2020-07-09T10:24:15-07:00 2019-06-30 990 2018-07-01 540544705 Johnston Memorial Hospital Inc JOHN 2762582800 1021 W Oakland Avenue Suite 103 Johnson City TN 37604 John Jeter JMH CEO 2020-07-09 2018 2020-11-19 02:30:22Z John Jeter 16000 Johnston Memorial Drive Abingdon VA 24211 169015643 false false X balladhealth.org X 1917 VA Mission: Honor those we serve by delivering the best possible care.Vision: To build a legacy of superior health by listening to and caring for those we serve. 15 11 0 159 117614 52712 111403 144986 156513664 158289382 6079914 8148872 1446173 1430781 164151154 168014021 144694 131797 0 53745939 50232583 0 0 83909880 85874921 137800513 136239301 26350641 31774720 409773302 445027954 11799102 10058042 397974200 434969912 X Honor those we serve by delivering the best possible care. true false 102444272 131797 158284825 See Schedule O 102444272 true true false false false false false false false false true false false false true true false true false false false false false false false false true true true false true false false false false false false false false false true false false false false false false true true true false false true 140 0 true 0 false true true false false false false false false 0 false false false false false false false false false false false false X 15 11 false false false false true true true true true false false true true true true true true false false false TN VA X Lynn Krutak 4233023374 303 Med Tech Parkway Suite 300 Johnson City TN 37604 John Patterson MD Physician 1.00 39.00 X 0 716393 32886 Amit Vashist MD Physician 1.00 39.00 X 0 326504 33335 Gary Peacock Director 1.00 3.20 X 0 0 0 Bill Hayter Director 1.00 0.00 X 0 0 0 Marvin Eichorn EVP/COO,Vice-Ch 1.00 59.00 X X 0 1014015 36694 John Fowlkes Treasurer 1.00 0.00 X X 0 0 0 Brendan McSheehy Director 1.00 0.00 X 0 0 0 Rachel Fowlkes EdD Director 1.00 0.00 X 0 0 0 Joanne Gilmer Director 1.00 0.00 X 0 0 0 Eric Miller Secretary 1.00 0.00 X X 0 0 0 Kathy Mitchell Director 1.00 0.00 X 0 0 0 Dick Gail Chairman 1.00 0.00 X X 0 0 0 Marvin Gilliam Director 1.00 0.00 X 0 0 0 Mike Spiegler Director 1.00 0.00 X 0 0 0 Donnie Meadows Director 1.00 0.00 X 0 0 0 Justin Ivory end 83118 JMH CFO 0.00 40.00 X 0 120052 13425 John Domansky begin 101518 JMH AVP/CFO 44.50 0.50 X 0 30787 1339 John Jeter JMH CEO 44.00 1.00 X 0 333115 29581 Bryan Mullins JMH COO 45.00 0.00 X 0 193864 30235 Brian Condit MD VP/CMO-NE Market 45.00 0.00 X 0 329872 33016 Linda Shepherd JMH CNO 40.00 0.00 X 0 147185 6500 Lea Mullins Pharmacy Director 40.00 0.00 X 0 157741 31346 Scott Hunter PA-C Hospitalist 40.00 0.00 X 0 134096 27046 James White Pharmacist 40.00 0.00 X 0 140849 16142 John Ray MD Fmr JMH Highest Paid 0.00 40.00 X 0 216173 9441 Stan Hickson Former VP/CEO JMH 0.00 45.00 X 0 430310 34702 Sean McMurray Former VP Mkt Ops/Svc Line Integrtn 0.00 40.00 X 0 142433 0 4433389 335688 31 true true false Virginia Highlands Anesthesia PC PO Box 1476 Abingdon VA 24212 Anesthesia Services 2375686 Construction Partners LLC 3101 Browns Mill Rd Suite 6 119 Johnson City TN 37604 Construction 959594 Abingdon Physicians ASC Group 612 Campus Drive Abingdon VA 24210 Med Director Fees 644236 Blood Assurance Inc 705 East Fourth Street Chattanooga TN 37403 Blood Products 465701 Pharmalogic Holdings Corp 101 Dillon Court Gray TN 37615 Diagnostic Imaging 457900 19 138478 6508 144986 Hosp Rent to Related Org 900099 307676 307676 Hospital Patient Revenue 900099 157004100 157004100 Hospital Residency Prog 900099 505917 505917 P/S Business Income 541900 368650 344105 24545 Reference Lab Revenue 621500 93069 93069 9970 9970 158289382 5504377 5504377 0 0 1031636 697940 333696 333696 333696 2948177 303682 2948177 -303682 2644495 -303682 2948177 0 0 0 IPO Settlement 900099 689850 689850 Rebates 900099 41250 41250 Revenue from Parent 900099 257875 257875 108110 108110 1097085 168014021 158167211 117614 9584210 X 131797 131797 0 0 0 736971 736971 0 39087751 32798772 6288979 1083722 864245 219477 6839436 4277421 2562015 2484703 2365643 119060 0 125674 125674 19017 19017 0 0 474159 328615 145544 29839177 13612488 16226689 75202 8045 67157 1174559 1003038 171521 1831731 1771751 59980 0 1431507 1261912 169595 211917 189515 22402 0 0 9955 9955 0 11382060 10443279 938781 124062 102072 21990 Medical Supplies 27699267 27739873 -40606 Management Fees 5434341 208362 5225979 Maintenance 4101934 3956546 145388 Taxes - UBIT 19236 19236 1921123 1380898 540225 136239301 102444272 33795029 0 X 5040226 2966082 0 0 23980702 23747975 0 0 83824 41049 2931544 3183987 781738 348337 255868255 122461830 143566421 133406425 231091062 272633416 0 84950 56310 35200 35200 2177635 8609173 409773302 445027954 8862485 7664686 1078294 596482 1858323 1796874 11799102 10058042 X 397974200 434968912 1000 397974200 434969912 409773302 445027954 X 31774720 4813803 407189 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 7014450 7014450 156254823 54589263 101665560 6101696 3438056 2663640 85422604 63698500 21724104 1074682 736011 338671 133406425 Capital Lease Obligation 69930 Other Long-term Liabilities 14326 Pharmacy, Medical, Worker's Comp 912666 Reserve for Professional Liab 799952 1796874 X Part X : FIN48 Footnote "The Hospital and APP are classified as organizations exempt from income taxes under Section 501(c)(3) of the Internal Revenue Code. JMH ER is organized as a limited liability corporation and is considered a disregarded entity for tax purposes. As such, no provision for federal income taxes is included in the accompanying consolidated financial statements. No significant uncertain tax positions exist at June 30, 2019. Tax returns for 2016 through 2018 are subject to examination by the Internal Revenue Service." true true X true X 225.000000000 true X 450.000000000 true true false false false false 1261231 1261231 0.00930 1261231 1261231 0.00930 787178 26319 760859 0.00560 5721545 1793727 3927818 0.02880 5852894 3948617 1904277 0.01400 2676 2676 94897 94897 0.00070 12459190 5768663 6690527 0.04910 13720421 5768663 7951758 0.05840 11400 11400 0.00010 11400 11400 0.00010 true 10434951 3860932 42943803 38202578 4741225 X true true 1 1 Johnston Memorial Hosp Inc 16000 Johnston Memorial Drive Abingdon VA 24211 balladhealth.org/locations H 1864 X X X X Johnston Memorial Hosp Inc 1 false false true X X X X X X X X X X 18 true true false true X balladhealth.org/locations#hospitals X true 19 false true false true X 225.0000 450.0000 X X X true true X X X X true X balladhealth.org X balladhealth.org X balladhealth.org X X X X X X true X false X X X X true X false false Facility: Johnston Memorial Hosp., Inc. - Part V, Section B, Line 3j During FY19, JMH was operating under the CHNA approved by its board of directors at the end of FY18. Priorities established for our CHNA were determined by the most significant health needs of the community. MSHA hospitals, including JMH, conducted their fourth CHNA this tax reporting period with board approval and publication occurring during FY19. For the FY18 CHNA, Ballad Health and its hospitals and entities agreed to focus on an index of 25 active population health index measures (plus an additional 31 measures for monitoring). The population health index itself is based on the focus areas outlined in the previous FY15 CHNA and align with national health improvement efforts, such as Healthy People 2020. MSHA's affiliates, Wellmont Health System and its hospitals, focused on the same population health index measures determined by Ballad Health, our health system's parent, when completing their individual FY19 CHNA's.To understand each communitys 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.JMH is located in Washington County, Virginia. The Washington County CHNA community members evaluated measures that make up JMH's population health index and a few additional measures related to access to health screenings. The Washington County groups members completed a survey relative to what health priorities should be a focus for their specific community over the next three years. After all the details and data collection was complete and interviews with various focus groups were complete, the Washington County representatives identified four top focus areas:-Smoking-Physical activity/obesity -Substance abuse/mental health-Maternal/infant health Facility: Johnston Memorial Hosp., Inc. - Part V, Section B, Line 5 As part of the FY18 CHNA process, MSHA hospitals conducted localized community focus groups with organization representatives such as those from local health departments, school systems, health clinics, emergency services, businesses, and philanthropic boards. The individuals in JMHs community were selected for participation by the hospitals CEO. The JMH focus group members were represented by Virginia Department of Health, Childrens Advocacy Center of Highlands Community Service, Ballad Health Government Relations, United Way of Southwest Virginia, Washington County Services, Washington County Emergency Management, Virginia Highlands Community College, Washington County Higher Education, Washington County Chamber of Commerce, Highlands Community Service Board, Mount Rogers Health District, Faith in Action, Washington County Public Schools and Johnston Memorial Hospital Foundation Board. Low income, minority and medically underserved populations were represented by Mount Rogers Health Department, Virginia Department of Health, United Way of SWVA, Faith in Action and Childrens Advocacy Center of Highlands Community Service. Also, between our foundation board and the community board, there are a number of individuals that sit on these boards that represent low income, minority populations, and medically underserved.Activities associated with the June 2018 assessment took place from fall of 2017 through the spring of 2018. Community members from Washington County met with Ballad Health and JMH representatives to discuss health priorities and identify potential solutions. Community members were made aware of the 25 measures that make up Ballad Healths population health index plus 3 additional measures related to access to health screening. Participants then completed a survey to indicate their opinion on what health priorities should be a focus for their community. Facility: Johnston Memorial Hosp., Inc. - Part V, Section B, Line 6a Each hospital within Mountain States Health Alliance completed a CHNA. JMHs CHNA was conducted with all MSHA hospitals to include: Johnson City Medical Center (includes Niswonger Children's Hospital and Woodridge Hospital), Franklin Woods Community Hospital,Indian Path Community Hospital, 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: Johnston Memorial Hosp., Inc. - Part V, Section B, Line 11 During the year, JMH continued to focus on its CHNA priorities as identified in its FY18 CHNA report. JMHs primary areas of focus included: diabetes, cardiovascular disease, cancer, obesity and mental health. 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 hospitals 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. JMH made financial contributions to other nonprofit organizations providing community services that support the hospitals CHNA. JMH contributed to an organization focused on providing quality primary medical services to low income residents in Appalachia, organizations that provide nutritious food for low income families in Washington County, an organization providing health education to the community, and an organization that provides mental health, substance abuse, and developmental services to the residents of Washington County. JMH offered 67 free low dose lung nodule screenings in FY19 and the JMH family birth center staff provided education for at risk mothers related to substance abuse.Free medications were provided to some low-income patients at the time of their discharge and the hospital continued its practice of providing medications and supplies to area rescue squads this year. The hospital continues to conduct activities consistent with our respective implementation plan. For example, a partnership was developed with Feeding America of Southwest Virginia to fund health food options for the mobile food bank and provide nutritional education to recipients that addresses obesity and diabetes. JMH supports the Washington County School Systems Morning Mile program. This is a school-based program in which kids arrive at school early and participate in a supervised walk or run for a mile. Facility: Johnston Memorial Hosp., Inc. - 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. Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used) 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 Healths qualifications for financial assistance is based on federal poverty guidelines, asset values may also be used to determine 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 hospitals charity write-offs exceed the hospitals charity budget.All Ballad Health hospitals provide an uninsured discount; the current uninsured discount 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 our 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, we have 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 - Explanation of Costing Methodology 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. Due to new Virginia Medicaid supplemental funding in FY19, JMH did not incur a Medicaid loss. 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 nursing, pharmacy, and therapy students) with schools and universities, allowing their health profession students to get hands-on training in a hospital setting. Another source of health professions education reported on line 7f is our Medicare-approved family medicine and internal medicine programs (in their fourth year). The medical resident program cost and reimbursement information comes from our filed Medicare cost report. For line 7g subsidized health care services, we use our cost accounting system because we have established, standard costing reports for these services. We are careful to ensure no double counting of cost. Although we have other service lines within our hospital that lose money, we do not report services that hospitals are required by state licensure to provide, routine services or ancillary services. Line 7h research represents JMH's expense allocation from Ballad Health for research. Line 7i cash and in-kind contributions include cash disbursements and in-kind donations of medications to local nonprofit rescue squads and fire departments. In-kind donations of medications are based on our actual cost for these items. Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense Self-pay balances include accounts after payments and contractual adjustments (discounts) have been applied from all third-party payers such as Medicare, 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 Healths system-wide self-pay policy, any patient who has no insurance and is ineligible for any government assistance program received an 80% discount until September 30, 2018, at which time the uninsured discount increased to 85%. Many self-pay patients will further qualify for financial assistance (sometimes referred to as charity care) if they provide the financial information we need to deem them eligible.After the normal collection process has indicated an account is uncollectible, JMH writes the account off to bad debt. The hospital's 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 - Methodology of Estimated Amount & Rationale for Including in Community Benefit Our primary external collection agency estimates that 37% of JMHs bad debt would likely qualify for financial assistance if patients had provided our hospitals with a financial assistance application and required documentation. The agency based their likely eligible for charity assumption on individuals with a low score. An individuals score is based on an algorithm that includes data points such as FICO credit score, property value, years at current residence, number of times an individual has moved and an individuals propensity to pay score. Just over 90% of completed financial assistance applications processed during FY19 received a full discount (complete write-off). An additional 9% received a partial discount, resulting in an overall approval rate of 99% for completed applications. Therefore, only 1% of completed financial assistance applications were denied. Unfortunately, many patients either do not submit an application for financial assistance or do not provide a complete application. A letter is sent to the patient outlining missing information on incomplete applications. The letter also provides a contact phone number patients may call for assistance in completing the application. All self-pay patients receive follow up calls from a company JMH pays to process charity care applications for uninsured patients and to offer patients enrollment assistance in Medicaid (VA) or TennCare (TN). The follow up calls are as follows: every 31 days, 31-60 days up to 3 calls are made, after 60 days up to 2 additional calls are made, with a minimum of 4 days between all calls. Our financial counselors follow up with patients that have a balance after insurance has paid. We have many instances of patients with large account balances and no health insurance coverage that we believe would qualify for financial assistance. Although patients are encouraged to apply for assistance, many will not do so. JMH would prefer for patients to submit completed financial assistance applications given that historical data clearly indicates that most uninsured patients and many underinsured will qualify for financial assistance under our program. Without a completed application, we have no choice other than to record an unpaid account as bad debt instead of charity care. Part III, Line 4 - Bad Debt Expense The text of JMH's financial statements that describes bad debt expense appears on pages 11-12 in our most recent audited financial stateme(attached). Part III, Line 8 - Explanation Of Shortfall As Community Benefit Excluding Medicare losses reported in Part I subsidized health, the Part III Medicare gain is reported using JMH's filed Medicare cost report (C/R). The C/R uses a cost to charge ratio based on a step-down allocation methodology. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients 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 patients 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.Our collection policy clearly states that all patients are treated equally - with dignity and respect. We ensure that outside collection agencies used by our hospital adhere to our billing and collection guidelines. Our hospitals collection program includes communicating expected financial responsibility prior to service. Our hospital provides assistance to help underinsured and uninsured patients determine sources of payment for medical bills and to help patients determine eligibility for programs such as Medicaid or TennCare.After insurance benefit verification, our hospital bills 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. Our hospital provides 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- our hospital accepts 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- payment arrangements are available so 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 our financial assistance policy. Part VI, Line 2 - Needs Assessment Focusing on 25 active population health index measures 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 will expand partnerships so that organizations work together more to address community health needs.Ballad Health developed a comprehensive process to gather input for and draft a population health plan last year. An executive steering team was established, aided by national experts with experience in large-scale population health improvement. Because our hospitals are located in a region with many chronic disease challenges, Ballad Health's goal is to target population health issues to make lasting improvements. Ballad conducted approximately 150 interviews and held 40 meetings with external groups, including the regional health departments, United Way agencies, chambers of commerce, schools and community organizations, the regional accountable care community steering committee, as well as internal groups such as our population health and social responsibility committee of the Ballad Health board of directors, the Ballad Health population health clinical committee, and our hospital community boards. Part VI, Line 3 - Patient Education of Eligibility for Assistance Consistent with the Ballad Health financial assistance policy, JMH communicates with and provides education to our patients through variousavenues regarding governmental assistance programs and hospital financial assistance. Various educational and application documents related to obtaining financial assistance are widely available at JMH 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 hospital. Our financial assistance policy and documents are available in our Emergency Department and admitting areas. We are also happy to mail all documents to patients. We offer a plain language summary and all of our documents are available in English and Spanish. Financial assistance information is available during pre-registration, registration and/or during financial counseling. We offer governmental program eligibility representatives to assist patients in securing eligibility for Medicaid or TennCare, federal disability and other governmental assistance programs. Additionally, if a patient or community resident expresses an interest in the ACA healthcare exchange, our representatives have the qualifications and experience to assist them through the entire process. Our 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 financialassistance along with contact information. Our 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 - Community Information JMH is located in Abingdon, Virginia (Washington County), which is in Southwest Virginia. Southwest Virginia (SWVA) is located within the Appalachian Mountains, specifically the Blue Ridge Mountain Region. SWVA is considered rural and much different than the rest of the state. SWVA has been and remains a major coal mining region. According to U.S. Census Bureau estimates, the Town of Abingdon has a population of 8,020, while Washington County's population is 54,406. The latest census bureau data estimates the median age of residents of Washington County is 45.9 which is older than the median age of 38.3 in Virginia. 20.9% of Washington County's residents are 65 or older compared to 14.2% for the state. While the overall population of Washington County is projected to remain relatively flat over the next five years, the 65+ age group is expected to grow significantly (by 11.3%) over the same five-year period. The aging population of the county presents opportunities for earlier identification and better management of health conditions that oftentimes affect elderly populations in rural areas.The bureau estimates Washington County median household income at $46,262 ($42,716 for the Town of Abingdon) compared to $72,577 for the State of Virginia. 19% of Washington County's children live in poverty compared to 11% statewide. Washington County is 71.7% rural compared with the statewide rural rate of 24.5%. This factor is a significant contributing factor in influencing health outcomes in a population. Many rural residents must travel a greater distance to access different points of the health care delivery system; however, due to geographic distance, sometimes extreme weather conditions, lack of public transportation and challenging roads, rural residents may be limited, and in some instances, even prohibited from accessing health care services. More than 50% of vehicle crash-related fatalities occur in rural areas, even though less than one-third of miles traveled in a vehicle occur there and there is an additional 22% risk of injury-related deaths in rural communities. Within our own county, injury deaths are 28% higher than the statewide rate. And, while our area has generally unfavorable health statistics, the number of residents per primary care physician in our county is 12% higher than the overall state rate and 40% higher than top performing U.S. counties.Recruiting physicians to rural areas is often challenging due to a myriad of factors, such as geography, economics, culture and education. Geographically, rural communities are often far removed from suburban and urban centers that provide access to education, cultural and economic opportunities. These limitations influence the relocation decision of the physician candidate and his/her spouse/children to locate to a rural area.A number of factors contribute to a unique and challenging environment that influence overall health standing in our county. According to the Robert Wood Johnson Foundations County Health Rankings, 30% of the adults in JMHs home county are obese. Obesity increases the risk for many health conditions such as coronary heart disease, type 2 diabetes, hypertension, stroke, cancer, sleep apnea and respiratory problems, and osteoarthritis. Evidence indicates physical activity, independent of its effect on weight, has substantial benefits for health. Our countys inactivity rate of 25% is 14% higher than the statewide rate and access to exercise opportunities in the county is 30% lower than the overall state rate. According to the 2019 County Health Rankings, Washington County is ranked 65th (down from 63rd in 2018) out of 133 in Virginia for health outcomes and 54th (down from 52nd in 2018) in health behaviors. As for social and economic factors, Washington County ranks 60th primarily due to high rates of children in poverty and above average unemployment rates. Part VI, Line 4 - Community Building Activities JMH 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 JMH 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. We do not capture costs associated with team members that serve on other nonprofit boards or provide services to other nonprofits.JMH, 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 our area. Most of these organizations work to improve the lives of community members that have limited, or no, financial resources. Part VI, Line 5 - Promotion of Community Health JMH is dedicated to operating efficiently so that waste is minimized. JMHs leadership remains mindful of managing limited resources so that adequate facilities and equipment are available for the care of our patients. Surplus funds are invested into improving treatment options for our patients through new technologies, recruiting physicians and trained staff in shortage areas, and improving our facilities. Various checks and balances are established to ensure that expenditures for operating expenses and capital costs are reasonable and necessary.JMH serves as a training site for many types of health professions: nursing, pharmacy, psychology, lab, respiratory therapy, EMT, public health, etc. Students from several colleges receive training and hands-on experience in our hospital. We devote resources to health conferences for local health professionals and offer other programs focused on improving the health of our residents. While we operate in a predominantly low-income, rural area, we continue to offer services that operate at a loss because Washington County residents would otherwise need to leave their home town or county to receive needed care.The majority of JMH's governing body is comprised of persons who reside in the organization's primary service areas. Only two directors, Marvin Eichorn and Joanne Gilmer, live outside the area. There are four directors deemed non-independent, per IRS instructions: two are physicians employed by a JMH owned, nonprofit physician practice, one director has a family member employed by JMH and one is an employee of MSHA, JMHs majority member. Physicians that request privileges who are qualified and credentialed are extended privileges by JMH.JMH entered into a lease agreement with Highlands Community Services (HCS), a non-profit organization that provides mental health, substance abuse and developmental services to residents of Washington County and Bristol, Virginia to open a crisis intervention team (CIT) assessment site that will provide a non-criminal justice setting where persons with mental illness can be taken by law enforcement officers for assessment. The goals of the CIT programs are generally oriented toward reducing injuries to both law enforcement and citizens, reducing arrest of persons in behavioral health crisis, improving access and linkage to appropriate community treatment, and supporting and promoting dignity and respect for individuals with behavioral health disorders. The foregoing goals are consistent with JMH's mission which is why our hospital agreed to provide space to HCS for an annual rental of just $1. JMH is providing the space to HCS in order to ensure the availability of a crisis intervention site within our community. The fair market value of the lease is $34,376 annually. HCS moved into the space in April so the value of FY19's rental is $8,594. Part VI, Line 6 - Affilated Health Care System JMH is a 116-bed, acute-care facility operated under the direction of a 15-member board of directors primarily comprised of local community residents. It is one of the hospitals within the Ballad Health system. Ballad Health operates a family of 21 hospitals, including three tertiary care facilities, a dedicated children's hospital, 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.Patients benefit from JMH's affiliation with a healthcare system where theycan be efficiently moved along an integrated, comprehensive continuum ofcare as their health status dictates. If needed, patients can be moved toone of Ballad Health's tertiary care facilities providing advancedtreatment options.Hospitals in the Ballad Health system work closely with one another toshare expertise and resources. Part VI, Line 7 - States Filing of Community Benefit Report TN VA Part VI - Additional Information Ballad Health is required to report community benefit estimates on aquarterly basis with the states of Tennessee and Virginia. The reportingincludes all of Ballad's hospital organizations and is reported using IRSForm 990, Schedule H instructions for reporting community benefit. Balladoperates under a Cooperative Agreement (CA) in Virginia and a Certificateof Public Advantage (COPA) in Tennessee as obligated by agreements betweenBallad and the two states to allow Mountain States Health Alliance andWellmont Health System to merge. true Barter Theatre PO Box 867 Abingdon VA 24212 546000120 501c3 14000 0 Sponsorship VHCC Educational Foundation PO Box 828 Abingdon VA 24212 521225133 501c3 80000 0 Nursing program faculty Washington Co Public Schools 812 Thompson Dr Abingdon VA 24210 546001671 501c3 7250 0 Annual donation William King Museum PO Box 2256 Abingdon VA 24210 541144120 501c3 10000 0 Sponsorship 4 0 Grantmaker's Description of How Grants are Used The 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 accomplishments false false false false false false false false false false Amit Vashist MD Physician 283401 36473 6630 11475 21860 359839 Brian Condit MD VP/CMO-NE Market 310947 15000 3925 10402 22614 362888 Bryan Mullins JMH COO 172120 15000 6744 9835 20400 224099 James White Pharmacist 135670 2466 2713 7271 8871 156991 John Jeter JMH CEO 283683 47287 2145 9898 19683 362696 John Patterson MD Physician 623476 92453 464 12025 20861 749279 John Ray MD Fmr JMH Highest Paid 190435 22982 2756 9441 225614 Lea Mullins Pharmacy Director 142456 11519 3766 9785 21561 189087 Linda Shepherd JMH CNO 145888 1297 4476 2024 153685 Marvin Eichorn EVP/COO,Vice-Ch 678984 300000 35031 12241 24453 1050709 Scott Hunter PA-C Hospitalist 94343 37772 1981 7821 19225 161142 Sean McMurray Former VP Mkt Ops/Svc Line Integrtn 142433 142433 97188 Stan Hickson Former VP/CEO JMH 408432 21878 12307 22395 465012 Ginger McSheehy Family Member 65447 See Part V false Schedule L, Part V Supplemental Information Brendan McSheehy, JMH board member,is a family member of Ginger McSheehy, an employee of JMH. Client Note 1 Client Note 1 - Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder The corporation is organized as a Virginia non-stock, nonprofit corporation with two members: Mountain States Health Alliance, which maintains a 50.1% interest and Johnston Memorial Healthcare Foundation, which maintains a 49.9% interest. Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body There are two classes of members, and each class is entitled to elect a specified number of directors to the board. The Mountain States Health Alliance class is elected by the MSHA Board of Directors and the Johnston Memorial Hospital class is elected by the Johnson Memorial Healthcare Foundation's Board of Directors. Neither side can veto an appointment. Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders Certain decisions of the board are pursuant to charter and Virginia statute, subject to approval of the members. These decisions include: dissolution of the corporation; merger of the corporation; non-ordinary course of business sale of assets, etc. No ordinary day-to-day decisions are subject to member approval. Form 990, Part VI, Line 11b: Form 990 Review Process The CFO reviewed the Form 990 with the Board of Directors prior to filing the return with the IRS. The return was made available to each board member in an electronic format prior to the review. Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts Ballad 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, including Johnston Memorial Hospital. 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 interestinvolving 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 committees 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 mayask 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, Line 19: Other Organization Documents Publicly Available Governing documents and conflict of interest policy are made available upon request to appropriate parties requesting them. Financial statements are made available to those parties who own indebtedness of the company on a quarterly basis. Other Changes In Net Assets Or Fund Balances - Other Increases Elimination of Intercompany Rec/Pay = $747524 Other Changes In Net Assets Or Fund Balances - Other Increases Partnership Expense Not on Books = $40305 Other Changes In Net Assets Or Fund Balances - Other Decreases Partnership Income Not on Books = -$368650 Other Changes In Net Assets Or Fund Balances - Other Decreases Partnership Interest Income Not on Books = -$12990 Other Changes In Net Assets Or Fund Balances - Other Increases Temporarily Restricted Net Asset Change = $1000 Form 990, Part III, Line 4a addition to clinical training, the healthcare students entering our system are required to have orientation and computer training. Participants receiving clinical experience at JMH during FY19 included 183 nursing students from various colleges, universities and programs. This nursing clinical experience required extensive JMH nursing staff involvement. JMH invested $258,054 in the clinical setting and hands-on instruction for nursing students. JMH provided a clinical setting for another 221 students training in health-related programs such as radiology, pharmacy, respiratory therapy, EMT/paramedic, occupational/physical/speech therapy, social work, and other allied-health disciplines. Training for these clinical students cost JMH $254,350. In addition to the hands-on training of clinical students, JMH provides cash donations to local schools. During FY19, JMH donated $80,000 to a local college to be used for nursing faculty.Ballad Healths Johnston Memorial Hospital is planning a dental residency program to provide dental care for the underserved. Pending approval from the Commission on Dental Accreditation (CODA), the residency will begin in FY2020. According to U.S. Census data, more than 160,000 Southwest Virginia residents do not have adequate access to a dentist. The dire need for dental care in Southwest Virginia was one of the catalysts for Johnston Memorial to plan a dental residency program that will offer advanced training to dentists who have obtained licensure and are interested in furthering their education or specializing in a certain field. The program is a partnership with two local dentists who have a practice located in Bristol, VA and one other dentist who is a professor at the University of Alabama-Birmingham School of Dentistry and co-director of the Comprehensive Implant Residency Program, and Mission Dental Virginia, a nonprofit Virginia corporation organized for the purpose of providing charitable dental services for underserved and uninsured individuals and families of Southwest Virginia. The residency program will establish the Appalachian Highlands Community Dental Center, where a dental resident will provide a variety of services, including preventive care such as sealants, as well as restorative care like crowns, fillings and dentures. The dental care will be offered on a sliding scale to uninsured community members throughout Southwest Virginia. In the coming months, a site will be identified for the clinic. When the clinic reaches full capacity, up to 10 dental residents will provide dental care to members of the community. The clinic will accept patients with a low household income and will benefit countless people in our region, significantly impacting their health. It will also bring dental residents to the area to experience life in Southwest Virginia and, hopefully, some will choose to stay here and practice. Charity and Unreimbursed Costs:Charity Care: While reimbursement for healthcare services rendered is critical to the operation and sustainability of the organization, JMH recognizes its obligation to provide care to individuals who cannot afford essential medical services, including emergency care. JMH accepts all patients regardless of their ability to pay. A patient is classified as a charity patient when they meet the established financial assistance policies of Ballad Health and guidelines outlined by the federal government. However, financial assistance decisions are not solely based on income. Unique financial circumstances are weighed with verified patient assets which can determine financial assistance eligibility. It is not until after verification of income and assets that a decision regarding the amount of financial assistance can be made. In Fiscal Year 2019, JMH incurred a loss of $1,261,231 attributable to the provision of charity care. This amount does not include the costs associated with bad debt accounts.Uninsured Discount: Uninsured patients received an 80% discount through September 30, 2018, at which time the uninsured discount increased to 85%. Certain elective procedures are not eligible for the uninsured discount. This uninsured discount is calculated each year in accordance with Tennessee regulations and without regard to a patients income or assets. Although the uninsured discount is not required by the Commonwealth of Virginia, Ballad Health applies the same discount to our Virginia hospitals, including JMH. The approximate cost of this discount in FY19, using a cost to charge ratio, was $3,791,461 for JMH. JMH partnered with the company Bolder Outreach Solutions to work with self-paying patients who have limited financial resources. Representatives were available at JMH to determine possible governmental medical assistance (Medicaid or TennCare) eligibility, and to help with the application process and follow-up. 1,848 patients were approved during FY19 for coverage. Once a person is approved for Medicaid or TennCare through this program offered through JMH, they retain coverage for future medical care. JMH incurred expense of $167,810 during FY19 to provide this service. Community Donations:JMH provides direct financial contributions that support community healthcare needs and those nonprofit agencies that advocate for the health and well-being of community members. During FY19, JMH made donations to numerous health and human service organizations, social and well-being nonprofits, and others within our service area. We continued our support of local fire and emergency medical rescue organizations with donations of $7,847 in pharmacy drugs and supplies$7,250 was contributed to Washington County Public Schools Crossroads Medical Mission, Inc., a nonprofit that provides medical care to uninsured and low-income patients - $2,100Ecumenical Faith In Action emergency medicine & medical care - $1,000Highlands Community Service Board - child abuse & neglect - $500Washington County Fair - $1,500United Way of SW Virginia nutritious weekend meals to at-risk students in the region - $2,200Town of Abingdon, VA: economic development/support - $2,500University of Virginia womens health event - $1,200Virginia Highlands Festival $1,500Barter Theatre - $14,000William King Museum - $10,000Other small donations - $200In addition to the cost of drugs we donated to nine local medical emergency rescue organizations, our pharmacy staff time to prepare and stock drug boxes for these organizations cost the hospital $5,297. We provided the first aid station at the Virginia Highlands Festival.Our board of directors and senior management encourages team members to devote time to local community service projects, task forces, committees, boards, volunteer programs, and other charitable organizations that benefit our communities. Team members, within reason, are allowed to serve on these outside activities as representatives of the hospital. JMH team members also donate their personal time and money to fundraising activities within the community to benefit other not for profit organizations, such as United Way.Awards and Recognitions:In their 2019 Hospital Quality Rating for Medical Excellence, CareChex Hospital Ratings awarded JMH their highest ratings in the categories of Chronic Obstructive Pulmonary Disease, Heart Attack Treatment, Neurological Care and Womens Health. CareChex provides a comprehensive evaluation of inpatient hospital quality performance using a variety of outcomes of care measures, expressed as a composite quality score.JMH received Healthgrades 2019 Patient Safety Excellence Award. This is the fifth year in a row the hospital has received the award. The safety award places JMH in the top 10% of the nation for patient safety. Healthgrades is a company that provides information about hospitals, physicians, and healthcare providers and has amassed information on over 3 million U.S. health care providers. The patient safety award recognizes hospitals for how well a hospital prevents injuries, infections, and other serious conditions based on 14 serious, potentially preventable adverse events. Patient safety excellence award recipient hospitals have, on average, a lower risk of experiencing patient safety events. JMH received the Chest Pain-MI Registry 2019 Platinum Performance Achievement Award from the American College of Cardiology-NCDR. This award recognizes hospitals participating in Chest Pain-MI Registry who have demonstrated sustained, top level performance in quality of care and adherence to guideline recommendations. Through full participation in the registry, hospitals engage in a robust quality improvement process, using data to drive improvements and positively impact patient outcomes for heart attack patients. The Chest Pain-MI Registry is formerly the ACTION Registry. Form 990, Part III, Line 4a Johnston Memorial Hospital (JMH) is located in Abingdon, Virginia (Washington County). The hospital owns and operates a 116-bed nonprofit acute care hospital. Our primary service area encompasses 7 counties in Southwest Virginia. JMH is the sole member of Abingdon Physician Partners, a tax exempt organization that owns and operates physician practices. Our membership consists of Mountain States Health Alliance (majority owner) and Johnston Memorial Healthcare Foundation, Inc. JMH is part of the Ballad Health network, created when Mountain States Health Alliance and Wellmont Health System merged February 2018.During FY19, 7,157 patients were admitted to our hospital, with just over 27,000 patient days. There were an additional 4,156 observation days and 1,323 newborn days. We provided service for 157,958 outpatient visits this year. There were 34,190 visits to our emergency department, 6,590 surgeries performed and we delivered 581 babies. Promote Community Health:JMH entered into a lease agreement with Highlands Community Services (HCS), a non-profit organization that provides mental health, substance abuse and developmental services to residents of Washington County, Virginia to open a crisis intervention team (CIT) assessment site that will provide a non-criminal justice setting where persons with mental illness can be taken by law enforcement officers for assessment. The goals of the CIT programs are generally oriented toward reducing injuries to both law enforcement and citizens, reducing arrest of persons in behavioral health crisis, improving access and linkage to appropriate community treatment and support, and while promoting dignity and respect for individuals with behavioral health disorders. The foregoing goals are consistent with JMHs mission which is why our hospital agreed to provide space to HCS for an annual rental of just $1. JMH is providing the space to HCS in order to ensure the availability of a crisis intervention site within our community. The fair market value of the lease is $34,376 annually. HCS moved into the space in April so the value of FY19s rental is $8,594.Ballad Health embarked on a campaign near the end of fiscal year 2018 to reduce hospital-acquired C. diff by 30% in 90 days. This was a bold undertaking by Ballad Healths new Clinical Council and our Infection Prevention Department. C. diff is a significant threat to hospital patients everywhere. Its our duty as caregivers to protect our patients from harm at all times, so preventing C. diff is vital. Our plan involves some basic steps our clinical team members should always take to avoid this infection. The plan requires all team members to be mindful of how they treat C. diff., with team members involved in the treatment process receiving specific information appropriate for their role. In addition, a video is available on our intranet site that illustrates some of the key takeaways. Our ultimate goal is zero hospital-acquired C. diff infections. It should be noted that the 30/90 initiative to reduce hospital-acquired C. diff infections was a huge success, as the team, led by Ballad Healths Clinical Council Chair and System Chair of Ballads Hospitalist Division, Dr. Vashist, easily exceeded their goal, reducing C. diff infections system-wide by 44% in FY19. A cost analysis estimates the cost of C. diff at Ballad Health is between $15,642 to $20,736 per case, or an average of $18,189 per case. If applied to the 122 cases of C. diff system-wide that were avoided in FY19, the initiative represents cost savings of $2.2 million dollars for Ballad Health.Additionally, Dr. Vashists efforts have been instrumental in getting Ballad Health selected to participate in two prestigious Coalitions/Collaborative Projects that feature some of the leading healthcare systems in the country: the High Value Care Collaborative through the American Hospital Association in collaboration with the American Board of Internal Medicines (ABIM) Choosing Wisely and Costs of Care and the ACT Coalition to Improve Diagnosis through the Society to Improve Diagnosis in Medicine (SIDM). Both of these collaborative projects involve like-minded health systems sharing data and best practices on increasing evidence-based care, preventing harm, and reducing unnecessary procedures and testing. Ballad Health leaders have been asked to share with other clinical leaders across the nation information about the keys to success in the C. diff program and other clinical quality improvement initiatives.The JMH Center for Comprehensive Wound Care is the only facility in Southwest Virginia offering hyperbaric oxygen therapy - the delivery of oxygen at levels higher than atmospheric pressure in a chamber setting that stimulates the healing process. The nearest facility offering hyperbaric oxygen therapy is an hour away. Our trained staff follow a team approach to wound healing. Each patient receives a comprehensive individualized plan designed to help difficult-to-heal wounds. JMH staff strive to address the underlying cause of the problem, control infection, and improve the overall health of our patients. We offer a number of services at a significant financial loss to the hospital, such as our Center for Comprehensive Wound Care described above. Some other subsidized services include hyperbaric oxygen, our outpatient diabetes program, inpatient neonatology, and others. The hospital continues to invest resources in these valuable services despite financial loss so that community members do not need to leave the area to obtain needed care. Our diaper assistance program provides diapers to low-income families that deliver at JMH for the first 6 months of the babys life. We had 474 women enroll with their babies this year and incurred expense of $8,455 for this program. We assisted some patients who could not pay for their prescriptions upon discharge from the hospital. Our unreimbursed cost for these prescriptions was $11,038.JMH spent $263,293 during FY19 to recruit and retain physicians and mid-level providers such as hospitalists, family practice physicians, nurse practitioners, and specialists. JMH recruitment efforts are based on documented community need. Our hospital is located in a MUA (medically underserved area/population), as designated by the U.S. Health Resources & Services Administration (HRSA). MUA designation indicates an area as: having too few primary care providers, having a high infant mortality, a high poverty rate or a high elderly population. Based on our FY19 inpatient discharge data, 87% of our patients live in a medically underserved area. Form 990, Part III, Line 4a Mountain States Health Alliance (Mountain States) is one of only 29 organizations in the country participating in the Centers for Medicare & Medicaid Services (CMS) new initiative, Accountable Health Communities Model (referred to as AHC Program), aimed at improving the health of eligible Medicare and Medicaid beneficiaries. The AHC Program is designed to integrate care for health-related social needs into usual care by implementing systematic screening, referral, and patient navigation services for needs such as food insecurity, housing instability, safety, transportation needs, and utility assistance. Mountain States serves as the Bridge Organization for the AHC Program locally, leading a collaborative of multiple organizations and clinical delivery sites to bring needed services to beneficiaries residing in Southwest Virginia. Full implementation of the AHC Program was achieved during FY19. There are nine full-time team members for the program, whose positions are financed by federal funds, (six Navigators, one Lead Navigator, one Screening and Referral Specialist, and one Program Manager), while two part-time Navigator positions remain open. Fifty-two locations serve as clinical delivery sites in Southwest Virginia and Northeast Tennessee and have processes in place to identify health-related social needs. Patients that screen positive for health-related social needs are given a Community Referral Summary, which contains contact and program information for relevant resources that assist with the needs identified by the screening. Since formal go-live of the AHC Program on November 17, 2018 through June 30, 2019 there have been 61,705 offered screenings, 35,544 answered screenings, 9,050 needs identified, 5,030 Community Referral Summaries given to patients, and 2,142 navigated patients. The stats provided are inclusive of the Ballad Health Virginia hospitals plus three Tennessee hospitals located close to Southwest Virginia. Mountain States also created an internally-produced data system for the screening, referral, and navigation services in lieu of using the CMS AHC Data System. This data system improved operational efficiency by at least five-fold over the CMS Data System. Patient Navigators have been re-deployed from five Virginia Community Services Boards in our service area to hospital emergency departments and primary care offices. This allows the Navigators to establish initial contact with a patient and complete a personal interview and action plan related to the health-related social needs identified by the patient. Laptops and cell phones were purchased for the Navigators to have the ability to work at the clinical delivery sites and from other locations, as needed.We host programs within the community that provide health education to both health professionals and the general public. During Octobers National Breast Cancer Awareness Month, JMH hosted a breast cancer educational event. The Regional Cancer Center oncology team from JMH, including medical and radiation oncologists, gave presentations throughout the evening. The program included health screenings, health education booths and more. JMH incurred expense of $11,493 to host the event. During the year we also funded a first aid tent for an outdoor community festival. The event focused on health and safety. The hospital invested an additional cost of over $86,111 for public service health education, such as heart health, womens health and cancer.JMH is committed to providing comprehensive health education to aid in patient recovery and disease management. We offer classes and support groups, such as diabetes education and support, cardiac care education and support, joint replacement education, cancer education and support through our cancer center, prenatal parenting/sibling classes, and others. In order to increase public awareness of early detection for lung cancer, JMH continued to offer some low-dose CT lung screenings free of charge. The free service started in FY18, continued into FY19, providing an additional 67 free scans. The hospital notified the public as well as local physician offices of the free service. Following JMHs lead, some other Ballad hospitals offered free scans.Our health systems parent company, Ballad Health, provides numerous services to improve the health of our communities. The following services are provided by the Ballad Health entity but funded by the various hospitals and other divisions within our health system. The funding levels by JMH for these services are reflected below:Ballad Health parish nurses work with individual congregations to help people in religious communities improve their health, prevent illness and injury and ease suffering associated with any health crisis. The parish nurse acts as counselor, educator and healthcare provider by identifying needs of the congregation, coordinating health screenings, providing educational programs, supplying health literature and referring congregants to supportive health services where appropriate. Also, the parish nurse maintains an active visitation program to parishioners who are homebound, hospitalized or in nursing homes. Currently, there are dozens of churches in Northeast Tennessee and Southwest Virginia that are serviced by the Ballad Health parish nurse program. JMH funded $8,178 for this program. Ballad Healths Enterprise Call Center is a toll-free line that connects community members with experienced nurses around the clock. The nurses provide expert medical advice anytime, day or night, make referrals to a new primary care provider with a location and hours convenient to the community member and referrals to a physician specialist when they need advanced local medical care. They also provide health information and resources, including health screenings, immunizations, and make referrals to urgent care clinics to see a doctor near the community member the same day. JMH funded $20,113 toward this popular service during FY19.People struggle with having enough to eat throughout the year. Ballad Health hosted a food drive to support Second Harvest Food Bank of Northeast Tennessee and Feeding America of Southwest Virginia. The drive coincided with National Food Bank Day on September 7th, but our drive continued until September 30th. Donation bins were located at JMHs HR department to collect food items to be donated to our partner agencies who operate food pantries and to individuals and families through some of our direct service programs like the Mobile Food Pantry and Senior Grocery Program.In FY19, Ballad Health made a major change regarding air ambulance services. Ballad selected Med-Trans, locally known as Wings Air Rescue, to continue to operate four full-time bases in Elizabethton, TN, Greeneville, TN, Jenkins, KY and Marion, VA plus a base at Bristol Motor Speedway, which is active during race events. Licensed in Tennessee, Ballad Health One air ambulance provides transport of critically ill and injured patients to one of the closest tertiary hospitals in the region. We also provided staffing, physicians, and medical supplies to the Commonwealth of Virginia for the Virginia State Polices Med Flight air ambulance service. VSP Med Flight will continue to maintain its base in Abingdon, VA. JMHs contribution for the air ambulance services that are especially critical in rural areas was $75,773.Rural hospitals are struggling and our communities are not as healthy as they could be. Ballad Health was created specifically to address the most critical healthcare needs of communities in Northeast Tennessee and Southwest Virginia. Ballad has made commitments that include the investment of $75 million over 10 years to improve population health needs with a focus on some of the most serious threats to our regions health, like diabetes and infant mortality. Ballad Health established a new department, Population Health, during FY19 to focus on the needs. JMH invested $92,977 toward this initiative that supplements the many other forms of community benefit provided by our health systems hospitals. Health Professions Education:The idea of an internal medicine program at JMH was sparked by the acknowledged physician shortage in Southwest Virginia. The JMH residency program welcomed its fourth class of 11 residents this year. Thirty-three residents are currently in training at JMH, 17 in family medicine and 16 in internal medicine. The JMH family medicine residency program and the internal medicine program are committed to providing advanced, innovative, and specialized training in osteopathic family medicine and internal medicine. Upon completion of residency training, JMH physicians will be well prepared to serve the community by practicing comprehensive family medicine or internal medicine and caring for diverse populations. There is a national shortage of family medicine doctors. The Association of American Medical Colleges recently predicted a shortage of nearly 100,000 p Form 990, Part VI, Line 15 b - Compensation Process for Officers Similar to JMH/APP's CEO, JMH/APP's CFO receives compensation that complieswith Ballad Health's salary policy. His pay is set at a market percentilespecific to his position as CFO of JMH and APP. Key employee Bryan Mullins,JMH COO, is not a Vice-President or in a senior leadership position,therefore his compensation and benefits are consistent with other JMH non-executive positions. Form 990, Part VI, Line 15a - Compensation Process for Top Official 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. The review includes JMH/APP's CEO. 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 President & CEO evaluates the data and submits his recommendations to Ballad Health's Board of Directors for their final review and approval. In addition, Ballad Health offers an incentive plan to executives based on targeted achievement metrics set in advance of the pay year. Established metrics include: quality and access measures, evidence-based care scores, and value based purchasing, etc. Mountain States Health Alliance 303 Med Tech Parkway Suite 220 Johnson City TN 37604 620476282 Hospital System TN 501c3 3 BALLAD false MSHA Auxiliary 400 N State of Franklin Road Johnson City TN 37604 581418345 Supporting Organization TN 501c3 12a MSHA false Smyth County Community Hospital 245 Medical Park Drive Marion VA 24354 540794913 Hospital VA 501c3 3 MSHA false Norton Community Hospital 100 15th Street NW Norton VA 24273 540566029 Hospital VA 501c3 3 NA false Dickenson Community Hospital 312 Hospital Drive Clintwood VA 24228 770599553 Hospital VA 501c3 3 NCH false Auxiliary to Johnston Memorial Hosp 16000 Johnston Memorial Drive Abingdon VA 24211 540917478 Supporting Organization VA 501c3 12a NA false Abingdon Physician Partners 16000 Johnston Memorial Drive Abingdon VA 24211 205485346 Medical Services VA 501c3 12a JMH true Johnston Memorial Healthcare Fdn 16000 Johnston Memorial Drive Abingdon VA 24211 262870970 Fundraiser VA 501c3 12b NA false Ballad Health 303 Med Tech Parkway Suite 220 Johnson City TN 37604 611771290 Supporting Organization TN 501c3 12b NA false East TN Holdings Inc 203 Gray Commons Circle Gray TN 37615 815475903 Opioid Treatment TN 501c3 3 MSHA false Wellmont Health System 1905 American Way Kingsport TN 37660 621636465 Hospital System TN 501c3 3 BALLAD false Wellmont Hawkins Co Memorial Hosp 851 Locust Street Rogersville TN 37857 621816368 Hospital TN 501c3 3 WHS false Takoma Regional Hospital Inc DBA GCH 1420 Tusculum Boulevard Greeneville TN 37745 510603966 Hospital TN 501c3 3 WHS false Wellmont Cardiology Services 1905 American Way Kingsport TN 37660 263557623 Medical Services TN 501c3 10 WHS false Wellmont Medical Associates 1905 American Way Kingsport TN 37660 270898372 Medical Services TN 501c3 7 WHS false Ballad Health Foundation 1019 West Oakland Ave Suite 2 Johnson City TN 37604 581594191 Fundraiser TN 501c3 7 BALLAD false Wellmont Madison House 2000 Greenway Street Kingsport TN 37660 621308216 Assisted Living TN 501c3 10 WHS false Wellmont Wexford House 2421 N John B Dennis Hwy Kingsport TN 37660 581859039 Nursing Home TN 501c3 10 WHS false Wellmont Imaging Services Inc 1905 American Way Kingsport TN 37660 861103148 Healthcare TN 501c3 12a WHS false Wellmont Sleep Services 1905 American Way Kingsport TN 37660 273777167 Medical Services TN 501c3 3 WHS false Laughlin Memorial Hospital Inc 1420 Tusculum Boulevard Greeneville TN 37745 620701119 Hospital TN 501c3 3 MSHA false Laughlin Healthcare Foundation 1420 Tusculum Boulevard Greeneville TN 37745 582105493 Fundraiser TN 501c3 12a MSHA false Emmaus Community Healthcare PLLC 6070 HWY 11E Piney Flats TN 37686 200577483 Medical Services TN NA false false Medical Specialists of JC LLC 2528 Wesley Street Suite 2 Johnson City TN 37601 272199037 Medical Services TN NA false false East TN Ambulatory Surgery Cntr 701 Med Tech Parkway Suite 100 Johnson City TN 37604 621787537 Medical Services TN NA false false Greeneville Physician Services LLC 1905 American Way Kingsport TN 37660 455070419 Medical Services TN NA false false Blue Ridge Medical Management Corp 1905 American Way Kingsport TN 37660 621490616 Medical Services TN MSHA C false Mediserve Medical Equipment 1905 American Way Kingsport TN 37660 621212286 Durable Medical Equipment TN BRMMC C false Mountain States Properties 1905 American Way Kingsport TN 37660 621845895 Property Management TN BRMMC C false Mountain States Physician Group 1905 American Way Kingsport TN 37660 621700412 Medical Services TN BRMMC C false Community Home Care Inc 1490 Park Avenue NW Suite B Norton VA 24273 541453810 Durable Medical Equipment VA NCH C false Wilson Pharmacy Inc P B Box 5289 Johnson City TN 37604 620329587 Pharmacy TN BRMMC C false Crestpoint Health Insurance Company 509 Med Tech Parkway Suite 100 Johnson City TN 37604 620381170 Insurance TN ISHN C false Wellmont Inc 1905 American Way Kingsport TN 37660 621320035 Medical Services TN WHS C false Wellmont Collections Inc 2004 American Way Suite 101 Kingsport TN 37660 621325938 Bus. Serv. TN NA C false Medical Mall Pharmacy Inc 1905 American Way Kingsport TN 37660 621565006 Medical Services TN NA C false Wellmont Physician Services 1905 American Way Kingsport TN 37660 621567353 Medical Services TN NA C false WPS Providers Inc 1905 American Way Kingsport TN 37660 205564642 Medical Services TN NA C false Wellmont Health Services Inc 1905 American Way Kingsport TN 37660 621254373 Medical Services TN NA C false Nolichuckey Management Svcs Inc 1420 Tusculum Boulevard Greeneville TN 37745 621776681 Medical Services TN LMH C false Wellmont Insurance Co SPC LTD PO Box 30600 Grand Cayman CJ KY1-1203 981195624 Insurance CJ NA C false true false true false false false true false false true false true true true true true true true true Abingdon Physician Partners a 889031 FMV Abingdon Physician Partners c 747524 FMV Abingdon Physician Partners q 605016 FMV