TY 2017 Form 990

(A) Name and business address	(B) Description of services	(C) Compensation
PT SOLUTIONS, P O BOX 441146 KENNESAW,GA30160	PHYS THRPY SVCS	1,865,577
MEDICAL SERVICES BILLING, P O BOX 22266 CHATTANOOGA,TN37422	BILLING SVCS	767,651
ARUP LABORATORIES, P O BOX 27964 SALT LAKE CITY,UT84127	LAB SERVICES	501,080
ARAMARK, 1101 MARKET STREET DRIVE PHILADELPHIA,PA19101	CLINIC ENG SVCS	260,786
TELE-PHYSICIAN PC, 1768 BUSINESS CENTER DRIVE SUITE 10 RESTON,VA20190	CONSULTING FEES	149,458
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 47

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

TAKOMA REGIONAL HOSPITAL INC

Employer identification number

51-0603966

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2019

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2018. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2019. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2019

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2018. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2019

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2019

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2019

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
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

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2019

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

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 2019 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-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Name of the organization

TAKOMA REGIONAL HOSPITAL INC

Employer identification number

51-0603966

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2

Name of organization TAKOMA REGIONAL HOSPITAL INC

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 3

Name of organization TAKOMA REGIONAL HOSPITAL INC		Employer identification number 51-0603966

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 4


Name of organization TAKOMA REGIONAL HOSPITAL INC			Employer identification number 51-0603966
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

TAKOMA REGIONAL HOSPITAL INC

Employer identification number

51-0603966

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2019

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Term endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	2,558,118		2,558,118
b	Buildings ....	6,700,419	450,077	6,250,342
c	Leasehold improvements
d	Equipment ....	6,189,622	1,140,167	5,049,455
e	Other .....	142,092	35,446	106,646
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				13,964,561

Schedule D (Form 990) 2019

Page 3

Part VII

InvestmentsOther Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	613,247
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2019

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

SCHEDULE D, PAGE 3, PART X

TAKOMA REGIONAL HOSPITAL, INC. IS INCLUDED IN THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS OF BALLAD HEALTH. THE FOOTNOTE EXPLANATION RELATIVE TO INCOME TAXES READS: "BALLAD IS CLASSIFIED AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS SUCH, NO PROVISION FOR FEDERAL INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS FOR BALLAD AND ITS TAX- EXEMPT SUBSIDIARIES. BALLAD'S TAXABLE SUBSIDIARIES ARE DISCUSSED IN NOTE L. BALLAD HAS NO SIGNIFICANT UNCERTAIN TAX POSITIONS AT JUNE 30, 2018. AT JUNE 30, 2018, TAX RETURNS FOR MSHA AND WHS FOR 2015 THROUGH 2017 ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE."

Schedule D (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

TAKOMA REGIONAL HOSPITAL INC

Employer identification number

51-0603966

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other 225.0000000000 %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other 450.0000000000 %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	972,691		972,691	1.500 %
b	Medicaid (from Worksheet 3, column a) . . . . .	5,754,326	3,426,475	2,327,851	3.600 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	6,727,017	3,426,475	3,300,542	5.100 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	215,289	2,347	212,942	0.330 %
f	Health professions education (from Worksheet 5) . . .	52,318		52,318	0.080 %
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	2,005		2,005
j	Total. Other Benefits . .	269,612	2,347	267,265	0.410 %
k	Total. Add lines 7d and 7j .	6,996,629	3,428,822	3,567,807	5.510 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019

Schedule H (Form 990) 2019

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

4,086,782

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

11,291,112

Enter Medicare allowable costs of care relating to payments on line 5.....

11,510,948

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-219,836

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2019

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	TAKOMA REGIONAL HOSPITAL INC 401 TAKOMA AVENUE GREENEVILLE,TN37743 BALLADHEALTH.ORG/LOCATIONSHOSPITALS 0000000054	X	X	X

Schedule H (Form 990) 2019

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	TAKOMA REGIONAL HOSPITAL INC
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 15

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): BALLADHEALTH.ORG/LOCATIONSHOSPITALS

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): BALLADHEALTH.ORG/LOCATIONSHOSPITALS

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	TAKOMA REGIONAL HOSPITAL INC
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 225.000000000000%
and FPG family income limit for eligibility for discounted care of 450.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

BALLADHEALTH.ORG

The FAP application form was widely available on a website (list url):

BALLADHEALTH.ORG

A plain language summary of the FAP was widely available on a website (list url):
BALLADHEALTH.ORG

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	TAKOMA REGIONAL HOSPITAL INC
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	TAKOMA REGIONAL HOSPITAL INC
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
FACILITY 1, TAKOMA REGIONAL HOSPITAL, INC. - PART V, LINE 3E	THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR TAKOMA REGIONAL HOSPITAL, INC., CONDUCTED IN 2016, PROVIDED A BROAD OVERVIEW OF THE HEALTH STATUS OF THE COMMUNITY SERVED AS OUTLINED IN THE REPORT, REVEALING THAT THE REGION SUFFERS FROM HIGHER RATES OF DIABETES, CARDIOVASCULAR DISEASE, AND BEHAVIOR RELATED CANCERS (RELATED TO SMOKING, OBESITY, SEDENTARY LIFESTYLES, ETC.). THAT ASSESSMENT WAS POSTED PUBLICLY AND HAS BEEN USED IN THE INTERVENING YEARS TO SHAPE THE PRIORITIZED COMMUNITY BENEFIT INVESTMENTS MADE BY THE SYSTEM TO PARTNER WITH COMMUNITY ORGANIZATIONS. SUCH INVESTMENTS HAVE FUNDED PROGRAMS FOCUSED ON INCREASING PHYSICAL ACTIVITY AND REDUCING TOBACCO USE, TWO OF THE PRIMARY BEHAVIORS THAT DRIVE POOR HEALTH AND ADVERSE HEALTH OUTCOMES IN OUR REGION. IN ADDITION, PARTNERSHIPS HAVE BEEN FORMED WITH A VARIETY OF OTHER ORGANIZATIONS, INCLUDING REGIONAL YMCAS TO ENACT AFTER SCHOOL PROGRAMS WITH THE SIMILAR GOAL TO REDUCE CHILDHOOD OBESITY AND PREVENT TOBACCO USE. THE CHNA CONTINUES TO INFORM PROGRAMMATIC INVESTMENTS MADE BY THE HEALTH SYSTEM TO SUPPORT EFFORTS SUCH AS NURSE CONNECT THAT IS AVAILABLE THROUGHOUT OUR REGION. NURSE CONNECT, A DEPARTMENT OF WELLMONT HEALTH SYSTEM, IS A 24/7 TOLL-FREE PHONE LINE AVAILABLE TO EAST TENNESSEE AND SOUTHWEST VIRGINIA RESIDENTS THAT CONNECTS CALLERS WITH EXPERIENCED NURSES AROUND THE CLOCK WHO PROVIDE MEDICAL ADVICE, MAKE REFERRALS TO PRIMARY CARE PROVIDERS OR PHYSICIAN SPECIALISTS, PROVIDE HEALTH INFORMATION AND RESOURCES INCLUDING HEALTH SCREENINGS AND IMMUNIZATIONS, AND PROVIDE INFORMATION ON URGENT CARE CLINIC LOCATIONS.
FACILITY 1, TAKOMA REGIONAL HOSPITAL, INC. - PART V, LINE 5	IN CONJUNCTION WITH CONDUCTING OUR COMMUNITY HEALTH NEEDS ASSESSMENT, TAKOMA REGIONAL HOSPITAL, INC. (TRH) CREATED A COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE (CHNAC) TO PROVIDE INPUT AND GUIDE THE HEALTH NEEDS ASSESSMENT PROCESS. ORGANIZATIONS AND INDIVIDUALS SERVING ON THE CHNAC INCLUDED REPRESENTATIVES FROM COUNTY AND CITY GOVERNMENT, THE GREENE COUNTY PUBLIC HEALTH DEPARTMENT, GREENE COUNTY PUBLIC SCHOOL HEALTH COORDINATORS, AND LAUGHLIN MEMORIAL HOSPITAL. THE SPECIFIC ORGANIZATIONS AND INDIVIDUALS PARTICIPATING IN THE CHNAC AND REPRESENTING THE MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY POPULATIONS, AND POPULATIONS WITH CHRONIC DISEASE INCLUDED REPRESENTATIVES FROM FRONTIER HEALTH, A PROVIDER OF BEHAVIORAL HEALTH SERVICES, FOOD BANK OF GREENEVILLE, TABERNACLE SOUP KITCHEN, RURAL RESOURCES, AN ORGANIZATION SERVING AS A RESOURCE AND EDUCATOR WITH RESPECT TO SUSTAINABLE AGRICULTURAL PRACTICES, AND WESLEY HEIGHTS, A LOWER-INCOME UNDERSERVED NEIGHBORHOOD LOCATED WITHIN THE HOSPITAL'S COMMUNITY. THE LISTING BELOW REFLECTS ALL OF THE ORGANIZATIONS/COMMUNITY AREAS REPRESENTED ON THE HOSPITAL'S CHNAC: -TRH REPRESENTATIVES -GREENE COUNTY MAYOR'S OFFICE -RURAL RESOURCES -GREENE COUNTY HEALTH DEPARTMENT -CITY OF GREENEVILLE MAYOR'S OFFICE -THE HOPE CENTER -LAUGHLIN MEMORIAL HOSPITAL REPRESENTATIVES -FRONTIER HEALTH -WESLEY HEIGHTS -FOOD BANK OF GREENEVILLE -TABERNACLE SOUP KITCHEN -GREENE COUNTY PUBLIC SCHOOLS -GREENEVILLE CITY SCHOOLS PRIMARY AND SECONDARY DATA WERE COLLECTED FOR THE PURPOSE OF THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. IN ADDITION TO THE INPUT RECEIVED FROM INDIVIDUALS/ORGANIZATIONS SERVING ON THE CHNAC, PRIMARY DATA WAS COLLECTED. PRIMARY DATA CONSISTED OF FOCUS GROUPS, GROUP INTERVIEWS, AN ONLINE COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY AND A HARD COPY QUESTIONNAIRE. THE INTERVIEWS INCLUDED A CROSS SECTION OF INDIVIDUALS WHO WERE ASSOCIATED WITH ORGANIZATIONS THAT SERVED THE MEDICALLY UNDERSERVED, LOW INCOME, MINORITY, AND CHRONICALLY DISEASED POPULATIONS. THE QUESTIONNAIRE WAS COMPLETED BY 652 RESPONDENTS. APPROXIMATELY 12% OF THE RESPONDENTS HAD HOUSEHOLD INCOMES BELOW 25,000.
FACILITY 1, TAKOMA REGIONAL HOSPITAL, INC. - PART V, LINE 6A	THE COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED BY TAKOMA REGIONAL HOSPITAL, INC. WAS BASED UPON THE HOSPITAL'S INVOLVEMENT AND ENRICHMENT OF THOSE WHO LIVE WITHIN GREENE COUNTY, TENNESSEE. THE PRIMARY SERVICE AREA IS SHARED BY LAUGHLIN MEMORIAL HOSPITAL AND THUS THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED IN COOPERATION WITH BOTH HOSPITALS.
FACILITY 1, TAKOMA REGIONAL HOSPITAL, INC. - PART V, LINE 11	KEY FINDINGS NOTED DURING THE CHNA WERE THE LOW RANKINGS OF THE COUNTIES WE SERVE IN SEVERAL CATEGORIES RELATED TO HEALTH AND WELLNESS, INCLUDING PREVALENCE OF CHRONIC DISEASE MANAGEMENT, TOBACCO USE, DIET AND EXERCISE, AS WELL AS A NEED FOR EXPANDED AND ENHANCED MENTAL HEALTH SERVICES. THEY ALSO EMPHASIZED THE VULNERABILITY OF OUR UNDERINSURED AND UNINSURED POPULATIONS, AND THAT IF OUR COMMUNITIES ARE TO THRIVE, WE MUST FOCUS ON ENCOURAGING HEALTHY CHILDREN AND FAMILIES. TAKOMA REGIONAL HOSPITAL OPERATES A DIABETES TREATMENT CENTER. THE CENTER OFFERS DIABETES SERVICES AND FREE EDUCATIONAL PROGRAMS. DIETITIANS, NURSES AND CERTIFIED DIABETES EDUCATORS TEACH ABOUT TOPICS SUCH AS PREPARING NUTRITIOUS MEALS, TRACKING BLOOD SUGAR, REDUCING DIABETES' LONG-TERM EFFECTS, AND OTHER DIABETES RELATED TOPICS. TO HELP MEET THESE NEEDS, TAKOMA REGIONAL HOSPITAL, INC. WILL CONTINUE TO STRENGTHEN OUR PARTNERSHIPS AND CONTINUUM OF CARE OPPORTUNITIES WITH AREA HEALTH DEPARTMENTS, FEDERALLY QUALIFIED HEALTH CENTERS, AND FRONTIER HEALTH, THE REGION'S LEADING PROVIDER OF BEHAVIORAL HEALTH SERVICES.
FACILITY 1, TAKOMA REGIONAL HOSPITAL, INC. - PART V, LINE 13H	BALLAD HEALTH'S FINANCIAL ASSISTANCE POLICY ALLOWS FOR SOME EXCEPTIONS TO STRICTLY ADHERING TO FEDERAL POVERTY GUIDELINES WHEN AWARDING FINANCIAL ASSISTANCE. UNIQUE CIRCUMSTANCES MAY BE WEIGHED AND ASSESSED FOR FINANCIAL ASSISTANCE CONSIDERATION ON A CASE-BY-CASE BASIS. ALSO, THERE ARE SOME SERVICES WHERE FINANCIAL ASSISTANCE MAY BE PROVIDED OUTSIDE OF FEDERAL POVERTY GUIDELINES. THESE ARE NOTED IN BALLAD HEALTH'S FINANCIAL ASSISTANCE POLICY.

Schedule H (Form 990) 2019

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?9
Name and address		Type of Facility (describe)
1	TAKOMA MEDICAL ASSOCIATES 438 E VANN ROAD GREENEVILLE,TN37743	PHYSICIAN SERVICES
2	WOMENS CENTER OF GREENEVILLE 1021 COOLIDGE STREET SUITE 2 GREENEVILLE,TN37743	OUTPATIENT CLINIC
3	GREENEVILLE URGENT CARE & OCC MED 1021 COOLIDGE STREET SUITE 4 GREENEVILLE,TN37743	OUTPATIENT CLINIC
4	KIDSFIRST PEDIATRICS 5000 MONARCH POINTE GREENEVILLE,TN37745	OUTPATIENT CLINIC
5	KIDSFIRST PEDIATRICS 600 BOONES CREEK ROAD JONESBOROUGH,TN37659	OUTPATIENT CLINIC
6	TAKOMA CENTER FOR SLEEP DISORDERS 1024 COOLIDGE STREET GREENEVILLE,TN37743	OUTPATIENT CLINIC
7	TAKOMA OUTPATIENT REHABILITATION 108 W SUMMERS STREET GREENEVILLE,TN37743	REHABILITATION SERVICES
8	TAKOMA OUTPATIENT REHABILITATION 1321 TUSCULUM BOULEVARD GREENEVILLE,TN37743	REHABILITATION SERVICES
9	TAKOMA OUTPATIENT REHABILITATION 3135 PEOPLES STREET JOHNSON CITY,TN37604	REHABILITATION SERVICES
10

Schedule H (Form 990) 2019

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
PART I, LINE 3C - OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARE	FINANCIAL ASSISTANCE APPROVAL CAN APPLY TO AN ASSORTMENT OF PATIENTS SUCH AS THOSE WHO HAVE EXHAUSTED THEIR TENNCARE/MEDICAID BENEFITS, THOSE WHO QUALIFIED FOR TENNCARE/MEDICAID AFTER THE DATE OF SERVICE, DECEASED PATIENTS WITH NO ESTATE OR ASSETS, UNINSURED PATIENTS, AND UNDERINSURED PATIENTS. WHILE BALLAD HEALTH'S QUALIFICATIONS FOR FINANCIAL ASSISTANCE IS BASED ON FEDERAL POVERTY GUIDELINES, ASSET VALUES MAY ALSO BE USED TO DETERMINE ELIGIBILITY. UNIQUE CIRCUMSTANCES MAY BE ASSESSED ON A CASE-BY- CASE BASIS. CHARITY APPROVAL COVERS ALL DATES OF SERVICE FOR THE PATIENT WHEN THEY ARE APPROVED AND THERE IS NO LIMITATION OR CAP ON THE AMOUNT OF CHARITY THAT A PATIENT MAY RECEIVE. BALLAD HEALTH HOSPITALS DO NOT STOP APPROVING FINANCIAL ASSISTANCE FOR PATIENT ACCOUNTS IF A HOSPITAL'S CHARITY WRITE-OFFS EXCEED THE HOSPITAL'S CHARITY BUDGET. ALL BALLAD HEALTH HOSPITALS PROVIDE AN UNINSURED DISCOUNT. THE CURRENT UNINSURED DISCOUNT IS 74% FOR TAKOMA REGIONAL HOSPITAL, INC. IN ADDITION TO THE UNINSURED DISCOUNT, MANY PATIENTS WILL FURTHER QUALIFY FOR ADDITIONAL FINANCIAL ASSISTANCE. ALL PATIENTS SEEKING FINANCIAL ASSISTANCE MUST SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE AND SUBMIT DOCUMENTS IN SUPPORT OF THE INFORMATION ON THE APPLICATION, UNLESS SPECIFICALLY EXCLUDED PER OUR POLICY GUIDELINES. MEDICAID ELIGIBLE PATIENTS WILL QUALIFY FOR 100% FINANCIAL ASSISTANCE AND NOT BE REQUIRED TO COMPLETE THE REQUIRED DOCUMENTATION WHEN: A) MEDICAID ELIGIBILITY REQUIREMENTS ARE MET AFTER THE SERVICE IS PROVIDED, B) NON-COVERED CHARGES OCCUR ON A MEDICAID ELIGIBLE ENCOUNTER, OR C) BENEFITS HAVE BEEN EXHAUSTED. DECEASED PATIENTS WITH NO ESTATE ALSO QUALIFY FOR 100% FINANCIAL ASSISTANCE. FINANCIAL ASSISTANCE DETERMINATIONS MAY BE RETROACTIVE FOR ALL OUTSTANDING BALANCES. IN ADDITION, WE HAVE A NUMBER OF PROGRAMS WITH SPECIAL DISCOUNTS SUCH AS LACTATION CONSULTATION SERVICES, ONCOLOGY TREATMENT REGIMENS, ENROLLMENT IN VARIOUS COMMUNITY PROGRAMS, AND PRESCRIPTION DRUGS FILLED POST-DISCHARGE.
PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION	THE COST TO CHARGE RATIO (WORKSHEET 2 "RATIO OF PATIENT CARE COST TO CHARGES") WAS USED TO COMPUTE THE COST RELATED TO FINANCIAL ASSISTANCE (LINE 7A) AND TENNCARE/MEDICAID LOSSES (LINE 7B). LINE 7E COMMUNITY HEALTH IMPROVEMENT INCLUDES COSTS TAKEN DIRECTLY FROM DEPARTMENTAL OPERATING REPORTS OR SPECIFIC GENERAL LEDGER EXPENSE ACCOUNTS, WITH NO ADDITIONAL OVERHEAD INCLUDED. LINE 7F HEALTH PROFESSIONS EDUCATION IS COMPRISED OF COSTS ASSOCIATED WITH HOSPITAL STAFF INVOLVED WITH TRAINING STUDENTS FROM COLLEGES, UNIVERSITIES AND PROGRAMS. STUDENTS RECEIVE HANDS-ON TRAINING AT OUR HOSPITAL AS PART OF THEIR HEALTH PROFESSIONS CURRICULUM. LINE 7I REPORTS CASH CONTRIBUTIONS MADE TO LOCAL NONPROFITS THAT PROVIDE HEALTH AND WELLNESS SERVICES TO COMMUNITY RESIDENTS.
PART II - COMMUNITY BUILDING ACTIVITIES	BALLAD HEALTH 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 BALLAD TEAM MEMBERS, SERVING VOLUNTARILY ON COMMITTEES AND BOARDS OF LOCAL SERVICE AND NONPROFIT ORGANIZATIONS. SOME ALSO SERVE AS MEMBERS AND CONSULTANTS ON PROFESSIONAL COMMITTEES AND TASK FORCES THAT AFFECT REGIONAL DEVELOPMENT IN HEALTHCARE AND EDUCATION. EXAMPLES OF TRH PROFESSIONAL COMMITTEE AND TASK FORCE INVOLVEMENT INCLUDE: - GREENE COUNTY ANTI-DRUG COALITION - GREEN COUNTY HEALTH COUNCIL - GREENE COUNTY PARTNERSHIP LEADERSHIP PROGRAM - HEALTHY TN COMMUNITY COMMITTEE THE HOSPITAL, IN COLLABORATION WITH AREA HEALTH AGENCIES AND PROVIDERS, MAY OFFER ASSISTANCE WITH COORDINATION, ADVOCACY, PROVIDE SPACE, 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. EXAMPLES INCLUDE: - OUR DIABETES EDUCATOR PROVIDED CORE EDUCATION CLASSES ON HOW TO MANAGE DIABETES AND READ FOOD LABELS, PRESENTED A HEALTHCARE LECTURE TO THE TOWN OF GREENEVILLE PUBLIC WORKS AND PROVIDED SEVERAL LECTURES ON NUTRITION TIPS AND TRENDS TO THE ADULT CENTER FOR AGING - AN INFECTION PREVENTION RN SPOKE TO 6TH GRADERS ON THE PROPER WAY OF HANDWASHING - A PHARMACIST AND PHYSICAL THERAPIST PRESENTED LECTURES TO THE HOPE CHEST CANCER SUPPORT GROUP ON LYMPHEDEMA MANAGEMENT AND THE SHORT AND LONG- TERM EFFECTS OF CHEMOTHERAPY - OUR ACTIVITY ROOM WAS PROVIDED TO THE STROKE SUPPORT GROUP TO CONDUCT THEIR GROUP MEETINGS SEVERAL TAKOMA REGIONAL HOSPITAL, INC. EMPLOYEES SERVED ON THE GREENE COUNTY HEALTH COUNCIL AND SUB-COMMITTEES.
PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY	SELF-PAY BALANCES INCLUDE ACCOUNTS AFTER PAYMENTS AND CONTRACTUAL ADJUSTMENTS (DISCOUNTS) HAVE BEEN APPLIED FROM ALL THIRD-PARTY PAYERS SUCH AS MEDICARE, TENNCARE, COMMERCIAL INSURERS, AND OTHERS - GENERALLY LEAVING THE PATIENT RESPONSIBLE FOR ANY REMAINING DEDUCTIBLE AND/OR CO-PAYMENT. OTHER SELF-PAY ACCOUNTS ARE FROM PATIENTS WITH NO INSURANCE OR OTHER THIRD-PARTY COVERAGE. UNDER OUR SELF-PAY POLICY, ANY PATIENT WHO HAS NO INSURANCE AND IS INELIGIBLE FOR ANY GOVERNMENT ASSISTANCE PROGRAM RECEIVED A 76% DISCOUNT THROUGH FEBRUARY 1, 2018, AT WHICH TIME THE UNINSURED DISCOUNT WAS ADJUSTED TO 74%. MANY SELF-PAY PATIENTS WILL FURTHER QUALIFY FOR FINANCIAL ASSISTANCE (SOMETIMES REFERRED TO AS CHARITY CARE) IF THEY PROVIDE THE FINANCIAL INFORMATION WE NEED TO DEEM THEM ELIGIBLE. AFTER THE NORMAL COLLECTION PROCESS HAS INDICATED AN ACCOUNT IS UNCOLLECTIBLE, TAKOMA REGIONAL HOSPITAL, INC. WRITES THE ACCOUNT OFF TO BAD DEBT. THE HOSPITAL'S OVERALL SELF-PAY ACCOUNTS RECEIVABLE BALANCE IS EVALUATED ON AN ONGOING BASIS TO EVALUATE THE AGE OF ACCOUNTS RECEIVABLE, HISTORICAL WRITE-OFFS AND RECOVERIES AND ANY UNUSUAL INSTANCES (SUCH AS LOCAL, REGIONAL OR NATIONAL ECONOMIC CONDITIONS) WHICH AFFECT THE COLLECTIVITY OF RECEIVABLES.
BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS	BALLAD HEALTH'S AUDITED FINANCIAL STATEMENTS INCLUDE A FOOTNOTE ON PAGES 13-14 THAT DESCRIBES BAD DEBT. TAKOMA REGIONAL HOSPITAL, INC. IS INCLUDED IN THE JUNE 30, 2018 AUDITED FINANCIAL STATEMENTS OF BALLAD HEALTH. THE AUDITED FINANCIAL STATEMENTS ARE FOR THE FIVE MONTHS ENDING AFTER THE FEBRUARY 1, 2018 MERGER OF WELLMONT HEALTH SYSTEM AND MOUNTAIN STATES HEALTH ALLIANCE (ATTACHED).
PART VI, LINE 2 - NEEDS ASSESSMENT	AS REPORTED IN SCHEDULE H, PART V, SECTION B, TAKOMA REGIONAL HOSPITAL, INC. CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA'S) IN 2012 AND 2015. IN ADDITION TO THE CHNA, A VARIETY OF PRACTICES AND PROCESSES ARE IN PLACE TO ENSURE THAT THE FILING ORGANIZATION IS RESPONSIVE TO THE HEALTH NEEDS OF ITS COMMUNITY. SUCH PRACTICES AND PROCESSES INVOLVE THE FOLLOWING: 1. A HOSPITAL OPERATING/COMMUNITY BOARD COMPOSED OF INDIVIDUALS BROADLY REPRESENTATIVE OF THE COMMUNITY, COMMUNITY LEADERS, AND THOSE WITH SPECIALIZED MEDICAL TRAINING AND EXPERTISE, 2. POST-DISCHARGE PATIENT FOLLOW-UP RELATED TO THE ON-GOING CARE AND TREATMENT OF PATIENTS WHO SUFFER FROM CHRONIC DISEASES, 3. SPONSORSHIP AND PARTICIPATION IN COMMUNITY HEALTH AND WELLNESS ACTIVITIES THAT REACH A BROAD SPECTRUM OF THE FILING ORGANIZATION'S COMMUNITY, AND 4. COLLABORATION WITH OTHER LOCAL COMMUNITY GROUPS TO ADDRESS THE HEALTH CARE NEEDS OF THE FILING ORGANIZATION'S COMMUNITY.
PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	CONSISTENT WITH THE BALLAD HEALTH FINANCIAL ASSISTANCE POLICY, TAKOMA REGIONAL HOSPITAL, INC. (TRH) COMMUNICATES WITH AND PROVIDES EDUCATION TO OUR PATIENTS THROUGH VARIOUS AVENUES REGARDING GOVERNMENTAL ASSISTANCE PROGRAMS AND HOSPITAL FINANCIAL ASSISTANCE. VARIOUS EDUCATIONAL AND APPLICATION DOCUMENTS RELATED TO OBTAINING FINANCIAL ASSISTANCE ARE WIDELY AVAILABLE AT TRH AND ALL DOCUMENTS ARE AVAILABLE ON THE BALLAD HEALTH WEBSITE. PRINTED FINANCIAL ASSISTANCE EDUCATIONAL MATERIALS ARE PART OF EACH REGISTRATION PACKET AND POSTERS ARE DISPLAYED IN HIGHLY VISIBLE AREAS OF THE HOSPITAL. OUR FINANCIAL ASSISTANCE POLICY AND DOCUMENTS ARE AVAILABLE IN OUR EMERGENCY DEPARTMENT AND ADMITTING AREAS. WE ARE ALSO HAPPY TO MAIL ALL DOCUMENTS TO PATIENTS. WE OFFER A PLAIN LANGUAGE SUMMARY AND ALL OF OUR DOCUMENTS ARE AVAILABLE IN ENGLISH AND SPANISH. FINANCIAL ASSISTANCE INFORMATION IS AVAILABLE DURING PRE-REGISTRATION, REGISTRATION AND/OR DURING FINANCIAL COUNSELING. WE OFFER GOVERNMENTAL PROGRAM ELIGIBILITY REPRESENTATIVES TO ASSIST PATIENTS IN SECURING ELIGIBILITY FOR MEDICAID OR TENNCARE, FEDERAL DISABILITY AND OTHER GOVERNMENTAL ASSISTANCE PROGRAMS. ADDITIONALLY, IF A PATIENT OR COMMUNITY RESIDENT EXPRESSES AN INTEREST IN THE ACA-HEALTHCARE EXCHANGE, OUR REPRESENTATIVES HAVE THE QUALIFICATIONS AND EXPERIENCE TO ASSIST THEM THROUGH THE ENTIRE PROCESS. OUR FINANCIAL COUNSELORS OFFER FINANCIAL ASSISTANCE APPLICATIONS TO PATIENTS WHO DO NOT QUALIFY FOR GOVERNMENTAL ASSISTANCE PROGRAMS AND ARE UNABLE TO PAY FOR SOME OR ALL OF THEIR HEALTHCARE. ALL PATIENT BILLING STATEMENTS HAVE VERBIAGE DISCUSSING FINANCIAL ASSISTANCE ALONG WITH CONTACT INFORMATION. OUR LAST LETTER TO THE PATIENT DISPLAYS THE PLAIN LANGUAGE SUMMARY. IN ALL ORAL CORRESPONDENCES WITH A PATIENT, IF IT IS IDENTIFIED THE PATIENT CANNOT MEET PAYMENT REQUIREMENTS ON THEIR ACCOUNT, FINANCIAL ASSISTANCE IS DISCUSSED AS AN OPTION. APPLICANTS ARE NOTIFIED OF FINANCIAL ASSISTANCE DETERMINATION IN WRITING.
PART VI, LINE 4 - COMMUNITY INFORMATION	TAKOMA REGIONAL HOSPITAL, INC. IS LOCATED IN GREENEVILLE, TENNESSEE (GREENE COUNTY) ON THE EASTERN BORDER OF THE STATE. THE COUNTY IS PRIMARILY RURAL AND THE POPULATION IS ESTIMATED BY UNITED STATES CENSUS BUREAU TO BE 68,808. THE LATEST CENSUS BUREAU DATA ESTIMATES THE MEDIAN AGE OF RESIDENTS OF GREENE COUNTY IS 44.3,WHICH IS OLDER THAN THE MEDIAN AGE OF 38.6 IN TENNESSEE. 20.3% OF THE COUNTY'S RESIDENTS ARE 65 OR OLDER COMPARED TO 15.4% FOR THE STATE. THE BUREAU ESTIMATES GREENE COUNTY'S MEDIAN HOUSEHOLD INCOME AT 38,266 (33,445 FOR THE TOWN OF GREENEVILLE) COMPARED TO 48,708 FOR THE STATE OF TENNESSEE. 23.9% OF THE COUNTY'S CHILDREN (UNDER 18 YEARS) LIVE IN POVERTY, WHILE 30.6% OF CHILDREN UNDER 5 YEARS LIVE BELOW THE POVERTY LEVEL. GREENE COUNTY IS 65.2% RURAL COMPARED WITH THE STATEWIDE RURAL RATE OF 33.6%. THIS IS A SIGNIFICANT CONTRIBUTING FACTOR IN INFLUENCING HEALTH OUTCOMES IN A POPULATION. MANY RURAL RESIDENTS MUST TRAVEL A GREATER DISTANCE TO ACCESS DIFFERENT POINTS OF THE HEALTH CARE DELIVERY SYSTEM. DUE TO GEOGRAPHIC DISTANCE, SOMETIMES EXTREME WEATHER CONDITIONS, LACK OF PUBLIC TRANSPORTATION AND CHALLENGING ROADS, RURAL RESIDENTS MAY BE LIMITED, AND IN SOME INSTANCES, EVEN PROHIBITED FROM ACCESSING HEALTH CARE SERVICES. ALTHOUGH 19% OF PEOPLE IN THE U.S. LIVE IN RURAL AREAS AND 30% OF THE VEHICLE MILES TRAVELED OCCUR IN RURAL AREAS, ALMOST HALF OF CRASH DEATHS OCCUR THERE.
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH	TAKOMA REGIONAL HOSPITAL, INC. (TRH) WAS GOVERNED BY WELLMONT HEALTH SYSTEM, ITS SOLE MEMBER, UNTIL FEBRUARY, 2018. WHEN WELLMONT HEALTH SYSTEM (WHS) MERGED WITH MOUNTAIN STATES HEALTH ALLIANCE (MSHA) IN FEBRUARY TO FORM THE BALLAD HEALTH HEALTHCARE SYSTEM, BALLAD HEALTH'S BOARD OF DIRECTORS ASSUMED BOARD RESPONSIBILITIES FOR BOTH WELLMONT HEALTH SYSTEM (INCLUDING TRH) AND MOUNTAIN STATES HEALTH ALLIANCE. WELLMONT AND MOUNTAIN STATES STILL EXIST AS LEGAL ENTITIES AND CONTINUE TO OPERATE MULTIPLE HOSPITALS. WHS REMAINS TRH'S SOLE MEMBER. TRH ALSO HAS A COMMUNITY BOARD THAT HAS CO-APPROVAL VOTING RIGHTS FOR CERTAIN DECISIONS. BOARD STRUCTURE AND RIGHTS ARE DISCUSSED IN MORE DETAIL IN SCHEDULE O (FORM 990, PART VI, LINES 6 & 7). THE TRH COMMUNITY BOARD IS COMPRISED PRIMARILY OF GREENE COUNTY RESIDENTS. THE TRH BOARD DELEGATED CERTAIN RESPONSIBILITIES TO THE COMMUNITY BOARD SUCH AS: ADMINISTER A QUALITY ASSURANCE PROGRAM, APPOINT MEDICAL STAFF AND ADMINISTER THE CREDENTIALING AND DISCIPLINARY PROCESS APPLICABLE TO THE TAKOMA MEDICAL STAFF. TRH EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN OUR COMMUNITY. TRH IS DEDICATED TO OPERATING EFFICIENTLY SO THAT WASTE IS MINIMIZED. VARIOUS CHECKS AND BALANCES ARE ESTABLISHED TO ENSURE THAT EXPENDITURES FOR OPERATING EXPENSES AND CAPITAL COSTS ARE REASONABLE AND NECESSARY.
PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM	TAKOMA REGIONAL HOSPITAL IS A SUBSIDIARY OF WELLMONT HEALTH SYSTEM. WELLMONT HEALTH SYSTEM ("WELLMONT") IS A TENNESSEE NON-PROFIT CORPORATION BASED IN KINGSPORT, TENNESSEE. WELLMONT INCLUDES FIVE ADDITIONAL HOSPITALS, AN INTEGRATED PHYSICIAN NETWORK AND SEVERAL AMBULATORY SITES. WELLMONT HOSPITALS OFFER A BROAD SCOPE OF SERVICES RANGING FROM COMMUNITY-BASED ACUTE CARE TO HIGHLY SPECIALIZED TERTIARY SERVICES INCLUDING TWO TRAUMA CENTERS, COMPREHENSIVE HEART CARE AND CANCER CARE CENTERS. WELLMONT HEALTH SYSTEM (WHS) IS THE SOLE MEMBER OF TAKOMA REGIONAL HOSPITAL, INC. (TRH). DURING FY2018, WELLMONT HEALTH SYSTEM (WHS) MERGED WITH MOUNTAIN STATES HEALTH ALLIANCE (MSHA) TO FORM BALLAD HEALTH. BALLAD HEALTH IS THE SOLE MEMBER OF WHS AND MSHA AND SERVES AS THE PARENT COMPANY. FOLLOWING MERGER, WHS AND MSHA CONTINUE TO EXIST AS SEPARATE LEGAL ENTITIES, EACH OPERATING MULTIPLE HOSPITALS. TAKOMA REGIONAL HOSPITAL, INC. (TRH)IS OWNED BY WHS. WITH THE MERGER OF WHS AND MSHA, THE EXPECTATION IS THAT TRH AND LAUGHLIN MEMORIAL HOSPITAL WILL WORK TOGETHER SO THAT COMBINED SYNERGIES WILL RESULT IN BETTER UTILIZATION OF LIMITED RESOURCES TO IMPROVE OVERALL DELIVERY OF HEALTHCARE IN THE AREA. BEING PART OF A 21-HOSPITAL HEALTHCARE SYSTEM BENEFITS PATIENTS WHERE THEY ARE ABLE TO BE MOVED EFFICIENTLY ALONG AN INTEGRATED, COMPREHENSIVE CONTINUUM OF CARE AS THEIR HEALTH STATUS DICTATES. IF NEEDED, A TRH PATIENT MAY BE MOVED TO ONE OF BALLAD HEALTH'S TERTIARY REFERRAL CENTERS FOR COMPLEX PATIENTS FROM TRH AND ITS SERVICE AREA.
PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT	TENNESSEE, VIRGINIA
ADDITIONAL INFORMATION	BALLAD HEALTH IS REQUIRED TO REPORT COMMUNITY BENEFIT ESTIMATES ON A QUARTERLY BASIS WITH THE STATES OF TENNESSEE AND VIRGINIA. THE REPORTING INCLUDES ALL OF BALLAD'S HOSPITAL ORGANIZATIONS AND IS REPORTED USING IRS FORM 990 SCHEDULE H COMMUNITY BENEFIT INSTRUCTIONS. BALLAD OPERATES UNDER A CERTIFICATE OF PUBLIC ADVANTAGE (COPA) IN TENNESSEE AND COOPERATIVE AGREEMENT (CA) IN VIRGINIA AS OBLIGATED BY AGREEMENTS BETWEEN BALLAD AND THE TWO STATES TO ALLOW MOUNTAIN STATES HEALTH ALLIANCE AND WELLMONT HEALTH SYSTEM TO MERGE.

Schedule H (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

TAKOMA REGIONAL HOSPITAL INC

Employer identification number

51-0603966

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ..

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2019

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1BARTON HOVE RETIRED 1312018 CHAIR/PRES/CEO-WHS	(i) (ii)	------------- 817,290	------------- 391,085	------------- 11,551	------------- 27,695	------------- 21,864	------------- 1,269,485	-------------
2ERIC DEATON SR VP MARKET OPR	(i) (ii)	------------- 398,970	------------- 196,460	------------- 9,269	------------- 18,578	------------- 15,003	------------- 638,280	-------------
3GARY MILLER TREAS/SR VP COPA	(i) (ii)	------------- 348,799	------------- 170,792	------------- 1,283	------------- 16,306	------------- 10,791	------------- 547,971	-------------
4TODD DOUGAN END 4302018 SEC/FIN INTEGRATION	(i) (ii)	------------- 344,429	------------- 143,894	------------- 95	------------- 15,519	------------- 21,208	------------- 525,145	-------------
5TAMMY ALBRIGHT PRESIDENT-TRH	(i) (ii)	186,599 -------------	15,737 -------------	310 -------------	6,823 -------------	19,229 -------------	228,698 -------------	-------------
6JOSEPH KRETSCHMAR MD PHYSICIAN	(i) (ii)	340,137 -------------	325,892 -------------	1,208 -------------	17,057 -------------	20,882 -------------	705,176 -------------	-------------
7TODD CHRISTENSEN MD PHYSICIAN	(i) (ii)	504,149 -------------	110,769 -------------	434 -------------	20,368 -------------	20,253 -------------	655,973 -------------	-------------
8WILLIAM BRIDGES MD PHYSICIAN	(i) (ii)	357,420 -------------	73,084 -------------	794 -------------	14,033 -------------	19,711 -------------	465,042 -------------	-------------
9JAMI GOODWIN MD PHYSICIAN	(i) (ii)	385,647 -------------	10,000 -------------	13,932 -------------	14,121 -------------	16,648 -------------	440,348 -------------	-------------
10HOWARD HERRELL MD PHYSICIAN	(i) (ii)	408,413 -------------	-------------	182 -------------	7,605 -------------	16,091 -------------	432,291 -------------	-------------

Schedule J (Form 990) 2019

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation

Schedule J (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

TAKOMA REGIONAL HOSPITAL INC

Employer identification number

51-0603966

Return Reference	Explanation
FORM 990, PAGE 2, PART III, LINE 4A	(CONT'D) REHABILITATION SERVICES; PRIMARY AND SPECIALTY PHYSICIAN CLINICS AND DIAGNOSTIC IMAGING. IN FISCAL YEAR 2018, WE PROVIDED SERVICES TO 2,443 INPATIENTS, HAD 1,793 SURGICAL CASES AND 17,705 EMERGENCY ROOM VISITS. CONSISTENT WITH OUR MISSION, WE HAVE WORKED TOWARD IMPROVING OUR COMMUNITY'S ACCESS TO QUALITY, AFFORDABLE HEALTHCARE, IMPROVING THE HEALTH STATUS OF OUR COMMUNITIES AND CONTRIBUTING TO THE OVERALL QUALITY OF LIFE IN THE AREAS WE SERVE. THE HOSPITAL AND ITS EMPLOYED PHYSICIAN PRACTICES WENT LIVE ON WELLMONT HEALTH SYSTEM'S EPIC ELECTRONIC HEALTH RECORD SYSTEM IN NOVEMBER 2017. THE EPIC SYSTEM IS THE PREMIER SUCH SYSTEM AND ENABLES A PATIENT AND THEIR HEALTHCARE PROVIDERS TO SEE ALL OF THE PATIENT'S HEALTH INFORMATION ACROSS, NOT ONLY TAKOMA'S SITES, BUT ALSO WELLMONT HEALTH SYSTEM AND ALL EPIC SITES IN THE COUNTRY. THIS RESULTS IN BETTER, QUICKER AND MORE EFFICIENT CARE OF THE PATIENT. TO FURTHER THE COMMUNITY'S HEALTH STATUS, TAKOMA REGIONAL TEACHES OR HAS AVAILABLE A VARIETY OF HEALTH PROGRAMS THAT INCLUDE: - A NATURE TRAIL, WHICH IS A LITTLE MORE THAN A MILE IN LENGTH - THE "BIGGEST LOSER" LIFESTYLE AND WEIGHT-LOSS PROGRAM - TOTAL LIFESTYLE PROGRAM - STROKE SUPPORT GROUP - DIABETES TREATMENT CENTER (SENIOR ADULT CENTER) - LECTURES AT THE LOCAL YMCA - A VARIETY OF HEALTH PROGRAMS, AVAILABLE FOR EVERYONE IN THE GREENE COUNTY SERVICE AREA, INCLUDING THE UNDERSERVED AND UNDERPRIVILEGED FOR FREE OR A NOMINAL FEE - ALONG WITH OTHER LOCAL AGENCIES, TRH TEAM MEMBERS VISITED FIVE HIGH SCHOOLS TO DEMONSTRATE THE DANGERS OF DISTRACTED DRIVING CHARITY AND OTHER UNREIMBURSED COSTS: CHARITY CARE: WHILE REIMBURSEMENT FOR HEALTHCARE SERVICES RENDERED IS CRITICAL TO THE OPERATION AND SUSTAINABILITY OF THE ORGANIZATION, TRH RECOGNIZES ITS OBLIGATION TO PROVIDE CARE TO INDIVIDUALS WHO CANNOT AFFORD ESSENTIAL MEDICAL SERVICES, INCLUDING EMERGENCY CARE. TRH ACCEPTS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. A PATIENT IS CLASSIFIED AS A CHARITY PATIENT WHEN THEY MEET THE ESTABLISHED POLICIES OF TRH AND GUIDELINES OUTLINED BY THE FEDERAL GOVERNMENT. HOWEVER, FINANCIAL ASSISTANCE DECISIONS ARE NOT SOLELY BASED ON INCOME. UNIQUE FINANCIAL CIRCUMSTANCES ARE WEIGHED WITH VERIFIED PATIENT ASSETS WHICH CAN DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY. IT IS NOT UNTIL AFTER VERIFICATION OF INCOME AND ASSETS THAT A DECISION REGARDING THE AMOUNT OF FINANCIAL ASSISTANCE CAN BE MADE. IN FISCAL YEAR 2018, TRH INCURRED A LOSS OF 972,691 ATTRIBUTABLE TO THE PROVISION OF CHARITY CARE, AN INCREASE OF MORE THAN 9.4% FROM FISCAL YEAR 2017. THIS AMOUNT DOES NOT INCLUDE THE COSTS ASSOCIATED WITH BAD DEBT ACCOUNTS. TENNCARE/MEDICAID: TRH PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS, SUCH AS TENNCARE (TENNESSEE RESIDENTS) AND MEDICAID. TRH INCURRED A LOSS OF 2,327,851 PROVIDING CARE TO THIS POPULATION OF PATIENTS DURING THE YEAR. UNINSURED DISCOUNT: UNINSURED PATIENTS RECEIVED A 74 PERCENT DISCOUNT THROUGHOUT FY2018. THE UNINSURED DISCOUNT IS APPLIED TO ALL UNINSURED PATIENTS AT WHS HOSPITALS. ALSO, CERTAIN ELECTIVE PROCEDURES ARE NOT ELIGIBLE FOR THE UNINSURED DISCOUNT. THE UNINSURED DISCOUNT IS CALCULATED EACH YEAR IN ACCORDANCE WITH TENNESSEE REGULATIONS AND WITHOUT REGARD TO A PATIENT'S INCOME OR ASSETS. THE APPROXIMATE COST OF THIS DISCOUNT IN FY2018, USING OUR COST TO CHARGE RATIO, WAS 1,862,165. THE BEST WAY TO KEEP OUR COMMUNITIES HEALTHY IS TO PROVIDE THEM WITH THE LATEST INFORMATION ABOUT THEIR HEALTH. WE STRIVE TO PROVIDE INFORMATION ABOUT EVERYTHING FROM DISEASE AND INJURY PREVENTION TO THE LATEST TREATMENTS AND TECHNOLOGIES AVAILABLE TO COPING WITH DISEASE AND ITS SYMPTOMS. SOME OF OUR PROGRAMS DURING FY2018 INCLUDE: -WE OFFERED DIABETES EDUCATION CLASSES THROUGOUT THE YEAR; THE CLASS IS TWO-PARTS, WITH FOUR-HOUR SESSIONS OVER TWO DAYS -NUTRITION PRESENTATIONS WERE PROVIDED BY OUR DIETITION ON TOPICS SUCH AS TIPS FOR HEALTHY EATING, HOW TO READ FOOD LABELS, WITH INFORMATION PAMPHLETS PROVIDED TO PARTICIPANTS, AND HEALTHY SNACKS -WE OFFERED MONTHLY PRENATAL CLASSES, WHICH WERE OPEN TO THE PUBLIC -OUR INFECTION CONTROL NURSE VISITED A LOCAL ELEMENTARY SCHOOL TO EXPLAIN THE IMPORTANCE OF HANDWASHING TO THE STUDENTS -NUMEROUS PRESENTATIONS WERE PROVIDED AT THE ADULT CENTER FOR AGING, DISCUSSIONS INCLUDED SUPERFOOD NUTRITION AND OTHER NUTRITION LEARNING SESSIONS FROM OUR DIETITION; GENERAL HEALTH; DIABETES CARE MANAGEMENT; HEPATITIS C; WOUND CARE; AND OTHERS WE PARTICIPATED IN HEALTH FAIRS, SUCH AS: -DIABETES HOLIDAY HEALTH FAIR -A GENERAL HOLIDAY HEALTH FAIR -TWO WORKPLACE HEALTH FAIRS -A HEALTH FAIR AT THE YMCA -GREENE COUNTY FAIR WORKING A FIRST AID STATION AND DISTRIBUTING WATER HOSPITAL TEAM MEMBERS ARE ENGAGED IN A MYRIAD OF COMMUNITY ACTIVITIES. SOME EXAMPLES DURING FY2018: -TRH STAFF WORKED AT THE I-40 WELCOME CENTER THE DAY OF THE SOLAR ECLIPSE TO KEEP PEOPLE'S EYESIGHT SAFE. THE WELCOME CENTER PROVIDED SOLAR GLASSES. -HOSPITAL STAFF WORKED AT THREE BLOOD DRIVES. -OUR WELLNESS COORDINATOR ORGANIZED A 5K RUN FOR THE TOWN OF GREENEVILLE POLICE DEPARTMENT. -THE HOSPITAL IS INVOLVED IN THE GREENE COUNTY ANTI-DRUG COALITION. -TWO TEAM MEMBERS REPRESENT THE HOSPITAL ON THE HEALTHIER TENNESSEE COMMITTEE FOR OUR AREA -TEAM MEMBERS SERVE ON THE GREENE COUNTY HEALTH COUNCIL HOSPITAL MEETING SPACE IS OPEN TO LOCAL ORGANIZATIONS THAT SUPPORT COMMUNITY HEALTH AND WELLNESS. SOME EXAMPLES INCLUDE CITY SCHOOL MEETINGS, SPORTS MEDICINE DISCUSSIONS FOR HIGH SCHOOLS AND A LOCAL COLLEGE, GREENE COUNTY PARTNERSHIP ADULT LEADERSHIP, A DIABETES SUPPORT GROUP, GREENE COUNTY MINISTERIAL ASSOCIATION, A STROKE SUPPORT GROUP, A BREAST CANCER SUPPORT GROUP, AND A CANCER SUPPORT GROUP. SOME OF THE HEALTHIER TENNESSEE COMMITTEE MEETINGS WERE ALSO HELD AT TRH. TAKOMA REGIONAL HOSPITAL SERVES AS A CLINICAL TRAINING SITE FOR HEALTH PROFESSIONAL EDUCATION STUDENTS. WE DEDICATE STAFF TO WORK WITH REGIONAL COLLEGES AND UNIVERSITIES TO COORDINATE PLACEMENT OF HEALTHCARE PROFESSIONAL STUDENTS AS PART OF THEIR EDUCATIONAL CURRICULUM. IN ADDITION TO CLINICAL TRAINING, THE HEALTH CARE STUDENTS ENTERING OUR SYSTEM ARE REQUIRED TO HAVE ORIENTATION AND COMPUTER TRAINING. INCLUDED IN THE NUMBER OF PARTICIPANTS RECEIVING CLINICAL EXPERIENCE AT TRH WERE 28 NURSING STUDENTS. THIS CLINICAL NURSING EXPERIENCE REQUIRED EXTENSIVE TRH NURSING STAFF INVOLVEMENT. THE CLINICAL SETTING AND HANDS-ON INSTRUCTION COST THE HOSPITAL 42,908. TRH PROVIDED CLINICAL TRAINING FOR ANOTHER 11 STUDENTS TRAINING IN OTHER ALLIED HEALTH DISCIPLINES. THE HOSPITAL INCURRED EXPENSE OF 9,411 TO PROVIDE THIS TRAINING.
FORM 990, PAGE 6, PART VI, LINE 6	WELLMONT HEALTH SYSTEM IS TRH'S SOLE MEMBER. THE BOARD OF DIRECTORS OF BALLAD HEALTH, WELLMONT'S PARENT ORGANIZATION, SERVES AS WELLMONT'S BOARD OF DIRECTORS AND IS RESPONSIBLE FOR APPOINTING THE DIRECTORS OF TRH'S BOARD. TAKOMA REGIONAL HOSPITAL'S BOARD OF DIRECTORS ARE RESPONSIBLE FOR: - DEVELOPMENT AND ESTABLISHMENT OF THE ORGANIZATION'S POLICIES AND STRATEGIC PLAN, - DEVELOPMENT AND APPROVAL OF THE ORGANIZATION'S ANNUAL CAPITAL AND OPERATING BUDGETS, - REGULAR REVIEW OF THE ORGANIZATION'S FINANCIAL PERFORMANCE, - ANNUAL REVIEW OF MEDICAL STAFF COMPETENCY STANDARDS, AND - REGULAR REVIEW OF THE ORGANIZATION'S CORPORATE COMPLIANCE PLAN.
FORM 990, PAGE 6, PART VI, LINE 7A	FOLLOWING THE MERGER OF TRH'S SOLE MEMBER, WELLMONT HEALTH SYSTEM, AND MOUNTAIN STATES HEALTH ALLIANCE IN FEBRUARY 2018 TO FORM BALLAD HEALTH, THE NEWLY APPOINTED BALLAD HEALTH BOARD OF DIRECTORS ASSUMED BOARD RESPONSIBILITIES FOR WELLMONT AND MOUNTAIN STATES. BOTH WELLMONT AND MOUNTAIN STATES REMAIN SEPARATE LEGAL ENTITIES.
FORM 990, PAGE 6, PART VI, LINE 7B	CERTAIN DECISIONS OF THE BOARD ARE, PURSUANT TO CHARTER, SUBJECT TO APPROVAL OF THE MEMBER. NO ORDINARY, DAY-TO-DAY DECISIONS ARE SUBJECT TO MEMBER APPROVAL.
FORM 990, PAGE 6, PART VI, LINE 9	BARTON HOVE (RETIRED 1/31/2018)
FORM 990, PAGE 6, PART VI, LINE 11B	THE PRESIDENT OF TAKOMA REGIONAL HOSPITAL, INC. REVIEWED THE TAKOMA REGIONAL HOSPITAL, INC.'S FORM 990 WITH THE BOARD OF DIRECTORS PRIOR TO FILING. 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	TAKOMA REGIONAL HOSPITAL, INC. IS PART OF THE NEWLY FORMED BALLAD HEALTH HEALTHCARE SYSTEM FORMED WHEN WELLMONT HEALTH SYSTEM AND MOUNTAIN STATES HEALTH ALLIANCE MERGED IN FEBRUARY 2018. BALLAD HEALTH HAS A CONFLICT OF INTEREST POLICY FOR ALL MEMBERS OF THE BOARD OF DIRECTORS, THE EXECUTIVE CHAIR/PRESIDENT, EXECUTIVE VICE PRESIDENTS, SENIOR VICE PRESIDENTS, AND VICE PRESIDENTS, AND APPLIES TO ALL BALLAD HEALTH ORGANIZATIONS. ALL PERSONS COVERED BY THIS POLICY ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM ON AN ANNUAL BASIS. SHOULD A CONFLICT ARISE, IT IS THE RESPONSIBILITY OF THE CONFLICTED INDIVIDUAL TO UPDATE HIS OR HER DISCLOSURE IMMEDIATELY. ALL MEETINGS OF THE BOARD OR BOARD COMMITTEES HAVE A STANDING AGENDA ITEM FIRST ON THE AGENDA TITLED "CONFLICTS OF INTEREST". IF A MEMBER OF THE BOARD OR BOARD COMMITTEE HAS A CONFLICT OF INTEREST INVOLVING ANY ISSUE ON THE BOARD AGENDA, HE OR SHE MUST DECLARE THE CONFLICT OF INTEREST DURING THE PERIOD ALLOTTED FOR DISCLOSURE. IF ANY ISSUE ARISES DURING A MEETING IN WHICH THE BOARD MEMBER HAS A CONFLICT OF INTEREST, HE OR SHE MUST IMMEDIATELY DECLARE THE CONFLICT. WHILE EACH MEMBER OF THE BOARD OR BOARD COMMITTEES ARE RESPONSIBLE FOR DISCLOSING CONFLICTS OF INTEREST, IT IS ALSO THE RESPONSIBILITY OF ANY BOARD MEMBER AWARE OF A CONFLICT WHICH HAS NOT BEEN DISCLOSED TO ENSURE THE BOARD IS MADE AWARE. THE PRESIDING OFFICER OF A BOARD OR BOARD COMMITTEE MEETING MAY ASK A CONFLICTED MEMBER TO EXCUSE THEMSELVES FROM THE MEETING DURING THE DISCUSSION RELATED TO THE ISSUE WITH WHICH THE CONFLICT OF INTEREST APPLIES. UNDER NO CIRCUMSTANCES SHALL A MEMBER VOTE ON A MATTER THAT GIVES RISE TO A POTENTIAL CONFLICT.
FORM 990, PAGE 6, PART VI, LINE 15A	ON AN ANNUAL BASIS, BALLAD HEALTH'S HUMAN RESOURCES (HR) DEPARTMENT EVALUATES COMPENSATION FOR ALL EXECUTIVES AT A POSITION LEVEL OF ASSISTANT VICE PRESIDENT AND ABOVE. THE REVIEW INCLUDES TRH'S BOARD PRESIDENT AND WELLMONT HEALTH SYSTEM CEO, MR. HOVE, AND TRH'S PRESIDENT, MS. ALBRIGHT. HR'S EVALUATION IS BASED ON MARKET DATA OBTAINED FROM AN INDEPENDENT COMPENSATION CONSULTANT FOR POSITIONS WITH SIMILAR RESPONSIBILITIES AT SIMILARLY SITUATED ORGANIZATIONS. BASED ON THIS COMPARABILITY DATA, BALLAD HEALTH'S PRESIDENT & CEO EVALUATES THE DATA AND SUBMITS HIS RECOMMENDATIONS TO BALLAD HEALTH'S BOARD OF DIRECTORS FOR THEIR FINAL REVIEW AND APPROVAL.
FORM 990, PAGE 6, PART VI, LINE 15B	THE COMPENSATION OF TRH'S OTHER OFFICERS, WITH THE EXCEPTION OF THE CONTROLLER, ARE EVALUATED EACH YEAR IN THE SAME MANNER AS TRH'S BOARD PRESIDENT AND TRH'S PRESIDENT. THE CONTROLLER POSITION IS EVALUATED CONSISTENT WITH OTHER BALLAD HEALTH NON-EXECUTIVE POSITIONS BASED ON A MARKET PERCENTILE SPECIFIC TO HER POSITION.
FORM 990, PAGE 6, PART VI, LINE 19	GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE UPON REQUEST TO THE APPROPRIATE PARTIES REQUESTING THEM. FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST TO APPROPRIATE PARTIES REQUESTING THEM, AND THEY ARE MADE AVAILABLE TO THOSE PARTIES WHO OWN INDEBTEDNESS.
FORM 990, PART XI, LINE 9	CAPITAL CONTRIBUTION FROM PARENT 33,679,398 EMPLOYER PROVIDED PARKING-NOT ON BOOKS -22,723 TOTAL 33,656,675
FORM 990, PAGE 12, PART XII, LINE 2C	BALLAD HEALTH (BALLAD) IS A TAX-EXEMPT ENTITY AND THE PARENT CORPORATION OF BOTH MOUNTAIN STATES HEALTH ALLIANCE (MSHA) AND WELLMONT HEALTH SYSTEM (WHS). THE TWO HEALTHCARE SYSTEMS CAME TOGETHER ON FEBRUARY 1, 2018 AS A RESULT OF A MERGER APPROVED BY BOTH TENNESSEE AND VIRGINIA DEPARTMENTS OF HEALTH. THE INDIVIDUALS SERVING AS THE BOARD OF DIRECTORS OF BALLAD ALSO SERVE AS THE BOARD OF DIRECTORS OF MSHA AND WHS. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS OF BALLAD INCLUDE MSHA, WHS AND THEIR SUBSIDIARIES AND AFFILIATES WHICH WERE PREVIOUSLY INCLUDED IN EITHER MSHA OR WHS AUDITED CONSOLIDATED FINANCIAL STATEMENTS. BALLAD HAS AN AUDIT COMMITTEE WHICH ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR. FORM 990 - ADDITIONAL INFORMATION FY18 FORM 990 HAS NUMEROUS REPORTING CHANGES FROM PRIOR YEAR RETURNS. WE BELIEVE THESE CHANGES ARE NECESSARY IN ORDER TO BETTER REFLECT THE ORGANIZATION'S ACTIVITY.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

TAKOMA REGIONAL HOSPITAL INC

Employer identification number

51-0603966

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)WELLMONT HEALTH SYSTEM 1905 AMERICAN WAY KINGSPORT,TN37660 62-1636465	HOSP. SYS.	TN	501C3	3	BALLAD		No
(2)WELLMONT HAWKINS CO MEMORIAL HOSP 851 LOCUST STREET ROGERSVILLE,TN37857 62-1816368	HOSPITAL	TN	501C3	3	WHS		No
(3)TAKOMA REGIONAL HOSPITAL FDN INC 1905 AMERICAN WAY KINGSPORT,TN37660 47-1334302	FUNDRAISER	TN	501C3	7	WHS		No
(4)WELLMONT CARDIOLOGY SERVICES 1905 AMERICAN WAY KINGSPORT,TN37660 26-3557623	MED. SERV.	TN	501C3	10	WHS		No
(5)WELLMONT MEDICAL ASSOCIATES INC 1905 AMERICAN WAY KINGSPORT,TN37660 27-0898372	MED. SERV.	TN	501C3	7	WHS		No
(6)WELLMONT SLEEP SERVICES 1905 AMERICAN WAY KINGSPORT,TN37660 27-3777167	MED. SERV.	TN	501C3	3	WHS		No
(7)WELLMONT FOUNDATION INC 1905 AMERICAN WAY KINGSPORT,TN37660 58-1594191	FUNDRAISER	TN	501C3	7	WHS		No
(8)WELLMONT MADISON HOUSE 1905 AMERICAN WAY KINGSPORT,TN37660 62-1308216	ASST. LIV.	TN	501C3	10	WHS		No
(9)WELLMONT WEXFORD HOUSE 1905 AMERICAN WAY KINGSPORT,TN37660 58-1859039	NSG. HOME	TN	501C3	10	WHS		No
(10)WELLMONT IMAGING SERVICES INC 1905 AMERICAN WAY KINGSPORT,TN37660 86-1103148	HEALTHCARE	TN	501C3	12A	WHS		No
(11)MOUNTAIN STATES HEALTH ALLIANCE 303 MED TECH PARKWAY SUITE 220 JOHNSON CITY,TN37604 62-0476282	HOSP. SYS.	TN	501C3	3	BALLAD		No
(12)MOUNTAIN STATES FOUNDATION 2335 KNOB CREEK ROAD SUITE 101 JOHNSON CITY,TN37604 58-1418862	FUNDRAISER	TN	501C3	12A	MSHA		No
(13)MSHA AUXILIARY 400 N STATE OF FRANKLIN ROAD JOHNSON CITY,TN37604 58-1418345	SUPP. ORG.	TN	501C3	12A	MSHA		No
(14)SMYTH COUNTY COMMUNITY HOSPITAL 245 MEDICAL PARK DRIVE MARION,VA24354 54-0794913	HOSPITAL	VA	501C3	3	MSHA		No
(15)NORTON COMMUNITY HOSPITAL 100 15TH STREET NW NORTON,VA24273 54-0566029	HOSPITAL	VA	501C3	3	NA		No
(16)DICKENSON COMMUNITY HOSPITAL 312 HOSPITAL DRIVE CLINTWOOD,VA24228 77-0599553	HOSPITAL	VA	501C3	3	NCH		No
(17)JOHNSTON MEMORIAL HOSPITAL 16000 JOHNSTON MEMORIAL DRIVE ABINGDON,VA24211 54-0544705	HOSPITAL	VA	501C3	3	NA		No
(18)ABINGDON PHYSICIAN PARTNERS 16000 JOHNSTON MEMORIAL DRIVE ABINGDON,VA24211 20-5485346	MED. SERV.	VA	501C3	12A	JMH		No
(19)BALLAD HEALTH 303 MED TECH PARKWAY SUITE 220 JOHNSON CITY,TN37604 61-1771290	SUPP. ORG.	TN	501C3	12B	NA		No
(20)EAST TN HEALTHCARE HOLDINGS INC 203 GRAY COMMONS CIRCLE GRAY,TN37615 81-5475903	OPIOID TRT	TN	501C3	3	MSHA		No
(21)LAUGHLIN MEMORIAL HOSPITAL INC 1420 TUSCULUM BOULEVARD GREENEVILLE,TN37745 62-0701119	HOSPITAL	TN	501C3	3	MSHA		No
(22)LAUGHLIN HEALTHCARE FOUNDATION 1420 TUSCULUM BOULEVARD GREENEVILLE,TN37745 58-2105493	FUNDRAISER	TN	501C3	12A	MSHA		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2019

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) SAPLING GROVE AMBULATORY SURGERY 220 MEDICAL PARK BOULEVARD BRISTOL,TN37620 20-4450153	MED. SERV.	TN	N/A				No			No
(2) HOLSTON VALLEY AMBULATORY SURGERY 103 WEST STONE DRIVE KINGSPORT,TN37660 62-1816864	MED. SERV.	TN	N/A				No			No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) WELLMONT INC 1905 AMERICAN WAY KINGSPORT,TN37660 62-1320035	MED. SERV.	TN	N/A					No
(2) MCOT INC 1905 AMERICAN WAY KINGSPORT,TN37660 62-1325938	BUS. SERV.	TN	N/A					No
(3) MEDICAL MALL PHARMACY INC 1905 AMERICAN WAY KINGSPORT,TN37660 62-1565006	MED. SERV.	TN	N/A					No
(4) WELLMONT PHYSICIAN SERVICES INC 1905 AMERICAN WAY KINGSPORT,TN37660 62-1567353	MED. SERV.	TN	N/A					No
(5) WPS PROVIDERS INC 1905 AMERICAN WAY KINGSPORT,TN37660 20-5564642	MED. SERV.	TN	N/A					No
(6) WELLMONT HEALTH SERVICES INC 1905 AMERICAN WAY KINGSPORT,TN37660 62-1254373	MED. SERV.	TN	N/A					No
(7) WELLMONT INSURANCE CO SPC LTD 1905 AMERICAN WAY KINGSPORT,TN37660 98-1195624	INSURANCE		N/A					No
(8) BLUE RIDGE MEDICAL MANAGEMENT CORP 1905 AMERICAN WAY KINGSPORT,TN37660 62-1490616	MED. SERV.	TN	N/A					No
(9) MEDISERVE MEDICAL EQUIPMENT 1905 AMERICAN WAY KINGSPORT,TN37660 62-1212286	DME	TN	N/A					No
(10) MOUNTAIN STATES PROPERTIES 1905 AMERICAN WAY KINGSPORT,TN37660 62-1845895	PROP. MGMT	TN	N/A					No
(11) MOUNTAIN STATES PHYSICIAN GROUP 1905 AMERICAN WAY KINGSPORT,TN37660 62-1700412	MED. SERV.	TN	N/A					No
(12) COMMUNITY HOME CARE INC 1490 PARK AVENUE NW SUITE B NORTON,VA24273 54-1453810	DME	VA	N/A					No
(13) WILSON PHARMACY INC PO BOX 5289 JOHNSON CITY,TN37604 62-0329587	PHARMACY	TN	N/A					No
(14) CRESTPOINT HEALTH INSURANCE COMPANY 509 MED TECH PARKWAY SUITE 100 JOHNSON CITY,TN37604 62-0381170	INSURANCE	TN	N/A					No
(15) INTEGRATED SOLUTIONS HEALTH NETWORK 509 MED TECH PARKWAY SUITE 100 JOHNSON CITY,TN37604 62-1711997	HLTH NETWK	TN	N/A					No
(16) NOLICHUCKEY MANAGEMENT SVCS INC 1420 TUSCULUM BOULEVARD GREENEVILLE,TN37745 62-1776681	MED. SERV.	TN	N/A					No

Schedule R (Form 990) 2019

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2019

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2019

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2019

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: MISSION: HONOR THOSE WE SERVE BY DELIVERING THE BEST POSSIBLE CARE. VISION: TO BUILD A LEGACY OF SUPERIOR HEALTH BY LISTENING TO AND CARING FOR THOSE WE SERVE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	3
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	0
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	726
6	Total number of volunteers (estimate if necessary) .............	6	46
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	22,723
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	19,623

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,129	346,073
9	Program service revenue (Part VIII, line 2g) .........	66,402,629	57,036,021
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....		46,440
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	2,628,603	3,310,992
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	69,032,361	60,739,526
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	63,429	2,100
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	41,332,333	34,912,746
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	30,517,257	29,807,269
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	71,913,019	64,722,115
19	Revenue less expenses. Subtract line 18 from line 12.......	-2,880,658	-3,982,589
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	4,262,778	32,494,699
21	Total liabilities (Part X, line 26).............	5,098,604	3,656,439
22	Net assets or fund balances. Subtract line 21 from line 20.....	-835,826	28,838,260

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 54,982,539 including grants of $ 2,100 ) (Revenue $ 60,370,730 )
	TAKOMA REGIONAL HOSPITAL, INC., IS A 100-BED ACUTE CARE FACILITY LOCATED IN GREENEVILLE, TENNESSEE. TAKOMA REGIONAL HOSPITAL FOUNDATION IS A SUPPORTING ORGANIZATION FOR THE HOSPITAL. WE PROVIDE A WIDE VARIETY OF SERVICES, INCLUDING EMERGENCY CARE; PHYSICAL, STROKE AND OCCUPATIONAL THERAPIES; SURGERY; ACUTE MEDICAL CARE SERVICES INCLUDING ICU, PROGRESSIVE CARE, AND GENERAL MED SURG; INPATIENT REHABILITATION UNIT; GERO-PSYCH SERVICES; LABORATORY SERVICES; RESPIRATORY THERAPY; SLEEP EVALUATIONS AND TREATMENT; INPATIENT AND OUTPATIENT (CONTINUED ON SCHEDULE 0) (CONT'D) REHABILITATION SERVICES; PRIMARY AND SPECIALTY PHYSICIAN CLINICS AND DIAGNOSTIC IMAGING. IN FISCAL YEAR 2018, WE PROVIDED SERVICES TO 2,443 INPATIENTS, HAD 1,793 SURGICAL CASES AND 17,705 EMERGENCY ROOM VISITS. CONSISTENT WITH OUR MISSION, WE HAVE WORKED TOWARD IMPROVING OUR COMMUNITY'S ACCESS TO QUALITY, AFFORDABLE HEALTHCARE, IMPROVING THE HEALTH STATUS OF OUR COMMUNITIES AND CONTRIBUTING TO THE OVERALL QUALITY OF LIFE IN THE AREAS WE SERVE. THE HOSPITAL AND ITS EMPLOYED PHYSICIAN PRACTICES WENT LIVE ON WELLMONT HEALTH SYSTEM'S EPIC ELECTRONIC HEALTH RECORD SYSTEM IN NOVEMBER 2017. THE EPIC SYSTEM IS THE PREMIER SUCH SYSTEM AND ENABLES A PATIENT AND THEIR HEALTHCARE PROVIDERS TO SEE ALL OF THE PATIENT'S HEALTH INFORMATION ACROSS, NOT ONLY TAKOMA'S SITES, BUT ALSO WELLMONT HEALTH SYSTEM AND ALL EPIC SITES IN THE COUNTRY. THIS RESULTS IN BETTER, QUICKER AND MORE EFFICIENT CARE OF THE PATIENT. TO FURTHER THE COMMUNITY'S HEALTH STATUS, TAKOMA REGIONAL TEACHES OR HAS AVAILABLE A VARIETY OF HEALTH PROGRAMS THAT INCLUDE: - A NATURE TRAIL, WHICH IS A LITTLE MORE THAN A MILE IN LENGTH - THE "BIGGEST LOSER" LIFESTYLE AND WEIGHT-LOSS PROGRAM - TOTAL LIFESTYLE PROGRAM - STROKE SUPPORT GROUP - DIABETES TREATMENT CENTER (SENIOR ADULT CENTER) - LECTURES AT THE LOCAL YMCA - A VARIETY OF HEALTH PROGRAMS, AVAILABLE FOR EVERYONE IN THE GREENE COUNTY SERVICE AREA, INCLUDING THE UNDERSERVED AND UNDERPRIVILEGED FOR FREE OR A NOMINAL FEE - ALONG WITH OTHER LOCAL AGENCIES, TRH TEAM MEMBERS VISITED FIVE HIGH SCHOOLS TO DEMONSTRATE THE DANGERS OF DISTRACTED DRIVING CHARITY AND OTHER UNREIMBURSED COSTS: CHARITY CARE: WHILE REIMBURSEMENT FOR HEALTHCARE SERVICES RENDERED IS CRITICAL TO THE OPERATION AND SUSTAINABILITY OF THE ORGANIZATION, TRH RECOGNIZES ITS OBLIGATION TO PROVIDE CARE TO INDIVIDUALS WHO CANNOT AFFORD ESSENTIAL MEDICAL SERVICES, INCLUDING EMERGENCY CARE. TRH ACCEPTS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. A PATIENT IS CLASSIFIED AS A CHARITY PATIENT WHEN THEY MEET THE ESTABLISHED POLICIES OF TRH AND GUIDELINES OUTLINED BY THE FEDERAL GOVERNMENT. HOWEVER, FINANCIAL ASSISTANCE DECISIONS ARE NOT SOLELY BASED ON INCOME. UNIQUE FINANCIAL CIRCUMSTANCES ARE WEIGHED WITH VERIFIED PATIENT ASSETS WHICH CAN DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY. IT IS NOT UNTIL AFTER VERIFICATION OF INCOME AND ASSETS THAT A DECISION REGARDING THE AMOUNT OF FINANCIAL ASSISTANCE CAN BE MADE. IN FISCAL YEAR 2018, TRH INCURRED A LOSS OF 972,691 ATTRIBUTABLE TO THE PROVISION OF CHARITY CARE, AN INCREASE OF MORE THAN 9.4% FROM FISCAL YEAR 2017. THIS AMOUNT DOES NOT INCLUDE THE COSTS ASSOCIATED WITH BAD DEBT ACCOUNTS. TENNCARE/MEDICAID: TRH PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS, SUCH AS TENNCARE (TENNESSEE RESIDENTS) AND MEDICAID. TRH INCURRED A LOSS OF 2,327,851 PROVIDING CARE TO THIS POPULATION OF PATIENTS DURING THE YEAR. UNINSURED DISCOUNT: UNINSURED PATIENTS RECEIVED A 74 PERCENT DISCOUNT THROUGHOUT FY2018. THE UNINSURED DISCOUNT IS APPLIED TO ALL UNINSURED PATIENTS AT WHS HOSPITALS. ALSO, CERTAIN ELECTIVE PROCEDURES ARE NOT ELIGIBLE FOR THE UNINSURED DISCOUNT. THE UNINSURED DISCOUNT IS CALCULATED EACH YEAR IN ACCORDANCE WITH TENNESSEE REGULATIONS AND WITHOUT REGARD TO A PATIENT'S INCOME OR ASSETS. THE APPROXIMATE COST OF THIS DISCOUNT IN FY2018, USING OUR COST TO CHARGE RATIO, WAS 1,862,165. THE BEST WAY TO KEEP OUR COMMUNITIES HEALTHY IS TO PROVIDE THEM WITH THE LATEST INFORMATION ABOUT THEIR HEALTH. WE STRIVE TO PROVIDE INFORMATION ABOUT EVERYTHING FROM DISEASE AND INJURY PREVENTION TO THE LATEST TREATMENTS AND TECHNOLOGIES AVAILABLE TO COPING WITH DISEASE AND ITS SYMPTOMS. SOME OF OUR PROGRAMS DURING FY2018 INCLUDE: -WE OFFERED DIABETES EDUCATION CLASSES THROUGOUT THE YEAR; THE CLASS IS TWO-PARTS, WITH FOUR-HOUR SESSIONS OVER TWO DAYS -NUTRITION PRESENTATIONS WERE PROVIDED BY OUR DIETITION ON TOPICS SUCH AS TIPS FOR HEALTHY EATING, HOW TO READ FOOD LABELS, WITH INFORMATION PAMPHLETS PROVIDED TO PARTICIPANTS, AND HEALTHY SNACKS -WE OFFERED MONTHLY PRENATAL CLASSES, WHICH WERE OPEN TO THE PUBLIC -OUR INFECTION CONTROL NURSE VISITED A LOCAL ELEMENTARY SCHOOL TO EXPLAIN THE IMPORTANCE OF HANDWASHING TO THE STUDENTS -NUMEROUS PRESENTATIONS WERE PROVIDED AT THE ADULT CENTER FOR AGING, DISCUSSIONS INCLUDED SUPERFOOD NUTRITION AND OTHER NUTRITION LEARNING SESSIONS FROM OUR DIETITION; GENERAL HEALTH; DIABETES CARE MANAGEMENT; HEPATITIS C; WOUND CARE; AND OTHERS WE PARTICIPATED IN HEALTH FAIRS, SUCH AS: -DIABETES HOLIDAY HEALTH FAIR -A GENERAL HOLIDAY HEALTH FAIR -TWO WORKPLACE HEALTH FAIRS -A HEALTH FAIR AT THE YMCA -GREENE COUNTY FAIR WORKING A FIRST AID STATION AND DISTRIBUTING WATER HOSPITAL TEAM MEMBERS ARE ENGAGED IN A MYRIAD OF COMMUNITY ACTIVITIES. SOME EXAMPLES DURING FY2018: -TRH STAFF WORKED AT THE I-40 WELCOME CENTER THE DAY OF THE SOLAR ECLIPSE TO KEEP PEOPLE'S EYESIGHT SAFE. THE WELCOME CENTER PROVIDED SOLAR GLASSES. -HOSPITAL STAFF WORKED AT THREE BLOOD DRIVES. -OUR WELLNESS COORDINATOR ORGANIZED A 5K RUN FOR THE TOWN OF GREENEVILLE POLICE DEPARTMENT. -THE HOSPITAL IS INVOLVED IN THE GREENE COUNTY ANTI-DRUG COALITION. -TWO TEAM MEMBERS REPRESENT THE HOSPITAL ON THE HEALTHIER TENNESSEE COMMITTEE FOR OUR AREA -TEAM MEMBERS SERVE ON THE GREENE COUNTY HEALTH COUNCIL HOSPITAL MEETING SPACE IS OPEN TO LOCAL ORGANIZATIONS THAT SUPPORT COMMUNITY HEALTH AND WELLNESS. SOME EXAMPLES INCLUDE CITY SCHOOL MEETINGS, SPORTS MEDICINE DISCUSSIONS FOR HIGH SCHOOLS AND A LOCAL COLLEGE, GREENE COUNTY PARTNERSHIP ADULT LEADERSHIP, A DIABETES SUPPORT GROUP, GREENE COUNTY MINISTERIAL ASSOCIATION, A STROKE SUPPORT GROUP, A BREAST CANCER SUPPORT GROUP, AND A CANCER SUPPORT GROUP. SOME OF THE HEALTHIER TENNESSEE COMMITTEE MEETINGS WERE ALSO HELD AT TRH. TAKOMA REGIONAL HOSPITAL SERVES AS A CLINICAL TRAINING SITE FOR HEALTH PROFESSIONAL EDUCATION STUDENTS. WE DEDICATE STAFF TO WORK WITH REGIONAL COLLEGES AND UNIVERSITIES TO COORDINATE PLACEMENT OF HEALTHCARE PROFESSIONAL STUDENTS AS PART OF THEIR EDUCATIONAL CURRICULUM. IN ADDITION TO CLINICAL TRAINING, THE HEALTH CARE STUDENTS ENTERING OUR SYSTEM ARE REQUIRED TO HAVE ORIENTATION AND COMPUTER TRAINING. INCLUDED IN THE NUMBER OF PARTICIPANTS RECEIVING CLINICAL EXPERIENCE AT TRH WERE 28 NURSING STUDENTS. THIS CLINICAL NURSING EXPERIENCE REQUIRED EXTENSIVE TRH NURSING STAFF INVOLVEMENT. THE CLINICAL SETTING AND HANDS-ON INSTRUCTION COST THE HOSPITAL 42,908. TRH PROVIDED CLINICAL TRAINING FOR ANOTHER 11 STUDENTS TRAINING IN OTHER ALLIED HEALTH DISCIPLINES. THE HOSPITAL INCURRED EXPENSE OF 9,411 TO PROVIDE THIS TRAINING.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses54,982,539

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)			(D) Reportable compensation from the organization (W-2/1099-MISC)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(1) BARTON HOVE RETIRED 1312018...................................................................... CHAIR/PRES/C	0.10 ................. 31.90	X	X		0	1,219,926	49,559
(2) ERIC DEATON...................................................................... SR VP MARKET	0.10 ................. 49.90	X			0	604,699	33,581
(3) GARY MILLER...................................................................... TREAS/SR VP	0.10 ................. 49.90	X	X		0	520,874	27,097
(4) TODD DOUGAN END 4302018...................................................................... SEC/FIN INTE	0.10 ................. 44.90	X	X		0	488,418	36,727
(5) TAMMY ALBRIGHT...................................................................... PRESIDENT-TR	45.00 .................		X		202,646	0	26,052
(6) JUDITH CLARK...................................................................... CONTROLLER	40.00 .................		X		94,853	0	3,548
(7) JOSEPH KRETSCHMAR MD...................................................................... PHYSICIAN	40.00 .................			X	667,237	0	37,939
(8) TODD CHRISTENSEN MD...................................................................... PHYSICIAN	40.00 .................			X	615,352	0	40,621
(9) WILLIAM BRIDGES MD...................................................................... PHYSICIAN	40.00 .................			X	431,298	0	33,744
(10) JAMI GOODWIN MD...................................................................... PHYSICIAN	40.00 .................			X	409,579	0	30,769
(11) HOWARD HERRELL MD...................................................................... PHYSICIAN	40.00 .................			X	408,595	0	23,696

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	2,829,560	2,833,917	343,333

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	346,073
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		346,073

		Business Code
2a	NET PATIENT REVENUE	621990	56,411,192	56,411,192
b	TMA OCC MED REVENUE	621990	480,926	480,926
c	LAB REVENUE	621990	56,007	56,007
d	TRH ADMINISTRATIVE REVENUE	621990	47,403	47,403
e	TMA BEHAVIORAL HEALTH REVENUE	622110	27,571	27,571
f	All other program service revenue.		12,922	12,922
g	Total. Add lines 2a–2f .....		57,036,021

3 Investment income (including dividends, interest, and othersimilar amounts) ......
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		2,736	6a
b	Less: rental expenses			6b
c	Rental income or (loss)		2,736	6c
d	Net rental income or (loss).......			2,736	2,736
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	92,873		7a
b	Less: cost or other basis and sales expenses	46,433		7b
c	Gain or (loss)	46,440		7c
d	Net gain or (loss).........			46,440	46,440
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	340B REVENUE		900099	3,046,531	3,046,531
b	CAFETERIA SALES		900099	148,469	148,469
c	EMPLOYER PROVIDED PARKING		900099	22,723		22,723
d	All other revenue ....			90,533	90,533
e	Total. Add lines 11a–11d ......			3,308,256
12	Total revenue. See instructions.....			60,739,526	60,370,730	22,723

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	2,100	2,100
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	536,292		536,292
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	28,206,867	27,566,752	640,115
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	718,539	711,914	6,625
9	Other employee benefits .......	3,622,953	3,477,055	145,898
10	Payroll taxes ...........	1,828,095	1,744,253	83,842
11	Fees for services (non-employees):
a	Management ......	595,295	5,836	589,459
b	Legal .........	11,847		11,847
c	Accounting ...........
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	3,509,817	1,597,894	1,911,923
12	Advertising and promotion ....	3,349	1,011	2,338
13	Office expenses .......	1,256,507	933,362	323,145
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	2,223,017	2,203,779	19,238
17	Travel ............	35,133	27,667	7,466
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	20,788		20,788
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	1,047,439	1,047,439
23	Insurance ...	124,932		124,932
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	PURCHASED SERVICES	7,981,538	7,557,534	424,004
b	MEDICAL SUPPLIES & DRUGS	6,667,839	6,667,839
c	MANAGEMENT FEES TO PARENT	4,501,515		4,501,515
d	REPAIRS & MAINTENANCE	773,825	495,012	278,813
e	All other expenses	1,054,428	943,092	111,336
25	Total functional expenses. Add lines 1 through 24e	64,722,115	54,982,539	9,739,576	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			7,753,853	1	3,662,160
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			-19,045,653	4	10,166,678
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7	799,101
8	Inventories for sale or use ............			1,447,363	8	1,269,767
9	Prepaid expenses and deferred charges ......			119,361	9	124,468
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	15,590,251
b	Less: accumulated depreciation	10b	1,625,690	11,527,175	10c	13,964,561
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............			2,460,679	14	2,507,964
15	Other assets. See Part IV, line 11 ...........				15
16	Total assets. Add lines 1 through 15 (must equal line 33)...			4,262,778	16	32,494,699

17	Accounts payable and accrued expenses .....	4,383,198	17	3,043,192
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	715,406	25	613,247
26	Total liabilities. Add lines 17 through 25..	5,098,604	26	3,656,439

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........		27
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	-835,826	32	28,838,260
33	Total liabilities and net assets/fund balances ........	4,262,778	33	32,494,699