Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i)Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) .... | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 6 | Total. Add lines 1 through 5. | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2015 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2015 |
(iii) Distributable Amount for 2015 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2015 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2015: | ||||
| a | ||||
| b | ||||
| c | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2015 distributable amount | ||||
|
i
Carryover from 2010 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2015 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2015 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
|---|
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| 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 | (CONT'D) DURING FY16, 8,409 PATIENTS WERE ADMITTED TO OUR HOSPITAL, WITH JUST UNDER 30,000 PATIENT DAYS. THERE WERE AN ADDITIONAL 4,301 OBSERVATION DAYS AND JUST UNDER 1,500 NEWBORN DAYS. WE EXPERIENCED 239,399 OUTPATIENT VISITS THIS YEAR, AN INCREASE OF 4.5% OVER PRIOR YEAR. THERE WERE 41,030 VISITS TO OUR EMERGENCY DEPARTMENT. SURGERIES INCREASED 8.1% THIS YEAR TO 7,279. WE DELIVERED 701 BABIES. PROMOTE COMMUNITY HEALTH: IN AN EFFORT TO REDUCE READMISSION RATES AND IMPROVE THE PATIENT EXPERIENCE, JMH DEVELOPED COORDINATED CARE GUIDES. CARE GUIDES FOCUS ON PATIENT CARE BY ASSISTING WITH PATIENT NEEDS AT DISCHARGE AND WORKING DAILY WITH CASE MANAGEMENT, SOCIAL WORK, AND NURSING STAFF TO REDUCE THE FACTORS THAT COULD LEAD TO A PATIENT BEING READMITTED. ASSISTANCE IS PROVIDED WITH PATIENTS' MEDICATIONS, DURABLE MEDICAL EQUIPMENT, AND OTHER OUTPATIENT NEEDS FOLLOWING INPATIENT DISCHARGE. AFTER PLANNING A NURSE NAVIGATION PROGRAM FOR ONCOLOGY PATIENTS LAST YEAR, THE PROGRAM WAS UP AND OPERATIONAL THIS YEAR. OUR NAVIGATOR PROGRAM IS DESIGNED TO SUPPORT CANCER PATIENTS AND THEIR FAMILIES, ADVOCATE FOR THE PATIENT, AND TO HELP COORDINATE THE PATIENT'S CARE THROUGHOUT THE CONTINUUM OF TREATMENT - FROM DIAGNOSIS TO SURVIVORSHIP. THERE IS NO CHARGE FOR THESE SERVICES REGARDLESS OF WHETHER A PATIENT CHOOSES TO RECEIVE THEIR TREATMENT AT JMH OR AN UNRELATED FACILITY. THOSE THAT JOIN THE PROGRAM RECEIVE ONE- ON-ONE ASSISTANCE FROM SPECIALLY TRAINED ONCOLOGY PROFESSIONALS. OUR CANCER NAVIGATORS COMMUNICATE WITH THE PATIENT'S DOCTOR, WILL COORDINATE TRANSPORTATION, SET UP APPOINTMENT REMINDERS AND PROVIDE EMOTIONAL SUPPORT FOR BOTH THE PATIENT AND THE PATIENT'S FAMILY. OUR NAVIGATORS WILL ALSO COORDINATE SUPPORT SERVICES SUCH AS TREATMENT PLANNING, PROSTHESIS SELECTION, NUTRITION COUNSELING, AND IDENTIFICATION OF RESOURCES FOR SPIRITUAL CARE, FINANCIAL ASSISTANCE AND OTHER NEEDS. OUR NAVIGATORS PARTICIPATE IN COMMUNITY EVENTS SUCH AS HEALTH FAIRS, CANCER EDUCATION EVENTS, AND CANCER SUPPORT GROUPS. THEY VISIT PHYSICIAN OFFICES, SENIORS' GROUPS, ATTEND MEETINGS WITH LOCAL BUSINESS ORGANIZATIONS, AND THEY WORK WITH MANY OTHER ORGANIZATIONS TO EXPLAIN THE NAVIGATION PROGRAM AND PROVIDE CANCER AWARENESS/EDUCATION THROUGH THE COMMUNITY. WE STARTED A DIAPER ASSISTANCE PROGRAM THE LAST QUARTER OF THIS FISCAL YEAR. DIAPERS ARE PROVIDED TO LOW-INCOME FAMILIES THAT DELIVER AT JMH FOR THE FIRST 6 MONTHS OF THE BABIES LIFE. WE ENROLLED 23 BABIES THE FIRST MONTH THAT HAS GROWN TO AN AVERAGE OF 39 SINCE. BASED ON PROJECTIONS, WE EXPECT THE PROGRAM TO COST THE HOSPITAL 24,000 FOR A FULL YEAR. THE REGIONAL CANCER CENTER AT JMH HOSTED A FAMILY FUN DAY ON THE GROUNDS OF THE CENTER TO EDUCATE PATIENTS AND FAMILY AND TO CELEBRATE OUR COMMUNITY. IN ADDITION TO A COOK-OUT AND ENTERTAINMENT, A PRESENTATION WAS GIVEN ON HOW TO RECOGNIZE AND PREVENT COMMON SKIN CANCERS. SAMPLES OF SUN SCREEN AND SKIN CARE INFORMATION WERE DISTRIBUTED. THE OUTPATIENT DIABETES CARE CENTER (CENTER) AT JMH CONTINUED TO EXPERIENCE INCREASED VOLUMES THIS YEAR. AFTER AN INCREASE OF ALMOST 170% FROM FY14 TO FY15, OUR VOLUME GREW AN ADDITIONAL 43% IN FY16. THE CENTERS FOR DISEASE CONTROL AND PREVENTION IDENTIFIES THE COUNTIES SERVED BY JMH AS BEING LOCATED IN WHAT IS REFERRED TO AS THE "DIABETES BELT" OF THE U.S. JMH'S DIABETES CENTER PROVIDES MEDICAL MANAGEMENT OF DIABETES AND DIABETES- RELATED CONDITIONS FOR PATIENTS AGED 12 AND UP. A COMPREHENSIVE DIABETES EDUCATION PROGRAM THAT IS RECOGNIZED BY THE AMERICAN DIABETES ASSOCIATION IS PART OF THE CENTER'S PROGRAM OF CARE. OUR FAMILY BIRTH CENTER HAS 16 LARGE PRIVATE ROOMS, 11 OF WHICH ARE DESIGNED FOR LABOR/DELIVERY/RECOVERY/POSTPARTUM STAYS. THE REMAINING FIVE ROOMS SERVE TO CARE FOR GYNECOLOGY PATIENTS. TRADITIONAL NURSES STATIONS HAVE BEEN REPLACED WITH "TOUCHDOWN STATIONS" THAT MAKE COMMUNICATION WITH FAMILY MEMBERS MORE INVITING. DEDICATED PEDIATRIC HOSPITALISTS ARE ONSITE DURING DELIVERY AND AFTERWARD TO CARE FOR BABIES AND COVERAGE IS AVAILABLE 24 HOURS A DAY, 7 DAYS A WEEK. THE JMH CENTER FOR COMPREHENSIVE WOUND CARE IS THE ONLY FACILITY IN SOUTHWEST VIRGINIA OFFERING HYPERBARIC OXYGEN THERAPY - THE DELIVERY OF OXYGEN AT LEVELS HIGHER THAN ATMOSPHERIC PRESSURE IN A CHAMBER SETTING THAT STIMULATES THE HEALING PROCESS. THE NEAREST FACILITY OFFERING HYPERBARIC OXYGEN THERAPY IS AN HOUR AWAY. OUR TRAINED STAFF FOLLOW A TEAM APPROACH TO WOUND HEALING. EACH PATIENT RECEIVES A COMPREHENSIVE INDIVIDUALIZED PLAN DESIGNED TO HELP DIFFICULT-TO-HEAL WOUNDS. JMH STAFF STRIVE TO ADDRESS THE UNDERLYING CAUSE OF THE PROBLEM, CONTROL INFECTION, AND IMPROVE THE OVERALL HEALTH OF OUR PATIENTS. OUR WOUND CENTER CONDUCTED A RAPID IMPROVEMENT EVENT THIS YEAR FOCUSED ON EXPEDITING PATIENT VISITS TO REDUCE WAIT TIMES IN TREATMENT ROOMS. PATIENTS SOMETIMES EXPERIENCE STRESS WHEN LEFT ALONE WHILE AWAITING A PHYSICIAN AND TREATMENT. THE WOUND CENTER WAS ABLE TO REDUCE PATIENT FLOW TIME 27% BY STANDARDIZING ALL ROOMS AND EQUIPMENT AND IMPLEMENTING A SUPPLY BIN SYSTEM. OTHER CHANGES INCLUDED ADDING SIGNAGE SETTING EXPECTATIONS TO REINFORCE THE PURPOSE OF ARRIVING ON TIME FOR APPOINTMENTS SO THAT OTHER PATIENTS ARE NOT NEGATIVELY IMPACTED BY PATIENTS ARRIVING OUTSIDE OF THEIR SCHEDULED APPOINTMENT TIMES. THIS SIMPLE CHANGE RESULTED IN A DROP OF 86% IN THE NUMBER OF PATIENTS ARRIVING OUTSIDE OF THEIR SCHEDULED APPOINTMENT AND THE NUMBER OF LATE PATIENT ARRIVALS CONTINUES TO DECLINE AS EXPECTATIONS FOR TIMELINESS ARE REINFORCED. MSHA HOLDS AN ANNUAL SYSTEM-WIDE QUALITY AWARDS COMPETITION. TEAM MEMBERS FROM ACROSS THE ORGANIZATION RECEIVE RECOGNITION FOR IMPROVEMENT PROJECTS THAT MAKE THINGS BETTER FOR OUR PATIENTS AS WELL AS FELLOW TEAM MEMBERS. PROJECTS MUST SHOW A MEASURED BENEFIT. JMH HAD 15 PROJECTS RECOGNIZED FOR RESULTS THEY ACHIEVED DURING THE YEAR. TWO OF THOSE PROJECTS RECEIVED SOME OF THE HIGHEST RECOGNITION, AS DETERMINED BY A TEAM OF EXPERT JUDGES FROM THE BUSINESS WORLD: -JMH'S CARDIAC CATH LAB'S PROJECT CALLED "THE HEART OF THE PROBLEM IS TIME", WHICH HELPED REDUCE THE AMOUNT OF TIME IT TAKES TO RECEIVE TREATMENT FOR STEMI HEART PATIENTS (ST SEGMENT ELEVATION MYOCARDIAL INFARCTION) WHO TRANSFER TO JMH FROM ANOTHER FACILITY. EVERY MINUTE IS CRUCIAL FOR HEART ATTACK PATIENTS. -"GOT SEPSIS" WAS A QUALITY PROJECT RECOGNIZED LAST YEAR FOR ITS REMARKABLE RESULTS IN LOWERING THE SEPSIS MORTALITY RATE AND THE AVERAGE LENGTH OF STAY AND COST FOR SEPSIS PATIENTS. THIS YEAR THE PROJECT WAS GIVEN A "HOLD THE GAINS AWARD" FOR CONTINUING TO DRIVE IMPROVEMENT. ANOTHER QUALITY PROJECT WITH OUTSTANDING RESULTS WAS A PROJECT TITLED "90 IN 90" TO INCREASE PHYSICIAN USE OF STANDARDIZED ORDER SETS AND PROTOCOLS THAT HAVE BEEN PROVEN TO IMPROVE THE QUALITY OF MEDICAL CARE AND ENHANCE PATIENT SAFETY. ORDER SET USAGE INVOLVES THE USE OF PRE-SET, CAREFULLY CREATED, BEST EVIDENCE-BASED PROCESSES ON WHAT KIND OF CARE THE PATIENT SHOULD RECEIVE FOR A PARTICULAR CONDITION. BY FOLLOWING THESE ORDER SETS, PATIENT CARE IS MORE EFFICIENT, MORE CONSISTENT AND HAS LESS CHANCE FOR ERROR OR REDUNDANCY. JMH'S PROJECT MEASURED ORDER SET USAGE FOR SEVEN COMMON ADMITTING MEDICAL DIAGNOSES AND FOUND USAGE WAS BETWEEN 45-49% AT THE BEGINNING OF THE PROJECT. THE PROJECT'S GOAL WAS TO INCREASE USAGE TO 90% WITHIN 90 DAYS. WITHIN JUST 60 DAYS, THE GOAL WAS MET WITH USAGE INCREASING TO 95% AND 97% COMPLIANCE WAS REACHED WITHIN 90 DAYS. BECAUSE THIS PROJECT SAW SUCH SUCCESS AT JMH, IT WAS ROLLED OUT TO ALL MSHA FACILITIES. JMH CONTINUES THE "LEAN" PROCESS OF PROVIDING VALUE TO CUSTOMERS (OUR PATIENTS, PHYSICIANS AND TEAM MEMBERS) THROUGH QUALITY IMPROVEMENT TEAMS THAT MEET ALL DAY FOR SEVERAL DAYS TO DEVELOP PROCESSES THAT WILL OPTIMIZE CARE OF PATIENTS, REDUCE RESOURCE UTILIZATION; AND, OFTENTIMES, IMPROVE BOTH. SOME OF THE PROJECTS THAT OCCURRED DURING THE YEAR INCLUDE: -MORE APPROPRIATE PATHWAYS WERE DEVELOPED FOR PATIENTS PRESENTING IN THE ER WITH LOW RISK CHEST PAIN RESULTING IN A LENGTH OF STAY REDUCTION OF 80%. -SEVERAL ADDITIONAL IMPROVEMENTS RELATING TO BED ASSIGNMENTS, DISCHARGE PROCESSES, ETC. POSITIVELY IMPACTED OTHER AREAS, SUCH AS AN 86% IMPROVEMENT IN AVOIDABLE DAYS (UNNECESSARY HOSPITAL DAYS DUE TO PLACEMENT, TESTING/TREATMENT ISSUES, AND OTHER PREVENTABLE FACTORS); A 57% REDUCTION IN ADMISSIONS HELD IN THE ER DUE TO A LIMITED BED CAPACITY WITHIN THE HOSPITAL; A 54% IMPROVEMENT IN DISCHARGE TURNAROUND TIME LESS THAN 90 MINUTES; AND A 21% IMPROVEMENT IN PATIENT SATISFACTION SCORES. -PROCESSES WERE IDENTIFIED AND IMPLEMENTED TO IMPROVE PHYSICIAN COVERAGE AND TO PROVIDE EASIER ACCESS FOR NEW ONCOLOGY PATIENTS FROM REFERRING PHYSICIANS ALLOWING PATIENTS TO SEE AN ONCOLOGIST AND BEGIN TREATMENT SOONER. -WORKING WITH TWO OTHER MSHA HOSPITALS, WE REALIGNED ONCOLOGY SERVICES AND PHYSICIAN RESOURCES, INCREASING PRODUCTIVITY AND PATIENT SATISFACTION. BASED ON COMMUNITY NEED, JMH INCURRED DIRECT EXPENSE OF 335,000 TO RECRUIT PHYSICIANS INTO OUR COMMUNITY. IN ADDITION, MSHA CORPORATE ALLOCATES A |
| FORM 990, PART V | LINE 2A: W-2 EMPLOYEES JMH TEAM MEMBERS ARE PAID BY MOUNTAIN STATES HEALTH ALLIANCE (MSHA). JMH REIMBURSES MSHA FOR ALL SALARY AND BENEFITS RELATED TO OUR TEAM MEMBERS AND THE EXPENSE IS RECORDED ON JMH'S BOOKS. THE ONLY EXCEPTION IS THAT PHYSICIANS WERE PAID DIRECTLY BY JMH FOR A SHORT PERIOD OF TIME THE FIRST OF 2015. |
| FORM 990, PAGE 6, PART VI, LINE 6 | THE CORPORATION IS ORGANIZED AS A VIRGINIA NON-STOCK, NONPROFIT CORPORATION WITH TWO MEMBERS: MOUNTAIN STATES HEALTH ALLIANCE, WHICH MAINTAINS A 50.1% INTEREST AND JOHNSTON MEMORIAL HEALTHCARE FOUNDATION, WHICH MAINTAINS A 49.9% INTEREST. |
| FORM 990, 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 THE RETURN WITH THE IRS. 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, INCLUDING THOSE AT JMH. 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 | MSHA'S HUMAN RESOURCE (H/R) DEPARTMENT EVALUATES SALARY AND BENEFITS FOR JMH'S CEO ON AN ANNUAL OR NEAR-ANNUAL BASIS. H/R'S EVALUATION IS BASED ON MARKET DATA OBTAINED FROM INDEPENDENT THIRD-PARTY CONSULTANTS FOR POSITIONS WITH SIMILAR RESPONSIBILITIES AT SIMILARLY SITUATED ORGANIZATIONS. BASED ON THAT REVIEW, H/R MAKES A RECOMMENDATION TO MSHA'S PRESIDENT & CEO, WHO HAS FINAL APPROVAL FOR THE COMPENSATION OF JMH'S CEO. IN ADDITION, MSHA OFFERS AN INCENTIVE PLAN TO EXECUTIVES BASED ON TARGETED ACHIEVEMENT METRICS SET IN ADVANCE OF THE PAY YEAR. ESTABLISHED METRICS INCLUDE: COMMUNICATION WITH PATIENTS, PATIENT EVIDENCE-BASED CARE SCORES AND PATIENT SAFETY, VALUE- BASED PURCHASING, ETC. THESE SAME METRICS ARE USED FOR ALL EMPLOYEES WITHIN MSHA, WITH A SMALL NUMBER OF EXCEPTIONS FOR OUR COMPANIES THAT DO NOT PROVIDE DIRECT PATIENT CARE. |
| FORM 990, PAGE 6, PART VI, LINE 15B | SIMILAR TO THE CEO'S COMPENSATION, THE CFO RECEIVES COMPENSATION AND BENEFITS THAT COMPLY WITH MSHA'S SALARY POLICY. HIS PAY IS SET AT A MARKET PERCENTILE SPECIFIC TO HIS 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 INDEBTEDNESS OF THE COMPANY ON A QUARTERLY BASIS. FORM 990, PART VII - RELATED ORGANIZATIONS DIRECTOR COMPENSATION: JOHNSTON MEMORIAL HOSPITAL'S BOARD MEMBER, BRIAN DAWSON, M.D. HAS 990 REPORTABLE COMPENSATION DERIVED FROM MEDICAL SERVICES PROVIDED TO JMH. HE DOES NOT RECEIVE COMPENSATION FOR SERVICES AS A JMH BOARD MEMBER. MARVIN EICHORN AND JAMES GARDNER, M.D. RECEIVE COMPENSATION FOR SERVICES PROVIDED TO RELATED ORGANIZATIONS AND DO NOT RECEIVE COMPENSATION FOR SERVICES AS A JMH BOARD MEMBER. |
| FORM 990, PART IX, LINE 11G | HOSPITAL BASED PROVIDERS 5,671,241 0 0 HOSPITAL SUPPORTED CLINICS 10,135,236 0 0 PHYSICIAN FEES 4,593,307 0 0 COLLECTION SERVICE FEES 0 821,049 0 JANITORIAL & LINEN FEES 729,737 0 0 CONSULTING FEES 0 544,378 0 DIALYSIS SERVICES 403,086 0 0 HYPERBARIC SERVICES 115,010 0 0 SLEEP DIAGNOSTICS SERVICES 525,204 0 0 NUC. MED./ONCOLOGY /RADIOLOGY 499,212 0 0 LABORATORY TESTS 517,479 0 0 AMBULATORY SURGERY CENTER 320,781 0 0 ENGINEERING SERVICES 0 277,369 0 DIETARY 1,652,099 0 0 TRANSCRIPTION & CODING 0 500,311 0 OTHER FEES 1,382,834 734,053 0 |
| FORM 990, PART XI, LINE 9 | ELIMINATION OF INTERCOMPANY REC/PAY 362,871 TEMPORARILY RESTRICTED NET ASSET CHANGE 52,290 TOTAL 415,161 |
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