JOHNSTON MEMORIAL HOSPITAL INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization: JOHNSTON MEMORIAL HOSPITAL INC (EIN 54-0544705)
Tax period: 2013-07-01 to 2014-06-30
Filed: 2015-05-07
IRS object ID: 201521279349301372
Schema version: 2013v4.0
Source: Download XML · Original 990 at ProPublica

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

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

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2015-05-07T13:40:19-05:00	ReturnTs
Tax Period End	2014-06-30	TaxPeriodEndDt
Return Type	990	ReturnTypeCd
Tax Period Begin	2013-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	540544705	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	JOHNSTON MEMORIAL HOSPITAL INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Business Name Control	JOHN	BusinessNameControlTxt
Phone	2762581000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	16000 JOHNSTON MEMORIAL DR	AddressLine1
City	ABINGDON	City
State	VA	State
ZIP Code	24211	ZIPCode

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	JOHN JETER	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	2762581000	PhoneNum
Signature	2015-04-29	SignatureDt

Field	Value	IRS element (for citing)
Tax	2013	TaxYr
Build TS	2016-02-25 16:41:14Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	SEAN MCMURRAY	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	16000 JOHNSTON MEMORIAL DR	AddressLine1
City	ABINGDON	City
State	VA	State
ZIP Code	24211	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	$128,796,681	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	HTTP://WWW.MSHA.COM/JMH	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1917	FormationYr
Legal Domicile State	VA	LegalDomicileStateCd
Activity Or Mission	JOHNSTON MEMORIAL HOSPITAL (JMH) IS COMMITTED TO BRINGING LOVING CARE TO HEALTH CARE. WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTH CARE NEEDS OF INDIVIDUALS AND COMMUNITIES IN OUR REGION AND TO ASSIST THEM IN ATTAINING THEIR HIGHEST POSSIBLE LEVEL OF HEALTH.	ActivityOrMissionDesc
Voting Members Governing Body	15	VotingMembersGoverningBodyCnt
Voting Members Independent	12	VotingMembersIndependentCnt
Total Employee	0	TotalEmployeeCnt
Total Volunteers	242	TotalVolunteersCnt
Total Gross UBI	$132,455	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$23,485	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$54,039	PYContributionsGrantsAmt
CY Contributions Grants	$101,108	CYContributionsGrantsAmt
PY Program Service Revenue	$126,824,002	PYProgramServiceRevenueAmt
CY Program Service Revenue	$119,469,249	CYProgramServiceRevenueAmt
PY Investment Income	$4,913,544	PYInvestmentIncomeAmt
CY Investment Income	$7,163,382	CYInvestmentIncomeAmt
PY Other Revenue	$2,570,450	PYOtherRevenueAmt
CY Other Revenue	$1,472,331	CYOtherRevenueAmt
PY Total Revenue	$134,362,035	PYTotalRevenueAmt
CY Total Revenue	$128,206,070	CYTotalRevenueAmt
PY Grants And Similar Paid	$116,677	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$280,949	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$53,104,147	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$49,011,100	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$63,865,533	PYOtherExpensesAmt
CY Other Expenses	$69,605,077	CYOtherExpensesAmt
PY Total Expenses	$117,086,357	PYTotalExpensesAmt
CY Total Expenses	$118,897,126	CYTotalExpensesAmt
PY Revenues Less Expenses	$17,275,678	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$9,308,944	CYRevenuesLessExpensesAmt
Total Assets BOY	$323,314,314	TotalAssetsBOYAmt
Total Assets EOY	$335,681,718	TotalAssetsEOYAmt
Total Liabilities BOY	$53,919,883	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$54,271,755	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$269,394,431	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$281,409,963	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	JOHNSTON MEMORIAL HOSPITAL (JMH) IS COMMITTED TO BRINGING LOVING CARE TO HEALTH CARE. WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTH CARE NEEDS OF INDIVIDUALS AND COMMUNITIES IN OUR REGION AND TO ASSIST THEM IN ATTAINING THEIR HIGHEST POSSIBLE LEVEL OF HEALTH.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$92,403,416	ExpenseAmt
Grant	$280,949	GrantAmt
Revenue	$120,090,523	RevenueAmt
Desc	JOHNSTON MEMORIAL HOSPITAL, INC. (JMH) IS A 116-BED NOT-FOR-PROFIT HOSPITAL LOCATED IN ABINGDON, VIRGINIA AND A MEMBER OF MOUNTAIN STATES HEALTH ALLIANCE (MSHA). JMH IS THE SOLE MEMBER OF ABINGDON PHYSICIAN PARTNERS, A TAX EXEMPT ORGANIZATION, ORGANIZED TO OPERATE EXCLUSIVELY FOR THE BENEFIT OF THE HOSPITAL. DURING 2013, JMH CREATED JMH EMERGENCY PHYSICIANS, ORGANIZED TO PROVIDE EMERGENCY ROOM PHYSICIANS FOR THE HOSPITAL. (CONTINUED ON SCHEDULE O) JMH OFFERS A FULL ARRAY OF MEDICAL SERVICES THROUGH HIGHLY TRAINED PHYSICIANS AND SUPPORT STAFF, PROUDLY SERVING SOUTHWEST VIRGINIA SINCE 1917. OUR GOAL IS TO BE A LEADER IN IMPROVING THE HEALTH AND QUALITY OF LIFE IN THE COMMUNITY, BY WORKING TOGETHER AS A TEAM DEDICATED TO EXCELLENCE. DURING FY14, WE EXPERIENCED 7,109 ADMISSIONS, WITH ALMOST 24,000 PATIENT DAYS. THERE WERE AN ADDITIONAL 4,760 OBSERVATION DAYS. OUR OUTPATIENT VISITS WERE JUST UNDER 146,000. THERE WERE 39,161 VISITS TO OUR EMERGENCY DEPARTMENT, WITH 5,403 RESULTING IN AN INPATIENT STAY. ALMOST 6,900 SURGERIES WERE PERFORMED DURING THE YEAR AND WE DELIVERED 752 BABIES. DURING FY14, JMH IMPLEMENTED AN ONLINE TOOL CALLED OWL (ONLINE WELLNESS LINK). OWL PROVIDES INPATIENTS WITH BETTER ACCESS TO THEIR HEALTH CARE INFORMATION SO THEY CAN VIEW A PORTION OF THEIR HEALTH RECORD ONLINE, INCLUDING: - A CONTINUITY OF CARE DOCUMENT WHICH PROVIDES A SUMMARY OF THE HOSPITAL VISIT - CURRENT MEDICATIONS - ALLERGIES AND ADVERSE REACTIONS - PAST MEDICAL HISTORY - CERTAIN LABORATORY AND RADIOLOGY RESULTS THE OWL PORTAL ALSO ALLOWS JMH CAREGIVERS TO EXCHANGE HEALTHCARE INFORMATION, WHICH HAS LED TO SAFER, MORE QUALTIY-ORIENTED AND STREAMLINED CARE FOR OUR PATIENTS. JMH SIGNED A NON-PROFIT BLOOD CENTER TENANT TO A ONE YEAR LEASE FOR ONLY 1. THE ANNUAL FAIR MARKET VALUE OF THE LEASE IS 32,770. THE FMV FOR THE EIGHT MONTHS FALLING WITHIN FY14 IS 21,846. BLOOD ASSURANCE IS A NON-PROFIT FULL SERVICE REGIONAL BLOOD CENTER SERVING 51 COUNTIES AND MORE THAN 70 HEALTHCARE FACILITIES IN VIRGINIA, TENNESSEE, NORTH CAROLINA, ALABAMA, AND GEORGIA. THE MISSION OF BLOOD ASSURANCE IS TO PROVIDE A SAFE AND ADEQUATE SUPPLY OF BLOOD AND BLOOD COMPONENTS IN A COST EFFECTIVE MANNER TO EVERY AREA PATIENT IN NEED. JMH IS COMMITTED TO PROVIDING COMPREHENSIVE MEDICAL EDUCATION TO AID IN PATIENT RECOVERY AND DISEASE MANAGEMENT. WE OFFER MANY CLASSES AND SUPPORT GROUPS, SUCH AS: CPR AND LIFE SAVING CLASSES; CARDIAC CARE; TOTAL JOINT; CANCER EDUCATION; PRENATAL PARENTING; AND, OTHERS. THE JMH CENTER FOR COMPREHENSIVE WOUND CARE IS ONE OF ONLY A FEW FACILITIES IN THE REGION THAT OFFERS HYPERBARIC OXYGEN THERAPY-THE DELIVERY OF OXYGEN AT LEVELS HIGHER THAN ATMOSPHERIC PRESSURE IN A CHAMBER SETTING THAT STIMULATES THE HEALING PROCESS. OUR TRAINED STAFF FOLLOW A TEAM APPROACH TO WOUND HEALING. AFTER AN INITIAL EVALUATION, 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. THE JMH DIABETES EDUCATION CENTER HAS ASSISTED PATIENTS IN DIABETES CARE SINCE 1999. DR. ANDREW RHINEHART, DIRECTOR OF THE CENTER, WAS AWARDED RECOGNITION, BY THE PRESTIGIOUS NATIONAL COMMITTEE FOR QUALITY ASSURANCE DIABETES RECOGNITION PROGRAM, A PRIVATE, NONPROFIT ORGANIZATION DEDICATED TO IMPROVING HEALTH CARE QUALITY. DR. RHINEHART IS BOARD-CERTIFIED IN ADVANCED DIABETES MANAGEMENT AND WAS THE FIRST PHYSICIAN IN THE U.S. TO GAIN THESE CREDENTIALS. HE BECAME ONE OF THE FIRST PHYSICIANS TO EARN DISTINCTION AS A CERTIFIED DIABETES TECHNOLOGY CLINICIAN, THE HIGHEST PROFESSIONAL CREDENTIAL THAT RECOGNIZES A PHYSICIAN AS AN EXPERT IN USING TECHNOLOGY TO MANAGE DIABETES. A STAFF OF CERTIFIED DIABETES EDUCATORS ASSISTS HIM AT THE DIABETES CARE CENTER. MOUNTAIN STATES REHABILITATION AT JMH HAS BEEN AWARDED AN OUTCOMES EXCELLENCE CERTIFICATE FROM FOCUS ON THERAPEUTIC OUTCOMES, INC. (FOTO), A NATIONWIDE OUTCOMES DATABASE AND REPORTING SERVICE FOR HEALTHCARE PROVIDERS ACROSS THE COUNTRY TO RECOGNIZE EXCELLENCE IN PATIENT OUTCOMES SUSTAINED OVER TIME. NATIONALLY, ONLY ABOUT 12 PERCENT OF NEARLY 3,000 ELIGIBLE CLINICS RECEIVED THIS AWARD OVER THE LAST YEAR. JMH RANKS HIGH COMPARED TO OTHER CLINICS IN THE FOTO NETOWRK WITH ITS PATIENTS ACHIEVING SIGNIFICANTLY HIGHER FUNCTIONAL IMPROVEMENTS, IN FEWER VISITS, AND WITH HIGHER PATIENT SATISFACTION. JMH HAS USED FOTO SINCE 2010 AS A WAY TO OBJECTIVELY TRACK PATIENTS' FUNCTIONAL OUTCOMES. PARTICIPATING IN THIS NATION-WIDE SYSTEM IS ANOTHER EXAMPLE OF JMH'S COMMITMENT TO PROVIDING EFFICIENT AND OUTSTANDING PATIENT CARE. FOTO HAS THE FIRST FUNCTIONAL HEALTH STATUS MEASURE APPROVED FOR PHYSICAL REHABILITATION BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES' LIST OF APPROVED QUALITY MEASURES IN NATIONAL QUALITY MEASURES CLEARINGHOUSE. THE HEAL (HEALTHLY EATING ACTIVE LIVING) APPALACHIA PROGRAM, WHICH BATTLES CHILDHOOD OBESITY IN OUR REGION, WAS SELECTED AS A 2014 INDUCTEE INTO THE FIRST LADY OF VIRGINIA'S OPPORTUNITY HALL OF FAME. THIS HONOR RELATES TO HEAL APPALACHIA'S WORK IN SOUTHWEST VIRGINIA. HEAL APPALACHIA IS A COLLABORATIVE EFFORT OF MOUNTAIN STATES HEALTH ALLIANCE (MSHA) AND EAST TENNESSEE STATE UNIVERSITY. IT WAS CREATED TO BUILD MOMENTUM IN THE FIGHT AGAINST CHILDHOOD OBESITY IN SOUTHERN APPALACHIA. JMH SUPPORTS OTHER LOCAL NON-PROFIT ORGANIZATIONS THAT PROVIDE HEALTHCARE SERVICES TO OUR RESIDENTS. WE DONATE MEDICATIONS AND SUPPLIES TO AREA RESCUE SQUADS AND FIRE DEPARTMENTS. THESE DRUG AND SUPPLY DONATIONS EXCEEDED 13,000 IN FY14. WE PROVIDED FINANCIAL ASSISTANCE TO A LOCAL COLLEGE FOR ITS NURSING PROGRAM. DURING FY14, WE CONTRIBUTED OVER 75,000 TO THE PROGRAM. MANY OTHER DONATIONS WERE MADE TO SUPPORT OUR SCHOOLS, MARCH OF DIMES, ETC. WITH HEALTHCARE INSURANCE COVERAGE CHANGING RAPIDLY, PATIENT PAYMENT RESPONSIBILTY IS INCREASING AT A RATE OF 5 TO 6 PERCENT EACH YEAR. MOUNTAIN STATES INTRODUCED A NEW PAYMENT OPTION LAST YEAR THAT OFFERS MORE FLEXIBILITY TO OUR PATIENTS - THE ABILITY TO SPREAD PAYMENTS OVER A 36-MONTH PERIOD WITH NO INTEREST CHARGED. OF COURSE, FOR PATIENTS THAT ARE UNABLE TO PAY THEIR ACCOUNT BALANCES, PATIENT RESPRESENTATIVES ARE AVAILABLE TO DISCUSS FINANCIAL ASSISTANCE PROGRAMS. JMH HAS PARTNERED WITH THE COMPANY FIRSTSOURCE SOLUTIONS USA TO WORK WITH SELF-PAYING PATIENTS WHO HAVE LIMITED FINANCIAL RESOURCES. DURING FY14, FIRSTSOURCE REPRESENTATIVES WERE AVAILABLE AT JMH TO ASSIST PATIENTS. THE REPRESENTATIVES WERE ABLE TO DETERMINE GOVERNMENTAL MEDICAL ASSISTANCE (MEDICAID OR TENNCARE) ELIGIBILITY, AND TO HELP WITH THE APPLICATION PROCESS AND FOLLOW-UP. ONCE A PERSON IS APPROVED FOR MEDICAID OR TENNCARE THROUGH THE PROGRAM OFFERED THROUGH JMH, THEY RETAIN COVERAGE FOR FUTURE MEDICAL CARE. 636 PATIENTS WERE APPROVED FOR GOVERNMENTAL ASSISTANCE DURING THE YEAR. FIRSTSOURCE IS COMPENSATED BY JMH. DURING FY14, JMH'S COST FOR THIS PROGRAM WAS 88,193. DURING FY14, JMH'S BOARD OF DIRECTORS VOTED TO PARTNER WITH THE EDWARD VIA COLLEGE OF OSTEOPATHIC MEDICINE (VCOM) TO ESTABLISH A RESIDENCY PROGRAM IN ABINGDON. THE AGREEMENT IS EXPECTED TO PLACE UP TO NINE RESIDENTS AT JMH IN THE FIRST YEAR, WITH THE NUMBER POTENTIALLY INCREASING DURING THE INITIAL FIVE YEARS OF THE PROGRAM. VCOM WILL PROVIDE SUPPORT PERSONNEL AND OTHER RESOURCES DURING THE FIVE-YEAR START-UP PHASE. JMH BELIEVES PRIMARY CARE PHYSICIANS ARE PARTICULARLY NEEDED IN THE REGION, ESPECIALLY WITH THE INFLUX OF NEW PATIENTS EXPECTED TO COME AS MORE PEOPLE OBTAIN HEALTH INSURANCE UNDER THE AFFORDABLE CARE ACT. VCOM SPECIALIZES IN TRAINING PHYSICIANS FOR PRIMARY CARE; HOSPITAL OFFICIALS BELIEVE THE PARTNERSHIP IS A NATURAL FIT. JMH SERVES AS A CLINICAL TRAINING HOSPITAL FOR HEALTH PROFESSIONAL EDUCATION STUDENTS. WE HAVE DEDICATED STAFF THAT WORK WITH REGIONAL COLLEGES AND UNIVERSITIES TO COORDINATE THE PLACEMENT OF HEALTHCARE PROFESSIONAL STUDENTS AS PART OF THEIR EDUCATIONAL CURRICULUM. IN 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 FY14 INCLUDED 349 NURSING STUDENTS FROM VARIOUS COLLEGES, UNIVERSITIES AND PROGRAMS. THIS NURSING CLINICAL EXPERIENCE REQUIRED EXTENSIVE JMH NURSING STAFF INVOLVEMENT. THE CLINICAL SETTING AND HANDS-ON INSTRUCTION COST JMH 724,962. JMH PROVIDED A CLINICAL SETTING FOR ANOTHER 174 STUDENTS TRAINING IN HEALTH-RELATED PROGRAMS SUCH AS RADIOLOGY, PHARMACY, PHYSICAL THERAPY, EMT/PARAMEDIC AND OTHER ALLIED-HEALTH DISCIPLINES. THESE ADDITIONAL CLINICAL STUDENTS COST JMH 173,134. BASED ON COMMUNITY NEEDS, JMH INCURRED EXPENSE OF 311,375 TO RECRUIT PHYSICIANS INTO OUR COMMUNITY. PHYSICIANS ARE RECRUITED TO REPLACE PHYSICIANS THAT RETIRE OR LEAVE THE AREA. ALL PHYSICIAN RECRUITMENT ACTIVITIES ARE BASED ON DOCUMENTED COMMUNITY NEED. MSHA'S VALUE OPTIMIZATION SYSTEM (VOS) GOAL IS TO ACCELERATE ACHIEVEMENT OF PATIENT CENTERED CARE TO MEET THE PATIENT'S	Desc
Total Program Service Expenses	$92,403,416	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	Yes (true)	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	133	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	0	EmployeeCnt
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	15	GoverningBodyVotingMembersCnt
Independent Voting Member	12	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	VA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	JOHN L JETER	PersonNm
Phone	2762581000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	16000 JOHNSTON MEMORIAL DR	AddressLine1
City	ABINGDON	City
State	VA	State
ZIP Code	24211	ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
DENNIS VONDERFECHT
TRUSTEE	9.00	51.00	Yes (X)	$0	$1,058,195	$68,381
ANN FLEMING
TREASURER	13.00	47.00	Yes (X)	$0	$753,909	$73,411
PAUL ARMSTRONG MD
TRUSTEE	3.00	37.00	Yes (X)	$0	$465,440	$36,131
JIM GARDNER MD
TRUSTEE	13.00	27.00	Yes (X)	$0	$227,657	$26,193
KATHY MITCHELL MD
TRUSTEE	13.00		Yes (X)	$0	$0	$0
MICHAEL SPIEGLER
SECRETARY	10.00		Yes (X)	$0	$0	$0
GARY PEACOCK
TRUSTEE	8.00	5.00	Yes (X)	$0	$0	$0
OTEY DUDLEY
TRUSTEE	12.00		Yes (X)	$0	$0	$0
HUGH FERGUSON
CHAIR	13.00		Yes (X)	$0	$0	$0
TOM FOWLKES
TRUSTEE	6.00	4.50	Yes (X)	$0	$0	$0
RACHEL FOWLKES EDD
TRUSTEE	11.00		Yes (X)	$0	$0	$0
JOANNE GILMER
VICE-CHAIR	13.00	6.00	Yes (X)	$0	$0	$0
KATHI LOWE
TRUSTEE	7.00		Yes (X)	$0	$0	$0
BILL HAYTER
TRUSTEE	13.00		Yes (X)	$0	$0	$0
BARBARA ALLEN
TRUSTEE	4.00	7.00	Yes (X)	$0	$0	$0
ERIC MILLER
TRUSTEE	13.00		Yes (X)	$0	$0	$0
SEAN MCMURRAY
CEO	50.00	5.00		$0	$309,946	$49,800	Yes (X)
JOHN JETER
CFO	45.00	10.00		$0	$153,530	$23,574	Yes (X)
KELLY CARTER MD
PHYSICIAN	40.00			$0	$341,868	$32,346		Yes (X)
DAVID SIMMONS MD
PHYSICIAN	40.00			$0	$330,402	$30,693		Yes (X)
SAMUEL MELTON MD
PHYSICIAN	40.00			$0	$317,898	$12,982		Yes (X)
MATHEW DYE MD
PHYSICIAN	40.00			$0	$308,669	$34,070		Yes (X)
JACQUELYN EARLY MD
PHYSICIAN	40.00			$0	$302,185	$30,861		Yes (X)

Field	Value	IRS element (for citing)
Tot Reportable Comp Rltd Org	$4,569,699	TotReportableCompRltdOrgAmt
Total Other Compensation	$418,442	TotalOtherCompensationAmt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1	CityContractorAddress/USAddress/City	StateContractorAddress/USAddress/State	ZIP CodeContractorAddress/USAddress/ZIPCode	ServicesServicesDesc	CompensationCompensationAmt
VIRGINIA HIGHLANDS ANESTHESIA
PO BOX 1476	ABINGDON	VA	24212	ANESTHESIA	$3,065,965
ABINGDON PHYSICIANS ASC GROUP
613 CAMPUS DRIVE SUITE 300	ABINGDON	VA	24210	SURG. CTR. MGMT	$742,999
EXECUTIVE HEALTH RESOURCES
15 CAMPUS BOULEVARD SUITE 200	NEWTOWN SQUARE	PA	19073	PT.RESOURCE MGT	$453,663
CROTHALL SERVICES EAST TN
955 CHESTERBROOK BLVD STE 300	WAYNE	PA	19087	LINEN SERVICES	$389,538
MEDIAS INC
PO BOX 10452	BLACKSBURG	VA	240620452	SLEEP STUDIES	$377,864

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	22	CntrctRcvdGreaterThan100KCnt
Related Organizations	$22,811	RelatedOrganizationsAmt
Government Grants	$64,674	GovernmentGrantsAmt
All Other Contributions	$13,623	AllOtherContributionsAmt
Total Contributions	$101,108	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	ExclusionExclusionAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT SERVICE REVENUE	621110	$116,952,245	$116,952,245
WELLNESS PROGRAMS	621110	$1,998,265	$1,998,265
P/S PREMIER AND ISHN	621110	$244,615	$244,615
RENT TO EXEMPT AFFILIATES	621110	$147,760		$147,760
LABORATORY	621500	$132,455			$132,455

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$6,091	TotalRevenueColumnAmt
Exclusion	-$6,091	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$119,469,249	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,055,268	TotalRevenueColumnAmt
Exclusion	$2,055,268	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$3,038	TotalRevenueColumnAmt
Exclusion	$3,038	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$697,046	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$590,611	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$106,435	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$106,435	TotalRevenueColumnAmt
Exclusion	$106,435	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$4,457,858	SecuritiesAmt
Other	$647,218	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$4,457,858	SecuritiesAmt
Other	$647,218	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,105,076	TotalRevenueColumnAmt
Related Or Exempt Func Income	$621,274	RelatedOrExemptFuncIncomeAmt
Exclusion	$4,483,802	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
CAFETERIA & VENDING	722210	$636,413	$636,413
PREMIER IPO VENDOR INCENTIVE	900099	$504,135	$504,135
MANAGEMENT FEES	561000	$180,921	$180,921

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$44,427	TotalRevenueColumnAmt
Exclusion	$44,427	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$1,365,896	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$128,206,070	TotalRevenueColumnAmt
Related Or Exempt Func Income	$119,816,399	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$132,455	UnrelatedBusinessRevenueAmt
Exclusion	$8,156,108	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$280,949	TotalAmt
Program Services	$280,949	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$557,980	TotalAmt
Management And General	$557,980	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$40,586,280	TotalAmt
Program Services	$33,944,178	ProgramServicesAmt
Management And General	$6,642,102	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$1,426,982	TotalAmt
Program Services	$1,208,802	ProgramServicesAmt
Management And General	$218,180	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$3,986,003	TotalAmt
Program Services	$3,956,825	ProgramServicesAmt
Management And General	$29,178	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$2,453,855	TotalAmt
Program Services	$2,289,057	ProgramServicesAmt
Management And General	$164,798	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$102,806	TotalAmt
Management And General	$102,806	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$12,319	TotalAmt
Management And General	$12,319	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$116,514	TotalAmt
Management And General	$116,514	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$231,721	TotalAmt
Management And General	$231,721	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$24,064,058	TotalAmt
Program Services	$20,423,322	ProgramServicesAmt
Management And General	$3,640,736	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$275,887	TotalAmt
Program Services	$8,559	ProgramServicesAmt
Management And General	$267,328	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,220,779	TotalAmt
Program Services	$975,994	ProgramServicesAmt
Management And General	$244,785	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$776,525	TotalAmt
Program Services	$768,146	ProgramServicesAmt
Management And General	$8,379	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$2,318,275	TotalAmt
Program Services	$1,658,692	ProgramServicesAmt
Management And General	$659,583	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$222,743	TotalAmt
Program Services	$189,463	ProgramServicesAmt
Management And General	$33,280	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$43,874	TotalAmt
Program Services	$41,855	ProgramServicesAmt
Management And General	$2,019	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$560,130	TotalAmt
Management And General	$560,130	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$11,801,342	TotalAmt
Program Services	$4,917,860	ProgramServicesAmt
Management And General	$6,883,482	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$997,468	TotalAmt
Program Services	$21,963	ProgramServicesAmt
Management And General	$975,505	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES & DRUGS	$18,374,666	$18,374,666
MANAGEMENT FEES TO PARENT	$4,727,688		$4,727,688
REPAIRS AND MAINTENANCE	$2,955,073	$2,872,718	$82,355
ALL OTHER	$785,810	$470,367	$315,443

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$17,399	TotalAmt
Management And General	$17,399	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$118,897,126	TotalAmt
Program Services	$92,403,416	ProgramServicesAmt
Management And General	$26,493,710	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$11,763,287	BOYAmt
EOY	$11,263,537	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$20,851,685	BOYAmt
EOY	$20,502,390	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$3,140,677	BOYAmt
EOY	$2,501,943	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$2,990,250	BOYAmt
EOY	$2,954,107	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$875,233	BOYAmt
EOY	$851,748	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$255,685,379	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$88,439,688	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$177,110,911	BOYAmt
EOY	$167,245,691	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$105,055,305	BOYAmt
EOY	$130,127,592	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
EOY	$199,510	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$35,200	BOYAmt
EOY	$35,200	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$1,491,766	BOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$323,314,314	BOYAmt
EOY	$335,681,718	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$11,747,745	BOYAmt
EOY	$11,358,879	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
EOY	$2,084,434	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$40,701,627	BOYAmt
EOY	$38,218,067	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,470,511	BOYAmt
EOY	$2,610,375	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$53,919,883	BOYAmt
EOY	$54,271,755	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$269,395,885	BOYAmt
EOY	$281,409,482	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	-$1,454	BOYAmt
EOY	$481	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$269,394,431	BOYAmt
EOY	$281,409,963	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$323,314,314	BOYAmt
EOY	$335,681,718	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$9,308,944	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$3,324,700	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$618,112	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

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

Contributor US Address ContributorUSAddress

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

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	Yes (true)	DirectContactLegislatorsInd
Direct Contact Legislators	$7,051	DirectContactLegislatorsAmt
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	false	OtherActivitiesInd
Total Lobbying Expenditures	$7,051	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE C, PART IV	FormAndLineReferenceDesc
Explanation	PART II-B, LINE 1 PORTION OF DUES PAID TO VIRGINIA HOSPITAL AND HEALTHCARE ASSOCIATION THAT ARE ATTRIBUTABLE TO DIRECT LOBBYING.	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$6,414,992	OtherCostOrOtherBasisAmt
Book Value	$6,414,992	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$148,392,946	OtherCostOrOtherBasisAmt
Depreciation	$23,025,328	DepreciationAmt
Book Value	$125,367,618	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$6,087,656	OtherCostOrOtherBasisAmt
Depreciation	$1,521,441	DepreciationAmt
Book Value	$4,566,215	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$93,864,257	OtherCostOrOtherBasisAmt
Depreciation	$63,629,978	DepreciationAmt
Book Value	$30,234,279	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$925,528	OtherCostOrOtherBasisAmt
Depreciation	$262,941	DepreciationAmt
Book Value	$662,587	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$167,245,691	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDesc	AmtAmt
OTHER LONG-TERM LIABILITIES	$1,126,666
CAPITAL LEASE OBLIGATIONS	$773,821
DUE TO THIRD-PARTY	$496,450
DUE TO AFFILIATES	$213,438

Field	Value	IRS element (for citing)
Total Liability	$2,610,375	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE D, PAGE 3, PART X	FormAndLineReferenceDesc
Explanation	FOOTNOTES FROM JOHNSTON MEMORIAL HOSPITAL'S JUNE 30, 2014 CONSOLIDATED AUDITED FINANCIAL STATEMENTS INCLUDE THE FOLLOWING TEXT: "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 INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. AT JUNE 30, 2014, TAX RETURNS FOR FISCAL YEARS 2010 THROUGH 2013 ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE HOSPITAL HAS NO UNCERTAIN TAX POSITIONS AT JUNE 30, 2014 AND 2013. AS SUCH, NO INTEREST OR PENALTIES ARE RECOGNIZED IN THE CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS RELATED TO UNRECOGNIZED TAX BENEFITS."	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
Annual Community Bnft Report	false	AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,679,061	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,679,061	NetCommunityBenefitExpnsAmt
Total Expense	0.02250	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$18,385,487	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$14,633,630	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,751,857	NetCommunityBenefitExpnsAmt
Total Expense	0.03160	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$21,064,548	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$14,633,630	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,430,918	NetCommunityBenefitExpnsAmt
Total Expense	0.05410	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$175,428	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$175,428	NetCommunityBenefitExpnsAmt
Total Expense	0.00150	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$898,097	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$898,097	NetCommunityBenefitExpnsAmt
Total Expense	0.00760	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,634,927	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,612,826	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,022,101	NetCommunityBenefitExpnsAmt
Total Expense	0.00860	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$184,634	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$184,634	NetCommunityBenefitExpnsAmt
Total Expense	0.00160	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,893,086	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,612,826	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,280,260	NetCommunityBenefitExpnsAmt
Total Expense	0.01920	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$25,957,634	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$17,246,456	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$8,711,178	NetCommunityBenefitExpnsAmt
Total Expense	0.07330	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,575	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$3,575	NetCommunityBenefitExpnsAmt

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,575	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$3,575	NetCommunityBenefitExpnsAmt

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$16,035,231	BadDebtExpenseAmt
Bad Debt Expense Attributable	$12,026,423	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$37,453,513	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$40,349,827	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$2,896,314	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	JOHNSTON MEMORIAL HOSPITAL INC	BusinessNameLine1

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	16000 JOHNSTON MEMORIAL DRIVE	AddressLine1
City	ABINGDON	City
State	VA	State
ZIP Code	24211	ZIPCode

Field	Value	IRS element (for citing)
Website Address	HTTP://WWW.MSHA.COM/JMH	WebsiteAddressTxt
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	JOHNSTON MEMORIAL HOSPITAL INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
CHNA Conducted	12	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	HTTP://WWW.MSHA.COM/JMH	OwnWebsiteURLTxt
Rpt Available Upon Request	Yes (X)	RptAvailableUponRequestInd
Adopt Implementation Strategy	Yes (X)	AdoptImplementationStrategyInd
Exec Implementation Strategy	Yes (X)	ExecImplementationStrategyInd
Develop Community Wide Plan	Yes (X)	DevelopCommunityWidePlanInd
Include Operational Plan	Yes (X)	IncludeOperationalPlanInd
Prioritize Health Needs	Yes (X)	PrioritizeHealthNeedsInd
Prioritize Services	Yes (X)	PrioritizeServicesInd
All Needs Addressed	false	AllNeedsAddressedInd
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Used Deter Elig Free Care	Yes (true)	FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care	200.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt Care	Yes (true)	FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care	400.000000000000	FPGFamilyIncmLmtDscntCarePct
Explained Basis	Yes (true)	ExplainedBasisInd
Income Level	Yes (X)	IncomeLevelInd
Asset Level	Yes (X)	AssetLevelInd
Medical Indigency	Yes (X)	MedicalIndigencyInd
Insurance Status	Yes (X)	InsuranceStatusInd
Uninsured Discount	Yes (X)	UninsuredDiscountInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
Posted On Website	Yes (X)	PostedOnWebsiteInd
Posted In Emergency Room	Yes (X)	PostedInEmergencyRoomInd
Posted In Admission Office	Yes (X)	PostedInAdmissionOfficeInd
Provided On Admission	Yes (X)	ProvidedOnAdmissionInd
Available On Request	Yes (X)	AvailableOnRequestInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Collection Activities	false	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
FAP Notified Before Discharge	Yes (X)	FAPNotifiedBeforeDischargeInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Other Method Used	Yes (X)	OtherMethodUsedInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FACILITY 1, JOHNSTON MEMORIAL HOSPITAL, INC. - PART V, LINE 3	MSHA MET WITH TEN FOCUS GROUPS EACH REPRESENTING ONE OF THE TEN HOSPITAL FACILITIES (INCLUDING JMH) LOCATED WITHIN THE CORE COUNTIES OF MSHA FACILITIES (16 COUNTIES). EACH GROUP CONSISTED OF PUBLIC HEALTH LEADERS, NURSES, NON-PROFIT DIRECTORS, COMMUNITY DEVELOPERS, FAITH BASED LEADERS, PUBLIC OFFICIALS AND SCHOOL REPRESENTATIVES. EACH GROUP RANGED IN ATTENDANCE FROM 6 TO 21 INDIVIDUALS. PARTICIPANTS WERE GIVEN SURVEYS TO DETERMINE A COUNTY'S HEALTH STATUS RATING, AVAILABLE RESOURCES, TOP HEALTH PRIORITIES, AND SUGGESTIONS FOR IMPROVEMENT. OPEN DISCUSSION FOLLOWED. THE COLLECTED INFORMATION WAS THEN PAIRED WITH STATISTICAL DATA IN ORDER TO PRIORITIZE HEALTH NEEDS. THE SPECIFIC NEEDS FOR EACH COUNTY WERE INCLUDED IN THE APPROPRIATE FACILITY'S IMPLEMENTATION PLAN.
FACILITY 1, JOHNSTON MEMORIAL HOSPITAL, INC. - PART V, LINE 4	EACH HOSPITAL WITHIN THE MSHA SYSTEM COMPLETED A CHNA; FOR THOSE HOSPITALS THAT ARE LOCATED IN THE SAME COUNTY, ONLY ONE COMMUNITY GROUP WAS SURVEYED. FOR INSTANCE, JOHNSON CITY MEDICAL CENTER AND FRANKLIN WOODS COMMUNITY HOSPITAL ARE BOTH LOCATED IN WASHINGTON COUNTY, TENNESSEE. JMH'S CHNA WAS CONDUCTED WITH ALL MSHA HOSPITALS TO INCLUDE: JOHNSON CITY MEDICAL CENTER, FRANKLIN WOODS COMMUNITY HOSPITAL, INDIAN PATH MEDICAL CENTER, SYCAMORE SHOALS HOSPITAL, JOHNSON COUNTY COMMUNITY HOSPITAL, RUSSELL COUNTY MEDICAL CENTER, SMYTH COUNTY COMMUNITY HOSPITAL, NORTON COMMUNITY HOSPITAL AND DICKENSON COMMUNITY HOSPITAL.
FACILITY 1, JOHNSTON MEMORIAL HOSPITAL, INC. - PART V, LINE 7	MSHA PUBLISHED ITS COMMUNITY HEALTH NEEDS ASSESSMENT ON JUNE 29, 2012. THE DATA INCLUDED WAS COLLECTED OVER THE COURSE OF 2011 AND 2012. AN IMPLEMENTATION PLAN WAS CREATED FOR EACH HOSPITAL, AND EACH HOSPITAL'S BOARD APPROVED THE IMPLEMENTATION PLAN DURING THE MONTHS OF MAY AND JUNE 2012. MSHA ANNUALLY TRACKS PROGRESS OF IMPLEMENTATION STRATEGIES FOR EACH HOSPITAL. DUE TO LACK OF RESOURCES, SOME OF MSHA FACILITIES WERE UNABLE TO ADDRESS ISSUES THAT WERE IDENTIFIED.
FACILITY 1, JOHNSTON MEMORIAL HOSPITAL, INC. - PART V, LINE 20D	UNINSURED PATIENTS RECEIVE A 63% DISCOUNT; AND, BASED ON OTHER FACTORS SUCH AS INCOME OR MEDICAL INDIGENCY, MAY QUALIFY FOR AN ADDITIONAL DISCOUNT. ALLOWABLE AMOUNTS FOR INSURED PATIENTS ARE BASED ON THE NEGOIATED RATE WITH COMMERCIAL INSURANCE OR MEDICARE.

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 6A - RELATED ORGANIZATION INFORMATION	JMH DID NOT COMPLETE A COMMUNITY BENEFIT REPORT DURING FY14. WE ARE PREPARING A COMMUNITY BENEFIT REPORT IN FY15.
PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION	A COST TO CHARGE RATIO (WORKSHEET 2 "RATIO OF PATIENT CARE COST TO CHARGES") WAS USED TO CALCULATE LINE 7A FINANCIAL ASSISTANCE (CHARITY CARE) COST. OUR COST ACCOUNTING SYSTEM PROVIDED MEDICAID/TNCARE LOSSES REPORTED ON LINE 7B. LINE 7E COMMUNITY HEALTH IMPROVEMENT INCLUDES COSTS THAT ARE TAKEN FROM ACTUAL EXPENSE REPORTS, WITH NO ADDITIONAL OVERHEAD INCLUDED IN THE COST, AND ONE IN-KIND LEASE BASED ON FAIR MARKET VALUE. LINE 7F HEALTH PROFESSIONS EDUCATION IS COMPRISED OF INTERNSHIPS WITH SCHOOLS AND UNIVERSITIES, ALLOWING THEIR HEALTH PROFESSION STUDENTS TO GET HANDS-ON TRAINING AT A HOSPITAL AS PART OF THEIR EDUCATION AND TRAINING. OUR ORGANIZATIONAL DEVELOPMENT DEPARTMENT KEEPS DETAILED RECORDS ON HOURS SPENT ON THESE STUDENT ACTIVITIES, THE NUMBER OF STUDENTS THAT ROTATE THROUGH OUR HOSPITALS, ETC. INFORMATION IS MAINTAINED FOR EACH HOSPITAL UNIT THAT PARTICIPATES. WE ONLY INCLUDE LABOR COSTS AND WE ONLY ASSUME A PERCENTAGE OF OUR TEAM MEMBERS' TIME IS DEVOTED TO THESE STUDENTS. FOR LINE 7G SUBSIDIZED HEALTH CARE SERVICES, WE USE OUR COST ACCOUNTING SYSTEM. WE ARE CAREFUL TO ENSURE NO DOUBLE COUNTING OF COST (FOR EXAMPLE, WE DO NOT INCLUDE CHARITY AND MEDICAID/TNCARE ALREADY REPORTED ON LINES 7A AND 7B). ALTHOUGH WE HAVE MANY SERVICE LINES WITHIN OUR HOSPITALS THAT LOSE MONEY, WE DO NOT REPORT SURGERY OR OTHER SERVICES THAT HOSPITALS ARE REQUIRED BY STATE LICENSURE TO PROVIDE. FOR THE SERVICE LINES WE DO REPORT, SUCH AS DIABETES AND WOUND CARE, WE USED OUR COST ACCOUNTING SYSTEM SINCE THESE HAVE STANDARD FINANCIAL REPORTS. LINE 7I REPORTS CASH CONTRIBUTIONS AND OUR COST OF MEDICATIONS DONATED TO LOCAL NON-PROFIT RESCUE SQUADS.
PART II - 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 MANAGING BOARDS OF LOCAL SERVICE AND NON-PROFIT ORGANIZATIONS. MANY ALSO SERVE AS MEMBERS AND CONSULTANTS ON PROFESSIONAL COMMITTEES AND TASK FORCES THAT AFFECT REGIONAL DEVELOPMENT IN HEALTHCARE AND EDUCATION. 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. WE MADE DONATIONS TO A MOBILE FOOD DISTRIBUTING PROVIDER AND OTHER DONATIONS WERE MADE TO BROADER-BASED ORGANIZATIONS SUCH AS THE UNITED WAY.
PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY	SELF-PAY BALANCES INCLUDE ACCOUNTS AFTER PAYMENTS AND CONTRACTUAL ADJUSTMENTS (DISCOUNTS)HAVE BEEN POSTED FROM ALL THIRD-PARTY PAYERS - GENERALLY LEAVING THE PATIENT RESPONSIBLE FOR DEDUCTIBLES AND/OR CO-PAYMENTS. OTHER SELF-PAY ACCOUNTS ARE FROM PATIENTS WITH NO INSURANCE OR THIRD-PARTY COVERAGE. ALL PATIENTS WITH NO FORM OF THIRD-PARTY PAYER COVERAGE RECEIVE A 63% DISCOUNT, AS REQUIRED BY TENNESSEE LAW. MSHA APPLIES TENNESSEE LAW TO OUR VIRGINIA HOSPITAL PATIENT ACCOUNTS AS WELL. 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 GATHER HISTORICAL INFORMATION TO APPLY TO THE CURRENT BALANCE. IN OTHER WORDS, THE HOSPITAL EVALUATES PAST COLLECTION HISTORY ON ACCOUNTS WRITTEN OFF TO BAD DEBT AND APPLIES THE HISTORICAL UNPAID RATE TO THE CURRENT SELF-PAY ACCOUNTS RECEIVABLE BALANCE.
PART III, LINE 3 BAD DEBT EXPENSE, PATIENTS ELIGIBLE FOR ASSISTANCE	IT IS IMPLAUSIBLE TO DETERMINE THE AMOUNT OF JMH'S BAD DEBT ASSOCIATED WITH THOSE PATIENTS WHO MAY HAVE MET THE CRITERIA SET FORTH IN OUR FINANCIAL ASSISTANCE POLICY WITHOUT HAVING A COMPLETED FINANCIAL ASSESSMENT. WE ARE UNABLE TO DETERMINE OUR PATIENTS' FINANCIAL CIRCUMSTANCES UNLESS A COMPLETED FINANCIAL ASSESSMENT FORM IS VOLUNTARILY PROVIDED TO US. WE CAN ASSERT THAT MORE THAN 97% OF OUR PATIENTS WHO HAVE PROVIDED COMPLETED FINANCIAL ASSESSMENT FORMS HAVE BEEN APPROVED FOR AT LEAST PARTIAL FINANCIAL ASSISTANCE. MSHA'S PATIENT FINANCIAL SERVICES MANAGEMENT ESTIMATES THAT 75% OF BAD DEBT EXPENSE IS ASSUMED ATTRIBUTABLE TO PATIENTS LIKELY ELIGIBLE FOR FINANCIAL ASSISTANCE. WE HAVE MANY INSTANCES OF PATIENTS WITH LARGE ACCOUNT BALANCES AND NO HEALTH INSURANCE COVERAGE THAT WE ARE SURE WOULD QUALIFY FOR CHARITY CARE. ALTHOUGH HOSPITAL TEAM MEMBERS ENCOURAGE THESE INDIVIDUALS TO COMPLETE OUR FINANCIAL ASSISTANCE APPLICATION, MANY WILL NOT DO SO. EVEN WHEN THESE INDIVIDUALS ARE TOLD WE FEEL SURE THEY DO QUALIFY FOR FULL OR PARTIAL ASSISTANCE, THEY STILL REFUSE TO COMPLETE OUR FINANCIAL ASSISTANCE APPLICATION.
BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS	THE TEXT OF JMH'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE APPEARS ON PAGE 10 IN OUR MOST RECENT AUDITED FINANCIAL STATEMENTS (ATTACHED).
PART III, LINE 8 - MEDICARE EXPLANATION	MEDICARE ALLOWABLE COSTS WERE 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. IN CARING FOR THE PATIENT, THERE ARE SEVERAL SERVICES THAT ARE CONSIDERED NON-ALLOWABLE SUCH AS TRANSPORTATION OF A PATIENT, COMFORT ITEMS TO INCLUDE A TELEVISION, MAGAZINES, OR A TELEPHONE. ADDITIONAL NON-ALLOWABLE COSTS INCLUDE THE RECRUITMENT OF PHYSICIANS, PHYSICIAN GUARANTEES AND A PORTION (ALMOST 16%) OF THE BAD DEBT ASSOCIATED WITH THE CARE OF THE PATIENT. MEDICARE LOSSES, INCLUDING SOME NON-ALLOWABLE COSTS, SHOULD BE COUNTED AS A COMMUNITY BENEFIT AS THIS IS THE COST OF CARE FOR SERVING THE AGING POPULATION. AS A NOT-FOR-PROFIT ORGANIZATION, WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTH CARE NEEDS OF THE COMMUNITY AND THE INDIVIDUAL WHILE MAINTAINING A HIGH LEVEL OF HEALTH CARE SERVICES WITHOUT LOSSES. SINCE LOSSES DO OCCUR THROUGH THE CMS SYSTEM OF REIMBURSEMENT, THESE LOSSES ARE A COST OF DOING BUSINESS FOR OUR COMMUNITY AND SHOULD BE CONSIDERED A COMMUNITY BENEFIT. AS A PARTICIPATING PROVIDER IN THE MEDICARE PROGRAM, JMH IS REQUIRED TO PROVIDE THE FULL REGIMEN OF CARE FOR OUR MEDICARE POPULATION. THERE ARE A NUMBER OF CARE REGIMENS THAT ARE COMPENSATED BY THE MEDICARE PROGRAM AT LEVELS BELOW OUR COST. THEREFORE IT IS ONLY LOGICAL TO ALLOW JMH TO REPORT THESE UNCOMPENSATED SERVICES AS A COMMUNITY BENEFIT. BY MAKING THIS CHANGE, NON-PROFIT PROVIDERS WILL BE ENCOURAGED TO SUSTAIN IMPORTANT CARE DELIVERY MODELS FOR OUR AGING POPULATION IN SPITE OF THE FACT IT IS SOMETIMES ECONOMICALLY INJURIOUS.
PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION	JMH HAS ESTABLISHED A STRONG COMMITMENT TO MEET THE MEDICAL NEEDS OF THE COMMUNITIES WE SERVE. ALL REQUESTS FOR FINANCIAL ASSISTANCE ARE EVALUATED USING ESTABLISHED GENERAL GUIDELINES, WHILE ALLOWING FOR UNIQUE FINANCIAL CIRCUMSTANCES. JOHNSTON MEMORIAL HOSPITAL RECOGNIZES ITS OBLIGATION TO PROVIDE QUALITY HEALTH CARE TO THOSE WHO ARE UNABLE TO PAY. FINANCIAL ASSISTANCE ELIGIBILITY ENCOMPASSES A VARIETY OF PATIENTS, SUCH AS THOSE WITH MEDICAID ELIGIBILITY AFTER THE DATE OF SERVICE, PATIENTS THAT ARE DECEASED WITH NO ESTATE, MEDICAID ELIGIBLE ENCOUNTERS WHERE BENEFITS HAVE BEEN EXHAUSTED, ETC. JMH CHARITY GUIDELINES ARE BASED ON THE NATIONAL POVERTY GUIDELINES. HOWEVER, FINANCIAL ASSISTANCE IS NOT BASED SOLELY ON INCOME. UNIQUE FINANCIAL CIRCUMSTANCES ARE CONSIDERED, WHICH CAN CHANGE THE CATEGORY OF ELIGIBILITY. IN ADDITION, CHARITY DETERMINATION MAY BE RETROACTIVE FOR ALL DATES OF SERVICES. WHEN A PATIENT REQUESTS FINANCIAL ASSISTANCE OR WHEN AN APPLICATION HAS BEEN RECEIVED, THE PATIENT ACCOUNT IS PLACED IN A HOLD STATUS TO PREVENT FURTHER COLLECTION ACTIVITIES UNTIL FINANCIAL ASSISTANCE ELGIBILITY IS DETERMINED.
PART VI, LINE 2 - NEEDS ASSESSMENT	MSHA INCLUDED AMERICA'S HEALTH RANKINGS (AHR) IN ITS ASSESSMENT IN ORDER TO BETTER DEFINE THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES. VIRGINIA RANKED 21ST AND TENNESSEE RANKED 45TH; HOWEVER, IT SHOULD BE NOTED THAT SOUTHWEST VIRGINIA (WHERE MSHA FACILITIES ARE LOCATED) CLOSELY RESEMBLES THE HEALTH RANKINGS FOR TENNESSEE. AMERICA'S HEALTH RANKINGS ARE BASED ON A SERIES OF MEASURES INCLUDING SEVERAL HEALTH OUTCOMES AND HEALTH FACTORS. A SURVEY WAS GIVEN TO 67 INDIVIDUALS REPRESENTING THE NINE COUNTIES IN WHICH MSHA OWNS A FACILITY. THESE INDIVIDUALS INCLUDED PHYSICIANS, PUBLIC HEALTH LEADERS, NON-PROFIT DIRECTORS, SCHOOL NURSES AND OFFICIALS, AND BUSINESS LEADERS. A SURVEY WAS GIVEN TO EACH INDIVIDUAL SEEKING FEEDBACK REGARDING AVAILABLE RESOURCES IN EACH AREA, THE HEALTH STATUS, HEALTH PRIORITIES, AND SUGGESTIONS FOR IMPROVEMENT. THE MAJORITY OF RESPONSES SUGGESTED FOCUSING ON EDUCATION IN ORDER TO PROMOTE HEALTHY HABITS. OTHER RESPONSES INCLUDED: MAKE PHYSICAL EDUCATION A REQUIREMENT AS PART OF SCHOOL CURRICULUM, IMPROVE NATURAL TRAILS AND WALKWAYS, INCREASE COMMUNITY SUPPORT FOR SMOKE-FREE AREAS, PARTNER WITH LOCAL FARMER'S MARKETS, SHARE HEALTH INFORMATION BETWEEN PHARMACIES, NETWORK WITH SMALL BUSINESSES AND NON-PROFITS IN ORDER TO AVOID DUPLICATING RESOURCES, AND PROVIDE EARLY SCREENINGS FOR THE UNINSURED OR UNDERINSURED. OVERALL, THE COMMUNITY MEMBERS GAVE MSHA'S CORE SERVICE AREA A HEALTH STATUS RANKING OF 4.24 OUT OF 10 (1 BEING THE LOWEST, 10 BEING THE HIGHEST). ALSO, ALL 67 PARTICIPANTS AGREED THAT OBESITY, CANCER, HEART DISEASE AND DIABETES WERE THE TOP HEALTH PRIORITIES IN EACH COUNTY. AHR REPORTS THAT BOTH VIRGINIA AND TENNESSEE SAW AN INCREASE IN DIABETES AND OBESITY WITHIN THE PAST TEN YEARS. AHR REPORTS 24% OF WASHINGTON COUNTY'S CITIZEN'S SMOKE COMPARED TO 18% IN THE STATE OF VIRGINIA. AND, 32% OF WASHINGTON COUNTY'S ADULTS ARE CONSIDERED OBESE. MSHA HAS PARTNERED WITH SCHOOLS, NON-PROFIT AGENCIES AND OTHERS ON VARIOUS INITIATIVES TO ADDRESS HEALTH ISSUES, OBESITY IN PARTICULAR.
PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	JMH PROVIDES COMMUNICATION OF FINANCIAL ASSISTANCE ON ITS WEBSITE AND ON POSTERS LOCATED IN PROMINENT AREAS OF THE HOSPITAL SUCH AS ADMITTING AND THE EMERGENCY DEPARTMENT. PRINTED EDUCATIONAL MATERIALS INCLUDING FINANCIAL ASSISTANCE CONTACT INFORMATION ARE ALSO PROVIDED IN EACH PATIENT'S PAPERWORK. POSTERS AND REFERENCE MATERIALS ARE WRITTEN IN BOTH ENGLISH AND SPANISH. ADMITTING STAFF ARE TRAINED TO EDUCATE PATIENTS ON JMH'S FINANCIAL ASSISTANCE POLICY. JMH ALSO HAS FINANCIAL COUNSELORS TO PROVIDE FURTHER INFORMATION AND ASSISTANCE TO PATIENTS REGARDING JMH'S FINANCIAL ASSISTANCE POLICY. THESE COUNSELORS ALSO HELP UNINSURED PATIENTS DETERMINE SOURCES OF PAYMENT FOR MEDICAL BILLS AND HELP PATIENTS DETERMINE ELIGIBILITY FOR PROGRAMS SUCH AS MEDICAID/TNCARE. JMH HAS PARTNERED WITH THE COMPANY FIRSTSOURCE SOLUTIONS USA TO WORK WITH SELF-PAYING PATIENTS WHO HAVE LIMITED FINANCIAL RESOURCES. DURING FY14, FIRSTSOURCE REPRESENTATIVES WERE AVAILABLE AT JMH TO ASSIST PATIENTS. THE REPRESENTATIVES WERE ABLE TO DETERMINE GOVERNMENTAL MEDICAL ASSISTANCE (MEDICAID OR TENNCARE) ELIGIBILITY, AND TO HELP WITH THE APPLICATION PROCESS AND FOLLOW-UP. ONCE A PERSON IS APPROVED FOR MEDICAID OR TENNCARE THROUGH THE PROGRAM OFFERED THROUGH JMH, THEY RETAIN COVERAGE FOR FUTURE MEDICAL CARE. 636 PATIENTS WERE APPROVED FOR GOVERNMENTAL ASSISTANCE DURING THE YEAR. FIRSTSOURCE IS COMPENSATED BY JMH. DURING FY14, JMH'S COST FOR THIS PROGRAM WAS 88,193.
PART VI, LINE 4 - COMMUNITY INFORMATION	JMH IS LOCATED IN ABINDGON, WASHINGTON COUNTY, WHICH IS IN RURAL 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. WASHINGTON COUNTY IS A FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREA AND HAS A HIGH RATE OF INDIVIDUALS WHO ARE UNINSURED. THE POPULATION OF WASHINGTON COUNTY IS JUST OVER 54,804 AND ACCORDING TO THE U.S. CENSUS BUREAU THE TOWN OF ABINGDON HAS A POPULATION OF 8,186. THE LATEST CENSUS BUREAU DATA ESTIMATES THE MEDIAN AGE OF RESIDENTS OF WASHINGTON COUNTY IS 43.5 WHICH IS OLDER THAN THE MEDIAN AGE OF 37.5 IN VIRGINIA. THE BUREAU ESTIMATES WASHINGTON COUNTY MEDIAN HOUSEHOLD INCOME AT 41,877, COMPARED TO 62,666 FOR THE STATE OF VIRGINIA, 21% OF WASHINGTON COUNTY'S CHILDREN LIVE IN POVERTY COMPARED TO 16% STATEWIDE.
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH	JMH IS DEDICATED TO OPERATING EFFICIENTLY SO THAT WASTE IS MINIMIZED AND SURPLUSES MAY BE APPLIED TO MAINTAINING ADEQUATE FACILITIES AND EQUIPMENT FOR THE CARE OF OUR PATIENTS. VARIOUS CHECKS AND BALANCES ARE ESTABLISHED TO ENSURE THAT EXPENDITURES FOR OPERATING EXPENSES AND CAPITAL COSTS ARE REASONABLE AND NECESSARY. THE MAJORITY OF JMH'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATIONS PRIMARY SERVICE AREAS. ONLY THREE DIRECTORS; DENNIS VONDERFECHT AND ANN FLEMING, EMPLOYEES OF MSHA, AND BARBARA ALLEN LIVE OUTSIDE THE AREA. PHYSICIANS THAT REQUEST PRIVILEGES WHO ARE QUALIFIED AND CREDENTIALED ARE EXTENDED PRIVILEGES BY JMH.
PART VI, LINE 6 - AFFILIATED 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. JMH IS MAJORITY OWNED BY MOUNTAIN STATES HEALTH ALLIANCE (MSHA) BASED IN JOHNSON CITY, TENNESSEE. MSHA IS INTEGRATED BOTH VERTICALLY AND HORIZONTALLY AND IS THE LARGEST REGIONAL HEALTHCARE SYSTEM WITH 14 HOSPITALS. MSHA PROVIDES CARE TO PEOPLE IN 29 COUNTIES IN TENNESSEE, VIRGINIA, KENTUCKY, AND NORTH CAROLINA. JMH SERVES AS THE COUNTY'S PRIMARY HEALTH SERVICE PROVIDER. PATIENTS BENEFIT FROM JMH'S AFFILIATION WITH A HEALTHCARE SYSTEM WHERE THEY CAN BE EFFICIENTLY MOVED ALONG AN INTEGRATED, COMPREHENSIVE CONTINUUM OF CARE AS THEIR HEALTH STATUS DICTATES. PATIENTS CAN BE MOVED TO THE SYSTEM'S FLAGSHIP FACILITY, JOHNSON CITY MEDICAL CENTER, WHICH IS A TERTIARY CARE FACILITY PROVIDING ADVANCED TREATMENT OPTIONS.
PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT	VIRGINIA

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (9 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt	Non Cash AssistanceNonCashAssistanceAmt
BARTER THEATRE
PO BOX 867	ABINGDON	VA	24212	546000120	501C3	$18,800	SPONSORSHIP
JOHN S BATTTLE HIGH SCHOOL
21264 BATTLE HILL DRIVE	BRISTOL	VA	24202	541604035	501C3	$16,296	FOOTBALL SCOREBOARD
JOHNSTON MEMORIAL HOSP AUXILIARY
16000 JOHNSTON MEMORIAL DRIVE	ABINGDON	VA	24211	540917478	501C3	$40,000	GENERAL SUPPORT
MARCH OF DIMES
PO BOX 799-2700 S ROAN ST 430	JOHNSON CITY	TN	37605	131846366	501C3	$5,200	GENERAL SPONSORSHIP
SALTVILLE RESCUE SQUAD
126 BATTLEGROUND AVENUE	SALTSVILLE	VA	24370	311638300	501C3		DRUG BOX REFILLS	$5,719
VHCC EDUCATIONAL FOUNDATION
PO BOX 828	ABINGDON	VA	24212	521225133	501C3	$36,155	FUND NURSING PROGRAM
VIRGINIA HIGHLANDS COMM COLLEGE
P O BOX 828	ABINGDON	VA	24212	541268289	501C3	$128,914	FUND NURSING PROGRAM
WASHINGTON COUNTY PUBLIC SCHOOLS
812 THOMPSON DRIVE	ABINGDON	VA	24210	546001671	501C3	$7,250	SPONSORSHIP
WILLIAM KING MUSEUM
PO BOX 2256	ABINGDON	VA	24210	541144120	501C3	$10,000	SPONSORSHIP

Field	Value	IRS element (for citing)
Total501c3 Org	9	Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE I, PAGE 1, PART I, LINE 2	FormAndLineReferenceDesc
Explanation	FUNDING MAY BE PROVIDED TO LOCAL 501(C)(3) ORGANIZATIONS WHOSE FOCUS IS ON HEALTH AND EDUCATION. FOR MANY YEARS, JMH HAS MADE DONATIONS OF MEDICATIONS TO AREA NON-PROFIT EMERGENCY MEDICAL SERVICE COMPANIES. WE ARE PROVIDING ASSISTANCE TO A LOCAL COLLEGE TO HELP FUND AN INSTRUCTOR FOR ITS NURSING PROGRAM. ADDITIONAL DONATIONS ARE MADE TO THE UNITED WAY, LOCAL SCHOOLS, AND THE LOCAL ARTS. MOST DONATION REQUESTS ARE MADE THROUGH AN APPLICATION PROCESS WHERE THE APPLICANT DESCRIBES HOW THE MONEY WILL BE USED, HOW IT BENEFITS THE COMMUNITY, HOW OUR DONATION WILL CORRELATE WITH HEALTH NEEDS IDENTIFIED BY OUR COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), AND THE AGREEMENT THAT THE DONEE WILL PROVIDE FOLLOW-UP OF HOW OUR DONATION WAS USED (WHO BENEFITED, ETC.). NOT ALL OF OUR DONATIONS ARE RESTRICTED TO OUR CHNA, BUT MANY ARE. MSHA'S SOCIAL RESPONSIBILITY COMMITTEE REVIEWS MOST DONATION REQUESTS TO DETERMINE WHICH REQUESTS MSHA, INCLUDING JMH, WILL FUND. THERE ARE MANY FACTORS THAT ARE CONSIDERED DURING THE REVIEW PROCESS BY THE COMMITTEE, SUCH AS OUR BUDGET CONSTRAINTS, IF THE APPLICANT HAS ALREADY RECEIVED A DONATION FROM A MSHA FACILITY, HOW THE REQUESTING ORGANIZATION FITS WITH OUR CNHA, ETC.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)

TitleTitleTxt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DENNIS VONDERFECHT
TRUSTEE	$780,241	$236,094	$41,860	$40,000	$28,381	$1,126,576
ANN FLEMING
TREASURER	$383,151	$87,911	$282,847	$55,452	$17,959	$827,320	$242,724
PAUL ARMSTRONG MD
TRUSTEE	$348,063	$116,939	$438	$18,051	$18,080	$501,571
JIM GARDNER MD
TRUSTEE	$174,206	$52,888	$563	$9,255	$16,938	$253,850
SEAN MCMURRAY
CEO	$266,258	$38,619	$5,069	$28,438	$21,362	$359,746
JOHN JETER
CFO	$149,322	$3,930	$278	$5,473	$18,101	$177,104
KELLY CARTER MD
PHYSICIAN	$262,640	$23,472	$55,756	$11,840	$20,506	$374,214
DAVID SIMMONS MD
PHYSICIAN	$255,033	$23,619	$51,750	$10,701	$19,992	$361,095
SAMUEL MELTON MD
PHYSICIAN	$269,189	$45,509	$3,200		$12,982	$330,880
MATHEW DYE MD
PHYSICIAN	$223,744	$20,019	$64,906	$12,094	$21,976	$342,739
JACQUELYN EARLY MD
PHYSICIAN	$219,337	$23,379	$59,469	$12,026	$18,835	$333,046

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

SCHEDULE J, PAGE 1, PART I, LINE 4

ANN FLEMING 0 39,222 0 SEAN MCMURRAY 0 13,524 0 SAMUEL MELTON, M.D. 0 13,050 0

SCHEDULE J, PART III

PART I, LINE 3: SALARY AND BENEFITS FOR JMH'S CEO ARE SUBJECT TO THE MOUNTAIN STATES HEALTH ALLIANCE (MSHA) COMPENSATION COMMITTEE PROCESS, WHEREBY THE MSHA CEO RECOMMENDS THE SALARY AND IT IS REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE, BASED UPON MARKET DATA, MADE AVAILABLE BY THIRD PARTY CONSULTANTS. THE COMPENSATION COMMITTEE HAS FINAL APPROVAL OF MSHA'S CEO RECOMMENDATIONS FOR PAY AND BENEFITS FOR THE JMH CEO. WE USE AN OUTSIDE, INDEPENDENT CONSULTING FIRM TO PROVIDE CONSULTATION ON EXECUTIVE PAY AS WELL AS OUR EXECUTIVE PAY AT RISK PLAN. PART I, LINE 4B: ANN FLEMING, SEAN MCMURRAY, AND SAMUEL MELTON PARTICIPATED IN A 457(F) RETIREMENT PLAN PROVIDED BY MOUNTAIN STATES HEALTH ALLIANCE (MSHA). THE 457(F)PLAN IS A NONQUALIFIED TAX-DEFERRED COMPENSATION PLAN AVAILABLE TO A SELECT GROUP OF KEY EXECUTIVES FOR THE INTENT OF SUPPORTING RETENTION AND TO OFFER A COMPETITIVE TOTAL RETIREMENT PROGRAM. ACCOUNT BALANCES HAVE A "SUBSTANTIAL RISK OF FORFEITURE". IN ADDITION TO CREDITOR RISK, SUBSTANTIAL RISK OF FORFEITURE IS CREATED THROUGH DEFAULT RISK IF THE PARTICIPANT'S EMPLOYMENT WITH MSHA IS TERMINATED PRIOR TO AGE 65. HOWEVER, THE 457(F) PLAN CONTAINS A NON-COMPETE PROVISION THAT PROVIDES THE ACCOUNT BALANCE TO BE PAID IN A LUMP SUM AFTER THE EXECUTIVE SATISFIES THE TWO-YEAR NON-COMPETE PERIOD. THIS PROVISION APPLIES TO EMPLOYER CONTRIBUTIONS IF THE EXECUTIVE HAS PROVIDED ELIGIBLE SERVICE FOR SIX OR MORE YEARS. (ELIGIBLE SERVICE IS OFFICER SERVICE THAT PERMITTED THE EXECUTIVE TO PARTICIPATE IN THE PLAN). THE EXECUTIVE WILL RECEIVE THE ENTIRE ACCOUNT BALANCE IF HE/SHE BECOMES DISABLED, DIES OR IF THE EXECUTIVE TERMINATES FOR "GOOD REASON" OR IS INVOLUNTARILY TERMINATED WITHOUT "GOOD CAUSE" WITHIN A 24-MONTH PERIOD AFTER A CHANGE-OF-CONTROL OCCURS. DISTRIBUTIONS FROM THIS PLAN ARE SUBJECT TO FEDERAL, STATE, AND LOCAL TAXES ON THE ENTIRE ACCOUNT BALANCE UPON DISTRIBUTION.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	2011 HOSPITAL FACILITY INVEST BOND	BusinessNameLine1
Business Name Line2	INDUSTRIAL DEV AUTHORITY OF SMYTH	BusinessNameLine2

Field	Value	IRS element (for citing)
Bond Issuer EIN	541758381	BondIssuerEIN
Bond Issued	2011-11-16	BondIssuedDt
Issue Price	$24,870,000	IssuePriceAmt
Purpose	REFINANCE CANCER CTR.	PurposeDesc
Defeased	false	DefeasedInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Pool Financing	false	PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Retired	$3,535,000	RetiredAmt
Total Proceeds	$24,870,000	TotalProceedsAmt
Issuance Costs From Proceeds	$238,423	IssuanceCostsFromProceedsAmt
Other Spent Proceeds	$24,631,577	OtherSpentProceedsAmt
Substantial Completion	2012	SubstantialCompletionYr
Current Refunding	Yes (true)	CurrentRefundingInd
Advance Refunding	false	AdvanceRefundingInd
Final Allocation Made	Yes (true)	FinalAllocationMadeInd
Adequate Books And Rec Maint	Yes (true)	AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	false	OwningBondFinancedPropertyInd
Any Lease Arrangements	false	AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop	Yes (true)	MgmtContractBondFincdPropInd
Engage Bond Counsel Contracts	Yes (true)	EngageBondCounselContractsInd
Any Research Agreements	false	AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt Test	false	BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop	Yes (true)	ChangeInUseBondFinancedPropInd
Remedial Action Taken	false	RemedialActionTakenInd
Procs Nonqualified Bond Remdtd	Yes (true)	ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	false	Form8038TFiledInd
Rebate Not Due Yet	Yes (true)	RebateNotDueYetInd
Exception To Rebate	Yes (true)	ExceptionToRebateInd
No Rebate Due	false	NoRebateDueInd
Variable Rate Issue	Yes (true)	VariableRateIssueInd
Hedge Identified In Bks And Rec	false	HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC	false	GrossProceedsInvestedInGICInd
Gross Proceeds Invested	false	GrossProceedsInvestedInd
Written Proc To Monitor Reqs	Yes (true)	WrittenProcToMonitorReqsInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE K - PURPOSE OF ISSUE DESCRIPTION	FormAndLineReferenceDesc
Explanation	2011 HOSPITAL FACILITY INVEST. BOND (LINE A) REFINANCE OF CANCER TREATMENT CENTER AND REFINANCING OF SERIES 1998 BONDS PART III, LINES 8B & 8C: A PORTION OF THE BONDS ISSUED IN 1998 THAT WAS REFUNDED WITH A PORTION OF THE REPORTED BOND ISSUE FINANCED HOSPITAL IMPROVEMENTS FOR A FACILITY THAT BECAME OUTMODED AND OBSOLETE. THE OBSOLETE FACILITY WAS SUBSEQUENTLY SOLD FOR A MINIMAL AMOUNT (LESS THAN 5% OF THE PROCEEDS OF THE BONDS). BASED ON THE AVAILABLE RECORDS, IT IS NOT POSSIBLE TO GIVE A PRECISE AMOUNT OF THE 1998 BOND PROCEEDS THAT WERE USED TO FINANCE THE PROPERTY THAT WAS DISPOSED. BECAUSE THE AMOUNT OF PRIVATE PAYMENTS WAS LESS THAN THE PERMITTED THRESHOLD, NO REMEDIAL ACTION WAS REQUIRED. PART IV, LINE 2C: THE 2011 BOND ISSUE HAS NO ARBITRAGE REBATE DUE SO THERE HAS BEEN NO REBATE COMPUTATION PERFORMED.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990 - ORGANIZATION'S MISSION	JOHNSTON MEMORIAL HOSPITAL (JMH) IS COMMITTED TO BRINGING LOVING CARE TO HEALTH CARE. WE EXIST TO IDENTIFY AND RESPOND TO THE HEALTH CARE NEEDS OF INDIVIDUALS AND COMMUNITIES IN OUR REGION AND TO ASSIST THEM IN ATTAINING THEIR HIGHEST POSSIBLE LEVEL OF HEALTH.
FORM 990, PAGE 2, PART III, LINE 4A	JMH OFFERS A FULL ARRAY OF MEDICAL SERVICES THROUGH HIGHLY TRAINED PHYSICIANS AND SUPPORT STAFF, PROUDLY SERVING SOUTHWEST VIRGINIA SINCE 1917. OUR GOAL IS TO BE A LEADER IN IMPROVING THE HEALTH AND QUALITY OF LIFE IN THE COMMUNITY, BY WORKING TOGETHER AS A TEAM DEDICATED TO EXCELLENCE. DURING FY14, WE EXPERIENCED 7,109 ADMISSIONS, WITH ALMOST 24,000 PATIENT DAYS. THERE WERE AN ADDITIONAL 4,760 OBSERVATION DAYS. OUR OUTPATIENT VISITS WERE JUST UNDER 146,000. THERE WERE 39,161 VISITS TO OUR EMERGENCY DEPARTMENT, WITH 5,403 RESULTING IN AN INPATIENT STAY. ALMOST 6,900 SURGERIES WERE PERFORMED DURING THE YEAR AND WE DELIVERED 752 BABIES. DURING FY14, JMH IMPLEMENTED AN ONLINE TOOL CALLED OWL (ONLINE WELLNESS LINK). OWL PROVIDES INPATIENTS WITH BETTER ACCESS TO THEIR HEALTH CARE INFORMATION SO THEY CAN VIEW A PORTION OF THEIR HEALTH RECORD ONLINE, INCLUDING: - A CONTINUITY OF CARE DOCUMENT WHICH PROVIDES A SUMMARY OF THE HOSPITAL VISIT - CURRENT MEDICATIONS - ALLERGIES AND ADVERSE REACTIONS - PAST MEDICAL HISTORY - CERTAIN LABORATORY AND RADIOLOGY RESULTS THE OWL PORTAL ALSO ALLOWS JMH CAREGIVERS TO EXCHANGE HEALTHCARE INFORMATION, WHICH HAS LED TO SAFER, MORE QUALTIY-ORIENTED AND STREAMLINED CARE FOR OUR PATIENTS. JMH SIGNED A NON-PROFIT BLOOD CENTER TENANT TO A ONE YEAR LEASE FOR ONLY 1. THE ANNUAL FAIR MARKET VALUE OF THE LEASE IS 32,770. THE FMV FOR THE EIGHT MONTHS FALLING WITHIN FY14 IS 21,846. BLOOD ASSURANCE IS A NON-PROFIT FULL SERVICE REGIONAL BLOOD CENTER SERVING 51 COUNTIES AND MORE THAN 70 HEALTHCARE FACILITIES IN VIRGINIA, TENNESSEE, NORTH CAROLINA, ALABAMA, AND GEORGIA. THE MISSION OF BLOOD ASSURANCE IS TO PROVIDE A SAFE AND ADEQUATE SUPPLY OF BLOOD AND BLOOD COMPONENTS IN A COST EFFECTIVE MANNER TO EVERY AREA PATIENT IN NEED. JMH IS COMMITTED TO PROVIDING COMPREHENSIVE MEDICAL EDUCATION TO AID IN PATIENT RECOVERY AND DISEASE MANAGEMENT. WE OFFER MANY CLASSES AND SUPPORT GROUPS, SUCH AS: CPR AND LIFE SAVING CLASSES; CARDIAC CARE; TOTAL JOINT; CANCER EDUCATION; PRENATAL PARENTING; AND, OTHERS. THE JMH CENTER FOR COMPREHENSIVE WOUND CARE IS ONE OF ONLY A FEW FACILITIES IN THE REGION THAT OFFERS HYPERBARIC OXYGEN THERAPY-THE DELIVERY OF OXYGEN AT LEVELS HIGHER THAN ATMOSPHERIC PRESSURE IN A CHAMBER SETTING THAT STIMULATES THE HEALING PROCESS. OUR TRAINED STAFF FOLLOW A TEAM APPROACH TO WOUND HEALING. AFTER AN INITIAL EVALUATION, 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. THE JMH DIABETES EDUCATION CENTER HAS ASSISTED PATIENTS IN DIABETES CARE SINCE 1999. DR. ANDREW RHINEHART, DIRECTOR OF THE CENTER, WAS AWARDED RECOGNITION, BY THE PRESTIGIOUS NATIONAL COMMITTEE FOR QUALITY ASSURANCE DIABETES RECOGNITION PROGRAM, A PRIVATE, NONPROFIT ORGANIZATION DEDICATED TO IMPROVING HEALTH CARE QUALITY. DR. RHINEHART IS BOARD-CERTIFIED IN ADVANCED DIABETES MANAGEMENT AND WAS THE FIRST PHYSICIAN IN THE U.S. TO GAIN THESE CREDENTIALS. HE BECAME ONE OF THE FIRST PHYSICIANS TO EARN DISTINCTION AS A CERTIFIED DIABETES TECHNOLOGY CLINICIAN, THE HIGHEST PROFESSIONAL CREDENTIAL THAT RECOGNIZES A PHYSICIAN AS AN EXPERT IN USING TECHNOLOGY TO MANAGE DIABETES. A STAFF OF CERTIFIED DIABETES EDUCATORS ASSISTS HIM AT THE DIABETES CARE CENTER. MOUNTAIN STATES REHABILITATION AT JMH HAS BEEN AWARDED AN OUTCOMES EXCELLENCE CERTIFICATE FROM FOCUS ON THERAPEUTIC OUTCOMES, INC. (FOTO), A NATIONWIDE OUTCOMES DATABASE AND REPORTING SERVICE FOR HEALTHCARE PROVIDERS ACROSS THE COUNTRY TO RECOGNIZE EXCELLENCE IN PATIENT OUTCOMES SUSTAINED OVER TIME. NATIONALLY, ONLY ABOUT 12 PERCENT OF NEARLY 3,000 ELIGIBLE CLINICS RECEIVED THIS AWARD OVER THE LAST YEAR. JMH RANKS HIGH COMPARED TO OTHER CLINICS IN THE FOTO NETOWRK WITH ITS PATIENTS ACHIEVING SIGNIFICANTLY HIGHER FUNCTIONAL IMPROVEMENTS, IN FEWER VISITS, AND WITH HIGHER PATIENT SATISFACTION. JMH HAS USED FOTO SINCE 2010 AS A WAY TO OBJECTIVELY TRACK PATIENTS' FUNCTIONAL OUTCOMES. PARTICIPATING IN THIS NATION-WIDE SYSTEM IS ANOTHER EXAMPLE OF JMH'S COMMITMENT TO PROVIDING EFFICIENT AND OUTSTANDING PATIENT CARE. FOTO HAS THE FIRST FUNCTIONAL HEALTH STATUS MEASURE APPROVED FOR PHYSICAL REHABILITATION BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES' LIST OF APPROVED QUALITY MEASURES IN NATIONAL QUALITY MEASURES CLEARINGHOUSE. THE HEAL (HEALTHLY EATING ACTIVE LIVING) APPALACHIA PROGRAM, WHICH BATTLES CHILDHOOD OBESITY IN OUR REGION, WAS SELECTED AS A 2014 INDUCTEE INTO THE FIRST LADY OF VIRGINIA'S OPPORTUNITY HALL OF FAME. THIS HONOR RELATES TO HEAL APPALACHIA'S WORK IN SOUTHWEST VIRGINIA. HEAL APPALACHIA IS A COLLABORATIVE EFFORT OF MOUNTAIN STATES HEALTH ALLIANCE (MSHA) AND EAST TENNESSEE STATE UNIVERSITY. IT WAS CREATED TO BUILD MOMENTUM IN THE FIGHT AGAINST CHILDHOOD OBESITY IN SOUTHERN APPALACHIA. JMH SUPPORTS OTHER LOCAL NON-PROFIT ORGANIZATIONS THAT PROVIDE HEALTHCARE SERVICES TO OUR RESIDENTS. WE DONATE MEDICATIONS AND SUPPLIES TO AREA RESCUE SQUADS AND FIRE DEPARTMENTS. THESE DRUG AND SUPPLY DONATIONS EXCEEDED 13,000 IN FY14. WE PROVIDED FINANCIAL ASSISTANCE TO A LOCAL COLLEGE FOR ITS NURSING PROGRAM. DURING FY14, WE CONTRIBUTED OVER 75,000 TO THE PROGRAM. MANY OTHER DONATIONS WERE MADE TO SUPPORT OUR SCHOOLS, MARCH OF DIMES, ETC. WITH HEALTHCARE INSURANCE COVERAGE CHANGING RAPIDLY, PATIENT PAYMENT RESPONSIBILTY IS INCREASING AT A RATE OF 5 TO 6 PERCENT EACH YEAR. MOUNTAIN STATES INTRODUCED A NEW PAYMENT OPTION LAST YEAR THAT OFFERS MORE FLEXIBILITY TO OUR PATIENTS - THE ABILITY TO SPREAD PAYMENTS OVER A 36-MONTH PERIOD WITH NO INTEREST CHARGED. OF COURSE, FOR PATIENTS THAT ARE UNABLE TO PAY THEIR ACCOUNT BALANCES, PATIENT RESPRESENTATIVES ARE AVAILABLE TO DISCUSS FINANCIAL ASSISTANCE PROGRAMS. JMH HAS PARTNERED WITH THE COMPANY FIRSTSOURCE SOLUTIONS USA TO WORK WITH SELF-PAYING PATIENTS WHO HAVE LIMITED FINANCIAL RESOURCES. DURING FY14, FIRSTSOURCE REPRESENTATIVES WERE AVAILABLE AT JMH TO ASSIST PATIENTS. THE REPRESENTATIVES WERE ABLE TO DETERMINE GOVERNMENTAL MEDICAL ASSISTANCE (MEDICAID OR TENNCARE) ELIGIBILITY, AND TO HELP WITH THE APPLICATION PROCESS AND FOLLOW-UP. ONCE A PERSON IS APPROVED FOR MEDICAID OR TENNCARE THROUGH THE PROGRAM OFFERED THROUGH JMH, THEY RETAIN COVERAGE FOR FUTURE MEDICAL CARE. 636 PATIENTS WERE APPROVED FOR GOVERNMENTAL ASSISTANCE DURING THE YEAR. FIRSTSOURCE IS COMPENSATED BY JMH. DURING FY14, JMH'S COST FOR THIS PROGRAM WAS 88,193. DURING FY14, JMH'S BOARD OF DIRECTORS VOTED TO PARTNER WITH THE EDWARD VIA COLLEGE OF OSTEOPATHIC MEDICINE (VCOM) TO ESTABLISH A RESIDENCY PROGRAM IN ABINGDON. THE AGREEMENT IS EXPECTED TO PLACE UP TO NINE RESIDENTS AT JMH IN THE FIRST YEAR, WITH THE NUMBER POTENTIALLY INCREASING DURING THE INITIAL FIVE YEARS OF THE PROGRAM. VCOM WILL PROVIDE SUPPORT PERSONNEL AND OTHER RESOURCES DURING THE FIVE-YEAR START-UP PHASE. JMH BELIEVES PRIMARY CARE PHYSICIANS ARE PARTICULARLY NEEDED IN THE REGION, ESPECIALLY WITH THE INFLUX OF NEW PATIENTS EXPECTED TO COME AS MORE PEOPLE OBTAIN HEALTH INSURANCE UNDER THE AFFORDABLE CARE ACT. VCOM SPECIALIZES IN TRAINING PHYSICIANS FOR PRIMARY CARE; HOSPITAL OFFICIALS BELIEVE THE PARTNERSHIP IS A NATURAL FIT. JMH SERVES AS A CLINICAL TRAINING HOSPITAL FOR HEALTH PROFESSIONAL EDUCATION STUDENTS. WE HAVE DEDICATED STAFF THAT WORK WITH REGIONAL COLLEGES AND UNIVERSITIES TO COORDINATE THE PLACEMENT OF HEALTHCARE PROFESSIONAL STUDENTS AS PART OF THEIR EDUCATIONAL CURRICULUM. IN 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 FY14 INCLUDED 349 NURSING STUDENTS FROM VARIOUS COLLEGES, UNIVERSITIES AND PROGRAMS. THIS NURSING CLINICAL EXPERIENCE REQUIRED EXTENSIVE JMH NURSING STAFF INVOLVEMENT. THE CLINICAL SETTING AND HANDS-ON INSTRUCTION COST JMH 724,962. JMH PROVIDED A CLINICAL SETTING FOR ANOTHER 174 STUDENTS TRAINING IN HEALTH-RELATED PROGRAMS SUCH AS RADIOLOGY, PHARMACY, PHYSICAL THERAPY, EMT/PARAMEDIC AND OTHER ALLIED-HEALTH DISCIPLINES. THESE ADDITIONAL CLINICAL STUDENTS COST JMH 173,134. BASED ON COMMUNITY NEEDS, JMH INCURRED EXPENSE OF 311,375 TO RECRUIT PHYSICIANS INTO OUR COMMUNITY. PHYSICIANS ARE RECRUITED TO REPLACE PHYSICIANS THAT RETIRE OR LEAVE THE AREA. ALL PHYSICIAN RECRUITMENT ACTIVITIES ARE BASED ON DOCUMENTED COMMUNITY NEED. MSHA'S VALUE OPTIMIZATION SYSTEM (VOS) GOAL IS TO ACCELERATE ACHIEVEMENT OF PATIENT CENTERED CARE TO MEET THE PATIENT'S EXPECTATIONS OF HIGH QUALITY, HIGH SATISFACTION AND EFFICIENT CARE. DURING FY14, A VOS RAPID IMPROVEMENT EVENT TEAM DEVELOPED STANDARD WORK PROCESSES TO IMPROVE PATIENT FLOW AT JMH AND TO REDUCE THE AVERAGE LENGTH OF STAY BY 5%. THE TEAM CREATED A VISUAL MANAGEMENT TOOL OF THE ESTIMATED DISCHARGE DATE FOR PATIENT CARE CLINICIANS IN ORDER TO IDENTIFY BARRIERS TO DISCHARGING PATIENTS IN A TIMELY MANNER AND HELP STAFF FOCUS ON REDUCING LENGTH OF STAY
FORM 990, PART V	LINE 2A: W-2 EMPLOYEES JOHNSTON MEMORIAL HOSPITAL (JMH) TEAM MEMBERS ARE PAID BY MOUNTAIN STATES HEALTH ALLIANCE (MSHA). JMH REIMBURSES MSHA FOR ALL SALARY AND BENEFITS AND THE EXPENSE IS RECORDED ON JMH'S BOOKS.
FORM 990, PAGE 6, PART VI, LINE 6	THE CORPORATION IS ORGANIZED AS A VIRGINIA NON-STOCK, NON-PROFIT 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, PAGE 6, PART VI, LINE 7A	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 JOHNSTON MEMORIAL HEALTHCARE FOUNDATION'S BOARD OF DIRECTORS. NEITHER SIDE CAN VETO AN APPOINTMENT.
FORM 990, PAGE 6, PART VI, LINE 7B	CERTAIN DECISIONS OF THE BOARD ARE PURSUANT TO CHARTER AND VIRGINIA STATUTE, SUBJECT TO APPROVAL OF THE MEMBERS. THESE DECISIONS INCLUDE: DISSOLUTION OF THE CORPORATION; MERGER OF THE CORPORATION; NON-ORDINARY COURSE OF BUSINESS SALE OF ASSETS, ETC. NO ORDINARY DAY-TO-DAY DECISIONS ARE SUBJECT TO MEMBER APPROVAL.
FORM 990, PAGE 6, PART VI, LINE 11B	THE CFO REVIEWED THE FORM 990 WITH THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS AND THE RETURN WAS MADE AVAILABLE TO EACH BOARD MEMBER IN AN ELECTRONIC FORMAT PRIOR TO THE REVIEW.
FORM 990, PAGE 6, PART VI, LINE 12C	ANNUALLY, THE CORPORATE AUDIT AND COMPLIANCE DEPARTMENT OF MSHA FORWARDS THE CONFLICT OF INTEREST POLICY AND DISCLOSURE FORM TO ALL MSHA MANAGEMENT TEAM MEMBERS AND BOARD MEMBERS. EMPLOYEES AND BOARD MEMBERS MUST NOTE ANY CONFLICTS OR ATTEST THEY HAVE "NONE", AND RETURN THE FORM TO THE AUDIT AND COMPLIANCE DEPARTMENT. ANY NOTED DISCLOSURES ARE FORWARDED TO THE APPROPRIATE MANAGEMENT OR BOARD PERSONNEL TO EVALUATE AND UTILIZE WHEN A TRANSACTION INVOLVING A CONFLICTED PERSON ARISES. ADDITIONALLY, PERSONNEL WHO HAVE A CONFLICT ARISE BETWEEN THE ANNUAL DISTRIBUTION OF THE POLICY AND FORMS ARE REQUIRED TO DISCLOSE THE CONFLICT AND WOULD BE DISCIPLINED IN ANY INSTANCE WHERE THEY HAVE NOT DISCLOSED AND ENGAGED IN A CONFLICTED TRANSACTION.
FORM 990, PAGE 6, PART VI, LINE 15A	THE CEO'S COMPENSATION AND BENEFITS ARE SUBJECT TO THE EXECUTIVE COMPENSATION POLICY OF MOUNTAIN STATES HEALTH ALLIANCE (MSHA). THE POLICY WAS ESTABLISHED BY MSHA'S BOARD OF DIRECTORS AND IS ALLIGNED WITH THE MSHA MISSION, VISION, AND VALUES, SUPPORTING THE ACHIEVEMENT OF THE HEALTH SYSTEM'S STRATEGIC PLANS AND ANNUAL GOALS AND OBJECTIVES. THE POLICY ENSURES THAT MSHA'S EXECUTIVE COMPENSATION IS COMPLIANT WITH THE LEGAL, REGULATORY, AND STATUTORY ENVIRONMENT AFFECTING COMPENSATION. MSHA'S PRESIDENT AND CEO MAKES RECOMMENDATIONS TO THE EXECUTIVE COMMITTEE OF THE MSHA BOARD FOR ALL ELEMENTS OF COMPENSATION FOR THE SENIOR MANAGEMENT TEAM, INCLUDING JOHNSTON MEMORIAL HOSPITAL'S CEO. THE BOARD OF DIRECTORS MONITORS THE PERFORMANCE OF THE SENIOR MANAGEMENT TEAM ON AN ONGOING BASIS, BUT AT LEAST ANNUALLY.
FORM 990, PAGE 6, PART VI, LINE 15B	SIMILAR TO THE CEO'S COMPENSATION, OTHER SENIOR EXECUTIVES RECEIVE COMPENSATION AND BENEFITS THAT COMPLY WITH MSHA'S SALARY POLICY. COMPENSATION FOR EACH OF THEM IS SET AT A MARKET PERCENTILE SPECIFIC TO HIS/HER POSITION.
FORM 990, PAGE 6, PART VI, LINE 19	GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE UPON REQUEST TO APPROPRIATE PARTIES REQUESTING THEM. FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST TO APPROPRIATE PARTIES REQUESTING THEM, AND THEY ARE MADE AVAILABLE TO THOSE PARTIES WHO OWN INDEBTNESS OF THE COMPANY ON A QUARTERLY BASIS.
FORM 990, PART IX, LINE 11G	HOSPITAL BASED PROVIDERS 5,095,262 0 0 HOSPITAL SUPPORTED CLINICS 7,108,164 0 0 PHYSICIAN FEES 5,781,157 0 0 COLLECTION SERVICE FEES 0 817,885 0 JANITORIAL & LINEN FEES 0 683,095 0 DIALYSIS SERVICES 210,044 0 0 HYPERBARIC SERVICES 151,160 0 0 SLEEP DIAGNOSTICS SERVICES 360,203 0 0 NUC. MED./ONCOLOGY /RADIOLOGY 253,496 0 0 LABORATORY TESTS 611,225 0 0 AMBULATORY SURGERY CENTER 273,964 0 0 ENGINEERING SERVICES 0 214,981 0 DIETARY 0 1,213,399 0 TRANSCRIPTION & CODING 0 611,402 0 OTHER FEES 578,647 99,974 0
FORM 990, PART XI, LINE 9	ELIMINATION OF INTERCOMPANY REC/PAY -353,185 P/S INCOME NOT ON BOOKS -238,524 P/S INTEREST INCOME NOT ON BOOKS -2,413 P/S CAPITAL GAIN NOT ON BOOKS -25,944 P/S CHARITABLE CONTRIBUTIONS NOT ON BOOKS 19 CHANGES IN TEMPORARILY RESTRICTED NET ASSETS 1,935 TOTAL TO FORM 990, PART XI, LINE 9 -618,112

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

Field	Value	IRS element (for citing)
Business Name Line1	JMH EMERGENCY PHYSICIANS LLC	BusinessNameLine1

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	16000 JOHNSTON MEMORIAL DRIVE	AddressLine1
City	ABINGDON	City
State	VA	State
ZIP Code	24211	ZIPCode

Field	Value	IRS element (for citing)
EIN	454786385	EIN
Primary Activities	MED. SERV.	PrimaryActivitiesTxt
Legal Domicile State	VA	LegalDomicileStateCd
Total Income	$3,578,213	TotalIncomeAmt
End Of Year Assets	$1,105,906	EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

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

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrganizationControlledOrganizationInd
JOHNSTON MEMORIAL HEALTHCARE FND
16000 JOHNSTON MEMORIAL DRIVE	ABINGDON	VA	24211	262870970	SUPPORT	VA	501C3	11B	NA	false
ABINGDON PHYSICIAN PARTNERS
16000 JOHNSTON MEMORIAL DRIVE	ABINGDON	VA	24211	205485346	MED. SERV.	VA	501C3	11A	JMH	false
MOUNTAIN STATES HEALTH ALLIANCE
400 N STATE OF FRANKLIN ROAD	JOHNSON CITY	TN	37604	620476282	HOSPITAL	TN	501C3	3	NA	false
MOUNTAIN STATES FOUNDATION
2335 KNOB CREEK ROAD SUITE 101	JOHNSON CITY	TN	37604	581418862	FUNDRAISER	TN	501C3	11A	MSHA	false
APPALACHIAN EMERGENCY PHYSICIANS
1021 W OAKLAND AVENUE SUITE 207	JOHNSON CITY	TN	37604	800592504	MED. SERV.	VA	501C3	11A	NA	false
AUXILIARY TO JOHNSTON MEMORIAL HOSP
1600 JOHNSTON MEMORIAL DRIVE	ABINGDON	VA	24211	540917478	SUPPORT	VA	501C3	11A	NA	false
MSHA AUXILIARY
400 N STATE OF FRANKLIN ROAD	JOHNSON CITY	TN	37604	581418345	SUPPORT	TN	501C3	11A	MSHA	false
NORTON COMMUNITY HOSPITAL
100 15TH STREET NW	NORTON	VA	24273	540566029	HOSPITAL	VA	501C3	3	NA	false
DICKENSON COMMUNITY HOSPITAL
ONE HOSPITAL DRIVE	CLINTWOOD	VA	24228	770599553	HOSPITAL	VA	501C3	3	NCH	false
SMYTH COUNTY COMMUNITY HOSPITAL
245 MEDICAL PARK DRIVE	MARION	VA	24354	540794913	HOSPITAL	VA	501C3	3	MSHA	false

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd
INTEGRATED SOLUTIONS HEALTH NETWORK
509 MED TECH PARKWAY SUITE 100	JOHNSON CITY	TN	37604	621711997	INVESTMENT	TN	NA	EXCLUDED	$643	false	false
EMMAUS COMMUNITY HEALTHCARE PLLC
6070 HWY 11E	PINEY FLATS	TN	37686	200577483	MED. SERV.	TN	NA	EXCLUDED		false	false
MEDICAL SPECIALISTS OF JC LLC
2528 WESLEY STREET SUITE 2	JOHNSON CITY	TN	37601	272199037	MED. SERV.	TN	NA	EXCLUDED		false	false

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd
BLUE RIDGE MEDICAL MANAGEMENT CORP
1021 W OAKLAND AVENUE SUITE 207	JOHNSON CITY	TN	37604	621711997	MED. SERV.	TN	NA	C CORP	false
MEDISERVE MED EQUIP OF KINGSPORT
1021 W OAKLAND AVE SUITE 207	JOHNSON CITY	TN	37604	621212286	DME	TN	NA	C CORP	false
MOUNTAIN STATES PROPERTIES
1021 W OAKLAND AVE SUITE 207	JOHNSON CITY	TN	37604	621845895	PROP. MGMT	TN	NA	C CORP	false
MOUNTAIN STATES PHYSICIAN GRP INC
1021 W OAKLAND AVENUE SUITE 207	JOHNSON CITY	TN	37604	621700412	MED. SERV.	TN	NA	C CORP	false
COMMUNITY HOME CARE INC
1460 PARK AVENUE	NORTON	VA	24273	541453810	DME	VA	NCH	C CORP	false
SOUTHWEST COMMUNITY HEALTH SERVICES
PO BOX 880	MARION	VA	24354	541460695	MED. SERV.	VA	SCCH	C CORP	false
WILSON PHARMACY INC
P O BOX 5289	JOHNSON CITY	TN	37604	620329587	PHARMACY	TN	NA	C CORP	false
CRESTPOINT HEALTH INSURANCE CO INC
509 MED TECH PARKWAY SUITE 100	JOHNSON CITY	TN	37604	620381170	INSURANCE	TN	ISHN	C CORP	false

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (true)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	false	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (true)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (true)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	false	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (true)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt
APPALACHIAN PHYSICIAN PARTNERS
B	$353,185
APPALACHIAN PHYSICIAN PARTNERS
J	$775,542