2015-05-07T13:40:19-05:00 2014-06-30 990 2013-07-01 540544705 JOHNSTON MEMORIAL HOSPITAL INC JOHN 2762581000 16000 JOHNSTON MEMORIAL DR ABINGDON VA 24211 JOHN JETER CFO 2762581000 2015-04-29 2013 2016-02-25 16:41:14Z SEAN MCMURRAY 16000 JOHNSTON MEMORIAL DR ABINGDON VA 24211 128796681 false X HTTP://WWW.MSHA.COM/JMH X 1917 VA 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. 15 12 0 242 132455 23485 54039 101108 126824002 119469249 4913544 7163382 2570450 1472331 134362035 128206070 116677 280949 0 53104147 49011100 0 0 63865533 69605077 117086357 118897126 17275678 9308944 323314314 335681718 53919883 54271755 269394431 281409963 X 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. false false 92403416 280949 120090523 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 92403416 true true false true false false false false false false true false false false true true false true false false false false false false false false true true true false true true false false false false false false false false false false false false false false true true true true false false true X 133 0 true 0 true true false false false false false false false false false X 15 12 false false false false true true true true true false false true true true true true true true true false VA X JOHN L JETER 2762581000 16000 JOHNSTON MEMORIAL DR ABINGDON VA 24211 DENNIS VONDERFECHT TRUSTEE 9.00 51.00 X 0 1058195 68381 ANN FLEMING TREASURER 13.00 47.00 X 0 753909 73411 PAUL ARMSTRONG MD TRUSTEE 3.00 37.00 X 0 465440 36131 JIM GARDNER MD TRUSTEE 13.00 27.00 X 0 227657 26193 KATHY MITCHELL MD TRUSTEE 13.00 X 0 0 0 MICHAEL SPIEGLER SECRETARY 10.00 X 0 0 0 GARY PEACOCK TRUSTEE 8.00 5.00 X 0 0 0 OTEY DUDLEY TRUSTEE 12.00 X 0 0 0 HUGH FERGUSON CHAIR 13.00 X 0 0 0 TOM FOWLKES TRUSTEE 6.00 4.50 X 0 0 0 RACHEL FOWLKES EDD TRUSTEE 11.00 X 0 0 0 JOANNE GILMER VICE-CHAIR 13.00 6.00 X 0 0 0 KATHI LOWE TRUSTEE 7.00 X 0 0 0 BILL HAYTER TRUSTEE 13.00 X 0 0 0 BARBARA ALLEN TRUSTEE 4.00 7.00 X 0 0 0 ERIC MILLER TRUSTEE 13.00 X 0 0 0 SEAN MCMURRAY CEO 50.00 5.00 X 0 309946 49800 JOHN JETER CFO 45.00 10.00 X 0 153530 23574 KELLY CARTER MD PHYSICIAN 40.00 X 0 341868 32346 DAVID SIMMONS MD PHYSICIAN 40.00 X 0 330402 30693 SAMUEL MELTON MD PHYSICIAN 40.00 X 0 317898 12982 MATHEW DYE MD PHYSICIAN 40.00 X 0 308669 34070 JACQUELYN EARLY MD PHYSICIAN 40.00 X 0 302185 30861 4569699 418442 false true false VIRGINIA HIGHLANDS ANESTHESIA PO BOX 1476 ABINGDON VA 24212 ANESTHESIA 3065965 ABINGDON PHYSICIANS ASC GROUP 613 CAMPUS DRIVE SUITE 300 ABINGDON VA 24210 SURG. CTR. MGMT 742999 EXECUTIVE HEALTH RESOURCES 15 CAMPUS BOULEVARD SUITE 200 NEWTOWN SQUARE PA 19073 PT.RESOURCE MGT 453663 CROTHALL SERVICES EAST TN 955 CHESTERBROOK BLVD STE 300 WAYNE PA 19087 LINEN SERVICES 389538 MEDIAS INC PO BOX 10452 BLACKSBURG VA 240620452 SLEEP STUDIES 377864 22 22811 64674 13623 101108 PATIENT SERVICE REVENUE 621110 116952245 116952245 WELLNESS PROGRAMS 621110 1998265 1998265 P/S PREMIER AND ISHN 621110 244615 244615 RENT TO EXEMPT AFFILIATES 621110 147760 147760 LABORATORY 621500 132455 132455 -6091 -6091 119469249 2055268 2055268 3038 3038 697046 590611 106435 106435 106435 4457858 647218 4457858 647218 5105076 621274 4483802 CAFETERIA & VENDING 722210 636413 636413 PREMIER IPO VENDOR INCENTIVE 900099 504135 504135 MANAGEMENT FEES 561000 180921 180921 44427 44427 1365896 128206070 119816399 132455 8156108 X 280949 280949 557980 557980 40586280 33944178 6642102 1426982 1208802 218180 3986003 3956825 29178 2453855 2289057 164798 102806 102806 12319 12319 116514 116514 231721 231721 24064058 20423322 3640736 275887 8559 267328 1220779 975994 244785 776525 768146 8379 2318275 1658692 659583 222743 189463 33280 43874 41855 2019 560130 560130 11801342 4917860 6883482 997468 21963 975505 MEDICAL SUPPLIES & DRUGS 18374666 18374666 MANAGEMENT FEES TO PARENT 4727688 4727688 REPAIRS AND MAINTENANCE 2955073 2872718 82355 ALL OTHER 785810 470367 315443 17399 17399 118897126 92403416 26493710 0 11763287 11263537 20851685 20502390 3140677 2501943 2990250 2954107 875233 851748 255685379 88439688 177110911 167245691 105055305 130127592 199510 35200 35200 1491766 323314314 335681718 11747745 11358879 2084434 40701627 38218067 1470511 2610375 53919883 54271755 X 269395885 281409482 -1454 481 269394431 281409963 323314314 335681718 X 9308944 3324700 -618112 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 7051 false false 7051 false SCHEDULE C, PART IV PART II-B, LINE 1 PORTION OF DUES PAID TO VIRGINIA HOSPITAL AND HEALTHCARE ASSOCIATION THAT ARE ATTRIBUTABLE TO DIRECT LOBBYING. 6414992 6414992 148392946 23025328 125367618 6087656 1521441 4566215 93864257 63629978 30234279 925528 262941 662587 167245691 OTHER LONG-TERM LIABILITIES 1126666 CAPITAL LEASE OBLIGATIONS 773821 DUE TO THIRD-PARTY 496450 DUE TO AFFILIATES 213438 2610375 X SCHEDULE D, PAGE 3, PART X 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." true true X true X true X true true true false false 2679061 2679061 0.02250 18385487 14633630 3751857 0.03160 21064548 14633630 6430918 0.05410 175428 175428 0.00150 898097 898097 0.00760 3634927 2612826 1022101 0.00860 184634 184634 0.00160 4893086 2612826 2280260 0.01920 25957634 17246456 8711178 0.07330 3575 3575 3575 3575 true 16035231 12026423 37453513 40349827 -2896314 X true true 1 1 JOHNSTON MEMORIAL HOSPITAL INC 16000 JOHNSTON MEMORIAL DRIVE ABINGDON VA 24211 HTTP://WWW.MSHA.COM/JMH X X X JOHNSTON MEMORIAL HOSPITAL INC 1 true X X X X X X X X 12 true true true X HTTP://WWW.MSHA.COM/JMH X X X X X X X false false true true 200.000000000000 true 400.000000000000 true X X X X X true true X X X X X true false X X X true X false false 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. 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 true BARTER THEATRE PO BOX 867 ABINGDON VA 24212 546000120 501C3 18800 SPONSORSHIP JOHN S BATTTLE HIGH SCHOOL 21264 BATTLE HILL DRIVE BRISTOL VA 24202 541604035 501C3 16296 FOOTBALL SCOREBOARD JOHNSTON MEMORIAL HOSP AUXILIARY 16000 JOHNSTON MEMORIAL DRIVE ABINGDON VA 24211 540917478 501C3 40000 GENERAL SUPPORT MARCH OF DIMES PO BOX 799-2700 S ROAN ST 430 JOHNSON CITY TN 37605 131846366 501C3 5200 GENERAL SPONSORSHIP SALTVILLE RESCUE SQUAD 126 BATTLEGROUND AVENUE SALTSVILLE VA 24370 311638300 501C3 5719 DRUG BOX REFILLS VHCC EDUCATIONAL FOUNDATION PO BOX 828 ABINGDON VA 24212 521225133 501C3 36155 FUND NURSING PROGRAM VIRGINIA HIGHLANDS COMM COLLEGE P O BOX 828 ABINGDON VA 24212 541268289 501C3 128914 FUND NURSING PROGRAM WASHINGTON COUNTY PUBLIC SCHOOLS 812 THOMPSON DRIVE ABINGDON VA 24210 546001671 501C3 7250 SPONSORSHIP WILLIAM KING MUSEUM PO BOX 2256 ABINGDON VA 24210 541144120 501C3 10000 SPONSORSHIP 9 SCHEDULE I, PAGE 1, PART I, LINE 2 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. X X X X X false true false false false false false false false DENNIS VONDERFECHT TRUSTEE 780241 236094 41860 40000 28381 1126576 ANN FLEMING TREASURER 383151 87911 282847 55452 17959 827320 242724 PAUL ARMSTRONG MD TRUSTEE 348063 116939 438 18051 18080 501571 JIM GARDNER MD TRUSTEE 174206 52888 563 9255 16938 253850 SEAN MCMURRAY CEO 266258 38619 5069 28438 21362 359746 JOHN JETER CFO 149322 3930 278 5473 18101 177104 KELLY CARTER MD PHYSICIAN 262640 23472 55756 11840 20506 374214 DAVID SIMMONS MD PHYSICIAN 255033 23619 51750 10701 19992 361095 SAMUEL MELTON MD PHYSICIAN 269189 45509 3200 12982 330880 MATHEW DYE MD PHYSICIAN 223744 20019 64906 12094 21976 342739 JACQUELYN EARLY MD PHYSICIAN 219337 23379 59469 12026 18835 333046 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. A 2011 HOSPITAL FACILITY INVEST BOND INDUSTRIAL DEV AUTHORITY OF SMYTH 541758381 2011-11-16 24870000 REFINANCE CANCER CTR. false false false A 3535000 24870000 238423 24631577 2012 true false true true A false false true true false false true false true A false true true false true false false false true SCHEDULE K - PURPOSE OF ISSUE DESCRIPTION 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. 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 JMH EMERGENCY PHYSICIANS LLC 16000 JOHNSTON MEMORIAL DRIVE ABINGDON VA 24211 454786385 MED. SERV. VA 3578213 1105906 JMH 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. 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