FURP.ORG / PUBLIC DATA EXPLORER

MOUNTAIN STATES HEALTH ALLIANCE: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
MOUNTAIN STATES HEALTH ALLIANCE (EIN 62-0476282)
Tax period
2021-07-01 to 2022-06-30
Filed
2023-05-11
IRS object ID
202311319349305146
Schema version
2021v4.2
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 ReturnHeader

FieldValueIRS element (for citing)
Return2023-05-11T15:24:48-05:00ReturnTs
Tax Period End2022-06-30TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2021-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN620476282EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Mountain States Health AllianceBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMOUNBusinessNameControlTxt
Phone4233023374PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1311 Princeton Road Suite 1AddressLine1Txt
CityJohnson CityCityNm
State AbbreviationTNStateAbbreviationCd
ZIP376012080ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLynn KrutakPersonNm
Person TitleBH EVP/CFOPersonTitleTxt
Phone4233023374PhoneNum
Signature2023-05-11SignatureDt

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstLynnPersonFirstNm
Person LastKrutakPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
PTINP03077501PTIN

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeYes (X)AddressChangeInd
Principal OfficerAlan Levine BH PresCEOPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1303 Med Tech Parkway Ste 300AddressLine1Txt
CityJohnson CityCityNm
State AbbreviationTNStateAbbreviationCd
ZIP37604ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$919,639,252GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addressballadhealth.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1945FormationYr
Legal Domicile StateTNLegalDomicileStateCd
Activity Or MissionHonor those we serve by delivering the best possible care.ActivityOrMissionDesc
Voting Members Governing Body4VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee6921TotalEmployeeCnt
Total Volunteers208TotalVolunteersCnt
Total Gross UBI$567,599TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$304,564NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$9,827,762PYContributionsGrantsAmt
CY Contributions Grants$11,065,205CYContributionsGrantsAmt
PY Program Service Revenue$767,814,082PYProgramServiceRevenueAmt
CY Program Service Revenue$899,832,195CYProgramServiceRevenueAmt
PY Investment Income$154,614PYInvestmentIncomeAmt
CY Investment Income$18,290CYInvestmentIncomeAmt
PY Other Revenue$11,799,342PYOtherRevenueAmt
CY Other Revenue$8,185,688CYOtherRevenueAmt
PY Total Revenue$789,595,800PYTotalRevenueAmt
CY Total Revenue$919,101,378CYTotalRevenueAmt
PY Grants And Similar Paid$12,370,549PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$3,286,642CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$293,270,688PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$324,864,142CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$511,355,179PYOtherExpensesAmt
CY Other Expenses$548,121,007CYOtherExpensesAmt
PY Total Expenses$816,996,416PYTotalExpensesAmt
CY Total Expenses$876,271,791CYTotalExpensesAmt
PY Revenues Less Expenses-$27,400,616PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$42,829,587CYRevenuesLessExpensesAmt
Total Assets BOY$541,476,325TotalAssetsBOYAmt
Total Assets EOY$541,592,959TotalAssetsEOYAmt
Total Liabilities BOY$171,820,583TotalLiabilitiesBOYAmt
Total Liabilities EOY$120,528,162TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$369,655,742NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$421,064,797NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionHonor those we serve by delivering the best possible care.Ballad Health is dedicated to improving the health of the 29-county Appalachian Highlands region.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$731,033,923ExpenseAmt
Grant$3,286,642GrantAmt
Revenue$902,322,745RevenueAmt
DescSee Schedule ODesc
Total Program Service Expenses$731,033,923TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document379IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee6921EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members4GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (1)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldTNStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldVAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Lynn KrutakBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone4233023374PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1303 Med Tech Parkway Suite 300AddressLine1Txt
CityJohnson CityCityNm
State AbbreviationTNStateAbbreviationCd
ZIP37604ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Alan Levine BH PresCEO
Director1.0064.00Yes (X)Yes (X)$0$4,083,029$240,343
Eric Deaton BH EVPCOO
Director1.0064.00Yes (X)Yes (X)$0$1,021,443$104,184
Marvin Eichorn BH EVPCAO
Director1.0064.00Yes (X)Yes (X)$0$1,154,466$43,904
Tim Belisle BH EVPGen Cnsl
Director1.0064.00Yes (X)Yes (X)$0$670,583$87,406
Lynn Krutak
BH EVP/CFO1.0064.00Yes (X)$0$956,968$104,263
Edward Hickson
VP/Pres - SW Mkt45.000.00$660,570$0$37,119Yes (X)
Joshua McFall
VP/CFO - Acute Services44.600.40$396,544$0$38,726Yes (X)
Kenneth Shafer
VP/CEO - JCMC45.000.00$347,128$0$37,010Yes (X)
Lemmie Taylor
VP/CEO - SSH45.000.00$333,254$0$51,527Yes (X)
Lisa Carter
Regional Pres - Southern Mkt45.000.00$344,022$0$40,086Yes (X)
Melanie Stanton
VP/CEO - FWCH45.000.00$375,610$0$39,641Yes (X)
Morgan May
VP/Regional CNO45.000.00$278,835$0$20,568Yes (X)
Brian Dawson MD
VP/CMO - Southern Mkt45.000.00$476,539$0$30,931Yes (X)
Corinne Allen
MultiFac Dir - Pharm Svcs40.000.00$198,694$0$33,560Yes (X)
Dwight Owens
Admin/COO - IPCH40.000.00$237,608$0$35,610Yes (X)
Greta Morrison
AVP, Admin/CNO - RCH40.000.00$203,178$0$37,468Yes (X)
Jeffery Stopka
Physical Therapist - HH40.000.00$204,366$0$17,391Yes (X)
Andrew Wampler Fmr Key Empl
BH VP - Oper Excellence0.0045.00$0$439,652$22,613Yes (X)
Linda White Fmr Offcr
VP/Pres - NW Mkt0.0045.00$0$546,749$60,387Yes (X)
Chase Wilson Fmr Key Empl
VP/COO - BHMA0.0045.00$0$279,940$38,130Yes (X)
Clay Runnels MD Fmr Offcr
BH EVP/Chief Phys Exec0.0065.00$0$811,148$93,765Yes (X)
Mark Wilkinson MD Fmr HComp
BH VP/CMIO0.0045.00$0$561,592$44,124Yes (X)
Matthew Loos Fmr HComp
BH VP/CAO0.0045.00$0$529,114$44,464Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$4,056,348TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$11,054,684TotReportableCompRltdOrgAmt
Total Other Compensation$1,303,220TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K345IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
East Tennessee State University
PO Box 70732Johnson CityTN37614Med Supp/Gen Acad Svcs$6,665,924
Associated Reg'l and Univ Pathologists
PO Box 27964Salt Lake CityUT84127Pathology Svcs$2,888,162
Medical Education Assistance Corp
PO Box 699Mountain HomeTN37684Medical Educ Svcs$2,547,594
Anesthesia & Pain Consultants
1009 Lark St Ste 2Johnson CityTN37604Anesthesiology Svcs$1,760,166
Clinical Pharmacy Service Inc
PO Box 787442PhiladelphiaPA19178Pharmacy Svcs$1,497,724
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K56CntrctRcvdGreaterThan100KCnt
Related Organizations$4,268,517RelatedOrganizationsAmt
Government Grants$6,096,194GovernmentGrantsAmt
All Other Contributions$700,494AllOtherContributionsAmt
Total Contributions$11,065,205TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
Patient Revenue622110$883,241,517$883,241,517
CARES Act Revenue900099$15,433,086$15,433,086
Diabetes Program Revenue900099$622,020$622,020
Lab Outreach Revenue621500$456,983$456,983
O/P Rehabilitation Revenue900099$78,589$78,589
FieldValueIRS element (for citing)
Total Program Service Revenue$899,832,195TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$152,478TotalRevenueColumnAmt
Exclusion$152,478ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$930,416RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$395,201RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$535,215RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$535,215TotalRevenueColumnAmt
Unrelated Business Revenue$110,616UnrelatedBusinessRevenueAmt
Exclusion$424,599ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$8,485OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$142,673OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$134,188OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$134,188TotalRevenueColumnAmt
Related Or Exempt Func Income-$134,188RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
Support Services900099$3,081,721$3,081,721
Cafeteria/Vending722514$2,295,237$2,295,237
Network Mgt Services900099$1,565,625$1,565,625

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$707,890TotalRevenueColumnAmt
Exclusion$707,890ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$7,650,473OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$919,101,378TotalRevenueColumnAmt
Related Or Exempt Func Income$902,322,745RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$567,599UnrelatedBusinessRevenueAmt
Exclusion$5,145,829ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$3,286,642TotalAmt
Program Services$3,286,642ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$3,072,875TotalAmt
Program Services$316,834ProgramServicesAmt
Management And General$2,756,041ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$261,604,008TotalAmt
Program Services$206,623,420ProgramServicesAmt
Management And General$54,980,588ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$7,164,124TotalAmt
Program Services$5,675,691ProgramServicesAmt
Management And General$1,488,433ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$36,309,313TotalAmt
Program Services$22,805,707ProgramServicesAmt
Management And General$13,503,606ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$16,713,822TotalAmt
Program Services$15,166,103ProgramServicesAmt
Management And General$1,547,719ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$270,106TotalAmt
Program Services$9,737ProgramServicesAmt
Management And General$260,369ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$7,009TotalAmt
Program Services$5,460ProgramServicesAmt
Management And General$1,549ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$204,914,038TotalAmt
Program Services$160,149,892ProgramServicesAmt
Management And General$44,764,146ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$916,083TotalAmt
Program Services$16,784ProgramServicesAmt
Management And General$899,299ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$4,947,364TotalAmt
Program Services$4,447,819ProgramServicesAmt
Management And General$499,545ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$12,448,639TotalAmt
Program Services$11,141,574ProgramServicesAmt
Management And General$1,307,065ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$10,997,591TotalAmt
Program Services$10,835,175ProgramServicesAmt
Management And General$162,416ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$1,087,179TotalAmt
Program Services$1,018,887ProgramServicesAmt
Management And General$68,292ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$21,739,537TotalAmt
Program Services$21,531,937ProgramServicesAmt
Management And General$207,600ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$33,391,231TotalAmt
Program Services$31,892,239ProgramServicesAmt
Management And General$1,498,992ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$3,706,857TotalAmt
Program Services$3,613,611ProgramServicesAmt
Management And General$93,246ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Supplies$205,067,217$205,067,217
Support Services$20,162,469$1,218,603$18,943,866
Maintenance$19,792,522$19,344,924$447,598
Dues & Subscriptions$2,013,068$1,026,658$986,410

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$6,660,097TotalAmt
Program Services$5,839,009ProgramServicesAmt
Management And General$821,088ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$876,271,791TotalAmt
Program Services$731,033,923ProgramServicesAmt
Management And General$145,237,868ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$27,382BOYAmt
EOY$13,797EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$533,456BOYAmt
EOY$247,772EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$131,622BOYAmt
EOY$172,025EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$92,535,896BOYAmt
EOY$99,587,487EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$13,512,169BOYAmt
EOY$12,937,884EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$18,530,781BOYAmt
EOY$20,187,849EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$5,047,161BOYAmt
EOY$3,573,367EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$994,688,687LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$637,994,679LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$369,712,713BOYAmt
EOY$356,694,008EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$13,141,003BOYAmt
EOY$13,141,003EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$28,304,142BOYAmt
EOY$35,037,767EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$541,476,325BOYAmt
EOY$541,592,959EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$80,414,766BOYAmt
EOY$78,960,736EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$12,004,272BOYAmt
EOY$11,689,902EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
EOY$61,266EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$79,401,545BOYAmt
EOY$29,816,258EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$171,820,583BOYAmt
EOY$120,528,162EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$369,587,413BOYAmt
EOY$421,051,078EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$68,329BOYAmt
EOY$13,719EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$369,655,742BOYAmt
EOY$421,064,797EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$541,476,325BOYAmt
EOY$541,592,959EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$42,829,587ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$8,579,468OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other OrganizationsYes (1)GrantsOtherOrganizationsInd
Grants Other Organizations$46,823GrantsOtherOrganizationsAmt
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other Activities0OtherActivitiesInd
Total Lobbying Expenditures$46,823TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationMountain States Health Alliance had lobbying expenses of $46,823 which represents the portion of dues paid to various organizations, including Tennessee Hospital Association and Virginia Hospital and Healthcare Association, attributable to direct lobbying.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$22,219,663OtherCostOrOtherBasisAmt
Book Value$22,219,663BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$526,472,573OtherCostOrOtherBasisAmt
Depreciation$262,585,539DepreciationAmt
Book Value$263,887,034BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,841,819OtherCostOrOtherBasisAmt
Depreciation$3,460,790DepreciationAmt
Book Value$1,381,029BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$427,328,432OtherCostOrOtherBasisAmt
Depreciation$366,262,388DepreciationAmt
Book Value$61,066,044BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$13,826,200OtherCostOrOtherBasisAmt
Depreciation$5,685,962DepreciationAmt
Book Value$8,140,238BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$356,694,008TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
Due from Affiliates$45,476,739
Due from 3rd Parties-$10,438,972
FieldValueIRS element (for citing)
Total Book Value Other Assets$35,037,767TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDescAmtAmt
Due to 3rd Party Payors$267,766
Due to Payor Medicare Adv Pmts ST$19,765,020
Operating Lease Obligation ST$824,801
Operating Lease Obligation LT$992,404
Professional Liabilities Reserve$7,719,609
Due to Payor Stimulus Reserve$246,658
FieldValueIRS element (for citing)
Total Liability$29,816,258TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart X, Line 2:FormAndLineReferenceDesc
ExplanationMountain States Health Alliance is included in the audited consolidated financial statements of Ballad Health. The footnote explanation relative to income taxes reads: "Ballad is classified as an organization exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code. As such, no provision for federal income taxes is included in the accompanying consolidated financial statements. Taxable subsidiaries are discussed in Note K. No significant uncertain tax positions exist at June 30, 2022 and 2021. Tax returns for 2019 through 2021 are subject to examination by the Internal Revenue Service."ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other225.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other450.000000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$11,402,856TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$11,402,856NetCommunityBenefitExpnsAmt
Total Expense0.01300TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$146,422,454TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$121,986,223DirectOffsettingRevenueAmt
Net Community Benefit Expns$24,436,231NetCommunityBenefitExpnsAmt
Total Expense0.02790TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$157,825,310TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$121,986,223DirectOffsettingRevenueAmt
Net Community Benefit Expns$35,839,087NetCommunityBenefitExpnsAmt
Total Expense0.04090TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,463,854TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$681,594DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,782,260NetCommunityBenefitExpnsAmt
Total Expense0.00430TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$17,115,126TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,417,293DirectOffsettingRevenueAmt
Net Community Benefit Expns$13,697,833NetCommunityBenefitExpnsAmt
Total Expense0.01560TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,500,755TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,681,458DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,819,297NetCommunityBenefitExpnsAmt
Total Expense0.00210TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$979,636TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$40,029DirectOffsettingRevenueAmt
Net Community Benefit Expns$939,607NetCommunityBenefitExpnsAmt
Total Expense0.00110TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,151,417TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,151,417NetCommunityBenefitExpnsAmt
Total Expense0.00360TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$33,210,788TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,820,374DirectOffsettingRevenueAmt
Net Community Benefit Expns$23,390,414NetCommunityBenefitExpnsAmt
Total Expense0.02670TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$191,036,098TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$131,806,597DirectOffsettingRevenueAmt
Net Community Benefit Expns$59,229,501NetCommunityBenefitExpnsAmt
Total Expense0.06760TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,000NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$10,000NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$35,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$35,000NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,000NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$47,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$47,000NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$54,335,359BadDebtExpenseAmt
Bad Debt Expense Attributable$20,104,083BadDebtExpenseAttributableAmt
Reimbursed By Medicare$155,168,850ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$147,829,964CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$7,338,886MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

FieldValueIRS element (for citing)
Business Name Line11 Med Spec of JC LLCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Primary ActivitiesMedical ServicesPrimaryActivitiesTxt
Org Profit Or Ownership0.51000OrgProfitOrOwnershipPct
Physicians Profit Or Ownership0.49000PhysiciansProfitOrOwnershipPct
FieldValueIRS element (for citing)
Hospital Facilities8HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (8 entries)

FacilityFacilityNumAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdWebsite AddressWebsiteAddressTxtState LicenseStateLicenseNumLicensed HospitalLicensedHospitalIndGeneral Medical And SurgicalGeneralMedicalAndSurgicalIndChildrens HospitalChildrensHospitalIndTeaching HospitalTeachingHospitalIndResearch FacilityResearchFacilityIndEmergency Room24 HrsEmergencyRoom24HrsIndOtherOtherDescFacility Reporting GroupFacilityReportingGroupCdCritical Access HospitalCriticalAccessHospitalInd
Johnson City Medical Center
1400 N State of Franklin RdJohnson CityTN37604balladhealth.org00000121Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Mental HealthA
Indian Path Community Hospital
22000 Brookside DriveKingsportTN37660balladhealth.org00000134Yes (X)Yes (X)Yes (X)Yes (X)A
Franklin Woods Community Hospital
3300 Med Tech ParkwayJohnson CityTN37604balladhealth.org00000123Yes (X)Yes (X)Yes (X)A
Sycamore Shoals Hospital
41501 W Elk AvenueElizabethtonTN37643balladhealth.org00000012Yes (X)Yes (X)Yes (X)Mental HealthA
Russell County Hospital
558 Carroll StreetLebanonVA24266balladhealth.orgH 1892Yes (X)Yes (X)Yes (X)Mental HealthA
Johnson County Community Hospital
61901 S Shady StreetMountain CityTN37683balladhealth.org00000039Yes (X)Yes (X)Yes (X)AYes (X)
Unicoi County Hospital
72030 Temple Hill RoadErwinTN37650balladhealth.org00000119Yes (X)Yes (X)Yes (X)A
Lee County Community Hospital
8127 Health Care DrivePennington GapVA24277balladhealth.orgH 1940Yes (X)Yes (X)Yes (X)AYes (X)

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Facility Reporting Group - ABusinessNameLine1Txt
FieldValueIRS element (for citing)
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
OtherYes (X)OtherInd
CHNA Conducted21CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLballadhealth.org/locations#hospitalsOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt22ImplementationStrategyAdptYr
Strategy Posted Website0StrategyPostedWebsiteInd
Strategy AttachedYes (1)StrategyAttachedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care225.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care450.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLballadhealth.orgFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLballadhealth.orgFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLballadhealth.orgFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Section BFacility Reporting Group A
Facility Reporting Group A consists of:- Facility 1: Johnson City Medical Center, - Facility 2: Indian Path Community Hospital, - Facility 3: Franklin Woods Community Hospital, - Facility 4: Sycamore Shoals Hospital, - Facility 5: Russell County Hospital, - Facility 6: Johnson County Community Hospital, - Facility 7: Unicoi County Hospital, - Facility 8: Lee County Community Hospital
Facility Reporting Group - A Part V, Section B, line 3j:To understand each community's individual needs, Ballad Health conducted a Community Health Needs Assessment (CHNA) for each Ballad hospital to profile the health of the residents within its service area. Throughout the CHNA process, high priority was given to determining the health disparities and available resources within each community. Community members from each county met with Ballad representatives to discuss current health priorities and identify potential solutions. Priorities established for the CHNAs were determined by the most significant health needs of each community. Ballad Health hospitals, including MSHA hospitals, conducted their fifth CHNA last year with board approval and publication occurring at the end of FY21. For FY21 CHNAs, Ballad Health utilized a mixed-methods approach for primary and secondary data collection to gather regional information to inform the 2021 community health needs assessments. The secondary data collection entailed the compilation of secondary data pertaining to agreed-upon metrics and indicators from an array of verified sources. The primary data collection component involved both a key stakeholder survey and key stakeholder focus groups. Findings from both research methods were used to prioritize the needs of the community served by each Ballad Health facility and determine priority focus areas for future improvement efforts. Analysis of secondary data for Washington County, TN findings from the key stakeholder survey, and the perspectives of diverse key stakeholders led to the prioritization of community issues for Washington County. For Johnson City Medical Center, Franklin Woods Community Hospital, Niswonger Children's Hospital, and Woodridge Hospital, the three priority areas for future improvement efforts that were selected by key stakeholders in Washington County are substance abuse, mental health, and Adverse Childhood Experiences (ACEs). Analysis of secondary data for Sullivan County, findings from the key stakeholder survey, and the perspectives of diverse key stakeholders led to the prioritization of community issues for Sullivan County. For Indian Path Community Hospital, the three priority areas for future improvement efforts that were selected by key stakeholders in Sullivan County, TN are substance abuse, mental health, and transportation. Analysis of secondary data for Carter County, TN findings from the key stakeholder survey, and the perspectives of diverse key stakeholders led to the prioritization of community issues for Carter County. For Sycamore Shoals Community Hospital, the three priority areas for future improvement efforts that were selected by key stakeholders in Carter County, TN are substance abuse, mental health, Adverse Childhood Experiences (ACEs), and transportation.Analysis of secondary data for Unicoi County, findings from the key stakeholder survey, and the perspectives of diverse key stakeholders led to the prioritization of community issues for Unicoi County. For Unicoi County Hospital, the three priority areas for future improvement efforts that were selected by key stakeholders in Unicoi County, TN are education, mental health, and Adverse Childhood Experiences (ACEs). Analysis of secondary data for Russell County, VA findings from the key stakeholder survey, and the perspectives of diverse key stakeholders led to the prioritization of community issues for Russell County. For Russell County Community Hospital, the three priority areas for future improvement efforts that were selected by key stakeholders in Russell County, VA are substance abuse, mental health, and poverty.Analysis of secondary data for Johnson County, TN findings from the key stakeholder survey, and the perspectives of diverse key stakeholders led to the prioritization of community issues for Johnson County. For Johnson County Community Hospital, the three priority areas for future improvement efforts that were selected by key stakeholders in Johnson County, TN are substance abuse, mental health, and Adverse Childhood Experiences (ACEs).
Facility Reporting Group - A Part V, Section B, line 5:The community health needs assessment process was guided by the Mobilizing for Action Through Planning and Partnerships (MAPP) model, with an understanding that aspects of the model may have to be adapted due to the purpose of the assessment for Ballad Health and constraints related to the COVID-19 pandemic. In coordination with the MAPP model, concepts from both Community-Based Participatory Research (CBPR) and the Arkansas Center for Health Improvement (ACHI) Community Health Assessment Toolkit were also utilized for the assessments. Following guidance from the MAPP model, a Key Stakeholder Survey was designed with the primary aim of identifying the most-pressing community issues. In aligning with principles of CBPR, the key stakeholder survey was designed to allow key stakeholders to frame community issues in their own words through the use of open-ended questions. In addition to the identification of community issues, the key stakeholder survey was also designed to discern why survey respondents believed the community issues they selected had the greatest effect on the overall health and wellbeing of their community. Questions related to ideas and suggestions for improvement efforts, gauging the success of efforts after the previous community health needs assessments, and community struggles related to the COVID-19 pandemic were also included in the survey. Independent focus groups were conducted for each Ballad Health facility in order to provide specific and unique information for each community being served. The MAPP model and questions from the key stakeholder survey were used to guide the development and construction of the focus groups. Because the key stakeholder survey primarily dealt with the identification of community issues, the focus groups were primarily designed to prioritize community issues identified through the key stakeholder survey and discuss actionable items around how to best address these community issues. Questions related to root causes of community issues, the current state of resources to address community issues, needed resources to initiate improvement efforts and be successful, and community struggles related to the COVID-19 pandemic were also included in the focus group facilitation guide. The key stakeholder focus groups were conducted virtually via WebEx and were one hour and thirty minutes in length.For Johnson City Medical Center, Niswonger Children's Hospital, Franklin Woods Community Hospital, and Woodridge Hospital there were thirty-five focus group participants. Similar to the key stakeholder survey representation, focus group participants represented an array of different sectors in Washington County, TN which included: the school system, businesses, government, the health care system, health departments, faith-based organizations, and a diverse group of community-based organizations. For stakeholders who were not able to attend the focus group in real-time, blank facilitation guide templates with questions concerning the three priority areas identified by the focus group participants were sent to them immediately after the conclusion of the focus group. This allowed key stakeholders who were not able to attend the focus group in real-time to still provide input and the hospital to ensure the involvement of diverse stakeholders. For Indian Path Community Hospital there were eighteen focus group participants. Similar to the key stakeholder survey representation, focus group participants represented an array of different sectors in Sullivan County, TN which included: the school system, businesses, government, the health care system, health departments, faith-based organizations, and a diverse group of community-based organizations. For stakeholders who were not able to attend the focus group in real-time, blank facilitation guide templates with questions concerning the three priority areas identified by the focus group participants were sent to them immediately after the conclusion of the focus group. This allowed key stakeholders who were not able to attend the focus group in real-time to still provide input and the hospital to ensure the involvement of diverse stakeholders.For Sycamore Shoals Community Hospital there were ten focus group participants. Similar to the key stakeholder survey representation, focus group participants represented an array of different sectors in Carter County, TN which included: the school system, businesses, government, the health care system, health departments, faith-based organizations, and a diverse group of community-based organizations. For stakeholders who were not able to attend the focus group in real-time, blank facilitation guide templates with questions concerning the three priority areas identified by the focus group participants were sent to them immediately after the conclusion of the focus group. This allowed key stakeholders who were not able to attend the focus group in real-time to still provide input and the hospital to ensure the involvement of diverse stakeholders.For Unicoi County Hospital there were six focus group participants. Similar to the key stakeholder survey representation, focus group participants represented an array of different sectors in Unicoi County, TN which included: the school system, businesses, government, the health care system, health departments, faith-based organizations, and a diverse group of community-based organizations. For stakeholders who were not able to attend the focus group in real-time, blank facilitation guide templates with questions concerning the three priority areas identified by the focus group participants were sent to them immediately after the conclusion of the focus group. This allowed key stakeholders who were not able to attend the focus group in real-time to still provide input and the hospital to ensure the involvement of diverse stakeholders.For Russell County Community Hospital there were nine focus group participants. Similar to the key stakeholder survey representation, focus group participants represented an array of different sectors in Russell County, VA which included: the school system, businesses, government, the health care system, health departments, faith-based organizations, and a diverse group of community-based organizations. For stakeholders who were not able to attend the focus group in real-time, blank facilitation guide templates with questions concerning the three priority areas identified by the focus group participants were sent to them immediately after the conclusion of the focus group. This allowed key stakeholders who were not able to attend the focus group in real-time to still provide input and the hospital to ensure the involvement of diverse stakeholders.For Johnson County Community Hospital, there were seven focus group participants. Similar to the key stakeholder survey representation, focus group participants represented an array of different sectors in Johnson County, TN which included: the school system, businesses, government, the health care system, health departments, faith-based organizations, and a diverse group of community-based organizations. For stakeholders who were not able to attend the focus group in real-time, blank facilitation guide templates with questions concerning the three priority areas identified by the focus group participants were sent to them immediately after the conclusion of the focus group. This allowed key stakeholders who were not able to attend the focus group in real-time to still provide input and the hospital to ensure the involvement of diverse stakeholders. Activities associated with the June 2021 assessments took place from summer of 2020 through the spring of 2021. The assessment activity including focus groups & surveys were used to develop the hospital implementation plans that were completed fall 2021.
Facility Reporting Group - A Part V, Section B, line 6a:Each hospital within Ballad Health completed a CHNA. MSHA's CHNAs were conducted with all Ballad Health hospitals at that time to include: Bristol Regional Medical Center, Hancock County Hospital, Hawkins County Memorial Hospital, Greeneville Community Hospital, Holston Valley Medical Center, Johnson City Medical Center (includes Niswonger Children's Hospital and Woodridge Hospital), Franklin Woods Community Hospital, Indian Path Community Hospital, Lonesome Pine Hospital (including Mountain View campus), Johnson County Community Hospital, Johnston Memorial Hospital, Norton Community Hospital, Dickenson Community Hospital, Russell County Hospital, Smyth County Community Hospital, Sycamore Shoals Hospital, and Unicoi County Hospital.
Facility Reporting Group - A Part V, Section B, line 11:During the year, MSHA focused on its CHNA priorities as identified in its FY21 CHNA report. MSHA's primary areas of focus included: substance abuse, mental health, and Adverse Childhood Experiences (ACEs). Many additional community needs exist in our region. It is fiscally impossible for a hospital to address every health need in a community, which is why the CHNA process is used to identify and prioritize areas of focus. A thoughtful CHNA evaluates overall community health needs to determine which ones the hospital can best influence in a positive way. Consideration is given to other organizations in the hospital's geographic area that already offer services addressing specific health needs. In some cases, it is best to simply support an identified health need through a financial donation to another nonprofit organization skilled in certain areas: teen pregnancy, dental health, fighting homelessness, etc. Hospitals also lend support to other nonprofit organizations by serving on their boards, committees, and assisting with fundraising efforts. Ballad Health made financial contributions to other nonprofit organizations providing community services that support MSHA hospitals' CHNAs.
Facility Reporting Group - A Part V, Section B, line 13h:Ballad Health's financial assistance policy allows for some exceptions to strictly adhering to federal poverty guidelines when awarding financial assistance. Unique circumstances may be weighed and assessed for financial assistance consideration on a case-by-case basis. Also, there are some services where financial assistance may be provided outside of federal poverty guidelines. These are noted in Ballad Health's financial assistance policy.
FieldValueIRS element (for citing)
Facility6FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - MSHA dba BH Homecare-Johnson City
509 Med Tech Parkway Ste 200Johnson CityTN37604Licensed Home Health Agency
2 - MSHA dba BH Homecare-Abingdon
611 Campus Dr Ste 300AbingdonVA24210Licensed Home Health Agency
3 - MSHA dba BH Homecare-Greeneville
1410 Tusculum Blvd Ste 1600GreenevilleTN37745Licensed Home Health Agency
4 - MSHA dba BH Homecare-Norton
96 15th St NW Ste 104ANortonVA24273Licensed Home Health Agency
5 - MSHA dba BH Hospice-Bristol
280 Steeles RoadBristolTN37620Licensed Hospice Agency
6 - MSHA dba BH Hospice-Abingdon
611 Campus Dr Ste 500AbingdonVA24210Licensed Hospice Agency

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3c:Financial assistance approval can apply to an assortment of patients such as those who have exhausted their Medicaid/TennCare benefits, those who qualified for Medicaid/TennCare after the date of service, deceased patients with no estate or assets, uninsured patients, and underinsured patients. While Ballad Health's qualifications for financial assistance is based on federal poverty guidelines, asset values may also be used to determine financial assistance eligibility. Unique circumstances may be assessed on a case-by-case basis. Charity approval covers current or active patient balances when they are approved and there is no limitation or cap on the amount of charity that a patient may receive. Ballad Health hospitals do not stop approving financial assistance for patient accounts if a hospital's charity write-offs exceed the hospital's charity budget.All Ballad Health hospitals provide an uninsured discount. The current uninsured discount for Critical Access Hospitals (CAH's) is 77% and for all other hospitals or physician practices it is 85%. In addition to the uninsured discount, many patients will further qualify for additional financial assistance. All patients seeking financial assistance must submit an application for financial assistance and submit documents in support of the information on the application, unless specifically excluded according to policy guidelines. Medicaid eligible patients will qualify for 100% financial assistance and not be required to complete the required documentation when: a) Medicaid eligibility requirements are met after the service is provided, b) non-covered charges occur on a Medicaid eligible encounter, or c) benefits have been exhausted. Deceased patients with no estate also qualify for 100% financial assistance.Financial assistance determinations may be retroactive for all outstanding balances. In addition, Ballad Health offers a number of programs with special discounts such as lactation consultation services, oncology treatment regimens, enrollment in various community programs and prescription drugs filled post-discharge.
Part I, Line 7:The cost to charge ratio (worksheet 2 "ratio of patient care cost to charges") was used to calculate line 7a financial assistance (charity care) cost. MSHA's cost accounting system was used to determine losses from Tenncare and Medicaid reported on line 7b, with the exception of home health and a small physician clinic. A cost to charge ratio was used for their data because these are smaller divisions not available in MSHA's cost accounting software. Line 7e community health improvement includes costs that are taken directly from departmental operating reports or expenses specific to a community health event, with no additional overhead included in the cost. Line 7f health professions education is comprised of internships (primarily internal medicine residents, nursing, pharmacy, and therapy students) with schools and universities, allowing their health profession students to receive hands-on training in a hospital setting. MSHA's Medicare-approved programs include medical residents, pharmacy and pastoral care. For these programs, Medicare-approved costs and Medicare reimbursement comes from filed Medicare cost reports. The Ballad Health Organizational Development Department (OD) maintains records for the non-Medicare programs. Only labor costs are included for MSHA team members that provide training (no overhead is applied) and only a percentage of team members' time is attributed to actual training. For line 7g subsidized health care services, MSHA's cost accounting system is used because MSHA has established, standard costing reports for these services. There are exceptions where MSHA does not use the cost accounting system. A small clinic inside JCCH, a federally designated critical access hospital, is subsidized by JCCH and the clinic's departmental operating report is used to compute the clinic's community benefit. The second exception is a palliative care program. For this program, the department's operating report is used. MSHA is careful to ensure no double counting of cost. Although there are other service lines within MSHA hospitals that lose money, MSHA does not report services that hospitals are required by state licensure to provide, routine services or ancillary services. Line 7h research represents MSHA's expense allocation from Ballad Health for research. Line 7i cash and in-kind contributions includes cash disbursements and in-kind donations of medications to local nonprofit rescue squads and fire departments. In-kind donations of medications are based on actual cost for these items.
Part II, Community Building Activities: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 boards of local service and nonprofit organizations. Some also serve as members and consultants on professional committees and task forces that affect regional development in healthcare and education. MSHA does not capture costs associated with team members that serve on other nonprofit boards or provide services to other nonprofits.MSHA, in collaboration with area health agencies and providers, may offer assistance with coordination, advocacy, or contribute supplies to support groups for their program activities that serve to assist special populations within the area. Most of these organizations work to improve the lives of community members that have limited, or no, financial resources.MSHA provided sponsorships for the Lee County Redevelopment and Housing Authority, the Northeast Tennessee Regional Economic Partnership, the Founders Forge Leadership Development Program, and the Summit Leadership Foundation-Youth Leadership Program.
Part III, Line 2:Self-pay balances include accounts after payments and contractual adjustments (discounts) have been applied from all third-party payers such as Medicare, TennCare/Medicaid, commercial insurers, and others - generally leaving the patient responsible for any remaining deductible and/or co-payment. Other self-pay accounts are from patients with no insurance or other third-party coverage. Under Ballad Health's system-wide self-pay policy, any patient who has no insurance and is ineligible for any government assistance program received an 85% discount. Many self-pay patients will further qualify for financial assistance (sometimes referred to as charity care) if they provide the financial information needed to deem them eligible or upon determination of presumptive charity eligibility. After the normal collection process has indicated an account is uncollectible, MSHA writes the account off to bad debt. The overall self-pay accounts receivable balance is evaluated on an ongoing basis to evaluate the age of accounts receivable, historical write-offs and recoveries and any unusual instances (such as local, regional or national economic conditions) which affect the collectability of receivables.
Part III, Line 3:MSHA's primary external collection agency historically estimated that approximately 37% of MSHA's bad debt would have qualified for financial assistance if patients had provided a financial assistance application and required documentation. Pursuant to the merger, MSHA has begun to score accounts using a presumptive eligibility tool. This tool utilizes various data points for a proprietary algorithm operated by an outside vendor to provide an individual's score which is then relied upon to assign presumptive charity eligibility. There are many instances of patients with large account balances and no health insurance coverage that MSHA believes would qualify for financial assistance. Although patients are encouraged to apply for assistance, many will not do so. MSHA would prefer for patients to submit completed financial assistance applications given that historical data clearly indicates that most uninsured patients and many underinsured patients will qualify for financial assistance under our program. Without a completed application, these are recorded as bad debt instead of charity care.
Part III, Line 4:Ballad Health's audited financial statements include a footnote on page 14 that describes bad debt. MSHA is included in the June 30, 2022 audited financial statements of Ballad Health (attached).
Part III, Line 8:Excluding Medicare losses reported in Part I subsidized health, the Part III Medicare allowable costs are reported using MSHA's filed Medicare cost report (C/R). The C/R uses a cost to charge ratio based on a step-down allocation methodology. MSHA believes Medicare losses should be allowed as a reportable community benefit, similar to governmental programs such as Medicaid. As a participating provider in the Medicare program, hospitals are required to provide the full regimen of care for the Medicare population. There are a number of care regimens that are compensated by the Medicare program at levels below cost. Therefore, it is only logical to allow hospitals to report these uncompensated services as a community benefit. By making this change, nonprofit providers will be encouraged to continue important care delivery models for our aging population in spite of the fact it may be economically injurious.
Part III, Line 9b:Requests for financial assistance are evaluated using established guidelines, while allowing for unique financial circumstances - for example, medically indigent patients with catastrophic medical costs that would threaten the patient's household financial viability. When a patient requests financial assistance or when an application has been received, the patient's account is placed in a hold status to prevent further collection activities until financial assistance eligibility is determined. All Ballad Health hospitals comply with IRS 501(r) regulatory guidelines.Ballad Health's collection policy clearly states that all patients are treated equally - with dignity and respect. Ballad Health ensures that outside collection agencies adhere to Ballad Health billing and collection guidelines. The collection program includes communicating expected financial responsibility prior to service. MSHA hospitals provide assistance to help underinsured and uninsured patients determine sources of payment for medical bills and to help patients determine eligibility for programs such as TennCare or Medicaid.After insurance benefit verification, MSHA hospitals bill insurance carriers. If the insurance carrier denies payment of the service/procedure as non-covered or the patient has exceeded their maximum benefits, the service/procedure will qualify for the uninsured discount.Financial counselors are available to discuss financial assistance with patients and their families. MSHA hospitals provide a number of payment options:- a pre-service discount may be offered- a discount in excess of established discounting rates may be granted for catastrophic high dollar accounts- MSHA hospitals accept all non-contracted and out-of-network payers and will make attempts to work with these payers regarding appropriate reimbursement and billing to their members- as part of Ballad Health's commitments to the State of Tennessee and Commonwealth of Virginia to form Ballad Health, not-in-network discounts are applied per policies in place for MSHA hospitals- payment arrangements are available as long as the account is not with a collection agencyReasonable efforts are made to determine if a patient is eligible for financial assistance - see Schedule H, Part VI, line 3 for information on how patients are informed about the Ballad Health financial assistance policy.
Part VI, Line 2:Focusing on population health improvement and associated priority metrics allows Ballad Health to further engage the efforts of its hospitals in partnership with communities in our service areas. It has helped Ballad to better identify health disparities that appear across the individual communities and has helped Ballad to prioritize issues that are most important in each hospital's community. Engaging local community organizations expands partnerships so that organizations work together more to address community health needs. Ballad Health uses a comprehensive process to gather input for and continues to evolve its population health plan. Because our hospitals are located in a region with many chronic disease challenges and high levels of health-related social risks, Ballad Health's goal is to target population health issues to make lasting improvements. Ballad conducts ongoing interviews, focus groups and meetings with external groups, including the regional health departments, United Way agencies, chambers of commerce, schools and community organizations, the regional accountable care community leadership council, as well as internal groups such as our population health and community benefit committee of the Ballad Health board of directors, the Ballad Health population health clinical committee, social needs council, grant advisory committees and our hospital community boards in the creation and on-going implementation of its population health plan.
Part VI, Line 3:Consistent with the Ballad Health financial assistance policy, MSHA communicates with and provides education to patients through various avenues regarding governmental assistance programs and hospital financial assistance. Various educational and application documents related to obtaining financial assistance are widely available at MSHA and all documents are available on the Ballad Health website. Printed financial assistance educational materials are part of each registration packet and posters are displayed in highly visible areas of the hospitals. Our financial assistance policy and documents are available in emergency departments and admitting areas. MSHA is also happy to mail all documents to patients and offers a plain language summary. All documents are available in English and Spanish. Financial assistance information is available during pre-registration, registration and/or during financial counseling. MSHA offers governmental program eligibility representatives to assist patients in securing eligibility for TennCare or Medicaid, federal disability and other governmental assistance programs. Additionally, if a patient or community resident expresses an interest in the ACA-healthcare exchange, MSHA representatives have the qualifications and experience to assist them through the entire process. Financial counselors offer financial assistance applications to patients who do not qualify for governmental assistance programs and are unable to pay for some or all of their healthcare.All patient billing statements have verbiage discussing financial assistance along with contact information. The last letter to the patient displays the plain language summary. In all oral correspondences with a patient, if it is identified the patient cannot meet payment requirements on their account, financial assistance is discussed as an option.Applicants are notified of financial assistance determination in writing.
Part VI, Line 4:MSHA serves the healthcare needs of 29 Appalachian counties in Northeast Tennessee, Southwest Virginia, Southeast Kentucky, and Northwest North Carolina. All of the counties MSHA serves are federally designated as medically underserved areas. MSHA's largest hospital, Johnson City Medical Center, is a tertiary referral center and level one trauma center. Medically underserved areas are designated by the U.S. Department of Health and Human Services. Shortage areas are identified through analysis of physician to population ratios depending on whether an area is considered to have a high need. Criteria used to determine high need are poverty rates, the percent of the population over age 65, infant mortality rates and fertility rates. MSHA operates 2 critical access hospitals: Johnson County Community Hospital in Tennessee and Lee County Community Hospital in Virginia.Additionally, according to the 2021 County Health Rankings, counties where MSHA hospitals are located ranked poorly for both health outcomes and health factors.
Part VI, Line 5:MSHA is dedicated to operating efficiently so that waste is minimized. MSHA's leadership remains mindful of managing limited resources so that adequate facilities and equipment are available for the care of patients. Surplus funds are invested into improving treatment options for patients through new technologies, recruiting physicians and trained staff in shortage areas, and improving MSHA facilities. Various checks and balances are established to ensure that expenditures for operating expenses and capital costs are reasonable and necessary. MSHA has several hospitals with Medicare-approved health profession education programs. In addition, MSHA hospitals serve as training sites for many types of health professions: nursing, pharmacy, psychology, lab, respiratory therapy, EMT, public health, etc. Students from numerous colleges, universities, and programs receive training and experience in MSHA hospitals. MSHA resources are devoted to health conferences for local health professionals, two health resources centers conveniently located in a shopping mall and a wellness center; provide for media coverage to educate residents on health issues; offer events to the public that combine fun activities with health education; and many other programs focused on improving the health of area residents. While MSHA operates hospitals in predominantly low-income, rural and isolated areas, MSHA continues to offer services that operate at a loss because residents would otherwise need to leave their hometown or county to receive needed care. Mountain States merged with Wellmont Health System in February 2018 to form Ballad Health healthcare system. Mountain States and Wellmont still exist as legal entities and continue to operate multiple hospitals. MSHA's governing body is comprised of persons who reside in the organization's primary service areas. Physicians that request privileges who are qualified and credentialed are extended privileges by MSHA.
Part VI, Line 6:Mountain State's merger with Wellmont opened up many opportunities not previously available to two competing health systems. Collaboration started post-merger and Ballad Health continues to see progress towards improving efficiencies within our health system, activities consistent with Ballad Health's population health initiative, sharing best practice quality improvements, and other benefits related to operating as one rather than operating in a competitive environment. A clinical council was formed immediately following the merger. The council includes physicians nominated from the leadership of all Ballad hospitals. A Community Benefit and Population Health Committee of the board was established, and various other infrastructures have been established since the merger. Across MSHA's hospitals, there were many projects, programs, and collaborative efforts that took place during the year. MSHA provides care to people in 29 counties in Tennessee, Virginia, Kentucky and North Carolina. Each hospital is fully accredited by The Joint Commission, with the exception of Johnson County Community Hospital and Lee County Community Hospital. JCCH and LCCH receive certification through the states of Tennessee and Virginia since they are critical access hospitals. MSHA, based in Johnson City, Tennessee includes 8 wholly owned hospitals which are included in this Form 990. In addition, MSHA owns 2 hospitals located in Southwest Virginia, each of which file separate returns. In addition to acute care hospitals, the system includes such services as:Primary/specialty physician practices, emergency departments, occupational medicine, rehabilitation, outreach laboratory, mental health, neonatal intensive care, a NACHARI-affiliated children's hospital, renal dialysis, St. Jude's Oncology, inpatient/outpatient surgery, skilled nursing, long-term care, home health, 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. MSHA's flagship facility, Johnson City Medical Center is at the core of the system offering full-service tertiary care. In addition to MSHA 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 rehabilitation.MSHA partners with East Tennessee State University to operate Overmountain Recovery, an opioid addiction recovery facility located in Gray, Tennessee.MSHA is the sole member of Integrated Solutions Health Network, LLC. (ISHN). ISHN operates Anewcare Collaborative, the region's first accountable care organization, bringing together community health care providers to provide better outcomes and improved patient satisfaction at a lower cost.Hospitals in the Ballad Health system work closely with one another to share expertise and resources.
Part VI, Line 7, Reports Filed With StatesTN,VA
Part VI, Additional InformationBallad Health is required to report community benefit estimates on a quarterly basis with the states of Tennessee and Virginia. The reporting includes all of Ballad Health's hospital organizations and is reported using IRS Form 990, Schedule H instructions for reporting community benefit. Ballad Health operates under a Certificate of Public Advantage (COPA) in Tennessee and a Cooperative Agreement (CA) in Virginia as obligated by agreements between Ballad Health and the two states to allow Mountain States Health Alliance and Wellmont Health System to merge.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (15 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtPurpose Of GrantPurposeOfGrantTxt
Appalachian School of Law
1169 Edgewater DriveGrundyVA24614541743079501c3$275,000$0Improve Access to Healthcare Program
Ballad Health Foundation
1019 W Oakland Avenue Suite 2Johnson CityTN37604581594191501c3$7,000$0Program support
Barter Theatre
PO Box 867AbingdonVA24212546000120501c3$10,000$0Sponsorship
Boones Creek Historical Trust
632 Hales Chapel RoadGrayTN37615800288021501c3$10,000$0Program support
City of Johnson City
601 E Main StreetJohnson CityTN37601626000320501c3$14,600$0Program support
East Tennessee State University
PO Box 70732Johnson CityTN37614626021046501c3$474,392$0College of Pharmacy/Cntr for Nursing Excellence
Emory & Henry College
PO Box 950EmoryVA24327540505892501c3$2,298,792$0Program to increase RNs in Northeast Tennessee & Southwest Virginia
Mtn Empire Comm College Fndn
3441 Mountain Empire RoadBig Stone GapVA24219541175620501c3$7,000$0Scholarship fund
Music For All
39 W Jackson Place Suite 150IndianapolisIN46225363413042501c3$18,000$0Bands of America - East Tennessee Regionals sponsorship
NE TN Reg'l Economic Partnership
300 E Main Street Suite 406Johnson CityTN37601814014871501c3$10,000$0Program support
President and Fellows of Harvard College
1033 Massachusetts AvenueCambridgeMA02138042103580501c3$15,000$0Health Policy Leadership Council sponsorship
Salvation Army
PO Box 1715Johnson CityTN37605580660607501c3$20,000$0Program support
Summit Leadership Foundation
3104 Hanover RoadJohnson CityTN37604201336099501c3$32,500$0Program support
Tenn Dept Environment & Conservation
312 Rosa L Parks AvenueNashvilleTN37243626001446501c3$9,004$0AEDS for emergency vehicles
Town of Lebanon
PO Drawer 309LebanonVA24266546026883501c3$10,000$0Festival sponsorships
FieldValueIRS element (for citing)
Total501c3 Org15Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 2:FormAndLineReferenceDesc
ExplanationThe Community Benefit and Population Health Committee for Ballad Health is comprised of members from Tennessee and Virginia. Committee members have various perspectives on community health improvement and work to develop an understanding of population health, philanthropy, community benefit obligations and the role Ballad Health plays in health access improvement. The senior leadership for Ballad Health, including the President and CEO and COO, attend the meetings. Among the responsibilities of the committee is ensuring charitable contributions comply with Ballad Health Board policies. All requests are submitted electronically with the required information to determine eligibility. After the committee has reviewed requests, various levels of approval are required, including the Ballad Health CEO or Ballad Health Board, based on the level of commitment. Applicants requesting funding for a specific event or program should include the following information: -Mission statement of organization -Year organization was founded -Tax status and federal taxpayer ID number -Website -Description of the event/program -Event/program budget -Other sources of income -Impact of the event/program on the health of residents in our region -Beneficiaries of contribution -Number of people served annually -Event/program accomplishments -Measure of accomplishmentsExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (23 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Alan Levine BH PresCEO
Director$0$1,328,603$0$1,687,893$0$1,066,533$0$216,552$0$23,791$0$4,323,372$0$1,002,170
Marvin Eichorn BH EVPCAO
Director$0$738,294$0$347,261$0$68,911$0$17,100$0$26,804$0$1,198,370$0$0
Eric Deaton BH EVPCOO
Director$0$656,895$0$334,180$0$30,368$0$83,012$0$21,172$0$1,125,627$0$0
Lynn Krutak
BH EVP/CFO$0$638,754$0$299,081$0$19,133$0$80,962$0$23,301$0$1,061,231$0$0
Clay Runnels MD Fmr Offcr
BH EVP/Chief Phys Exec$0$539,228$0$244,092$0$27,828$0$68,561$0$25,204$0$904,913$0$0
Tim Belisle BH EVPGen Cnsl
Director$0$444,154$0$202,357$0$24,072$0$61,801$0$25,605$0$757,989$0$0
Edward Hickson
VP/Pres - SW Mkt$256,355$0$165,100$0$239,115$0$14,934$0$22,185$0$697,689$0$0$0
Linda White Fmr Offcr
VP/Pres - NW Mkt$0$402,700$0$141,893$0$2,156$0$37,714$0$22,673$0$607,136$0$0
Mark Wilkinson MD Fmr HComp
BH VP/CMIO$0$398,522$0$140,367$0$22,703$0$17,600$0$26,524$0$605,716$0$0
Matthew Loos Fmr HComp
BH VP/CAO$0$387,294$0$129,920$0$11,900$0$16,839$0$27,625$0$573,578$0$0
Brian Dawson MD
VP/CMO - Southern Mkt$359,163$0$116,211$0$1,165$0$17,100$0$13,831$0$507,470$0$0$0
Andrew Wampler Fmr Key Empl
BH VP - Oper Excellence$0$293,071$0$108,548$0$38,033$0$0$0$22,613$0$462,265$0$15,569
Joshua McFall
VP/CFO - Acute Services$296,627$0$98,866$0$1,051$0$16,466$0$22,260$0$435,270$0$0$0
Melanie Stanton
VP/CEO - FWCH$271,430$0$95,884$0$8,296$0$17,455$0$22,186$0$415,251$0$0$0
Lemmie Taylor
VP/CEO - SSH$239,168$0$85,382$0$8,704$0$27,579$0$23,948$0$384,781$0$0$0
Kenneth Shafer
VP/CEO - JCMC$261,186$0$78,520$0$7,422$0$16,579$0$20,431$0$384,138$0$0$0
Lisa Carter
Regional Pres - Southern Mkt$250,643$0$85,219$0$8,160$0$16,694$0$23,392$0$384,108$0$0$0
Chase Wilson Fmr Key Empl
VP/COO - BHMA$0$216,688$0$63,133$0$119$0$13,770$0$24,360$0$318,070$0$0
Morgan May
VP/Regional CNO$200,645$0$73,175$0$5,015$0$0$0$20,568$0$299,403$0$0$0
Dwight Owens
Admin/COO - IPCH$219,394$0$11,229$0$6,985$0$13,816$0$21,794$0$273,218$0$0$0
Greta Morrison
AVP, Admin/CNO - RCH$155,889$0$40,607$0$6,682$0$12,673$0$24,795$0$240,646$0$0$0
Corinne Allen
MultiFac Dir - Pharm Svcs$191,791$0$6,462$0$441$0$12,273$0$21,287$0$232,254$0$0$0
Jeffery Stopka
Physical Therapist - HH$203,780$0$500$0$86$0$8,294$0$9,097$0$221,757$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Lines 4a-bFormAndLineReferenceDesc
ExplanationThe following executives listed in Schedule J, Part II participated in a 457(f) retirement plan provided by Ballad Health (BH). 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 Ballad Health 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. 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. Additionally, during the year a one-time acceleration of the supplemental executive retirement plan occurred for the CEO in the amount of $1,002,170. This amount was taxable in the year accelerated and is included in total compensation for purposes of reporting. Alan Levine $199,452 Eric Deaton $65,950 Tim Belisle $44,703 Lynn Krutak $63,862 Clay Runnels $50,611 Linda White $20,460 Lemmie Taylor $12,309 The following executives received a change-of-control payment. The payment was reported as taxable income with appropriate tax withheld and remitted to the IRS. Edward Hickson $237,700 Andrew Wampler $ 2,421ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1Health & Educ Facilities BoardBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN621464028BondIssuerEIN
CUSIP478271JV2CUSIPNum
Bond Issued2012-09-18BondIssuedDt
Issue Price$94,745,050IssuePriceAmt
PurposeConstr. & Equip.PurposeDesc
DefeasedYes (1)DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$37,880,000RetiredAmt
Bond Defeased$55,000,000BondDefeasedAmt
Total Proceeds$95,337,514TotalProceedsAmt
Issuance Costs From Proceeds$1,889,665IssuanceCostsFromProceedsAmt
Capital Expenditures$93,447,849CapitalExpendituresAmt
Substantial Completion2016SubstantialCompletionYr
Refunding Tax Exempt Bonds0RefundingTaxExemptBondsInd
Refunding Taxable Bonds0RefundingTaxableBondsInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd PropYes (1)MgmtContractBondFincdPropInd
Engage Bond Counsel ContractsYes (1)EngageBondCounselContractsInd
Any Research Agreements0AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due YetYes (1)RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate DueYes (1)NoRebateDueInd
Variable Rate IssueYes (1)VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (1)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (1)ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Date Rebate Computation PerformedIssuer Name: Health & Educ Facilities Board Date the Rebate Computation was Performed: 06/17/2022
Schedule K - Additional InformationHealth & Educ Facilities Board 2012 A&B&C Construct and equip susrgery center at Johnson City Medical Center; Construct and equip hospital facilities, including refinancing of taxable indebtedness relating thereto 1. Comment on Part I, Line A. In 2012, when the bonds referenced in Schedule K were issued, Mountain States Health Alliance owned and/or operated hospitals in a number of different locations both in Tennessee and in Virginia. As a result, Mountain States Health Alliance utilized conduit governmental bond issuers in multiple jurisdictions in order to finance improvements to its hospital facilities. In 2012, Mouontain 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 Line A because the bonds that were issued were part of a single "issue" for federal tax purposes. Additional Issuer EIN: 54-1276910 Additional CUSIP #s: 478271JWO; 977220AA0 2. Comment on Part II, Line 3. Line 3 for the listed bond issues does not match the applicable issue price for such bond issue because of interest earnings earned on the proceeds of such bonds.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonLaura LevinePersonNm
FieldValueIRS element (for citing)
Relationship DescriptionFamily MemberRelationshipDescriptionTxt
Transaction$55,192TransactionAmt
TransactionSee Part VTransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart IV, Supplemental InformationFormAndLineReferenceDesc
ExplanationAlan Levine, President and CEO of the Ballad Health/Mountain States Health Alliance Board of Directors, is a family member of Laura Levine, an employee of Mountain States Health Alliance.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (24 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part III, Program Service AccomplishmentsBallad Health (Ballad) is an integrated healthcare delivery system consisting of 21 hospitals in Northeast Tennessee and Southwest Virginia, including a Level 1 Trauma Center, dedicated children's hospital, several community hospitals, three critical access hospitals, a behavioral health hospital, an addiction treatment facility, long-term care facilities, home care and hospice services, retail pharmacies, outpatient services and a comprehensive medical management corporation. Ballad works closely with an active independent medical community and community stakeholders to improve the health and well-being of over one million people in 29 counties of the Appalachian Highlands in Northeast Tennessee, Southwest Virginia, Northwest North Carolina, and Southeast Kentucky. Ballad is a Tennessee non-profit corporation and is the main provider of healthcare services in Northeast Tennessee and Southwest Virginia. Ballad Health is a tax-exempt entity and the parent corporation of both Mountain States Health Alliance (MSHA) and Wellmont Health System (WHS). On February 1, 2018, Ballad was formed through a merger of two legacy systems, Mountain States Health Alliance and Wellmont Health System. Ballad was formed under state-action immunity in compliance with federal antitrust law, to create a healthier region and keep healthcare local. The action approving the merger was officially taken through the agreements made between Ballad and the State of Tennessee in the Certificate of Public Advantage (the "COPA") and the Letter Authorizing the Cooperative Agreement (the "CA") in Virginia. Pursuant to the COPA and CA, Ballad must fulfill certain obligations, commitments, and covenants. Tennessee and Virginia, through their respective health departments, supervise specific aspects of Ballad's operations under certain conditions of the COPA and the CA. The COPA and amendments is publicly available on the website of the Tennessee Department of Health, at https://www.tn.gov/health/health-program -areas/health-planning/certificate-of-public-advantage.html. The Cooperative Agreement is available on the website of the Virginia Department of Health, at https://www.vdh.virginia.gov/licensure- and-certification/cooperative-agreement/. Form 990 for Mountain States Health Alliance (MSHA) includes eight wholly owned hospitals including a children's hospital and a behavioral health hospital; two others, also wholly owned by MSHA, each file a separate return. Form 990 for WHS includes six wholly owned hospitals; three others, also wholly owned, each file a separate return. MSHA is sole shareholder of Blue Ridge Medical Management Corporation (BRMMC), a for-profit entity that owns and manages physician practices and real estate and provides other health care services to patients in Tennessee and Virginia. MSHA is the sole member of Integrated Solutions Health Network, LLC (ISHN). ISHN, also included in this Form 990, is a regional health solutions company headquartered in Johnson City, Tennessee. ISHN is an expansive network of providers serving residents of Northeast Tennessee and Southwest Virginia and consists of provider groups, primary care physicians, specialists, and allied health providers. Specific to the hospitals included in this Form 990, services were provided to: 41,650 inpatients 599,645 outpatient visits 161,525 emergency visits 3,776 deliveries 21,365 surgeries 113,080 home health visits
WASHINGTON COUNTY, TN: JOHNSON CITY MEDICAL CENTER (JCMC)- Located in Johnson City, Tennessee and serving the community since 1911. The 585-bed regional tertiary referral center has 416 beds dedicated to acute care, 85 beds for children and 84-beds for behavioral. - Provides a wide array of acute care services, including a complete range of cardiovascular, neurology, oncology, surgical and rehabilitation services. JCMC is a comprehensive, acute-care teaching hospital affiliated with James H. & Cecile C. Quillen College of Medicine at East Tennessee State University (ETSU). - Region's only Level I trauma center, one of only five in Tennessee, with 24/7 orthopedic traumatologist specialist coverage. - Region's only safety net hospital. - Regional Cancer Center at JCMC has relationships with Harvard, Duke, and Vanderbilt universities. - Quantros named JCMC in the top 10% of hospitals in the nation for patient safety in overall medical care, trauma care, heart attack and heart failure treatment, stroke care, hip fracture treatment and major neurological surgery in its 2023 CareChex awards. JCMC was also recognized among the top 100 hospitals and top 10% of hospitals in the nation for medical excellence in hip fracture care. - U.S. News recognized JCMC as "high performing" for knee replacement procedures, heart attack care and treatment, heart failure care and treatment, and care of stroke patients. - Niswonger Children's Hospital (NsCH) is a hospital within a hospital located on the campus of JCMC. NsCH is the only children's hospital in northeast Tennessee and serves more than 200,000 children in the four state, 29-county region. NsCH has more than 20 pediatric subspecialties providing specialty care through a pediatric emergency room and 85 inpatient beds, including a 16-bed neonatal abstinence syndrome. The Level III designated neonatal intensive care unit is only one of five state-designated tertiary centers for high-risk maternal fetal care in Tennessee and is the regional referral center for neonatal patents. A Ronald McDonald House is located on the campus and provides services to the pediatric patients and family members. In October 1999, a clinical affiliation was entered with St. Jude's Children's Research Hospital to provide pediatric cancer and other catastrophic disease treatment services. The affiliation with St. Jude's in one of only eight in the country. The First Regional Hemophilia Program, a state sponsored program for congenital bleeding disorders, is housed in the St. Jude affiliate clinic and provides programs for both children and adults with hemophilia. - Woodridge Hospital, a free-standing 84-bed behavioral health hospital located across the street from JCMC, provides mental health and chemical dependency services for adults, adolescents, and children in Northeast Tennessee and Southwest Virginia. Woodridge is the only dedicated inpatient behavioral health hospital in the region and provides a 24/7 intervention helpline. In 2023, Woodridge opened a new access point for behavioral healthcare with a 24/7 walk-in behavioral crisis clinic for patients experiencing behavioral health emergencies, such as suicidal or homicidal ideation, acute psychosis, auditory and/or visual hallucinations and other extreme mental or emotional crises.
WASHINGTON COUNTY, TN: FRANKLIN WOODS COMMUNITY HOSPITAL (FWCH)- 80-bed acute care hospital located in Johnson City, Tennessee and providing services since 2010. - Provides specialty and subspecialty care, including general acute medical, maternity, comprehensive diagnostic imaging, emergency services and advanced surgical services, including minimally invasive robotic surgery. - FWCH was the first "Leadership Energy and Environmental Design" (LEED) certified hospital in Tennessee. - U.S. News recognized FWCH as "high-performing" for pulmonary disease care. - Healthgrades recognized FWCH as a Five-Star Recipient for Treatment of Sepsis in 2023.
SULLIVAN COUNTY, TN: INDIAN PATH COMMUNITY HOSPITAL (IPCH)- 239-bed acute care hospital located in Kingsport, Tennessee serving the community since 1984. - Provides general medical and surgical services, including the Center for Women and Babies, various outpatient services, including advanced services such as the lung nodule clinic, a regional cancer center, and a sleep center. - IPCH opened the third Niswonger Children's Network Pediatric Emergency department in 2023, strengthening the system of care for children by joining Niswonger Children's Hospital in Johnson City and the J.D. Nicewonder Family Pediatric Emergency Department at Bristol Regional Medical Center. - Quantros named IPCH in the top 10% of hospitals in the nation for patient safety in overall surgical care, medical excellence in general surgery, patient safety in gastrointestinal care in its 2023 CareChex awards. IPCH was also named in the top 10% in the State of Tennessee for patient safety in general surgery. - U.S. News recognized IPCH as "high-performing" in pneumonia care in 2023.
CARTER COUNTY, TN: SYCAMORE SHOALS HOSPITAL (SSH)- 21-bed acute care facility located in Elizabethton, Tennessee providing services to the community since 1955. - Provides inpatient, geropsychiatric, and outpatient care for medical and surgical patients. - Healthgrades named SSH among the Top 10% in the Nation for Patient Safety in 2022 and Recipient of the Healthgrades 2022 Patient Safety Excellence Award. - Quantros named SSH in the top 10% in the nation for medical excellence in gallbladder removal in its 2023 CareChex awards and in the top 10% of hospitals in the State of Tennessee for gastrointestinal hemorrhage.
JOHNSON COUNTY, TN: JOHNSON COUNTY COMMUNITY HOSPITAL (JCCH)- Federally designated critical access hospital located in Mountain City, Tennessee serving residents of the upper Northeast Tennessee, parts of western North Carolina and Southwest Virginia since 1998. - Provides inpatient, emergency and outpatient care along with cardiac rehabilitation, diagnostic, and physical therapy services.
RUSSELL COUNTY, VA: RUSSELL COUNTY HOSPITAL (RCH)- 78-bed Medicare dependent hospital located in Lebanon, Virginia. - Included in the 78-bed complement, is a 20-bed inpatient psychiatric unit. RCH offers a full array of primary care services and some specialty services, including a cancer center.
UNICOI COUNTY, TN: UNICOI COUNTY HOSPITAL (UCH)- 10-bed acute care hospital, located in Erwin, Tennessee and providing services since 2018. - Provides general acute inpatient, emergency, cardiology, diagnostic imaging, sleep lab, and rehabilitation services.
LEE COUNTY, VA: LEE COUNTY COMMUNITY HOSPITAL (LCCH)- 6-bed critical access hospital located in Pennington Gap, Virginia providing services since 2021 to residents of Southwest Virginia and Southeast Kentucky. - LCCH was specially designed to meet the needs of its community, with acute and emergency services, diagnostic radiology and lab services, outpatient cardiology and additional rotating clinics for specialty care and telehealth access.
Novel Coronavirus (COVID-19) Public Health EmergencyIn March 2020, Ballad Health (Ballad) executed its disaster plan in response to the COVID-19 pandemic. This plan included the activation of its Corporate Emergency Operations Command (CEOC) to coordinate efforts across the system and around the region to rapidly plan for and execute an ongoing response to the issues resulting from the COVID-19 pandemic. Throughout 2021, Ballad continued to battle against COVID-19 as new variants emerged, such as the Delta and Omicron variants. As these variants spread through the Ballad service area, Ballad's emergency rooms experienced significant surges. In addition to caring for patients within the hospital's walls, Ballad also supported the community through testing and vaccination efforts. In 2021 alone, Ballad conducted almost 300,000 tests and delivered over 88,000 total doses of COVID-19 vaccines. In September 2021, Ballad expanded its Safe at Home program, which was designed to provide at-home COVID-19 care to include patients presenting at Ballad urgent care and primary care locations and those visiting Ballad hospitals. Launched in November 2020, the program aimed to prevent hospital overcrowding and conserve inpatient beds during current and expected COVID-19 surges. Eligible patients in the Safe at Home program were equipped with a pulse oximeter and thermometer to monitor their vitals at home and ensure they receive timely and appropriate care if their condition worsened. The program also involved regular interactions with Ballad's clinical team members via phone calls. In April of 2021, Ballad launched the region's first Center for Post-COVID Care, an innovative approach to COVID-19 care that creates an access point to comprehensive clinical care for patients struggling with post-COVID symptoms. Through the Center for Post-COVID Care, Ballad offers a full spectrum of services, including care navigation and case management, for post-COVID patients. The health system is also fostering research and learning opportunities and collaborating with other leading institutions to understand post-COVID care and increase awareness among healthcare providers, patients, and community members of this condition. In April 2022, Ballad closed its Corporate Emergency Operations Center. Ballad continues to vigilantly monitor COVID-19 and its variants in its service area and will respond accordingly. FOCUSING ON QUALITY
EMPHASIZING ZERO-HARM THROUGH TIERED SAFETY HUDDLES - As part of BalladHealth's systemwide initiative to improve safety and reduce harm, Ballad Health continued its tiered safety huddle program throughout the pandemic. Each day, frontline team members across the Ballad Health organization begin their morning with huddles focused on clinical quality and safety. These huddles provide an organized manner for team members to express opportunities to improve safety and quality and strive towards becoming a zero-harm institution. Any issues identified during those huddles are elevated to hospital leadership. If hospital leadership needs help to resolve the problem, the issue is further elevated to the market and corporate levels. Using this approach, Ballad Health can improve outcomes and enhance safety by rapidly deploying resources to support and solve safety issues as they arise. LAUNCH OF IBM/WATSON TOP HEALTH SYSTEM JOURNEY - Since the merger in 2018, one of Ballad Health's priorities has been to instill a zero-harm culture and become one of the highest-performing health systems in America for the quality of care it delivers to patients. After a rigorous review of the various systems for measuring that success, Ballad Health leaders chose IBM/Watson because it provided measurable, achievable, and valid guideposts for the health system. To help lead Ballad Health on this journey to become a top health system in the nation, health system leaders formed the IBM/Watson Top 15 Health System Task Force, comprised of stakeholders from multiple departments of Ballad Health. IBM/Watson identifies the 15 top-performing health systems in the nation based on four key performance domains: inpatient outcomes, extended outcomes, operational efficiency, and patient experience. Dr. Amit Vashist, Ballad Health's chief clinical officer, who leads the IBM/Watson top health system journey, stated, "We looked far and wide at various methodologies to identify the most appropriate benchmarks to measure ourselves against, and we ultimately chose IBM/Watson because it included an ideal blend of metrics and measures that are truly meaningful and appealed to our frontline clinicians, such as hospital-acquired conditions, ED throughput, readmissions, mortality, costs of care and length of stay." CLINICAL COUNCIL - A unique feature of Ballad Health is the establishment of a robust and diverse Clinical Council, comprised of about 30 physicians. The physicians were nominated by the leadership of all Ballad Health hospitals, the health system's medical group and independently practicing community physicians. The Council's members also include pharmacists, advanced practice providers and nurses. The Council reports directly to the Quality Committee of the Ballad Health Board of Directors. The council aims to ensure excellence in clinical care through physician engagement and leadership and is charged with guiding Ballad Health's transformation into a community health improvement system. As a result of the council's efforts, several important quality measures are now performing among the top-decile health systems in America. CONTINUED PUBLIC ADVANTAGE - Ballad's compliance with each of the COPA and CA is supervised by Tennessee and Virginia respectively. Ballad is in compliance with all terms of the COPA and CA. Each year since the creation of Ballad, the State of Tennessee and Commonwealth of Virginia have independently confirmed the public advantage created by the unification of the hospitals in the rural region. In the latest report dated June 2022, the Tennessee Department of Health highlighted that despite the significant changes for population health across the United States during the COVID-19 pandemic, the 11 Tennessee counties served by Ballad in "the COPA region performed better, and [were] shown to be healthier, than peer counties in 50 percent of population health" measures and that drug overdoses have decreased considerably in the region since the merger. The region also outperforms peer counties on all vaccination measures for children and adults. The overall cost of healthcare was reduced due to the reduction of preventable hospitalizations in adults 65 and older by almost half. The merger has reduced unnecessary administrative overhead costs and eliminated unnecessary duplication of high-cost services reducing the overall cost of care for the Appalachian Highlands. In the Tennessee Department of Health report covering the period of July 1, 2020 to June 30, 2021, the department noted that as a combined health system, Ballad Health was able to respond to the COVID-19 pandemic "in ways that would not have been possible with two separate health systems" to ensure the deployment of staff, beds and personal protective equipment met the needs of the community and served as a trusted voice in the region for COVID-19 information. In each year before the COVID-19 pandemic, Ballad Health also maintained one of the nation's most successful Accountable Care Organizations, which has been highlighted by the Centers for Medicare and Medicaid Services as one of a handful of organizations that have produced savings for taxpayers in each year since the program's creation, while making high-quality scores.
ENVIRONMENTAL, SOCIAL, AND GOVERNANCE (ESG)Ballad Health is committed to being a responsible and concerned citizen of the communities of the service area where it operates and is driven by its mission: "honor those we serve by delivering the best possible care." Ballad continues to deploy initiatives intended to improve the overall health and well-being of the over one million people living in its service area. ENVIRONMENTAL - Environmental stewardship and preserving the environment is important to Ballad and is demonstrated in the following practices: - Environmentally responsible supply chain - Encourage the recycling of materials and minimization of waste - Encourage the reduction of energy usage - Incorporate environmentally preferable alternatives when designing new construction SOCIAL - Social commitments are an integral part of Ballad's mission, vision, and values. By working and collaborating with others in the communities in which it serves, Ballad works "to build a legacy of superior health by listening to and caring for those we serve". Ballad provides direct and in-kind support to improve access to care and deliver healthy lifestyle services, education, and activities. The community health programs are designed to improve access and quality of care, strengthen community outreach and partnerships, decrease healthcare costs, and assist in the reduction of health care disparities in the region. Ballad has opened two new rural hospitals in the past five years. Ballad offers extensive education and outreach programs throughout the community at little or no cost to participants. Program areas include: - Community events, such as health fairs, screenings, flu shots, health and safety education, support groups, stroke education, baby and child health, and medical libraries - Children's resources, such as the Morning Mile Program, B.E.A.R. Buddies, car seat safety, and Families Thrive. - Heart and Soul, senior health, and well-being programs. - General health resources, individual health, nutrition, and safety education. - Regular health education speakers covering a wide range of topics. The following are some of the programs designed to improve healthcare equity and availability: Ballad as a Community Health Improvement Organization: Ballad's goal is to ensure the sustainability of rural healthcare services while improving the health and well-being of the region as a whole. In the short-term, Ballad will address health related social needs to improve access to care, reduce inequity, and empower individuals to adopt healthy behaviors and manage health conditions. In the long-term, Ballad will address social drivers of health to provide a community level foundation for permanent regional health improvement through multi-sector collective impact. Ballad is taking an intergenerational approach to focus on children's health initiatives to give kids a strong start in life, as well as assisting adults with overcoming obstacles to health and self-sufficiency. Ballad is on a journey to universalize social needs screening and prioritized navigation resources throughout the system using embedded Epic tools combined with the UniteUs referral management platform. These efforts are informed and supported by a multi-departmental team called the Social Needs Council which has accountability to the system Population Health Council, the Chief Population Health Officer, and ultimately the board Population Health and Social Responsibility Committee. STRONG Accountable Care Community: Driving Community Level Action and Change: The STRONG Accountable Care Community is a regional collective impact model focusing on community level strategies across a life course model that includes a multi-generation approach to parenting support and family self-sufficiency. Established in 2018, the STRONG Accountable Care Community (STRONG ACC), sponsored by Ballad, is a 350 organization, multi-sector model serving the same geographic footprint as Ballad and additional contiguous counties. The STRONG ACC has adopted the "Five Conditions of Collective Impact": a common agenda, shared measurement, mutually reinforcing activities, continuous communication, and backbone support. Ballad is providing backbone support and investing in the STRONG ACC because the health system believes the collective impact model is necessary to accelerate, leverage, and sustain community level change. The STRONG ACC is also using the UniteUs platform for a "no wrong door" approach to social needs across hundreds of networked organizations. The organization is also creating an Early Care and Education Plan for all of Northeast Tennessee and Southwest Virginia. For more information, visit https://www.strongacc.org/. Accountable Health Communities ("AHC"): When Ballad was awarded the Accountable Health Communities grant from the Centers for Medicare and Medicaid Services in 2017, the system acted on its vision to universalize social needs screening and navigation. Health related social needs create major barriers to health for some individuals. Since its inception, the program has screened 182,000 individuals on Medicare or Medicaid and identified 50,000 distinct needs, working with nearly 2,000 regional organizations to successfully connect individuals to services which provide food, housing, transportation, safety support, and utilities among other needs. AHC has provided 29,681 community referrals and navigation for 7,573 patients. The program has revealed new information about the extent of social needs within Ballad's patient environment and informed the goal to scale social needs screening and navigation services throughout the organization. Appalachian Highlands Care Network: Appalachian Highlands Care Network, started in 2020, is Ballad's program to serve low-income, uninsured people of the region through a realignment of charity care dollars. The goals of the Appalachian Highlands Care Network are to identify low-income uninsured people, enroll them in the program, and serve them to improve quality of care, increase access to care, and reduce avoidable cost of care. Patients in the program receive free needed medical care from Ballad and a network of other providers. This includes ensuring all patients have a source of primary care and are screened and navigated to social need resources, provided with medical care coordination, and assisted through care management services. Ballad partners significantly with Appalachian Mountain Project Access, the region's free and reduced cost clinics and health departments, and hundreds of regional social support agencies to break down barriers to medical care, improve chronic conditions like diabetes, and address social needs. To date, the program has enrolled more than 4,800 individuals.
STRONG Starts: Ballad believes safe, stable, nurturing environmentsfor children are essential to optimal early development and later success in life. Started in 2021, STRONG Starts is aimed at improving birth outcomes and reducing the negative impact of chronic stress for mothers, babies and families. The birth of a new baby is a pivotal time for a mother and her family. No one should feel alone or unsupported during this time. Ballad seeks to connect with every expectant mother as early in her pregnancy as possible to ensure access to early prenatal care - all in partnership with the region's obstetric providers. As the life situation and pregnancy experience for every woman is different, Ballad will build supportive relationships aligned with the unique circumstances of every woman and family. With embedded staff in the region's obstetric practices and hospital birthing centers, these relationships begin early. Staff will help families connect with community resources for issues from food/housing insecurity to parenting resources to education/job training. To date, the program has screened more than 7,300 women and served nearly 3,000 through the course of their pregnancies. The program continues into the post-natal and early stage of life. Ballad staff assist those in the program through kindergarten entry with a whole-family approach. This ongoing relationship will help with evolving needs and the transition in healthcare from the obstetric environment to the pediatric environment. Ballad works with regional pediatricians to ensure they can refer children and families into the program. The developmental milestones of children will be assessed so early supports can be provided, and Ballad assist with connections to community resources as children grow, including programs which support resiliency and early learning environments. Ballad seeks to further support the safety, stability, and self-sufficiency of families and to help ensure children enter kindergarten developmentally, socially, and emotionally ready to learn. This first experience with the educational system is foundational, as it sets the tone for later success with grade level reading, math proficiency, and the academic discipline needed to ensure high school graduation and college and career readiness. These benchmarks are predictors of later economic and health outcomes which can reshape the life trajectory, health, and well-being for children and families for generations to come. To date, this section of the program has served more than 2,000 families. In addition to these programs, Ballad invests significant funding annually to support partnering organizations, Community Health Improvement Sites, who provide aligned services and mutually serve the populations mentioned above. These services include free health services, care coordination, housing supports, substance use and recovery, social needs support, maternal/child supports, early learning and literacy improvement initiatives, and women's health services. Ballad also provides a host of other services to vulnerable populations including free cancer screenings, mobile health services, health fairs, children's resources, and health education programs notably through a network of faith community nurses. The health system continued to address the cost of care in the region. For example, Ballad successfully managed the care of thousands of COVID-19 patients in their homes through the "Safe at Home" program. The program served 5,654 patients and saved millions of dollars in potential hospitalization costs and freed up hospital capacity for the most seriously ill patients. Based on the strength of this program, Ballad's Hospital at Home waiver was approved by the Centers for Medicare and Medicaid Services (CMS) for Ballad's Bristol Regional Medical Center, Holston Valley Medical Center and Johnson City Medical Center. This waiver will allow Ballad to provide hospital-level care at home for Medicare patients who traditionally qualify for hospital admission. Early results from similar programs around the country indicate high patient satisfaction and quality outcomes at a lower cost than traditional inpatient hospitalization.
GovernanceGovernance is overseen by the Ballad Board of Directors and ongoing ESG work through the following committees: - Audit and Compliance - environmental and sustainability performance - Community Benefit & Population Health - social and community goals and performance - Executive Compensation - human capital; diversity, equity, and inclusion; and pay equity goals and performance - Governance - governance goals and performance - Quality - equity of care, patient safety and quality of care goals and performance Ballad has a conflict-of-interest policy and plans to align reporting with the Sustainability Accounting Standards Board's topics for disclosure and other reporting frameworks in the coming years. Ballad has leader diversity with 30% of CEOs being females and 33% of Executive Vice Presidents being females. Forbes recognized Ballad as The Best Employers for Diversity in 2020. CHARITABLE CONTRIBUTIONS - From its inception in February of 2018, Ballad Health made significant contributions to the community it serves totaling over $29 million to date in direct contributions and other community health improvement initiatives. A few examples from fiscal year 2022 include: Support for Speedway Children's Charities, aid to Feeding Southwest Virginia, provision of new EKG equipment to regional emergency medical services, and investments in regional programs for schoolchildren. IMPROVING ACCESS TO HEALTHCARE SERVICES RE-IMAGINE RURAL HEALTHCARE - Our region has a variety of health, economic and other issues that, when combined, present a unique and challenging environment for healthcare access and outcomes. These unique challenges were reaffirmed in a 2017 report issued by the Appalachian Regional Commission, the Robert Wood Johnson Foundation and the Foundation for a Healthier Kentucky (Health Disparities in Appalachia), which found that the health outcomes in the greater Appalachian region are worse than those experienced in the United States as a whole in 7 of the 10 leading causes of death: heart disease, cancer, chronic obstructive pulmonary disease (COPD), injury, stroke, diabetes and suicide. The region also faces economic challenges, with performance on incomes, poverty rates, unemployment rates and postsecondary education lagging the national level. This is relevant because, as the study notes, socioeconomic and health outcomes are often interrelated, if not interdependent. Since 2010, more than 151 rural hospitals have closed in the United States, according to the North Carolina Rural Health Research Program. Compared to other states, Tennessee ranks amongst the worst in the nation, with 15 rural hospital closures since 2005. In the region served by Ballad Health, however, it is a different story. Every community in the region with a hospital prior to the merger creating Ballad Health continues to be served by a hospital. In fact, in the middle of the pandemic, Ballad Health opened the country's newest rural hospital. In July 2021, Ballad Health followed through on its promise to the residents of Lee County, Virginia, and reopened Lee County Community Hospital in Pennington Gap. CREATED SINGLE COORDINATED REGIONAL TRAUMA SYSTEM - A critical success factor of the COPA and CA is avoidance of duplication of hospital resources. Ballad Health consolidated two Level I trauma centers operating within 25 miles of each other and subsequently created a coordinated regional trauma system. In approving this move in advance of the merger, the State of Tennessee relied upon the evidence published in multiple respected studies which found higher volume trauma centers lead to improved outcomes. The move toward a single coordinated trauma system followed the guidance of the American College of Surgeons (ACS), which verifies trauma centers. The Tennessee Department of Health, after conducting a rigorous review of the trauma program at Johnson City Medical Center, issued its Level I Trauma Center Reverification Site Visit Report. The report found the hospital "has demonstrated an outstanding commitment to care for the injured patient." Further, the survey resulted in zero deficiencies, a first for trauma care in the region. CONSOLIDATED REGIONAL PERINATAL CENTER - Tennessee law requires a regionalized system of care for high-risk newborns. As a result of this law, Tennessee recognizes five regional perinatal centers. Niswonger Children's Hospital at Johnson City Medical Center is the designated center for regional perinatal care for the Appalachian Highlands. Prior to the merger, two neonatal intensive care units (NICUs) existed and were not coordinated. After the merger, Ballad Health immediately took steps to consolidate the NICUs to achieve a more sustainable and coordinated system of care for neonates, while also reducing the costs associated with maintaining two lower-volume units. After this consolidation, Ballad Health partnered with ETSU's Quillen College of Medicine to provide ongoing expert neonatology coverage for the hospital 24 hours per day. As a result of the merger and NICU consolidation, every newborn in the region has access to more than 25 pediatric specialists at the regional Perinatal Center. EXPANDED ACCESS TO PEDIATRIC SPECIALTIES - With financial support from Ballad Health and the State of Tennessee, the ETSU Quillen College of Medicine was able to successfully recruit pediatric surgeons to support Niswonger Children's Hospital. Our partners at ETSU's Quillen College of Medicine also provide 24/7 neonatology coverage for the NICU. Ballad Health now proudly meets the highest standards for regional perinatal care, something that was not thought possible prior to the merger creating Ballad Health. PARTNERSHIP WITH ETSU TO CREATE FELLOWSHIP PROGRAM IN ADDICTION MEDICINE - Ballad Health and East Tennessee State University formed a partnership to create a new fellowship program in addiction medicine. As part of its commitment to expand education and training in the region, Ballad Health will fund any unreimbursed costs of the fellowship program which, over a 10-year period, could cost more than $2.5 million. ESTABLISHMENT OF CENTER FOR RURAL HEALTH RESEARCH - Tennessee Governor Bill Lee announced the creation of a new Center for Rural Health Research that will be housed at the College of Public Health at East Tennessee State University. In addition to state funding, Ballad Health has committed to contributing more than $15 million during the next 10 years to the Center. The goal of the Center will be to work with Ballad Health, local healthcare delivery partners, national experts and the leadership of ETSU Health to identify new mechanisms to improve health in rural and nonurban communities. Specific emphasis will be placed on strategies that disrupt inter-generational cycles of behaviors that contribute to poor health outcomes, which ultimately can affect college and career-readiness. RECRUITMENT OF NEW PHYSICIANS TO THE APPALACHIAN HIGHLANDS - Ballad Health provided the necessary resources to recruit new specialists to serve our region, many of whom were recruited to private practices not owned by Ballad Health. The addition of specialists is helping to improve access to care in rural communities. For instance, Wise County, Virginia now benefits from an orthopedist, a cardiologist and several other physicians and providers. Wythe County, Virginia, a community not served by a Ballad Health hospital, benefits from a cardiologist recruited by Ballad Health. Throughout the region, new physicians and advanced practitioners, recruited and funded by Ballad Health, are serving the region - from trauma care to pediatrics, from Wythe County, Virginia to Hancock County, Tennessee.
OTHER NOTABLE EVENTS AND AWARDS- Ballad has invested significantly across the region specifically in academic and community institutions that serve the people in the Service Area. Examples of this investment are shown through the continuum of service from the offering of observation opportunities to students of all ages within our clinical facilities, to providing experts to lecture to school children on a broad variety of healthcare topics. The commitment to giving back extends to direct investment in regional educational partners. Some key examples of this include the Appalachian Highlands Center for Nursing Advancement, The Center for Rural Health Research, the STRONG BRAIN Institute, and the Gatton College of Pharmacy Center for Pharmacy, Education, Outreach, and Advocacy. The work of these centers at ETSU focuses on some of the leading issues facing the Service Area, from the development and support of the next evolution of nursing as a profession, to understanding the unique challenges facing our public health, to the scourge of adverse childhood experiences, to access and intervention at the community pharmacy, Ballad is committed to understanding and addressing the significant issues facing the Service Area. - Ballad is also engaged in funding the development of new and expanded healthcare training programs across the region. Ballad has granted support of programs in Nursing and Allied Health. From a new BSN program in Southwest Virginia at Emory & Henry College, to a new program in Ultrasonography at Southwest Virginia Community College, we are supporting programs large and small. We have expanded the Medical-legal partnership we have in the Appalachian Highlands to include all of the Ballad facilities as well as many of the outpatient clinics. This one-of-a-kind program partners Ballad with Virginia Tech and the Appalachian School of Law together to address the challenges of access to social supports for the poorest members of the Service Area. Ballad is a sponsor of a residency in Advanced Education Graduate Dentistry in Southwest Virginia. This program has seen dramatic growth over the years and surpassed 10,000 patients cared for in fiscal year 2022. The endemic problem of poor oral hygiene across Service Area accounts for loss of economic opportunity, loss of self-esteem, and profound impacts on the health of individuals suffering from missing or diseased teeth. - Ballad's research department serves as the central office for multi-specialty research oversight in the System. In addition to providing full spectrum support for studies generated and managed by the research department, the department provides oversight for studies generated by external groups. The research department has participated in several large-scale, multi-center trials with subject retention at nearly 100%. Oversight services include administrative, legal, regulatory support, internal service arrangement and financial management. Ballad is a world leader in cardiovascular clinical trials. Ballad's chair of clinical research and medical director of the interventional and diagnostic catheterization labs led a new clinical trial in the United States for a potentially groundbreaking new carotid stent. The cardiovascular program at Holston Valley has performed as the No. 1 or No. 2 enroller in the United States and globally in at least 30 top research trials. - Received its Accreditation/Department of Distinction from the International Association for Healthcare Security & Safety (IAHSS) - Recognized by Harvard University and UnitedHealthcare as one of four healthcare organizations leading the way towards a 3D model for value-based care - Earned the College of Healthcare Information Management Executives (CHIME) Digital Health Most Wired. - After the creation of a regional and coordinated system of trauma care nearly two years prior, in July 2021, a Tennessee Department of Health survey concluded the trauma program serving the Appalachian Highlands provides "outstanding commitment to care for the injured patient and found zero deficiencies at the Level I Trauma Center at Johnson City Medical Center, a first for trauma care in the region. As a result of the regional and coordinated system of trauma care, Ballad decreased mortality by 40% and reduced the cost of care by approximately $3 million. - Ballad has achieved seven EPIC Gold Stars.
Form 990, Part VI, Section A, line 6Line 6 explanation - Mountain States Health Alliance is a Tennessee non-stock, nonprofit organization with Ballad Health as its sole member.
Form 990, Part VI, Section A, line 7aLine 7a explanation - Ballad Health has the authority to appoint Mountain States Health Alliance board members. The President and CEO of Ballad Health serves as the President and CEO for Mountain States Health Alliance.
Form 990, Part VI, Section A, line 7bLine 7b explanation - Decisions of the Mountain States Health Alliance Board of Directors are subject to approval by the Ballad Health Board of Directors.
Form 990, Part VI, Section B, line 11bLine 11b Explanation - The Ballad Health Tax Department prepares and reviews the Form 990. During preparation other functional areas within the organization provide information and support to complete an accurate return. The return is reviewed by the organization's EVP/CFO and is provided in electronic form to all members of the Board of Directors prior to being filed with the IRS.
Form 990, Part VI, Section B, line 12cBallad Health has a conflict of interest policy for all members of the Board of Directors, the Executive Chair/President, Executive Vice Presidents, Senior Vice Presidents, and Vice Presidents, and applies to all Ballad Health organizations. All persons covered by this policy are required to complete a conflict of interest disclosure form on an annual basis. Should a conflict arise, it is the responsibility of the conflicted individual to update his or her disclosure immediately. All meetings of the board or board committees have a standing agenda item first on the agenda titled "Conflicts of Interest". If a member of the board or board committee has a conflict of interest involving any issue on the board agenda, he or she must declare the conflict of interest during the period allotted for disclosure. If any issue arises during a meeting in which the board member has a conflict of interest, he or she must immediately declare the conflict. While each member of the board or board committee is responsible for disclosing conflicts of interest, it is also the responsibility of any board member aware of a conflict which has not been disclosed to ensure the board is made aware. The presiding officer of a board or board committee meeting may ask a conflicted member to excuse themselves from the meeting during the discussion related to the issue with which the conflict of interest applies. Under no circumstances shall a member vote on a matter that gives rise to a potential conflict.
Form 990, Part VI, Section B, line 15Line 15a - Compensation Process for Top Official The executive compensation committee serves as the compensation oversight committee of Ballad Health's Board of Directors. The executive compensation committee is comprised of members who are determined to be independent and whom are not reliant upon any business relationship with Ballad Health for income or compensation. The compensation plan for Alan Levine, Ballad Health's Chairman, President and CEO, was reviewed and approved by the executive compensation committee and then by the Ballad Health Board of Directors in accordance with the Board's compensation policy and practice. The Board of Directors relies upon the advice of an independent and experienced compensation consultant with knowledge about pay practices for comparable positions within the industry, and who has access to broad data, studies and surveys in order to ensure the compensation falls within competitive and appropriate ranges for the position. Line 15b - Compensation Process for Officers On an annual basis, Ballad Health's Human Resources (H/R) Department evaluates compensation for all executives at a position level of Assistant Vice President and above. H/R's evaluation is based on market data obtained from independent third-party consultants for positions with similar responsibilities at similarly situated organizations. Based on this comparable data, Ballad Health's CEO evaluates the data and, if appropriate, makes necessary adjustments. Any adjustments to Senior Vice Presidents or above are reviewed by the Board of Directors Executive Compensation Committee. In addition, Ballad Health offers an incentive plan to executives based on targeted achievement metrics categorized by; Quality, Service and Safety; Access to Care; Financial Stewardship, and any other metrics approved from time to time by the Board of Directors.
Form 990, Part VI, Section C, line 19Governing documents and conflict of interest policy are made available upon request to the appropriate parties requesting them. Financial statements are made available upon request to appropriate parties requesting them, and they are made available to those parties who own indebtedness of the company on a quarterly basis.
Form 990, Part IX, line 11gCollection Services: Program service expenses 0. Management and general expenses 34,866,922. Fundraising expenses 0. Total expenses 34,866,922. Consulting Fees: Program service expenses 75,369. Management and general expenses 265,149. Fundraising expenses 0. Total expenses 340,518. Contract Labor: Program service expenses 38,831,004. Management and general expenses 2,838,659. Fundraising expenses 0. Total expenses 41,669,663. Dietary Services: Program service expenses 12,197,627. Management and general expenses 0. Fundraising expenses 0. Total expenses 12,197,627. Environmental Services: Program service expenses 8,217,147. Management and general expenses 675,869. Fundraising expenses 0. Total expenses 8,893,016. Hospital Supported Clinics: Program service expenses 47,516,695. Management and general expenses 0. Fundraising expenses 0. Total expenses 47,516,695. Laboratory Services: Program service expenses 6,134,627. Management and general expenses 0. Fundraising expenses 0. Total expenses 6,134,627. Laundry Services: Program service expenses 2,870,831. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,870,831. Other: Program service expenses 10,356,210. Management and general expenses 6,117,547. Fundraising expenses 0. Total expenses 16,473,757. Physician Fees: Program service expenses 33,950,382. Management and general expenses 0. Fundraising expenses 0. Total expenses 33,950,382.
Form 990, Part XI, line 9:Temporarily Restricted Grants 284,916. Intercompany Transfers 8,293,963. Other Acquisition 589.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1Integrated Solutions Health NetworkBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1509 Med Tech Parkway Suite 100AddressLine1Txt
CityJohnson CityCityNm
State AbbreviationTNStateAbbreviationCd
ZIP37604ZIPCd
FieldValueIRS element (for citing)
EIN621711997EIN
Primary ActivitiesHealth NetworkPrimaryActivitiesTxt
Legal Domicile StateTNLegalDomicileStateCd
Total Income$2,196,469TotalIncomeAmt
End Of Year Assets-$1,488,382EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1MSHABusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (16 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
MSHA Auxiliary
400 N State of Franklin RoadJohnson CityTN37604581418345Supporting OrganizationTN501C312aMSHAYes (1)
Smyth County Community Hospital
245 Medical Park DriveMarionVA24354540794913HospitalVA501C3Line_3_Hospital_CoopMSHAYes (1)
Dickenson Community Hospital
312 Hospital DriveClintwoodVA24228770599553HospitalVA501C3Line_3_Hospital_CoopWHS0
Johnston Memorial Hospital
16000 Johnston Memorial DriveAbingdonVA24211540544705HospitalVA501C3Line_3_Hospital_CoopMSHAYes (1)
Abingdon Physician Partners
16000 Johnston Memorial DriveAbingdonVA24211205485346Medical ServicesVA501C312aJMH0
Ballad Health
303 Med Tech Parkway Suite 220Johnson CityTN37604611771290Supporting OrganizationTN501C312b0N/A
East TN Healthcare Holdings Inc
203 Gray Commons CircleGrayTN37615815475903Opioid TreatmentTN501C3Line_3_Hospital_CoopMSHAYes (1)
Wellmont Health System
1905 American WayKingsportTN37660621636465Hospital SystemTN501C3Line_3_Hospital_CoopBALLAD HEALTH0
Wellmont Hawkins Co Memorial Hosp
851 Locust StreetRogersvilleTN37857621816368HospitalTN501C3Line_3_Hospital_CoopWHS0
Takoma Regional Hospital Inc DBA GCH
1420 Tusculum BoulevardGreenevilleTN37745510603966HospitalTN501C3Line_3_Hospital_CoopWHS0
Wellmont Cardiology Services
1905 American WayKingsportTN37660263557623Medical ServicesTN501C3Line_10_OrganizationWHS0
Wellmont Medical Associates
1905 American WayKingsportTN37660270898372Medical ServicesTN501C3Line_7_Organization_WHS0
Ballad Health Foundation
1019 West Oakland Ave Suite 2Johnson CityTN37604581594191FundraiserTN501C3Line_7_Organization_BALLAD HEALTH0
Wellmont Madison House
2000 Greenway StreetKingsportTN37660621308216Assisted LivingTN501C3Line_10_OrganizationWHS0
Wellmont Wexford House
2421 N John B Dennis HwyKingsportTN37660581859039Nursing HomeTN501C3Line_10_OrganizationWHS0
Wellmont Imaging Services Inc
400 N State of Franklin RoadJohnson CityTN37604861103148HealthcareTN501C312aWHS0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdPredominant Income TypePredominantIncomeTypeTxtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPct
Emmaus Community Healthcare PLLC
6419 Bristol HwyPiney FlatsTN37686200577483Medical ServicesTNN/AN/A00
Medical Specialists of JC LLC
2528 Wesley St Ste 2Johnson CityTN37601272199037Medical ServicesTNExcluded00MSHA-$85,742$456,5260.51000
East Tennessee Ambulatory Surgery Center
701 Med Tech Parkway Suite 100Johnson CityTN37604621787537Medical ServicesTNN/AN/A00
Rehabilitation Hospital of Bristol LLC
103 North StreetBristolVA24201205612001Medical ServicesVAN/AN/A00

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (13 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACdAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdForeign PostalForeignAddress/ForeignPostalCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
Blue Ridge Medical Management Corp
1905 American WayKingsportTN37660621490616Medical ServicesTNMSHAC$130,961,478$221,268,8531.000000
Mediserve Medical Equipment
1905 American WayKingsportTN37660621212286DMETNBRMMCC-$2,049,696$6,252,0401.000000
Mountain States Properties
1905 American WayKingsportTN37660621845895Property ManagementTNBRMMCC$15,159,843$148,273,3721.000000
Mountain States Physician Grp
1905 American WayKingsportTN37660621700412Medical ServicesTNBRMMCC$51,586,650$9,440,1141.000000
Community Home Care Inc
1490 Park Avenue NW Suite BNortonVA24273541453810Durable Medical EquipmentVAC0N/A
Wilson Pharmacy Inc
PO Box 5289Johnson CityTN37604620329587PharmacyTNBRMMCC$6,177,545$6,793,6551.000000
Wellmont Inc
1905 American WayKingsportTN37660621320035Medical ServicesTNC0N/A
Wellmont Physician Services
1905 American WayKingsportTN37660621567353Medical ServicesTNC0N/A
WPS Providers Inc
1905 American WayKingsportTN37660205564642Medical ServicesTNC0N/A
Wellmont Health Services Inc
1905 American WayKingsportTN37660621254373Medical ServicesTNC0N/A
Wellmont Insurance Co SPC LTD
981195624InsuranceC0N/APO Box 30600Grand CaymanCJKY1-1203CJ
Nolichuckey Mgmt Svcs Inc
1420 Tusculum BlvdGreenevilleTN37745621776681Medical ServicesTNC0N/A
Ballad Ventures LLC
400 N State of Franklin RdJohnson CityTN37604844214681InvestmentsTNC0N/A
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (1)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (12 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Wilson Pharmacy Inc
A$70,333FMV
Blue Ridge Medical Management Corp
A$514,467FMV
Mountain States Properties
K$432,167FMV
Mediserve Medical Equipment
K$64,529FMV
Blue Ridge Medical Management Corp
L$493,980FMV
Blue Ridge Medical Management Corp
M$150,231FMV
Abingdon Physician Partners
O$128,891Cost
Johnston Memorial Hospital
P$266,874Cost
Johnston Memorial Hospital
Q$942,624Cost
Smyth County Community Hospital
Q$229,442Cost
Blue Ridge Medical Management Corp
R$49,503,175Cash
Abingdon Physician Partners
R$454,112Cash