIONS ON ACTIVITIES TO BENEFIT MSHA HOSPITALS, PATIENTS AND THEIR FAMILIES, AND THE COMMUNITY. SINCE MSHA HAS NUMEROUS HOSPITALS OF VARYING SIZE AND SERVICES, THE OPPORTUNITY TO PROVIDE ASSISTANCE IS TREMENDOUS AND THE AUXILIARY OFTEN TAILORS ITS ACTIVITIES TO THE UNIQUE NEEDS WITHIN A SPECIFIC HOSPITAL. ALTHOUGH WE REPORT ACTIVE VOLUNTEERS OF 1,759 ON PAGE 1, LINE 6, THE ACTUAL NUMBER OF VOLUNTEERS IS MUCH HIGHER. WE KEEP PRECISE RECORDS ONLY FOR THOSE ACTIVE MEMBERS WHO WORK REGULARLY SCHEDULED HOURS. FOR EXAMPLE, OUR VOLUNTEERS WHO SEW AND DO NEEDLEWORK, ETC. INSIDE THEIR HOMES ARE NOT COUNTED. OUR ACTIVE VOLUNTEERS SERVED 145,423 HOURS DURING FISCAL YEAR 2011. ALL OF OUR ACTIVE VOLUNTEERS RECEIVE ORIENTATION AND ONGOING TRAINING; AND, ALL RECEIVE AN ANNUAL EVALUATION TO PROMOTE STAKEHOLDER SAFETY, ADHERENCE TO INTERNAL COMPLIANCE STANDARDS, AND TO ENSURE A CONSISTENT PROVISION OF QUALITY SERVICE TO PATIENTS, VISITORS, AND TEAM MEMBERS. SOME OF THE ACTIVITIES PROVIDED BY THE AUXILIARY VOLUNTEERS DURING FISCAL YEAR 2011 ARE REPORTED BELOW: MUSICAL ENTERTAINMENT, TAPED CONCERTS AND PERFORMANCES BY LOCAL STUDENTS, CHURCHES AND COMMUNITY GROUPS ARE PLAYED ON A VOLUNTEER MUSIC CHANNEL AT JOHNSON CITY MEDICAL CENTER (JCMC). A MUSICAL EVENTS CALENDAR IS MAINTAINED ON THE INTRANET FOR ALL HOSPITALS AND IN THE DAILY "MSHA MOMENT" - AN INFORMATIONAL COMMUNICATION TO ALL TEAM MEMBERS. SUNDAY AFTERNOON MUSICAL PERFORMANCES ARE GIVEN AT 5 MSHA HOSPITALS. A HARMONICA PLAYER WALKS THE HALLS AND PROVIDES HARMONICA MUSIC. HE WILL GO IN ANY PATIENT ROOM WHEN THE PATIENT/PATIENT FAMILY REQUESTS AND HE OFFERS FREE HARMONICAS WITH BEDSIDE LESSONS ESPECIALLY FOR CHILDREN AT OUR NISWONGER CHILDREN'S HOSPITAL. THESE HARMONICA LESSONS ARE ALSO HELPFUL TO HEART PATIENTS WHO ARE HAVING TROUBLE USING THEIR BREATHING DEVICE. VISUAL ARTS. THE AUXILIARY PREPARES A ROTATING ART EXHIBIT AT JCMC AND INDIAN PATH MEDICAL CENTER (IPMC). WE HAVE CERTIFIED MASTER GARDNER VOLUNTEERS AT JCMC, WOODRIDGE HOSPITAL, AND QUILLEN REHAB HOSPITAL. DIRECTION CARDS WERE DEVELOPED FOR JCMC AND FRANKLIN WOODS COMMUNITY HOSPITAL DURING THE YEAR. LITERARY ARTS. A READING PROGRAM IS PROVIDED FOR THE PATIENTS AT NISWONGER CHILDREN'S HOSPITAL. CULINARY. VOLUNTEERS BAKE AND DELIVER COOKIES DAILY TO JCMC, FWCH, AND IPMC. VOLUNTEERS ARRIVE EARLY EACH MORNING TO BAKE THE COOKIES. THE COOKIES ARE WRAPPED AND DELIVERED TO SURGERY, ICU, HEART CATH, AND ER WAITING ROOMS. A VARIETY OF SNACKS AND MEALS ARE DELIVERED TO NORTON COMMUNITY HOSPITAL FAMILY KITCHENS. GOODY BASKET DELIVERIES ARE MADE TO JCMC'S ICU WAITING ROOM. CREATIVE ARTS. VOLUNTEERS FROM AREA CHURCH GROUPS MAKE QUILTS AND PERSONAL CARE KITS FOR ER PATIENTS AT IPMC. VOLUNTEERS CREATE COLORING BOOKS FOR WAITING AREAS. ALL NEWBORNS RECEIVE HAND-KNITTED OR CROCHETED BABY HATS AND MANY RECEIVE BLANKETS AND/OR BOOTIES. ALL BABIES BORN DURING DECEMBER RECEIVE A HANDMADE, OVER-SIZED CHRISTMAS STOCKING. VOLUNTEERS BEGIN WORKING ON THE STOCKINGS IN THE SUMMER AND COMPLETE OVER 400 STOCKINGS. THE BABIES ARE OFTEN SENT HOME NESTLED IN THE STOCKINGS. VOLUNTEERS MAKE IV COVERS, SOFT CAPS FOR ONCOLOGY PATIENTS, AND HEATABLE BABY POSITIONING PADS. SPECIAL ENTERTAINMENT FOR CHILDREN INCLUDES VOLUNTEER CLOWNS AND SANTA. BOTH SANTA AND THE CLOWNS MAKE MONTHLY VISITS TO NISWONGER CHILDREN'S HOSPITAL. VOLUNTEERS ALSO MAKE PILLOWS FOR BARIATRIC PATIENTS. COMMUNITY INVOLVEMENT. VOLUNTEERS ARE AVAILABLE 7 DAYS A WEEK, 24 HOURS A DAY FOR NISWONGER CHILDREN'S HOSPITAL NICU. THIS PROGRAM'S PURPOSE IS TO HOLD AND COMFORT BABIES IN THE NICU AND IS APTLY CALLED THE NICU CUDDLER PROGRAM. THE AUXILIARY MAINTAINS A PROGRAM FOR HEART PATIENTS CALLED MENDED HEARTS. MENDED HEARTS HAS 19 TRAINED VOLUNTEERS TO VISIT WITH CARDIAC PATIENTS BEFORE AND AFTER OPEN HEART SURGERY EVERY DAY. THEY ALSO HAVE MONTHLY SUPPORT MEETINGS WITH PROGRAMS ON HEART HEALTH AND OFFER ANOTHER CLASS EVERY SIX WEEKS TO THE CARDIAC REHAB PROGRAM. THIS PROGRAM SERVED 761 PATIENTS AND FAMILY MEMBERS DURING THE YEAR. COURTESY CARTS AND A VAN OPERATED BY VOLUNTEERS ARE PROVIDED TO TRANSPORT PATIENTS AND VISITORS TO ANY DOOR AT JCMC. JCMC IS A LARGE HOSPITAL WITH MULTIPLE ENTRY POINTS AND PARKING CAN BE A GOOD DISTANCE AWAY FROM THE FACILITY. THIS TRANSPORT PROGRAM HAS BEEN VERY WELL RECEIVED BY OUR PATIENTS AND THEIR VISITORS. THE CARTS AND VAN OPERATE THREE SHIFTS DAILY AND ONE TO TWO SHIFTS ON WEEKENDS. FRANKLIN WOODS COMMUNITY HOSPITAL (FWCH). FWCH IS A BRAND-NEW MSHA HOSPITAL. WE ARE VERY PROUD OF THIS NEW FACILITY, WHICH IS A CERTIFIED "GREEN" HOSPITAL. SINCE OPENING IN THE SUMMER OF 2010, THE AUXILIARY VOLUNTEER TEAM EXPANDED ITS VOLUNTEER SERVICE OPERATIONS TO INCLUDE THIS NEW HOSPITAL.
STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED)	FORM 990, PART III, LINE 4A	- MSHA HAS A NO-RETALIATION AND NO-RETRIBUTION POLICY FOR THE PROTECTION OF INDIVIDUALS WHO, IN GOOD FAITH, REPORT LEGAL OR ETHICAL CONCERNS. TEAM MEMBERS ARE REQUIRED TO REPORT CONCERNS TO APPROPRIATE PERSONS FOR INVESTIGATION OR FOLLOW-UP. "ALERTLINE" IS A CONFIDENTIAL, RISK-FREE HOTLINE FOR REPORTING SUSPECTED ILLEGAL BEHAVIOR, ETHICAL VIOLATIONS OR SAFETY RISKS AND IS AVAILABLE TO ALL TEAM MEMBERS VIA A TOLL-FREE NUMBER. MEDICAL EDUCATION AND RESEARCH MSHA PROVIDES CLINICAL EXPERIENCE TO MEDICAL STUDENTS AND RESIDENTS OF THE JAMES H. QUILLEN COLLEGE OF MEDICINE AT ETSU. MSHA CONTRIBUTED AN UNREIMBURSED COST AMOUNT OF $3,877,766 TO THE RESIDENCY PROGRAM IN FY11. MSHA FACILITIES SERVE AS CLINICAL TRAINING AREAS FOR HEALTH PROFESSIONAL EDUCATION STUDENTS. MSHA HAS DEDICATED STAFF TO WORK WITH REGIONAL COLLEGES AND UNIVERSITIES TO COORDINATE THE PLACEMENT OF HEALTH CARE PROFESSIONAL STUDENTS AS PART OF THEIR EDUCATIONAL CURRICULUM. MANY OF THE HEALTH CARE STUDENTS ENTERING OUR SYSTEM ARE REQUIRED TO HAVE ORIENTATION AND COMPUTER TRAINING. ALSO RECEIVING CLINICAL EXPERIENCE AT MSHA WERE 1,298 NURSING STUDENTS FROM VARIOUS COLLEGES, UNIVERSITIES AND PROGRAMS. THIS NURSING CLINICAL EXPERIENCE REQUIRED EXTENSIVE MSHA NURSING STAFF INVOLVEMENT AT FIVE MSHA FACILITIES. THE CLINICAL SETTING AND HANDS-ON INSTRUCTION COST MSHA $2,307,917. MSHA PROVIDED A CLINICAL SETTING FOR ANOTHER 1,162 STUDENTS TRAINING IN HEALTH-RELATED PROGRAMS SUCH AS RADIOLOGY, PHARMACY, LABORATORY, PHYSICAL THERAPY AND OTHER ALLIED-HEALTH DISCIPLINES. THESE ADDITIONAL CLINICAL STUDENTS COST MSHA $1,022,679. MSHA PROVIDED ASSISTANCE TO 383 HIGH SCHOOL AND COLLEGE STUDENTS WHO WERE CONSIDERING A HEALTHCARE CAREER PATH BY ALLOWING THEM TO OBSERVE LICENSED MSHA CLINICAL PROFESSIONALS. THE SHADOWING OF CLINICAL STAFF BY THESE STUDENTS COST MSHA $8,686. MSHA'S LEARNING RESOURCE CENTER (LRC) IS A MEDICAL LIBRARY THAT PROVIDES ACCESS TO MEDICAL DATABASES, VARIOUS PAPER PUBLICATIONS AND FACILITATES INTER-LIBRARY JOURNAL LOANS TO INCREASE LIBRARY RESOURCES. THE LRC SUBSCRIBES TO SEVERAL ONLINE MEDICAL DATABASES AS WELL AS PRINTED MEDICAL EDUCATION MATERIALS. THE LRC IS PRIMARILY UTILIZED BY MEDICAL RESIDENTS, PHARMACY AND NURSING STUDENTS. THIS SERVICE IS ALSO USED BY OTHER HEALTH PROFESSION EDUCATION STUDENTS, PHYSICIANS AND STAFF, AND IS OPEN TO THE COMMUNITY. THE FY11 COST OF PROVIDING THIS SERVICE WAS $306,197. MARKETING - MSHA PROVIDES ACCESS TO SEVERAL ONLINE HEALTH INFORMATION SERVICES. "MY HEALTH NEWS" ALLOWS ACCESS TO HEALTH INFORMATION TOPICS AND SERVICES THAT MATTER TO THE USER. THIS SERVICE SENDS UP-TO-DATE INFORMATION FROM NATIONAL HEALTH RESOURCES TAILORED TO THE INDIVIDUAL'S NEEDS. MSHA PROVIDES ACCESS TO "KIDSHEALTH", A SERVICE THAT PROVIDES PRACTICAL PARENTING INFORMATION AND NEWS. THIS SERVICE ALSO PROVIDES HOMEWORK HELP FOR KIDS AND STRAIGHT TALK ANSWERS FOR TEENS. NEW TO THE MSHA WEB SITE IS "ITRIAGE", A LINK THAT ALLOWS THE USER TO CHECK FOR A WIDE ARRAY OF SYMPTOMS AND CAUSES/TREATMENTS, DISEASES AND CONDITION INFORMATION, EXPLANATIONS OF VARIOUS MEDICAL PROCEDURES, AND AN APP IS AVAILABLE FOR DOWNLOADING. MSHA PROVIDES CME AND CEU OPPORTUNITIES WITH "MEDNEWSPLUS" FOR PHYSICIANS AND NURSES FREE OF CHARGE. THE SERVICE IS OPEN TO ANY PHYSICIAN OR NURSE IN THE REGION AND OFFERS CME AND CEU CREDITS. MSHA ALSO PROVIDES LINKS TO HELPFUL HEALTH-RELATED SITES ON THE INTERNET. PATIENT CARE SERVICES DATA SHOWS THAT THE HEALTH STATUS OF MSHA'S SERVICE AREA IS GENERALLY POOR. MSHA'S SERVICE AREA CONSISTS OF COUNTIES IN TENNESSEE AND SOUTHWEST VIRGINIA. AMONG THE 50 STATES, TENNESSEE RANKED 42ND AND VIRGINIA RANKED 22ND IN TERMS OF HEALTH STATUS. SOME OF THE OVERWHELMING HEALTH ISSUES IN OUR SERVICE AREA INCLUDE: 1. HIGH PREVALENCE OF OBESITY 2. POOR CARDIOVASCULAR HEALTH 3. HIGH RATE OF CIGARETTE SMOKING 4. POOR AIR QUALITY 5. LOW RATE OF DIABETIC CARE 6. HIGH RATE OF UNINSURED 7. LOW LEVEL OF EDUCATION 8. HIGH RATE OF DEATHS DUE TO CARDIOVASCULAR CONDITIONS, CANCER AND DIABETES GIVEN THIS HEALTH PROFILE, MSHA EXISTS TO IDENTIFY AND RESPOND TO THE HEALTHCARE NEEDS OF ALL INDIVIDUALS AND COMMUNITIES IN THE REGION AND TO ASSIST THEM IN ATTAINING THEIR HIGHEST POSSIBLE LEVEL OF HEALTH. MSHA LIVES ITS MISSION TO BRING LOVING CARE TO HEALTH CARE IN OUR REGION. MSHA OPERATES ON A NON-DISCRIMINATORY BASIS, PROVIDING QUALITY HEALTH CARE TO ALL PATIENTS REGARDLESS OF RACE, RELIGION, GENDER, ETHNICITY, DISABILITY, AGE OR ABILITY TO PAY. CHARITY AND UNREIMBURSED COSTS CHARITY CARE: WHILE REIMBURSEMENT FOR HEALTHCARE SERVICES RENDERED IS CRITICAL TO THE OPERATION AND SUSTAINABILITY OF THE ORGANIZATION, MSHA RECOGNIZES ITS OBLIGATION TO PROVIDE CARE TO INDIVIDUALS WHO CANNOT AFFORD ESSENTIAL MEDICAL SERVICES, INCLUDING EMERGENCY CARE. A PATIENT IS CLASSIFIED AS A CHARITY PATIENT BY REFERENCE TO ESTABLISHED POLICIES OF MSHA AND GUIDELINES OUTLINED BY THE FEDERAL GOVERNMENT. HOWEVER, FINANCIAL ASSISTANCE DECISIONS ARE NOT SOLELY BASED ON INCOME. UNIQUE FINANCIAL CIRCUMSTANCES ARE WEIGHED WITH VERIFIED PATIENT ASSETS WHICH CAN DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY. IT IS NOT UNTIL AFTER VERIFICATION OF INCOME AND ASSETS THAT A DECISION AS TO THE AMOUNT OF WRITE-OFF WILL BE MADE. IN FISCAL YEAR 2011, MSHA INCURRED A LOSS OF $13,141,846 ATTRIBUTABLE TO THE PROVISION OF FREE CARE TO INDIGENT PATIENTS. GOVERNMENTAL PROGRAM ENROLLEES: MSHA PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS, INCLUDING MEDICARE AND MEDICAID AND STATE-FUNDED TENNCARE. IN FY11, THE UNREIMBURSED COST OF SERVICES PROVIDED TO THIS PATIENT POPULATION WAS $5,789,329 (MEDICARE, BASED ON MEDICARE ALLOWABLE COSTS), $3,388,560 (MEDICAID) AND $23,287,060 (TENNCARE). BAD DEBT: MSHA PROVIDES AN INCREASING LEVEL OF SERVICE TO SELF-PAY PATIENTS FOR WHICH IT RECEIVES LITTLE OR NO PAYMENT. DURING FY11, BAD DEBTS RESULTED IN UNREIMBURSED COSTS OF $11,418,733. PROMOTE COMMUNITY HEALTH MSHA OFFERS MANY REDUCED-PRICE OR FREE SERVICES AND PROGRAMS YEAR-ROUND IN CARE SETTINGS THAT IT ESTABLISHED TO ACCOMMODATE THE WIDELY SCATTERED, AGING AND SOCIOECONOMICALLY DISADVANTAGED POPULATION. SUCH PROGRAMS SERVE BONA FIDE COMMUNITY HEALTH NEEDS AND RESULT IN FINANCIAL LOSSES TO THE ORGANIZATION. WINGS AIR RESCUE (WINGS), THE REGION'S ONLY EMERGENCY MEDICAL HELICOPTER SERVICE, IS CONSIDERED BY MSHA TO BE A REGIONAL ASSET. LICENSED IN THE STATE OF TENNESSEE AND THE COMMONWEALTHS OF KENTUCKY AND VIRGINIA, WINGS PROVIDED AIR TRANSPORT OF CRITICALLY ILL AND INJURED PATIENTS TO THE CLOSEST TERTIARY FACILITIES, INCLUDING NON-MSHA FACILITIES. 74% OF THEIR PATIENTS ARE FROM TRAUMA SCENES TO TERTIARY CARE CENTERS, WITH OTHERS BEING CARDIAC, OB, PEDIATRIC AND MEDICAL. DURING FY11, WINGS TRANSPORTED 1,591 PATIENTS AND MADE 11 SEARCH AND RESCUE FLIGHTS AT A NET OPERATING LOSS OF $740,905 TO MSHA. NURSE LINK MEDICAL CALL CENTER IS A 24-HOUR TOLL-FREE MEDICAL INFORMATION LINE. EXPERIENCED REGISTERED NURSES ANSWER CALLS AND PROVIDE INVALUABLE CONFIDENTIAL HEALTH INFORMATION. THEY MANAGE PHYSICIAN-APPROVED PATIENT TRIAGE SERVICES; MAKE INDIVIDUAL CALLBACKS FOR PEDIATRIC AND ADULT PATIENTS WITH SERIOUS SYMPTOMS; AND COORDINATE PATIENT TRANSPORTS AND EMERGENCY DEPARTMENT ACCESS. IN FY11, NURSE LINK HANDLED 52,359 CALLS INCLUDING 3,410 PHYSICIAN REFERRALS. MSHA INCURRED AN EXPENSE OF $560,241 TO PROVIDE THIS SERVICE AT NO COST TO THE COMMUNITY. DURING FY11, MSHA OPERATED A SATELLITE DISPENSARY OF HOPE. THE DISPENSARY OF HOPE PROVIDES PRESCRIPTION DRUGS TO THOSE WHO MAY NOT HAVE OTHERWISE BEEN ABLE TO AFFORD NEEDED MEDICATIONS. DURING FY11, THE DISPENSARY FILLED 12,358 PRESCRIPTIONS FOR 2,792 PEOPLE WHOM OTHERWISE COULD NOT HAVE AFFORDED THEM. THE SITE HAS ITS OWN PHARMACY, A FULL TIME PHARMACIST, A FULL-TIME PHARMACY TECH AND A SOCIAL WORKER/RECEPTIONIST. THE LOCAL DISPENSARY OF HOPE IS STAFFED, IN PART, BY VOLUNTEER PHARMACISTS FROM THE COMMUNITY AND WILL SERVE AS A TRAINING SITE FOR THE BILL GATTON COLLEGE OF PHARMACY AT EAST TENNESSEE STATE UNIVERSITY. DURING FY11, MSHA INCURRED UNREIMBURSED EXPENSES OF $194,980 FOR THIS PROGRAM. THE HEALTH RESOURCES CENTER (HRC) IS A COMMUNITY OUTREACH SERVICE PROVIDED BY MSHA. THE HRC IS CONVENIENTLY LOCATED IN THE REGION'S LARGEST SHOPPING MALL. THE HRC OFFERS FREE CLASSES, BLOOD PRESSURE CHECKS, INFORMATIONAL MATERIALS AND RESOURCES AS WELL AS A NUMBER OF OTHER SERVICES IN AN EFFORT TO MEET COMMUNITY MEMBERS' BASIC HEALTH AND HEALTH EDUCATION NEEDS. THE HRC HAD 25,565 VISITS TO THEIR OFFICE AND PERFORMED 1,698 HEALTH SCREENINGS. THE HRC ALSO HOSTED MORE THAN 7,802 ATTENDEES WHO PARTICIPATED IN MONTHLY HEALTH EDUCATION PROGRAMS. THE HRC ALSO PROVIDES OUTREACH SERVICES WHERE THEY SCREENED AN ADDITIONAL 5,489 COMMUNITY MEMBERS. THE UNCOMPENSATED COST OF HRC WAS $388,247.
PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED)	FORM 990, PART III, LINE 4A	SOME OF THE FREE CLASSES AND SUPPORT GROUPS OFFERED TO THE PUBLIC BY MSHA INCLUDE: SMOKING SESSATION PROGRAMS; NURTITION AND COOKING CLASSES; EDUCATIONAL SESSIONS ON THE DANGERS OF RECREATIONAL DRUGS SUCH AS BATH SALTS AND SYNTHETIC MARIJUANA; CPR CLASSES; RELAXATION TRAINING; SAFE BABYSITTING TRAINING; BALANCE AND FALLS PREVENTION; WEIGHT LOSS; EXERCISE PROGRAMS, ETC. MSHA'S COMMUNITY HEALTH AND WELLNESS SCREENING CENTER (CHAWS) WORKS WITH LOCAL SCHOOLS AND BUSINESSES AS WELL AS INDIVIDUAL COMMUNITY MEMBERS TO PROVIDE ONSITE HEALTH EDUCATION PROGRAMS, PERFORM HEALTH ASSESSMENTS AND OFFER HEALTHY LIFESTYLE COUNSELING. IN FY11, CHAWS PROVIDED 983 SCREENINGS WITH AN UNREIMBURSED EXPENSE OF $351,985. IN OCTOBER OF 2010, MSHA INTRODUCED THE HEART COACH. THE HEART COACH IS A MOBILE CARDIOVASCULAR SCREENING CENTER WHICH IS OFFERED IN EAST TENNESSEE AND SOUTHWEST VIRGINIA. DURING FY11, THE HEART COACH PROVIDED 2,721 CARDIOVASCULAR SCREENINGS. 183 OF THESE SCREENINGS HAD ABNORMAL RESULTS FOR CARDIOVASCULAR ISSUES AND 202 ABNORMAL RESULTS FOR OTHER ISSUES (GLUCOSE, BLOOD PRESSURE, ETC.). THE STAFF OF THE HEART COACH WAS ABLE TO PROVIDE REFERRALS FOR FOLLOW UP APPROPRIATE TO EACH MEDICAL CONDITION. IN FY11, THE HEART COACH HAD UNREIMBURSED EXPENSES OF $170,752. BASED ON COMMUNITY NEEDS, MSHA INCURRED AN EXPENSE OF $150,215 TO RECRUIT PHYSICIANS INTO CLINICAL/GEOGRAPHICAL AREAS THAT WERE FEDERALLY DESIGNATED AS MEDICALLY UNDERSERVED. MSHA INCURRED AN ADDITIONAL EXPENSE OF $1,989,030 TO RECRUIT PHYSICIANS INTO OTHER AREAS SERVICED BY MSHA. JOHNSON COUNTY COMMUNITY HOSPITAL (JCCH) IS A FEDERALLY DESIGNATED CRITICAL ACCESS HOSPITAL. THIS FACILITY IS LOCATED IN ONE OF TENNESSEE'S POOREST COUNTIES AND PROVIDES EMERGENCY, INPATIENT AND OUTPATIENT CARE TO THE COUNTY'S RESIDENTS, MANY OF WHOM ARE OVER 65 YEARS OLD. JCCH CONTINUES TO BE DESIGNATED AS A PHYSICIAN SHORTAGE AREA FOR MANY SPECIALTIES. JCCH OPERATES A PHYSICIAN SPECIALTY CLINIC, WHICH INCURRED AN OPERATING LOSS OF $59,254 IN FY11. THE SPECIALTY CLINIC INCLUDES GENERAL SURGERY, PODIATRY, CARDIOLOGY 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 LOCATED MORE THAN AN HOUR AWAY), RESOLVING ACCESS LIMITATIONS FOR SPECIALTY SERVICES, AND PROVIDING RELIEF TO THE SPECIAL HEALTH PROBLEMS OF A LARGELY ELDERLY POPULATION. RURAL LIFE OFTEN INCLUDES HAZARDOUS OCCUPATIONS SUCH AS FARMING, WHICH INCREASES THE RISK FOR CHRONIC RESPIRATORY DISEASES AND CANCER- RELATED ILLNESSES CAUSED BY FERTILIZATION AND OTHER CHEMICALS. THIS RURAL POPULATION HAS A HIGHER INCIDENCE OF CARDIOVASCULAR DISEASE DUE TO DIET AND GENETIC PREDISPOSITION. GIVEN THESE FACTORS, RURAL HOSPITALS MUST REMAIN FLEXIBLE AND DIVERSE IN THEIR FACILITIES AND THE SERVICES THEY OFFER THE COMMUNITY. MSHA REMAINS FIRM IN THE BELIEF THAT FINANCIALLY SUPPORTING THE SERVICES OF JCCH AND THE SPECIALTY CLINIC TO ASSIST RESIDENTS IN ATTAINING A HIGH LEVEL OF HEALTH CONTINUES TO BE A CORE VALUE OF OUR BUSINESS AND COMMUNITY SUPPORT. MSHA 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 CLINIC'S LARGEST PAYOR IS MEDICARE, WHICH ACCOUNTS FOR 36% OF THEIR PATIENTS. DURING FY11, THE CLINIC HAD 10,101 OUTPATIENT VISITS. DURING FY11, RCMC PROVIDED A $399,460 SUBSIDY TO SUPPORT THE CLINIC'S OPERATIONS. MSHA HAS PARTNERED WITH THE COMPANY FIRSTSOURCE SOLUTIONS TO WORK WITH SELF-PAYING PATIENTS WHO HAVE LIMITED FINANCIAL RESOURCES. DURING FY11, FIRSTSOURCE REPRESENTATIVES WERE AVAILABLE AT ALL MSHA FACILITIES FOR DAILY INTERACTION AND FINANCIAL SCREENING OF PATIENTS. FIRSTSOURCE REPRESENTATIVES WERE ABLE TO DETERMINE GOVERNMENTAL MEDICAL ASSISTANCE (TENNCARE OR MEDICAID) ELIGIBILITY, AND TO HELP WITH THE APPLICATION PROCESS AND FOLLOW-UP. DURING FY11, 4,339 POTENTIALLY ELIGIBLE PATIENTS TOOK ADVANTAGE OF FIRST SOURCE'S HELP, AND OF THOSE PATIENTS WHO APPLIED FOR TENNCARE OR VIRGINIA MEDICAID COVERAGE, 2,580 (60%) WERE APPROVED FOR COVERAGE. ONCE A PERSON IS APPROVED FOR TENNCARE OR MEDICAID THROUGH THE FIRSTSOURCE PROGRAM OFFERED THROUGH MSHA, THEY RETAIN COVERAGE FOR FUTURE MEDICAL CARE. FIRSTSOURCE IS COMPENSATED BY MSHA. DURING FY11, MSHA'S COST FOR THIS PROGRAM WAS $755,834. MSHA ALSO GIFTS THE LAND LEASE TO THE RONALD MCDONALD HOUSE AT A FAIR MARKET VALUE OF $60,000. THE RONALD MCDONALD HOUSE IS LOCATED ON THE CAMPUS OF NISWONGER CHILDREN'S HOSPITAL AND JOHNSON CITY MEDICAL CENTER. MSHA CONTRIBUTED $53,027 TO CARESPARK. CARESPARK WAS ESTABLISHED TO EXPLORE WAYS TO SHARE HEALTH INFORMATION SECURELY, EFFICIENTLY AND COST-EFFECTIVELY. CARESPARK WAS INITIATED BY VOLUNTEERS WITH THE COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP, WHO HAD BEEN WORKING TOGETHER FOR MORE THAN A DECADE THROUGH THE LOCAL NON-PROFIT CITIZEN ORGANIZATION, KINGSPORT TOMORROW, TO DEVELOP COLLABORATIVE PROCESSES TO IMPROVE HEALTH WITHIN THE COMMUNITY. MSHA CONTRIBUTED $30,000 TO THE ETSU FOUNDATION TO SUPPORT THE JOHNSON CITY DOWNTOWN CLINIC. THE JOHNSON CITY DOWNTOWN CLINIC WAS ORIGINALLY ESTABLISHED TO SERVE THE NEEDS OF THE LOCAL HOMELESS POPULATION IN JOHNSON CITY AND HAS EXPANDED OVER THE PAST NEARLY 15 YEARS TO INCLUDE THE UNINSURED, UNDERINSURED, TENNCARE ENROLLEES, A GROWING HISPANIC POPULATION, AND MEDICALLY INDIGENT INDIVIDUALS. MSHA CONTRIBUTED $25,360 TO SUSAN G. KOMEN BREAST CARE FOUNDATION. SUSAN G. KOMEN IS THE GLOBAL LEADER OF THE BREAST CANCER MOVEMENT AND THE WORLD'S LARGEST GRASSROOTS NETWORK OF BREAST CANCER SURVIVORS AND ACTIVISTS. COMMUNITY CONTRIBUTIONS AS THE SECOND LARGEST EMPLOYER IN THE REGION, MSHA IS ONE OF THE AREA'S PRINCIPLE BENEFACTORS AND HAS MADE CORPORATE CITIZENSHIP AN INTEGRAL PART OF ITS CULTURE. FROM SYSTEM-WIDE INITIATIVES TO INDIVIDUAL EFFORTS OF CARING TEAM MEMBERS, ITS AIM IS TO ENRICH THE COMMUNITIES THAT THE ORGANIZATION SERVES. MSHA'S COMMITMENT INCLUDES FINANCIAL CONTRIBUTIONS, IN-KIND (NON-CASH) CONTRIBUTIONS AND LEADERSHIP RESOURCES WITHIN THREE BROAD CATEGORIES OF GIVING: 1) DIRECT CONTRIBUTIONS THAT SUPPORT COMMUNITY HEALTHCARE NEEDS AND THOSE NONPROFIT AGENCIES THAT ADVOCATE THE HEALTH AND WELL-BEING OF COMMUNITY MEMBERS; 2) MSHA-RUN AND MSHA-SUPPORTED PROGRAMS THAT CONTRIBUTE TO THE HEALTH AND WELL-BEING OF AREA RESIDENTS; AND 3) EDUCATION/TRAINING; BOTH AS A COMMUNITY CITIZEN AND AS AN EMPLOYER. 1.) DIRECT CONTRIBUTIONS - IN-KIND AND CASH 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 HEALTH CARE AND EDUCATION. TEAM MEMBERS SERVED THE BOYS & GIRLS CLUB, KIWANIS CLUBS, ROTARY CLUBS, SUSAN G. KOMEN BREAST CANCER FOUNDATION, ECONOMIC DEVELOPMENT STEERING COMMITTEE FOR WASHINGTON COUNTY, JUNIOR ACHIEVEMENT, SALVATION ARMY, AMERICAN HEART ASSOCIATION, HANDS ON! MUSEUM, APPALACHIAN MOUNTAIN PROJECT ACCESS, WASHINGTON COUNTY EMERGENCY MEDICAL SERVICES, WASHINGTON COUNTY VETERAN'S MEMORIAL COMMITTEE OF THE JOHNSON CITY PARKS AND RECREATION FOUNDATION, EATING DISORDERS COALITION OF TENNESSEE, JOHNSON CITY SYMPHONY ORCHESTRA, DAWN OF HOPE, UNITED WAY, CHAMBER OF COMMERCE BOARDS, AND MANY OTHERS. ALTHOUGH MSHA DID NOT FULLY MONITOR THESE ACTIVITIES DURING FY11 TO TABULATE THE TOTAL FINANCIAL COST, THE AMOUNT WOULD BE SIGNIFICANT SINCE SOME OF THESE TEAM MEMBERS DEVOTED TWO WEEKS OF NORMAL WORK TIME TO OUTSIDE CHARITABLE ACTIVITIES. SUMMARY LIST OF CHARITABLE GIVING: IN FY11, MSHA PROVIDED CASH AND IN-KIND SUPPORT TO NUMEROUS HEALTH AND HUMAN SERVICE AGENCIES, INCLUDING, BUT NOT LIMITED TO, THE FOLLOWING RECIPIENTS. MAJOR PROGRAMS ARE DESCRIBED IN MORE DETAIL IN THE SECTIONS THAT FOLLOW. - CARESPARK - $50,027 - ETSU FOUNDATION - $51,581 - SUSAN G. KOMEN BREAST CANCER FOUNDATION - $25,360 - EAST TENNESSEE STATE UNIVERSITY - $20,664 - BOYS AND GIRLS CLUB OF KINGSPORT - $20,000 - CROSSROADS MEDICAL MISSION - $12,500 - LINCOLN THEATRE - $12,500 - COALITION FOR KIDS - $8,560 - CITY OF JOHNSON CITY - $9,541 - RUSSELL COUNTY CAREER AND TECHNOLOGY CENTER - $17,474 - HANDS ON! REGIONAL MUSEUM - $7,500 - RUSSELL COUNTY AMBULANCE - $4,074 - RUSSELL COUNTY CAREER & TECHNOLOGY CENTER - $17,474 - SECOND HARVEST FOOD BANK - $4,583 - TENNESSEE CENTER FOR PERFORMANCE EXCELLENCE - $4,150 - THE SALVATION ARMY - $1,768 - UMOJA UNITY FESTIVAL - $2,237 - ECUMENICAL FAITH IN ACTION - $1,000 - FIRST TENNESSEE HUMAN RESOURCE AGENCY - $1,000 - GOD OF SECOND CHANCE MISSION - $1,000
PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED)	FORM 990, PART III, LINE 4A	- MOUNTAIN STATES FOUNDATION - $2,665 - GOOD SAMARITAN MISITRY - $1,759 MSHA, IN COLLABORATION WITH AREA HEALTH AGENCIES AND PROVIDERS, MAY OFFER ASSISTANCE WITH COORDINATION, ADVOCACY AND PUBLICITY; PROVIDE SPACE; OR CONTRIBUTE SUPPLIES TO SUPPORT GROUPS FOR THEIR PROGRAM ACTIVITIES. MSHA VALUES SOCIAL RESPONSIBILITY AND IS COMMITTED TO COMMUNITY HEALTH AND HEALTH EDUCATION. ANNUALLY, MSHA MAKES GENEROUS MONETARY DONATIONS TO AREA HEALTH AND HUMAN SERVICE AGENCIES WHOSE PROGRAMS ARE SPECIFICALLY DESIGNED TO PROVIDE FOR THE HEALTHCARE NEEDS OF THE HOMELESS, INDIGENT AND UNDERSERVED POPULATIONS. THROUGHOUT THE YEAR, MSHA MAKES CONTRIBUTIONS TO LOCAL SCHOOLS AND ORGANIZATIONS THAT PROVIDE EDUCATIONAL AND SOCIAL SUPPORT FOR YOUNG PEOPLE. SOME OF THE CONTRIBUTIONS TO YOUTH PROGRAMS INCLUDE: - REGIONAL COUNTY AND CITY SCHOOLS - $19,340 - ETSU FIT KIDS PROGRAM - $30,750 - HANDS ON! REGIONAL MUSEUM - $7,500 - CARTER COUNTY IMAGINATION LIBRARY - $1,000 - COALITION FOR KIDS - $8,560 - BOYS AND GIRLS CLUB OF KINGSPORT - $20,000 - BOYS SCOUTS OF AMERICA - $1,000 - WARRIORS PARK BOUNDLESS PLAYGROUND - $1,050 - JASON WHITTON SCORE FOUNDATION - $2,300 - KERMIT TIPTON SCHOLARSHIP FOUNDATION - $2,500 - CASA FOR KIDS - $622 - CITY YOUTH BALLET - $408 - ETSU SCHOLARSHIP PROGRAM - $1,000 MSHA CONTRIBUTES ANNUALLY TO LOCAL CHAPTERS OF SEVERAL NATIONAL NONPROFIT ORGANIZATIONS WHOSE RESEARCH FOCUSES ON THOSE DISEASES AND CONDITIONS MOST PREVALENT IN THE REGION. FY11: - SUSAN G. KOMEN BREAST CANCER FOUNDATION - $25,360 - AMERICAN CANCER SOCIETY - $2,401 - MARCH OF DIMES - $1,225 - UNITED WAY - $1,357 - VARIOUS ORGANIZATION FOCUSED ON CHILDHOOD OBESITY - $66,750 - JOHNSTON MEMORIAL HOSPTIAL - $1,000 - KEYSTONE DENTAL CARE, INC. - $651 - CROSSROADS MEDICAL MISSION - $12,000 2.) COMMUNITY PROGRAMS DEMOGRAPHIC STUDIES AND A CUSTOMER MARKET NEEDS ANALYSIS, PERFORMED ANNUALLY DURING STRATEGIC PLANNING, INDICATE THE NECESSITY OF HAVING A WIDE ARRAY OF FREE AND PRICE-REDUCED SERVICES THAT ARE WELL-SITUATED FOR EASY ACCESS FROM RURAL, MOUNTAINOUS AREAS. MSHA HAS GIVEN HIGH PRIORITY TO INVESTMENTS IN COMMUNITY OUTREACH, AND AS A RESULT, HAS ESTABLISHED COUNCILS AND DEPARTMENTS WHOSE FOCUS IS TO TRANSLATE FINDINGS INTO VIABLE HEALTHCARE PROGRAMS BOTH FOR THE COMMUNITY AT LARGE AND FOR POPULATIONS WITH SPECIAL NEEDS. AMONG INITIATIVES AND ONGOING SERVICES THAT PROMOTE COMMUNITY HEALTH AND SOCIAL WELL-BEING ARE DISEASE MANAGEMENT, WELLNESS PROGRAMS, HEALTH-RELATED EDUCATION SESSIONS BY MSHA NURSES, STAFF PHYSICIANS, NUTRITIONISTS, AND OTHER SPECIALISTS; HEALTH SCREENINGS AND SUPPORT. MSHA ALSO OFFERS SPECIAL PROGRAMS FOR YOUTH, THE ELDERLY, THE DISABLED AND THE MEDICALLY UNDERSERVED. DURING FY11, MSHA CONTINUED THE LARGEST COMMUNITY HEALTH NEEDS ASSESSMENT IN ITS HISTORY IN AN EFFORT TO PROFILE THE HEALTH OF THE RESIDENTS WITHIN THE LOCAL REGION. THIS ASSESSMENT SPECIFICALLY FOCUSED ON MSHA'S 13-COUNTY CORE SERVICE AREA, WHICH INCLUDES, BUT IS NOT LIMITED TO, ALL THE COUNTIES IN WHICH MSHA HAS A FACILITY. THE SEVEN TENNESSEE COUNTIES INCLUDED IN THIS NEEDS ASSESSMENT WERE: CARTER COUNTY, GREENE COUNTY, HAWKINS COUNTY, JOHNSON COUNTY, SULLIVAN COUNTY, UNICOI COUNTY AND WASHINGTON COUNTY. THE OTHER SIX VIRGINIA COUNTIES ARE LOCATED IN SOUTHWEST VIRGINIA. AFTER ANALYZING THE MANY HEALTH DISPARITIES IN THE REGION, MSHA CHOSE CHILDHOOD OBESITY AS ITS HEALTH PRIORITY. MSHA COLLABORATED WITH EAST TENNESSEE STATE UNIVERSITY'S COLLEGE OF PUBLIC HEALTH TO DEVELOP THE MSHA-ETSU OBESITY COLLABORATIVE. THE FOCUS OF THIS COLLABORATIVE IS TO PULL TOGETHER MANY PARTNERS AND ORGANIZATIONS TO REDUCE THE LEVEL OF CHILDHOOD OBESITY THROUGHOUT NORTHEAST TENNESSEE AND SOUTHWEST VIRGINIA. MSHA PROVIDED THE FUNDING AND COORDINATION, WHILE ETSU WORKED ON RESEARCH EFFORTS. THIS INITIATIVE PROVIDED FUNDING FOR UP TO 25 MICRO-GRANTS OF $2,000 EACH TO LOCAL COMMUNITY ORGANIZATIONS SUCH AS CHURCHES, COMMUNITY GROUPS, SCHOOLS AND EMPLOYERS THAT WANT TO EXPLORE CHILDHOOD OBESITY REDUCTION EFFORTS. IN FY11, MSHA AND ETSU NAMED THE OBESITY COLLABORATIVE "HEAL APPALACHIA" - HEAL, STANDING FOR "HEALTHY EATING ACTIVE LIVING". MSHA RECEIVED OVER 100 APPLICATIONS FOR THE MICRO-GRANTS. THE APPLICANTS AWARDED THE GRANTS WERE ANNOUNCED AT A REGIONAL HEALTH SYMPOSIUM FOCUSING ON OBESITY. DURING FY11 MSHA SPENT $34,004 ON COORDINATING THE HEAL PROGRAM AND HOSTING THE SYMPOSIUM AND PAID 18 OF THE 25 GRANTS, OR $36,000. MSHA'S TOTAL FY11 COST: $70,004. THE HEAL APPALACHIA COMMITTEE WILL EVALUATE LOCAL PROGRAM GRANT RECIPIENTS AS TO THEIR ABILITY TO MAKE A MEASURABLE IMPACT ON THE LEVEL OF CHILDHOOD OBESITY THROUGHOUT THE REGION. THIS COMMITTEE WILL THEN MAKE RECOMMENDATIONS TO EXECUTIVE LEADERSHIP AS TO HOW MSHA SHOULD CONTINUE TO DIRECT FINANCIAL SUPPORT FOR SUCCESSFUL PROGRAMS. IN ADDITION TO THE HEAL APPALACHIA GRANTS AND SYMPOSIUM, MSHA DONATED $30,750 TO ETSU'S FIT KIDS PROGRAM, ANOTHER PROGRAM WITH A FOCUS ON REDUCING CHILDHOOD OBESITY AND IMPROVING THE HEALTH OF CHILDREN. PROGRAMS FOR THE COMMUNITY AT LARGE IN ADDITION TO THE HEALTH SCREENINGS AND SUPPORT GROUPS OFFERED THROUGH THE HEALTH RESOURCES CENTER, DESCRIBED ABOVE, A VARIETY OF SCREENINGS, SUPPORT GROUPS, HEALTH EDUCATION, AND HEALTH FAIRS WERE PROVIDED AT A COST OF MORE THAN $23,000. THESE ACTIVITIES INCLUDE PROVIDING COMMUNITY HEALTH EDUCATION ON SUCH TOPICS AS ORTHOPEDICS, PRE- AND POST- NATAL, NUTRITION, SLEEP DISORDERS, BEHAVIORAL HEALTH ISSUES, CARDIOVASCULAR HEALTH, AND MANY OTHERS. IN ADDITION TO HEALTH EDUCATION, MSHA PROVIDED FREE BLOOD PRESSURE SCREENINGS AND COLORECTAL SCREENINGS, FOR SPECIFIC POPULATIONS AS WELL AS PHYSICALS FOR PEE-WEE AND HIGH SCHOOL FOOTBALL PLAYERS IN JOHNSON COUNTY. THE HOSPICE PROGRAM OFFERS EXTENDED 13-MONTH BEREAVEMENT SUPPORT RATHER THAN THE REQUIRED 12-MONTH PERIOD, THUS SUPPORTING FAMILIES DURING THE ANNIVERSARY MONTH OF THE PATIENT'S DEATH, WHICH CAN BE A CHALLENGING TIME. ALSO PROVIDED IS A CELEBRATION OF LIFE PROGRAM FOR FAMILIES OF FORMER HOSPICE PATIENTS AND THE COMMUNITY AT LARGE. THE PARISH NURSE PROGRAM IS SPONSORED BY MSHA'S HOME HEALTH ORGANIZATION, WITH GOALS OF RECRUITING AREA CHURCHES AND REGISTERED NURSES TO THE PROGRAM AND PROVIDING PARTICIPANTS WITH EDUCATION ABOUT PARISH NURSING. PARISH NURSING IS AN AMALGAM OF SOCIAL WORK, GOOD NEIGHBORING AND NURSING. IT SUPPORTS, EDUCATES AND COUNSELS THOSE WITH HEALTHCARE NEEDS FROM WITHIN THEIR PLACES OF WORSHIP. A FEW OF THE SERVICES PROVIDED BY PARISH NURSES ARE BLOOD DRIVES, FLU SHOTS, HEALTH SCREENINGS, HEALTH FAIRS AND MONTHLY BLOOD PRESSURE CLINICS. SEVERAL OF THE NURSES ARE CERTIFIED TO TEACH CPR AND FIRST AID AT NO COST TO PARTICIPANTS. MSHA PROVIDES THE PARISH NURSE PROGRAM WITH COORDINATORS, SPONSORED ORIENTATION, MONTHLY EDUCATIONAL PROGRAMS AND OTHER SUPPORT FUNCTIONS. CURRENTLY, THERE ARE 26 CHURCHES PARTICIPATING IN TENNESSEE AND SIX IN SOUTHWEST VIRGINIA WITH PARISH NURSES ON STAFF. MSHA'S FY11 COST FOR THE PARISH NURSE PROGRAM WAS $60,211. THE RESPOND DEPARTMENT AT WOODRIDGE HOSPITAL (WH) OFFER ASSESSMENTS AND REFERRALS FOR INDIVIDUALS DEALING WITH MENTAL HEALTH ISSUES AND SUBSTANCE ABUSE. PROFESSIONAL STAFF INCLUDES BEHAVIORAL HEALTH COUNSELORS AND RN'S WHO ARE AVAILABLE 24 HOURS A DAY, SEVEN DAYS A WEEK TO ANSWER CALLS FROM THE COMMUNITY CONCERNING TREATMENT. THROUGHOUT THE ASSESSMENT PROCESS, RESPOND COLLABORATES WITH A PSYCHIATRIST TO DETERMINE THE MOST APPROPRIATE LEVEL OF CARE. THE RESPOND DEPARTMENT AT WH INCURRED UNREIMBURSED COSTS OF $708,633 DURING FY11. MSHA PROVIDED STAFF TO LOCAL AGENCIES, COUNCILS AND OTHER CHARITABLE ORGANIZATIONS TO ASSIST WITH LEADERSHIP PROGRAMS, PLANNING, SERVICE ON STEERING COMMITTEES AND PARTICIPATION WITH SPECIAL EVENTS. EXAMPLES INCLUDE AMERICAN RED CROSS BLOOD DRIVES, HEALTHY BABIES DAY, THE AMERICAN CANCER SOCIETY LEADERSHIP COUNCIL AND OTHERS AT A COST TO MSHA OF $26,565. WE FEEL SURE THIS AMOUNT IS UNDERREPORTED DUE TO THE DIFFICULTY IN TRACKING TEAM MEMBERS' MANY ACTIVITIES. PROGRAMS FOR SPECIAL POPULATIONS DUE TO THE USE OF EMERGENCY DEPARTMENTS AS WALK-IN CLINICS BY THE POOR AND UNDERSERVED, MSHA HAS HELPED ESTABLISH AND FINANCE ALTERNATIVE CARE SETTINGS SUCH AS THE ETSU COLLEGE OF NURSING'S DOWNTOWN CLINIC IN JOHNSON CITY, TN. THE DOWNTOWN CLINIC IS DEDICATED TO SERVING THE PRIMARY NEEDS OF THE HOMELESS, INDIGENT AND UNINSURED POPULATIONS, PROVIDING THEM WITH FREE LABORATORY TESTING AND ASSISTANCE WITH THEIR DIAGNOSIS AND TREATMENTS. MSHA GIFTS THE CLINIC RENT, WHICH IS VALUED AT A DISCOUNTED $35,000 ANNUALLY. MSHA HAS AN AGREEMENT WITH THE DOWNTOWN CLINIC TO PROCESS THEIR LAB SPECIMENS AS WELL AS PROVIDE SOME DIAGNOSTIC IMAGING SERVICES TO CLINIC PATIENTS AT NO COST TO THE PATIENT OR THE CLINIC. IN FY11, THE COST ASSOCIATED WITH THE CLINIC'S LAB TESTING WAS $63,860 AND THE COST OF DIAGNOSTIC IMAGING SERVICES WAS $10,428. THESE EXPENSES ARE INCLUDED IN MSHA'S CHARITY WRITE-OFFS.
PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED)	FORM 990, PART III, LINE 4A	DURING FY11, MSHA ALSO CONTRIBUTED AN ADDITIONAL $30,000 CONTRIBUTION TO ASSIST WITH THE CLINIC'S OPERATIONS. MSHA'S SERVICE AREA COMPRISES A STABLE, AGING POPULATION, SO THE ORGANIZATION HAS ESTABLISHED A NUMBER OF PROGRAMS TO SERVE THE NEEDS OF SENIOR CITIZENS. AN EXAMPLE OF A SENIOR PROGRAM IS THE PINNACLE CLUB A COMMUNITY OUTREACH PROGRAM FOR SERVICE-AREA SENIORS THAT OFFERS MONTHLY HEALTH-RELATED EVENTS AND FELLOWSHIP OPPORTUNITIES AT JOHNSON CITY MEDICAL CENTER, INDIAN PATH MEDICAL CENTER, RUSSELL COUNTY MEDICAL CENTER AND SYCAMORE SHOALS HOSPITAL. BENEFITS INCLUDE HEALTH SCREENINGS, FREE ANNUAL LAB SCREENINGS, AND DISCOUNTED FIRST-TIME ENROLLMENT FEES AT OUR WELLNESS CENTER AND FRANKLIN FITNESS CENTER. THE CLUB SPONSORS HEALTH FAIRS, THE SENIOR EXPO, AND MONTHLY EDUCATIONAL LUNCHEONS IN KINGSPORT, JOHNSON CITY, AND ELIZABETHTON, TN, AND IN LEBANON, VA. THE CLUB ALSO PROVIDES FREE NOTARY SERVICES, SOCIALS, TRAVEL OPPORTUNITIES AND DISCOUNTS THROUGH NUMEROUS VENDORS. DURING FY11, MSHA INCURRED A NET OPERATING LOSS OF $51,651 ATTRIBUTABLE TO ITS SUPPORT OF THE PROGRAM. 3) EDUCATION AND TRAINING COMMUNITY HEALTH EDUCATIONAL PROGRAMS MSHA PROVIDED A VARIETY OF WELLNESS AND HEALTH INFORMATION TO HELP EDUCATE AREA RESIDENTS ABOUT COMMUNITY-SPECIFIC HEALTH ISSUES. INFORMATION WAS PROVIDED THROUGH PRINTED MATERIALS, SPEAKING ENGAGEMENTS, RADIO AND TELEVISION INTERVIEWS, AND HEALTH FAIRS AND EXPOS. MSHA ACCEPTED INVITATIONS TO SPEAK ON HEALTH-RELATED TOPICS AT VARIOUS COMMUNITY ORGANIZATIONS AND SCHOOLS. A VARIETY OF TOPICS WERE PRESENTED SUCH AS SKIN CARE, STRESS MANAGEMENT, NUTRITION, WEIGHT MANAGEMENT, PREVENTIVE CARE MEASURES, CARE OF AGING PARENTS AND OTHERS. YOUTH EDUCATION PROGRAMS WERE PRESENTED TO STUDENTS RANGING FROM KINDERGARTEN TO COLLEGE AND WERE DESIGNED TO PROMOTE SAFETY AT PLAY; AGE-APPROPRIATE HEALTH ISSUES; ILLNESS AND INJURY PREVENTION TECHNIQUES; NUTRITION; AND THE DANGERS OF TOBACCO, ALCOHOL AND DRUG USE. DIETITIANS GAVE TALKS, PROVIDED FOOD DEMONSTRATIONS TO VARIOUS GROUPS AND VISITED AREA SCHOOLS TO DISCUSS NUTRITION. HOME HEALTH, HOSPICE AND PARISH NURSING ALSO PROVIDED NUMEROUS SPEAKING ENGAGEMENTS. THE COST OF PROVIDING THESE SPEAKING ENGAGEMENTS WAS APPROXIMATELY $62,027. MSHA'S AMERICAN HEART ASSOCIATION (AHA) TRAINING CENTER OFFERED SEVERAL COURSES TO HEALTHCARE PROVIDERS AND TO THE PUBLIC IN AN EFFORT TO EXPAND THE OUTREACH OF THE AMERICAN HEART ASSOCIATION AND MSHA IN PROMOTING WELLNESS AND SAVING LIVES. PROGRAMS INCLUDE: ADVANCED CARDIAC LIFE SUPPORT, BASIC CARDIAC LIFE SUPPORT, PEDIATRIC ADVANCED LIFE SUPPORT, FIRST AID AND LIFE SUPPORT INSTRUCTOR TRAINING. THE FY11 UNREIMBURSED COST TO PROVIDE THE EDUCATIONAL COURSES TO THE PUBLIC WAS $211,155. IMPORTANT TO THE EFFICIENT AND SAFE OPERATION OF THE AIR AMBULANCE IS A CLEAR UNDERSTANDING OF HOW TO CLEAR AND PREPARE LANDING ZONES AND APPROPRIATE METHODS FOR COMMUNICATING WITH AIR HELICOPTER PILOTS AT ACCIDENT SCENES AND TRANSPORT SITES. WINGS AIR RESCUE MADE MORE THAN 100 TRAINING RUNS TO AREA EMERGENCY MEDICAL SERVICE FACILITIES TO PERFORM TRAINING OF EMS CREWS.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (9 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg	Direct Controlling Entity NADirectControllingEntityNA
DICKENSON COMMUNITY HOSPITAL
PO BOX 1440 HOSPITAL DRIVE	CLINTWOOD	VA	24228	770599553	HOSPITAL	VA	501(C)(3)	LINE 3	NORTON COMMUNITY HOSPITAL	0
MOUNTAIN STATES FOUNDATION
2335 KNOB CREEK ROAD STE 101	JOHNSON CITY	TN	37604	581418862	FUNDRAISING FOR MSHA HOSPITALS	TN	501(C)(3)	LINE 11A		0	N/A
MSHA AUXILIARY
400 N STATE OF FRANKLIN ROAD	JOHNSON CITY	TN	37604	581418345	SUPPORTING ORGANIZATION TO MSHA HOSPITALS	TN	501(C)(3)	LINE 11A		0	N/A
SMYTH COUNTY COMMUNITY HOSPITAL
565 RADIO HILL ROAD	MARION	VA	24354	540794913	HOSPITAL	VA	501(C)(3)	LINE 3		0	N/A
NORTON COMMUNITY HOSPITAL
100 15TH STREET NW	NORTON	VA	24273	540566029	HOSPITAL	VA	501(C)(3)	LINE 3		0	N/A
JOHNSTON MEMORIAL HOSPITAL
16000 JOHNSTON MEMORIAL DRIVE	ABINGDON	VA	24211	540544705	HOSPITAL	VA	501(C)(3)	LINE 3		0	N/A
ABINGDON PHYSICIAN PARTNERS
16000 JOHNSTON MEMORIAL DRIVE	ABINGDON	VA	24211	205485346	MEDICAL SERVICES	VA	501(C)(3)	LINE 11A	JOHNSTON MEMORIAL HOSPITAL	0
JOHNSTON MEMORIAL HEALTHCARE FOUNDATION INC
16000 JOHNSTON MEMORIAL DRIVE	ABINGDON	VA	24211	262870970	SUPPORTING ORGANIZATION TO JMH	VA	501(C)(3)	LINE 11A		0	N/A
COMMUNITY HEALTHCARE FOUNDATION
100 15TH STREET NW	NORTON	VA	24273	542002314	SUPPORTING ORGANIZATION TO NCH	VA	501(C)(3)	LINE 11A		0	N/A

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 RD	JOHNSON CITY	TN	37604	621711997	INVESTMENT COMPANY	TN	N/A	(D)	-1770396	875222	0	0	0.96580
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	37601	272199037	MEDICAL SERVICES	TN	N/A	(D)	-95716	40295	0	0	0.51000

Form990 Schedule R Part IV Form990ScheduleRPartIV (7 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	Business Name Line1DirectControllingEntityName/BusinessNameLine1
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
1021 W OAKLAND AVE STE 207	JOHNSON CITY	TN	37604	621490616	PHYSICIAN OFFICES	TN	N/A	C	64405292	187714709	1.00000
MEDISERVE MEDICAL EQUIPMENT OF KINGSPORT
1021 W OAKLAND AVE STE 207	JOHNSON CITY	TN	37604	621212286	DURABLE MEDICAL EQUIPMENT CO.	TN		C	4307855	3872099	1.00000	BLUE RIDGE MEDICAL MGMT CORP
MOUNTAIN STATES PROPERTIES
1021 W OAKLAND AVE STE 207	JOHNSON CITY	TN	37604	621845895	PROPERTY MANAGEMENT	TN		C	12693987	146200242	1.00000	BLUE RIDGE MEDICAL MGMT CORP
MOUNTAIN STATES MEDICAL GROUP
1021 W OAKLAND AVE STE 207	JOHNSON CITY	TN	37604	621700412	HEALTHCARE SERVICES	TN		C	34535196	6178154	1.00000	BLUE RIDGE MEDICAL MGMT CORP
COMMUNITY HOME CARE INC
1460 PARK AVENUE	NORTON	VA	24273	541453810	MEDICAL EQUIP. SALES & RENTAL	VA		C	338141	414859	0.50100	NORTON COMMUNITY HOSPITAL
COMMUNITY PHYSICIANS SERV CORP
100 15TH STREET NW	NORTON	VA	24273	541641446	MEDICAL SERVICES	VA		C	2311	93	0.50100	NORTON COMMUNITY HOSPITAL
SOUTHWEST COMMUNITY HEALTH SERV
565 RADIO HILL RD PO BOX 880	MARION	VA	24354	541460695	MEDICAL SERVICES	VA		C	381781	1035717	0.80000	SMYTH CO COMMUNITY HOSPITAL

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	1	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	1	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	0	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	1	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	1	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	1	PerformOfServicesByOtherOrgs
Sharing Of Facilities	1	SharingOfFacilities
Sharing Of Paid Employees	1	SharingOfPaidEmployees
Reimbursement Paid To Other Org	1	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	1	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	1	OtherTransferToOtherOrg
Other Transfer From Other Org	0	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (27 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved
MOUNTAIN STATES PROPERTIES
G	451575
MOUNTAIN STATES PROPERTIES
J	1573432
MOUNTAIN STATES PROPERTIES
K	334926
MOUNTAIN STATES PROPERTIES
Q	455555
MOUNTAIN STATES PROPERTIES
P	852014
MEDISERVE
J	84541
MEDISERVE
P	787254
SMYTH COUNTY COMMUNITY HOSPITAL
P	102777
SMYTH COUNTY COMMUNITY HOSPITAL
K	3785651
SMYTH COUNTY COMMUNITY HOSPITAL
Q	1248529
DICKENSON COMMUNITY HOSPITAL
K	747170
JOHNSTON MEMORIAL HOSPITAL
B	4571429
JOHNSTON MEMORIAL HOSPITAL
K	10087256
JOHNSTON MEMORIAL HOSPITAL
N	168444
JOHNSTON MEMORIAL HOSPITAL
Q	480290
MOUNTAIN STATES FOUNDATION
K	826639
MOUNTAIN STATES FOUNDATION
C	1923710
BLUE RIDGE MEDICAL MGMT CORP
K	6625179
BLUE RIDGE MEDICAL MGMT CORP
L	25887666
BLUE RIDGE MEDICAL MGMT CORP
N	862919
BLUE RIDGE MEDICAL MGMT CORP
P	6470120
MOUNTAIN STATES HEALTH ALLIANCE AUXILIARY
O	138662
MOUNTAIN STATES HEALTH ALLIANCE AUXILIARY
P	183010
NORTON COMMUNITY HOSPITAL
K	2647824
INTEGRATED SOLUTIONS HEALTH NETWORK LLC
L	160858
INTEGRATED SOLUTIONS HEALTH NETWORK LLC
P	568740
MOUNTAIN STATES PROPERTIES
L	119790