TY 2017 Form 990

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC)
(1) CHARLES WHITFIELD LMH CEO...................................................................... LMH CEO	44.60 ................. 0.40	X	X	928,863	165,025	25,620
(2) MARVIN EICHORN EVP BALLAD HEALTH...................................................................... LMH COMM. BR	1.00 ................. 54.00	X		0	749,129	42,742
(3) MARK PATTERSON MD...................................................................... LMH COMM BRD	48.00 .................	X		474,964	0	19,736
(4) ARTHUR ADAMS...................................................................... LMH COMM BRD	1.00 .................	X		0	0	0
(5) ALAN CORLEY...................................................................... LMH COMM BRD	1.00 .................	X		0	0	0
(6) DOMINICK JACKSON...................................................................... LMH COMM BRD	1.00 .................	X	X	0	0	0
(7) CHARLES MONTGOMERY...................................................................... LMH COMM BRD	1.00 .................	X		0	0	0
(8) CRAIG SHEPHERD...................................................................... LMH COMM BRD	1.00 .................	X		0	0	0
(9) CRAIG SCHMALZRIED...................................................................... LMH COMM BRD	1.00 .................	X		0	0	0
(10) BOBBY WELLS...................................................................... LMH COMM BRD	1.00 .................	X		0	0	0
(11) BARBARA ALLEN...................................................................... BALLAD HEALT	0.10 ................. 3.70	X	X	0	0	0
(12) JULIE BENNETT...................................................................... BALLAD HEALT	0.10 ................. 1.40	X		0	0	0
(13) MICHAEL CHRISTIAN...................................................................... MSHA TREASUR	0.10 ................. 3.30	X	X	0	0	0
(14) ROBERT FEATHERS...................................................................... MSHA VICE CH	0.10 ................. 3.70	X	X	0	0	0
(15) JOANNE GILMER...................................................................... MSHA SECRETA	0.10 ................. 6.30	X	X	0	0	0
(16) DAVID GOLDEN...................................................................... BALLAD HEALT	0.10 ................. 2.30	X		0	0	0
(17) DAVID LESTER...................................................................... BH VICE CHAI	0.10 ................. 2.90	X	X	0	0	0

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) DAVID MAY MD........................................................................ BALLAD HEALT	0.10 .......................2.90	X				0	0	0
(19) BRENDAN MCSHEEHY........................................................................ MSHA DIRECTO	0.10 .......................4.80	X				0	0	0
(20) DAVID MOULTON MD........................................................................ MSHA DIRECTO	0.10 .......................2.80	X				0	0	0
(21) SCOTT NISWONGER........................................................................ BALLAD HEALT	0.10 .......................1.90	X				0	0	0
(22) BRIAN NOLAND........................................................................ BALLAD HEALT	0.10 .......................1.90	X				0	0	0
(23) GARY PEACOCK TREASURER........................................................................ BALLAD HEALT	0.10 .......................7.00	X	X			0	0	0
(24) BERT SMITH MD........................................................................ MSHA DIRECTO	0.10 .......................2.30	X				0	0	0
(25) DOUG SPRINGER MD........................................................................ BALLAD HEALT	0.10 .......................1.70	X	X			0	0	0
(26) RICK STOREY........................................................................ MSHA DIRECTO	0.10 .......................2.30	X				0	0	0
(27) GRANT SUMMERS........................................................................ MSHA DIRECTO	0.10 .......................1.80	X				0	0	0
(28) CLEM WILKES JR........................................................................ MSHA PAST CH	0.10 .......................3.30	X				0	0	0
(29) KEITH WILSON........................................................................ BALLAD HEALT	0.10 .......................1.70	X				0	0	0
(30) ALAN LEVINE BALLAD HEALTH PRESCEO........................................................................ BALLAD HEALT	0.10 .......................54.90	X	X			0	0	0
(31) MARK COMPTON........................................................................ LMH CFO	45.00 .......................		X			281,520	0	23,875
(32) LINDSAY HAUN........................................................................ LMH CFO	45.00 .......................		X			0	52,552	17,264
(33) BRENDA CANNON LMH CNO........................................................................ LMH CNO	45.00 .......................			X		219,103	0	21,474
(34) BILLY PARSLEY MD........................................................................ PHYSICIAN	40.00 .......................				X	626,479	0	28,381
(35) RICHARD PECTOL MD........................................................................ PHYSICIAN	40.00 .......................				X	587,504	0	17,386
(36) ROBERT NORTHRUP MD........................................................................ PHYSICIAN	40.00 .......................				X	466,184	0	27,945
(37) KYLE BOREN MD........................................................................ PHYSICIAN	45.00 .......................				X	437,805	0	10,491
(38) NATALIE SCOTT MD........................................................................ PHYSICIAN	40.00 .......................				X	344,584	0	28,381

(A) Name and business address	(B) Description of services	(C) Compensation
DIVERSIFIED CLINICAL SERVICES INC PO BOX 551187 JACKSONVILLE,FL32255	WOUND CARE SVCS	954,724
HANKINS & WEEMS PO BOX 520 GREENEVILLE,TN37744	LANDSCAPING	597,936
ALIGN MD 5121 MARYLAND WAY STE 300 BRENTWOOD,TN37027	HOSPITALISTS	519,580
BRADLEY ARANT BOULT CUMMINGS LLP PO BOX 340025 NASHVILLE,TN37203	LEGAL SVCS	519,327
ANGELICA CORPORATION PO BOX 535122 ATLANTA,GA30353	LINEN SVCS	470,455
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 20

- 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

LAUGHLIN MEMORIAL HOSPITAL INC

Employer identification number

62-0701119

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

LAUGHLIN MEMORIAL HOSPITAL INC

Employer identification number

62-0701119

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 LAUGHLIN MEMORIAL 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 LAUGHLIN MEMORIAL HOSPITAL INC		Employer identification number 62-0701119

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 LAUGHLIN MEMORIAL HOSPITAL INC			Employer identification number 62-0701119
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 C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

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

OMB No. 1545-0047

2019

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

LAUGHLIN MEMORIAL HOSPITAL INC

Employer identification number

62-0701119

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2019

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2019

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Yes

1,794

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Total. Add lines 1c through 1i ....................................................................................................

1,794

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
SCHEDULE C, PART II-B, LINE 1	A PORTION OF DUES PAID TO TENNESSEE HOSPITAL ASSOCIATION IS ATTRIBUTABLE TO DIRECT LOBBYING.

Schedule C (Form 990 or 990EZ) 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

LAUGHLIN MEMORIAL HOSPITAL INC

Employer identification number

62-0701119

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 .....	3,159,509		3,159,509
b	Buildings ....	20,630,074	700,436	19,929,638
c	Leasehold improvements
d	Equipment ....	6,668,777	2,156,863	4,511,914
e	Other .....	1,767,428	350,516	1,416,912
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				29,017,973

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
(1)DUE FROM SUBSIDIARY				11,600,085
(2)LONG TERM COMPENSATION INVESTMENT				1,104,833
(3)ASSETS WHOSE USE IS LIMITED				523,164
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				13,228,082

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
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	4,645,636
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

"BALLAD HEALTH 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

LAUGHLIN MEMORIAL HOSPITAL INC

Employer identification number

62-0701119

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? . . . . . . . . .

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

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) . . .	624,015		624,015	0.900 %
b	Medicaid (from Worksheet 3, column a) . . . . .	8,700,009	6,000,486	2,699,523	3.900 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	9,324,024	6,000,486	3,323,538	4.810 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	395,186	21,627	373,559	0.540 %
f	Health professions education (from Worksheet 5) . . .
g	Subsidized health services (from Worksheet 6) . . . .	2,005,378	54,203	1,951,175	2.820 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	13,750		13,750	0.020 %
j	Total. Other Benefits . .	2,414,314	75,830	2,338,484	3.380 %
k	Total. Add lines 7d and 7j .	11,738,338	6,076,316	5,662,022	8.190 %

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.

		(c) Total community building expense	(e) Net community building expense
1	Physical improvements and housing	500	500
2	Economic development	500	500
3	Community support	1,500	1,500
4	Environmental improvements
5	Leadership development and training for community members	500	500
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	3,000	3,000

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. ......

5,575,884

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. ......

2,286,112

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).....

17,515,255

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

20,791,387

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

-3,276,132

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	LAUGHLIN MEMORIAL HOSPITAL INC 1420 TUSCULUM BLVD GREENEVILLE,TN37745 WWW.BALLADHEALTH.ORG 0000000053	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)

	LAUGHLIN MEMORIAL 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): WWW.BALLADHEALTH.ORG

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?.........

If "Yes" (list url):

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

10b

Yes

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)

	LAUGHLIN MEMORIAL 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/LOCATIONSHOSPITALS

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

BALLADHEALTH.ORG/LOCATIONSHOSPITALS

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

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

	LAUGHLIN MEMORIAL 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)

	LAUGHLIN MEMORIAL 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, LAUGHLIN MEMORIAL HOSPITAL, INC. - PART V, LINE 3E	IT WAS CHALLENGING FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE TO IDENTIFY THE TOP TEN HEALTH ISSUES IN OUR AREA DUE TO THE MANY FACTORS CONTRIBUTING TO POOR HEALTH IN OUR AREA. ACCORDING TO DATA FROM NATIONAL, REGIONAL AND COUNTY HEALTH RANKINGS, TOBACCO, OBESITY AND LACK OF PHYSICAL ACTIVITY REMAIN A STRONG CONCERN RELATIVE TO THE HEALTH STATUS OF GREENE COUNTY RESIDENTS. A HARD COPY QUESTIONNAIRE WAS DEVELOPED AND SENT TO OVER 650 COMMUNITY MEMBERS WITH AN EFFORT TO REACH ALL LEVELS OF THE COMMUNITY SOCIAL STRUCTURE TO ENSURE UNDERSERVED AND UNDERPRIVILEGED RESIDENTS WERE INCLUDED IN THE COLLECTION OF HEALTH DATA. SECONDARY DATA CONSISTED OF DEMOGRAPHIC AND HEALTH DATA FOR GREENE COUNTY, THE STATE OF TENNESSEE AND THE NATION. THE COMMITTEE USED A DECISION TREE TO FIRST IDENTIFY TEN HEALTH PRIORITIES. THE DECISION TREE WAS THEN UTILIZED TO DETERMINE WHICH OF THE TEN RECOGNIZED HEALTH NEEDS WOULD BE PRIORITIZED TO THE FINAL FOUR. AN ASSET INVENTORY REPORT WAS DEVELOPED TO LOOK AT PROGRAMS CURRENTLY OFFERED IN THE COMMUNITY, THE CURRENT PROGRAMS THE HOSPITAL OFFERS, AND POTENTIAL PROJECTS THAT COULD BE DEVELOPED IN EACH AREA OF FOCUS. AS EACH OF THE TEN WERE EVALUATED BY THE COMMITTEE, SEVERAL WERE ELIMINATED BECAUSE THERE ARE OTHER ORGANIZATIONS IN THE AREA ADDRESSING THEM. FOR EXAMPLE, DENTAL CARE IS VERY POOR IN GREENE COUNTY. THE PROBLEM APPEARS TO BE THE COSTS ASSOCIATED WITH DENTAL CARE AND/OR AVAILABLE TRANSPORTATION. BECAUSE THE GREENE COUNTY HEALTH DEPARTMENT PROVIDES DENTAL CARE, THE COMMITTEE FELT THE HOSPITAL'S LIMITED RESOURCES SHOULD BE DIRECTED TO OTHER PRIORITIES. LMH OPERATES AT A LOSS SO CAREFUL CONSIDERATION WAS GIVEN TO NARROWING THE FINAL SELECTION TO FOUR HEALTH PRIORITIES: SMOKING AND THE USE OF TOBACCO PRODUCTS PHYSICAL INACTIVITY POOR NUTRITION FOR BOTH ADULTS AND CHILDREN SUBSTANCE ABUSE
FACILITY 1, LAUGHLIN MEMORIAL HOSPITAL, INC. - PART V, LINE 5	LMH CREATED A COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE (COMPRISED MOSTLY OF EXTERNAL INDIVIDUALS) TO GUIDE THE NEED'S ASSESSMENT PROCESS. EXTERNAL COMMITTEE MEMBERS RESPRESENTED A RANGE OF LOCAL ORGANIZATIONS THAT SERVE LOW-INCOME POPULATIONS, MEDICALLY UNDERSERVED INDIVIDUALS, MINORITY POPULATIONS, AND POPULATIONS WITH CHRONIC DISEASE NEEDS. EXTERNAL COMMITTEE MEMBERS REPRESENTED THE FOLLOWING ORGANIZATIONS: FOOD BANK OF GREENEVILLE RURAL RESOURCES WESLEY HEIGHTS TABERNACLE SOUP KITCHEN THE HOPE CENTER CITY AND COUNTY SCHOOL SYSTEMS THE COUNTY HEALTH DEPARTMENT FRONTIER HEALTH GREENEVILLE CITY MAYOR GREENE COUNTY MAYOR INTERNAL COMMITTEE MEMBERS INCLUDED LMH'S CEO, RADIOLOGY ONCOLOGY DIRECTOR, AND WELLNESS DIRECTOR. LMH'S PRIMARY SERVICE AREA INCLUDES TAKOMA REGIONAL HOSPITAL SO THE TWO HOSPITALS COMPLETED THE COMMUNITY HEALTH NEEDS ASSESSMENT BY WORKING TOGETHER. TAKOMA REGIONAL HOSPITAL'S COMMITTEE MEMBERS INCLUDED TAKOMA'S SR. VP OF PHYSICIAN SERVICES & MARKETING AND ITS WELLNESS DIRECTOR. THE PUBLIC HEALTH DEPARTMENT OF GREENE COUNTY WAS VERY INVOLVED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. THE COUNTY HEALTH DEPARTMENT PLAYED A KEY ROLE IN OUR CHNA DUE TO THE FACT THAT THEY UNDERTAKE A COMMUNITY HEALTH NEEDS ASSESSMENT PERIODICALLY AND ARE WELL VERSED IN THE PROCESS.
FACILITY 1, LAUGHLIN MEMORIAL HOSPITAL, INC. - PART V, LINE 6A	LAUGHLIN MEMORIAL HOSPITAL'S CHNA WAS CONDUCTED WITH TAKOMA REGIONAL HOSPITAL.
FACILITY 1, LAUGHLIN MEMORIAL HOSPITAL, INC. - PART V, LINE 11	LMH'S FY16 COMMUNITY HEALTH PLAN (IMPLEMENTATION STRATEGY) IDENTIFIED A NUMBER OF TARGETED INTERVENTIONS, MANY THAT ENGAGE VARIOUS COMMUNITY PARTNERS INCLUDING TAKOMA REGIONAL HOSPITAL (TRH), THE OTHER HOSPITAL IN OUR COUNTY THAT CONDUCTED THE CHNA WITH LMH. BELOW ARE PROJECTS FROM LMH'S IMPLEMENTATION STRATEGY: -THE DIABETES COALITION, A LOW-INCOME RESIDENTIAL PROJECT. THE GOAL IS TO PROVIDE A SERIES OF EDUCATIONAL MEETINGS WITH MEALS SERVED. DISCUSSIONS INCLUDE HOW TO AVOID DIABETES AND/OR MANAGE DIABETES. THE PROJECT HELPS FEED AT LEAST 3,500 RESIDENTS ONE FREE MEAL A WEEK. PARTNERS FOR THIS PROJECT INCLUDE LMH AND TRH, GREENE COUNTY DEPARTMENT OF HEALTH, SOME CHURCHES IN THE COMMUNITY, WESLEY HEIGHTS DIABETES COALITION, AND THE TABERNACLE CHURCH LOCATED IN THE WESLEY HEIGHTS COMMUNITY. OUR DIABETES DIRECTOR CONDUCTED OUTREACH EDUCATIONAL SESSIONS DURING THE YEAR. -ADDRESS OBESITY AND INACTIVITY, BOTH OF WHICH ARE MUCH HIGHER IN GREENE COUNTY THAN SEEN IN THE REST OF THE COUNTRY. LMH HAS A ONE-MILE WALKING TRAIL THAT CIRCLES THE HOSPITAL CAMPUS AND OPEN TO ALL COMMUNITY MEMBERS. LMH VOLUNTEERS ARE INVOLVED WITH THIS PROJECT; ENCOURAGING PARTICIPANTS TO WALK, JOG, OR RUN. THE LMH WELLNESS DIRECTOR IS RESPONSIBLE FOR OVERSEEING THIS PROJECT, INCLUDING ENSURING THE UPKEEP OF THE TRAIL IS MAINTAINED. THE HOSPITAL CONTINUES TO OFFER AN EXERCISE PROGRAM FOR COMMUNITY MEMBERS THAT IS WELL-ATTENDED. A HOSPITAL DIETITIAN CONDUCTS NUMEROUS EVENTS DURING THE YEAR TO PROMOTE HEALTHY EATING. -LMH, TRH AND GREENE COUNTY HEALTH DEPARTMENT ARE INVOLVED IN THE HEALTHIER TENNESSEE INITIATIVE, A GENERAL HEALTH PROGRAM THROUGH THE STATE OF TENNESSEE. THE PROGRAM PROMOTES FOOD ACCESS AND PHYSICAL ACTIVITY WITH A TARGETED AUDIENCE OF EMPLOYER WORKFORCES, HEALTHCARE AND THE LOCAL SCHOOL SYSTEM. THE GOAL IS TO INFLUENCE AT LEAST 1,000 PEOPLE'S HEALTH BY ENCOURAGING THEM TO PARTICIPATE IN THE HEALTHIER TENNESSEE PROGRAMS AND PROJECTS. -THE "LET'S MOVE" PROJECT. THIS IS ANOTHER PROGRAM WITH THE AIM OF LOWERING OBESITY AND INACTIVITY. THIS PROGRAM IS DIRECTED TO THE LOCAL CITY AND COUNTY GOVERNMENTS. GOALS INCLUDE IMPROVING NUTRITION AND PHYSICAL ACTIVITY, WHILE DECREASING SCREEN TIME. FOR INSTANCE, SMART FOOD SERVINGS TO STUDENTS; PROMOTING ACTIVE PLAY FOR KIDS; INCREASING THE NUMBER OF VENDING MACHINES THAT OFFER HEALTHIER CHOICES; ENSURING THAT AT LEAST 75% OF CITY AND COUNTY VENUES OFFER FOOD AND BEVERAGES THAT DISPLAY MYPLATE - MYPLATE HELPS US CHOOSE FOODS AND BEVERAGES THAT ARE HEALTHIER AND AVOID FOODS HIGH IN SATURATED FATS, SODIUM, AND ADDED SUGARS; AND, TO PROVIDE ACTIVITIES/EVENTS SUCH AS EXERCISE DEMONSTRATIONS, DISTRIBUTE HEALTH EDUCATIONAL MATERIALS, SCHEDULE GUEST SPEAKERS, AND DEVELOP A LIST OF LOCAL RESOURCES. -TO REDUCE THE INCIDENCE OF CANCER DUE TO SMOKING, THE TOBACCO COALITION OF GREENE COUNTY, PROMOTED THROUGH A GRANT BY THE GREENE COUNTY HEALTH DEPARTMENT, PROVIDED EDUCATION IN A VARIETY OF WAYS TO ENCOURAGE RESIDENTS TO NOT SMOKE. MULTIPLE BILLBOARD CAMPAIGNS ARE CHANGED OUT FROM TIME TO TIME, WITH THE BILLBOARDS DESIGNED TO TARGET SPECIFIC GROUPS: PREGNANT WOMEN, TEENS, OR ADULTS. THE PROJECT ALSO PURCHASED AND DISTRIBUTED IPADS TO ALL CITY AND COUNTY WELLNESS/PHYSICAL EDUCATION TEACHERS TO BE UTILIZED FOR LESSON PLANS AND TEACHING AIDS FOR TOBACCO PREVENTION. OUR RADIATION ONCOLOGY DEPARTMENT OFFERED AN ORAL CANCER SCREENING TO COMMUNITY MEMBERS THIS YEAR. IN ADDITION TO THE ABOVE PROGRAMS, THE HOSPITAL, IN COLLABORATION WITH FRONTIER HEALTH, PROVIDES SUBSTANCE ABUSE EDUCATION AND INFORMATION TO COMMUNITY MEMBERS. FRONTIER HEALTH IS A BEHAVIORAL HEALTH PROVIDER IN NORTHEAST TENNESSEE AND SOUTHWEST VIRGINIA. THE HOSPITAL DOES NOT ENJOY A HEALTHY FINANCIAL BOTTOM LINE. IN FACT, WE REPORTED A SIZEABLE LOSS IN FY18 AND THAT HAS BEEN THE CASE IN PRIOR YEARS AS WELL. WHILE THE HOSPITAL IS COMMITTED TO IMPROVING THE HEALTH OF ITS COMMUNITY MEMBERS, WE RECOGNIZE THAT WE LACK THE RESOURCES TO FULLY ADDRESS THE HEALTH PROBLEMS IN OUR SERVICE AREA. WE WORK CLOSELY WITH OTHER ORGANIZATIONS IN OUR AREA TO TARGET THE MOST URGENT HEALTH NEEDS OF OUR AREA'S CITIZENRY.
FACILITY 1, LAUGHLIN MEMORIAL 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

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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?2
Name and address		Type of Facility (describe)
1	LAUGHLIN HEALTHCARE CENTER 801 E MCKEE STREET GREENEVILLE,TN37743	NURSING HOME
2	LAUGHLIN HOME HEALTH 1420 TUSCULUM BLVD GREENEVILLE,TN37745	HOME HEALTH AGENCY
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4
5
6
7
8
9
10

Schedule H (Form 990) 2019

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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: LAUGHLIN'S UNINSURED DISCOUNT WAS 67% AT JUNE 30, 2018. IN ADDITION TO THE UNINSURED DISCOUNT, MANY PATIENTS WILL FURTHER QUALIFY FOR ADDITIONAL FINANCIAL ASSISTANCE. ALL PATIENTS SEEKING FINANCIAL ASSISTANCE MUST SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE AND SUBMIT DOCUMENTS IN SUPPORT OF THE INFORMATION ON THE APPLICATION, UNLESS SPECIFICALLY EXCLUDED ACCORDING TO OUR POLICY GUIDELINES. MEDICAID ELIGIBLE PATIENTS WILL QUALIFY FOR 100% FINANCIAL ASSISTANCE AND NOT BE REQUIRED TO COMPLETE THE REQUIRED DOCUMENTATION WHEN: A) MEDICAID ELIGIBILITY REQUIREMENTS ARE MET AFTER THE SERVICE IS PROVIDED, B) NON-COVERED CHARGES OCCUR ON A MEDICAID ELIGIBLE ENCOUNTER, OR C) BENEFITS HAVE BEEN EXHAUSTED. DECEASED PATIENTS WITH NO ESTATE ALSO QUALIFY FOR 100% FINANCIAL ASSISTANCE. FINANCIAL ASSISTANCE DETERMINATIONS MAY BE RETROACTIVE FOR ALL OUTSTANDING BALANCES. IN ADDITION, WE HAVE A NUMBER OF PROGRAMS WITH SPECIAL DISCOUNTS SUCH AS LACTATION CONSULTATION SERVICES; ONCOLOGY TREATMENT REGIMENS; ENROLLMENT IN VARIOUS COMMUNITY PROGRAMS, AND PRESCRIPTION DRUGS FILLED POST-DISCHARGE.
PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION	PART I, LINE 7A FINANCIAL ASSISTANCE: A COST TO CHARGE RATIO WAS USED TO COMPUTE THE COST RELATED TO FINANCIAL ASSISTANCE (CHARITY) WRITEOFFS. COSTS REPORTED IN THE OTHER COMMUNITY BENEFIT CATEGORIES WERE NOT INCLUDED WHEN COMPUTING THE COST TO CHARGE RATIO IN ORDER TO AVOID DUPLICATION OF COST. PART I, LINE 7B TENNCARE AND MEDICAID COMMUNITY BENEFIT WAS COMPUTED APPLYING THE COST TO CHARGE RATIO. PART I, LINE 7E COMMUNITY HEALTH IMPROVEMENT: ACTUAL COSTS ASSOCIATED WITH PROGRAMS AND ACTIVITIES WERE USED. COSTS ARE GENERALLY WELL DEFINED FOR COMMUNITY HEALTH IMPROVEMENT ACTIVITIES IN A SPECIFIC COST CENTER (HOSPITAL DEPARTMENT). PART I, LINE 7G SUBSIDIZED HEALTH SERVICES: THE HOSPITAL'S SUBSIDY OF ITS WHOLLY OWNED PHYSICIAN PRACTICE COMPRISED THE SIGNIFICANT MAJORITY OF OUR SUBSIDIZED HEALTH. OUR RURAL AREA IS CONSIDERED A MEDICALLY UNDERSERVED POPULATION, AS REPORTED BY HEALTH RESOURCES & SERVICES ADMINISTRATION, AN AGENCY OF THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. THE HOSPITAL SUBSIDY OF THE PHYSICIAN CLINIC WAS 1,908,301. THE HOSPITAL COVERS THE LOSS OF THE PRACTICE TO ENSURE PHYSICIANS ARE AVAILABLE IN THE COMMUNITY TO CARE FOR OUR COUNTY'S RESIDENTS. THE OTHER SOURCE OF SUBSIDIZED HEALTH IS OUR CARDIOPULMONARY REHAB CENTER. PART I, LINE 7I: CONTRIBUTIONS DURING FY18 WERE ALL CASH DONATIONS.
PART II - COMMUNITY BUILDING ACTIVITIES	LMH 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 LMH TEAM MEMBERS, SERVING VOLUNTARILY ON COMMITTEES AND BOARDS OF LOCAL SERVICE AND NONPROFIT ORGANIZATIONS. SOME ALSO SERVE AS MEMBERS AND CONSULTANTS ON PROFESSIONAL COMMITTEES AND TASK FORCES THAT AFFECT REGIONAL DEVELOPMENT IN HEALTHCARE AND EDUCATION. WE DO NOT CAPTURE COSTS ASSOCIATED WITH TEAM MEMBERS THAT SERVE ON OTHER NONPROFIT BOARDS OR PROVIDE SERVICES TO OTHER NONPROFITS. COMMUNITY BUILDING REPORTED ON THIS RETURN INCLUDES CHARITABLE CONTRIBUTIONS TO NONPROFITS DIRECTED TO PROVIDING ASSISTANCE TO LOW INCOME FAMILIES, MENTORING PROGRAMS FOR CHILDREN, ECONOMIC DEVELOPMENT AND OTHER PROGRAMS SPECIFIC TO CHILDREN. LMH, 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.
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 BALLAD HEALTH'S SELF-PAY POLICY, ANY PATIENT WHO HAS NO INSURANCE AND IS INELIGIBLE FOR ANY GOVERNMENT ASSISTANCE PROGRAM RECEIVED A 38% DISCOUNT THROUGH FEBRUARY 1, 2018, AT WHICH TIME THE UNINSURED DISCOUNT INCREASED TO 67%. 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, LMH 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.
PART III, LINE 3 BAD DEBT EXPENSE, PATIENTS ELIGIBLE FOR ASSISTANCE	OUR PRIMARY EXTERNAL COLLECTION AGENCY ESTIMATES THAT 41% OF LMH'S BAD DEBT WOULD LIKELY QUALIFY FOR FINANCIAL ASSISTANCE IF PATIENTS HAD PROVIDED OUR HOSPITAL WITH A FINANCIAL ASSISTANCE APPLICATION AND REQUIRED DOCUMENTATION. THE AGENCY BASED THEIR LIKELY ELIGIBLE FOR CHARITY ASSUMPTION ON INDIVIDUALS WITH A LOW SCORE. AN INDIVIDUAL'S SCORE IS BASED ON AN ALGORITHM THAT INCLUDES DATA POINTS SUCH AS FICO CREDIT SCORE, PROPERTY VALUE, YEARS AT CURRENT RESIDENCE, NUMBER OF TIMES AN INDIVIDUAL HAS MOVED AND AN INDIVIDUAL'S PROPENSITY TO PAY SCORE. JUST UNDER 83% OF COMPLETED FINANCIAL ASSISTANCE APPLICATIONS PROCESSED DURING FY18 RECEIVED A FULL DISCOUNT (COMPLETE WRITE-OFF). AN ADDITIONAL 12% RECEIVED A PARTIAL DISCOUNT, RESULTING IN AN OVERALL APPROVAL RATE OF 95% FOR COMPLETED APPLICATIONS. THEREFORE, ONLY 5% OF COMPLETED FINANCIAL ASSISTANCE APPLICATIONS WERE DENIED. UNFORTUNATELY, MANY PATIENTS EITHER DO NOT SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE OR DO NOT PROVIDE A COMPLETE APPLICATION. INCOMPLETE APPLICATIONS ARE RETURNED TO PATIENTS ALONG WITH A NOTICE OF MISSING INFORMATION. THE NOTICE ALSO PROVIDES A CONTACT PHONE NUMBER PATIENTS MAY CALL FOR ASSISTANCE IN COMPLETING THE APPLICATION. ALL SELF-PAY PATIENTS RECEIVE FOLLOW UP CALLS EVERY 21 DAYS FROM A COMPANY LMH PAYS TO PROCESS CHARITY CARE APPLICATIONS FOR UNINSURED PATIENTS AND TO OFFER PATIENTS ENROLLMENT ASSISTANCE IN TENNCARE (TN) OR MEDICAID (VA). OUR FINANCIAL COUNSELORS FOLLOW UP WITH PATIENTS THAT HAVE A BALANCE AFTER INSURANCE HAS PAID. WE HAVE MANY INSTANCES OF PATIENTS WITH LARGE ACCOUNT BALANCES AND NO HEALTH INSURANCE COVERAGE THAT WE BELIEVE WOULD QUALIFY FOR FINANCIAL ASSISTANCE. ALTHOUGH PATIENTS ARE ENCOURAGED TO APPLY FOR ASSISTANCE, MANY WILL NOT DO SO. LMH WOULD PREFER FOR PATIENTS TO SUBMIT COMPLETED FINANCIAL ASSISTANCE APPLICATIONS GIVEN THAT HISTORICAL DATA CLEARLY INDICATES THAT MOST UNINSURED PATIENTS AND MANY UNDERINSURED WILL QUALIFY FOR FINANCIAL ASSISTANCE UNDER OUR PROGRAM. WITHOUT A COMPLETED APPLICATION, WE HAVE NO CHOICE OTHER THAN TO RECORD AN UNPAID ACCOUNT AS BAD DEBT INSTEAD OF CHARITY CARE.
BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS	BALLAD HEALTH'S AUDITED FINANCIAL STATEMENTS INCLUDE A FOOTNOTE ON PAGES 13-14 THAT DESCRIBES BAD DEBT. LMH 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 MOUNTAIN STATES HEALTH ALLIANCE AND WELLMONT HEALTH SYSTEM (ATTACHED).
PART III, LINE 8 - MEDICARE EXPLANATION	MEDICARE ALLOWABLE COSTS ARE REPORTED USING LMH'S FILED MEDICARE COST REPORT (C/R). THE C/R USES A COST TO CHARGE RATIO BASED ON A STEP-DOWN ALLOCATION METHODOLOGY. IN CARING FOR THE PATIENT, THERE ARE SEVERAL SERVICES THAT ARE CONSIDERED NON-ALLOWABLE SUCH AS TRANSPORTATION OF A PATIENT AND COMFORT ITEMS THAT INCLUDE A TELEVISION AND A TELEPHONE. THE RECRUITMENT OF PHYSICIANS ARE NON-ALLOWED COSTS BY THE MEDICARE PROGRAM EVEN THOUGH PHYSICIANS ARE RECRUITED BASED ON DOCUMENTED COMMUNITY NEED AND TO FEDERALLY RECOGNIZED MEDICALLY UNDERSERVED AREAS. A PORTION OF THE BAD DEBT ASSOCIATED WITH THE CARE OF THE PATIENT IS NOT AN ALLOWED COST BY MEDICARE, LEAVING THE HOSPITAL TO ABSORB THE LOSS. MEDICARE LOSSES, INCLUDING SOME NON-ALLOWABLE COSTS SUCH AS THOSE NOTED ABOVE, SHOULD BE COUNTED AS A COMMUNITY BENEFIT AS THIS IS THE COST OF CARE FOR SERVING THE AGING POPULATION. WHILE WE AGREE THAT COSTS SUCH AS MARKETING TO ATTRACT PATIENTS AND LOBBYING ARE REASONABLE TO EXCLUDE, IT DOES NOT SEEM REASONABLE TO EXCLUDE RECRUITMENT OF PHYSICIANS AND BASIC ITEMS SUCH AS A TELEVISION AND PHONE IN PATIENT ROOMS. WE BELIEVE MEDICARE LOSSES SHOULD BE ALLOWED AS A REPORTABLE COMMUNITY BENEFIT, SIMILAR TO GOVERNMENTAL PROGRAMS SUCH AS MEDICAID. AS A PARTICIPATING PROVIDER IN THE MEDICARE PROGRAM, HOSPITALS ARE REQUIRED TO PROVIDE THE FULL REGIMEN OF CARE FOR THE MEDICARE POPULATION. THERE ARE A NUMBER OF CARE REGIMENS THAT ARE COMPENSATED BY THE MEDICARE PROGRAM AT LEVELS BELOW COST. THEREFORE, IT IS ONLY LOGICAL TO ALLOW HOSPITALS TO REPORT THESE UNCOMPENSATED SERVICES AS A COMMUNITY BENEFIT. BY MAKING THIS CHANGE, NONPROFIT PROVIDERS WILL BE ENCOURAGED TO CONTINUE IMPORTANT CARE DELIVERY MODELS FOR OUR AGING POPULATION IN SPITE OF THE FACT IT MAY BE ECONOMICALLY INJURIOUS. OUR HOSPITAL INCURRED A MEDICARE LOSS OF 3.3 MILLION THIS YEAR. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION REQUESTS FOR FINANCIAL ASSISTANCE ARE EVALUATED USING ESTABLISHED GUIDELINES, WHILE ALLOWING FOR UNIQUE FINANCIAL CIRCUMSTANCES - FOR EXAMPLE, MEDICALLY INDIGENT PATIENTS WITH CATASTROPHIC MEDICAL COSTS THAT WOULD THREATEN THE PATIENT'S HOUSEHOLD FINANCIAL VIABILITY. WHEN A PATIENT REQUESTS FINANCIAL ASSISTANCE OR WHEN AN APPLICATION HAS BEEN RECEIVED, THE PATIENT'S ACCOUNT IS PLACED IN A HOLD STATUS TO PREVENT FURTHER COLLECTION ACTIVITIES UNTIL FINANCIAL ASSISTANCE ELIGIBILITY IS DETERMINED. ALL BALLAD HEALTH HOSPITALS COMPLY WITH IRS 501(R) REGULATORY GUIDELINES. OUR COLLECTION POLICY CLEARLY STATES THAT ALL PATIENTS ARE TREATED EQUALLY - WITH DIGNITY AND RESPECT. WE ENSURE THAT OUTSIDE COLLECTION AGENCIES USED BY OUR HOSPITALS ADHERE TO OUR BILLING AND COLLECTION GUIDELINES. OUR HOSPITAL'S COLLECTION PROGRAM INCLUDES COMMUNICATING EXPECTED FINANCIAL RESPONSIBILITY PRIOR TO SERVICE. OUR HOSPITAL PROVIDES ASSISTANCE TO HELP UNDERINSURED AND UNINSURED PATIENTS DETERMINE SOURCES OF PAYMENT FOR MEDICAL BILLS AND TO HELP PATIENTS DETERMINE ELIGIBILITY FOR PROGRAMS SUCH AS TENNCARE OR MEDICAID. AFTER INSURANCE BENEFIT VERIFICATION, OUR HOSPITALS BILL INSURANCE CARRIERS. IF THE INSURANCE CARRIER DENIES PAYMENT OF THE SERVICE/PROCEDURE AS NON-COVERED OR THE PATIENT HAS EXCEEDED THEIR MAXIMUM BENEFITS, THE SERVICE/PROCEDURE WILL QUALIFY FOR THE UNINSURED DISCOUNT. FINANCIAL COUNSELORS ARE AVAILABLE TO DISCUSS FINANCIAL ASSISTANCE WITH PATIENTS AND THEIR FAMILIES. OUR HOSPITALS PROVIDE A NUMBER OF PAYMENT OPTIONS: - A PRE-SERVICE DISCOUNT MAY BE OFFERED - A DISCOUNT IN EXCESS OF ESTABLISHED DISCOUNTING RATES MAY BE GRANTED FOR CATASTROPHIC HIGH DOLLAR ACCOUNTS - OUR HOSPITAL ACCEPTS ALL NON-CONTRACTED AND OUT-OF-NETWORK PAYERS AND WILL MAKE ATTEMPTS TO WORK WITH THESE PAYERS REGARDING APPROPRIATE REIMBURSEMENT AND BILLING TO THEIR MEMBERS - PAYMENT ARRANGEMENTS ARE AVAILABLE SO LONG AS THE ACCOUNT IS NOT WITH A COLLECTION AGENCY REASONABLE EFFORTS ARE MADE TO DETERMINE IF A PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE - SEE SCHEDULE H, PART VI, LINE 3 FOR INFORMATION ON HOW PATIENTS ARE INFORMED ABOUT OUR FINANCIAL ASSISTANCE POLICY.
PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	CONSISTENT WITH THE BALLAD HEALTH FINANCIAL ASSISTANCE POLICY, LMH 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 LMH 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 TENNCARE OR MEDICAID, 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	LMH 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. WITHIN OUR OWN COUNTY, UNINTENTIONAL INJURY DEATHS ARE 14.5% HIGHER THAN THE STATEWIDE RATE AND 72.7% HIGHER THAN TOP PERFORMING U.S. COUNTIES. AND, WHILE OUR AREA HAS GENERALLY UNFAVORABLE HEALTH STATISTICS, THE NUMBER OF RESIDENTS PER PRIMARY CARE PHYSICIAN IN OUR COUNTY IS 18% HIGHER THAN THE OVERALL STATE RATE AND 58% HIGHER THAN TOP PERFORMING U.S. COUNTIES. IT CAN BE DIFFICULT TO RECRUIT PHYSICIANS TO SMALL, RURAL COMMUNITIES, WHICH IS WHY LMH SUBSIDIZES THE LOSSES INCURRED BY OUR WHOLLY-OWNED PHYSICIAN ORGANIZATION. A CDC (CENTERS FOR DISEASE CONTROL AND PREVENTION) STUDY DEMONSTRATED THERE IS A SIGNIFICANT GAP IN HEALTH BETWEEN RURAL AND URBAN AMERICANS. THE CDC NOTED THAT DEMOGRAPHIC, ENVIRONMENTAL, ECONOMIC, AND SOCIAL FACTORS MAY PUT RURAL RESIDENTS AT HIGHER RISK OF DEATH. RESIDENTS IN RURAL AREAS TEND TO BE OLDER AND SICKER THAN THEIR URBAN COUNTERPARTS. THEY HAVE HIGHER RATES OF CIGARETTE SMOKING, HIGH BLOOD PRESSURE AND OBESITY. RURAL RESIDENTS ALSO REPORT LESS LEISURE-TIME PHYSICAL ACTIVITY AND LOWER SEATBELT USE. THEY HAVE HIGHER RATES OF POVERTY, LESS ACCESS TO HEALTHCARE, AND ARE LESS LIKELY TO HAVE HEALTH INSURANCE. THE CDC STUDY FOUND THAT UNINTENTIONAL INJURY DEATHS WERE APPROXIMATELY 50% HIGHER IN RURAL AREAS, PARTLY DUE TO A GREATER RISK OF MOTOR VEHICLE CRASHES AND OPIOID OVERDOSES. THE CDC BELIEVES THE GAPS IN HEALTH BETWEEN RURAL AND URBAN CAN BE ADDRESSED BY: -SCREENING PATIENTS FOR HIGH BLOOD PRESSURE -INCREASING CANCER PREVENTION AND EARLY DETECTION -ENCOURAGING PHYSICAL ACTIVITY AND HEALTHY EATING -PROMOTING SMOKING CESSATION - CIGARETTE SMOKING IS THE LEADING CAUSE OF PREVENTABLE DISEASE DEATH IN THE U.S. -PROMOTING MOTOR VEHICLE SAFETY -ENGAGING PROVIDERS IN SAFER PRESCRIBING OF OPIOIDS FOR PAIN AND EDUCATING CITIZENS ON THE RISKS OF OPIOIDS A NUMBER OF FACTORS CONTRIBUTE TO A UNIQUE AND CHALLENGING ENVIRONMENT THAT INFLUENCE OVERALL HEALTH STANDING IN OUR COUNTY. ACCORDING TO THE ROBERT WOOD JOHNSON FOUNDATION'S COUNTY HEALTH RANKINGS, 34% OF THE ADULTS IN LMH'S HOME COUNTY ARE OBESE. OBESITY INCREASES THE RISK FOR MANY HEALTH CONDITIONS SUCH AS CORONARY HEART DISEASE, TYPE 2 DIABETES, HYPERTENSION, STROKE, CANCER, SLEEP APNEA AND RESPIRATORY PROBLEMS, AND OSTEOARTHRITIS. EVIDENCE INDICATES PHYSICAL ACTIVITY, INDEPENDENT OF ITS EFFECT ON WEIGHT, HAS SUBSTANTIAL BENEFITS FOR HEALTH. OUR COUNTY'S INACTIVITY RATE OF 37% IS 23% HIGHER THAN THE STATEWIDE RATE AND ACCESS TO EXERCISE OPPORTUNITIES IN THE COUNTY IS 32% LOWER THAN THE OVERALL STATE RATE. LMH SEEKS TO ADDRESS THE OBESITY ISSUE BY OFFERING AN EXERCISE PROGRAM, MAINTAINING A MILE-LONG WALKING TRAIL AND INVOLVEMENT IN OTHER COMMUNITY ACTIVITIES THAT ENCOURAGE PHYSICAL ACTIVITY. ALL FOUR OF OUR CHNA HEALTH PRIORITIES ARE INCLUDED IN THE CDC LIST SHOWN ABOVE. SOME OF OUR COMMUNITY HEALTH IMPROVEMENT PROGRAMS AND ACTIVITIES ARE COVERED IN OTHER PARTS OF THIS RETURN. AS PREVIOUSLY NOTED, OUR COUNTY'S MEDIAN AGE IS OLDER THAN THAT OF THE STATE AND OUR MEDIAN HOUSEHOLD INCOME IS SIGNIFICANTLY LOWER. BASED ON THESE TWO DEMOGRAPHIC FACTORS, IT IS NO SURPRISE THAT OUR HOSPITAL'S MEDICARE RATE IS 57% AND OUR TENNCARE/MEDICAID AND SELF-PAY RATE IS 16%. AT LAUGHLIN HEALTHCARE CENTER, OUR NURSING HOME, THE MEDICARE RATE IS 39% AND TENNCARE/MEDICAID IS 37%.
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH	LMH WAS GOVERNED BY MOUNTAIN STATES HEALTH ALLIANCE, ITS SOLE MEMBER, UNTIL FEBRUARY, 2018. WHEN MOUNTAIN STATES MERGED WITH WELLMONT HEALTH SYSTEM IN FEBRUARY TO FORM THE BALLAD HEALTH HEALTHCARE SYSTEM, BALLAD HEALTH'S BOARD OF DIRECTORS ASSUMED BOARD RESPONSIBILITIES FOR BOTH MOUNTAIN STATES (INCLUDING LMH) AND WELLMONT. MOUNTAIN STATES AND WELLMONT STILL EXIST AS LEGAL ENTITIES AND CONTINUE TO OPERATE MULTIPLE HOSPITALS. MSHA REMAINS LMH'S SOLE MEMBER. LMH ALSO HAS A COMMUNITY BOARD THAT HAS COAPPROVAL 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 LMH COMMUNITY BOARD IS COMPRISED OF MEMBERS ALMOST ENTIRELY FROM GREENE COUNTY. COUNTY BOARD MEMBERS CHUCK WHITFIELD, LMH'S CEO, MARK PATTERSON, M.D., AND MARVIN EICHORN ARE COMMUNITY BOARD MEMBERS THAT ARE LMH OR MSHA EMPLOYEES. FOLLOWING THE FEBRUARY MSHA-WHS MERGER, ONLY ONE BALLAD HEALTH BOARD MEMBER LACKED INDEPENDENCE - BALLAD HEALTH'S CEO BECAUSE HE WAS COMPENSATED BY A RELATED ORGANIZATION. LMH EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN OUR COMMUNITY. LMH 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	LMH IS A 140-BED ACUTE-CARE HOSPITAL THAT ALSO OPERATES A 90-BED SKILLED NURSING FACILITY. MOUNTAIN STATES HEALTH ALLIANCE (MSHA) IS THE SOLE MEMBER OF LMH. DURING FY18, MSHA MERGED WITH WELLMONT HEALTH SYSTEM (WHS) TO FORM BALLAD HEALTH. BALLAD HEALTH IS THE SOLE MEMBER OF MSHA AND WHS AND SERVES AS THE PARENT COMPANY. FOLLOWING MERGER, MSHA AND WHS CONTINUE TO EXIST AS SEPARATE LEGAL ENTITIES, EACH OPERATING MULTIPLE HOSPITALS. TAKOMA REGIONAL HOSPITAL (TRH), ALSO LOCATED IN LMH'S SERVICE AREA, IS OWNED BY WHS. WITH THE MERGER OF MSHA AND WHS, THE EXPECTATION IS THAT LMH AND TRH 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, AN LMH PATIENT MAY BE MOVED TO JOHNSON CITY MEDICAL CENTER, ONE OF BALLAD'S FLAGSHIP HOSPITALS AND THE TERTIARY REFERRAL CENTER FOR COMPLEX PATIENTS FROM LMH 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 INSTRUCTIONS FOR REPORTING COMMUNITY BENEFIT. BALLAD OPERATES UNDER A CERTIFICATE OF PUBLIC ADVANTAGE (COPA) IN TENNESSEE AND A 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

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

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

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
LAUGHLIN MEMORIAL HOSPITAL INC

Employer identification number
62-0701119

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) GREEN LEAF PO BOX 22 AFTON,TN37616	45-4418460	501C3	12,500	FUND COMPUTERS
(2) GREENEVILLE CITY SCHOOLS FOUNDATION PO BOX 1420 GREENEVILLE,TN37744	62-1672018	501C3	12,500	FUND COMPUTERS
(3) BOYS & GIRLS CLUB OF GREENEVILLE 740 W CHURCH STREET GREENEVILLE,TN37745	62-1706248	501C3	7,500	FUNDRAISER

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

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

Cat. No. 50055P

Schedule I (Form 990) 2019

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference

Explanation

SCHEDULE I, PAGE 1, PART I, LINE 2

DONATION REQUESTS REQUIRE THE CEO'S APPROVAL. LMH ADHERES TO THE BALLAD HEALTH CHARITABLE CONTRIBUTION POLICY. APPLICANTS REQUESTING DONATIONS FROM LMH MUST PROVIDE ADEQUATE DOCUMENTATION/JUSTIFICATION IN ORDER TO BE CONSIDERED FOR A DONATION. SOME OF THE INFORMATION APPLICANTS MUST PROVIDE INCLUDE: IF THE APPLICANT IS REQUESTING FUNDING FOR A SPECIFIC EVENT OR PROGRAM, THE DATE, LOCATION, AND TIME ARE REQUIRED DESCRIPTION OF THE EVENT/PROGRAM APPLICANT'S OTHER SOURCES OF INCOME EVENT/PROGRAM BUDGET HOW THE EVENT/PROGRAM SUPPORTS LMH'S MISSION WHO WILL BENEFIT FROM OUR CONTRIBUTION WHAT WILL THE EVENT/PROGRAM ACCOMPLISH HOW WILL THE EVENT/PROGRAM MEASURE ITS ACCOMPLISHMENTS APPLICANT ORGANIZATION'S MISSION STATEMENT NUMBER OF PEOPLE SERVED ANNUALLY BY THE APPLICANT APPLICANT'S WEBSITE TAX STATUS OF THE APPLICANT AND ITS FEDERAL TAXPAYER IDENTIFICATION NUMBER WITH FEW EXCEPTIONS, DONATIONS TO NATIONAL ORGANIZATIONS ARE FUNDED AT THE CORPORATE LEVEL, WHICH PREVENTS MULTIPLE CONTRIBUTIONS BEING MADE TO THE SAME NATIONAL ORGANIZATION AND ALLOWS THE HOSPITAL'S LIMITED CONTRIBUTION DOLLARS TO BE USED FOR REGION-SPECIFIC REQUESTS. ALL OF LMH'S FY18 DONATIONS WERE MADE TO LOCAL NONPROFIT ORGANIZATIONS. BALLAD HEALTH'S SOCIAL RESPONSIBILITY COMMITTEE IS COMPRISED OF COMMUNITY, VOLUNTEER AND BUSINESS LEADERS AS WELL AS THE PRESIDENT & CEO, COO, AND OTHER LEADERS FROM ACROSS THE BALLAD HEALTHCARE SYSTEM. COMMITTEE MEMBERS WERE SELECTED SO THAT MEMBERSHIP EXPERTISE INCLUDES PUBLIC HEALTH, HEALTH PROFESSIONS EDUCATION, KNOWLEDGE OF OTHER RESOURCES AVAILABLE TO CHARITABLE ORGANIZATIONS, AND INDIVIDUALS WITH HANDS-ON COMMUNITY VOLUNTEER EXPERIENCE.

Schedule I (Form 990) 2019

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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

LAUGHLIN MEMORIAL HOSPITAL INC

Employer identification number

62-0701119

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? .............

Yes

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

Yes

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)
1CHARLES WHITFIELD LMH CEO LMH CEO	(i) (ii)	184,726 ------------- 155,721	21,005 -------------	723,132 ------------- 9,304	9,452 -------------	13,240 ------------- 2,928	951,555 ------------- 167,953	-------------
2MARVIN EICHORN EVP BALLAD HEALTH LMH COMM. BRD DIR	(i) (ii)	------------- 576,562	------------- 128,590	------------- 43,977	------------- 18,900	------------- 23,842	------------- 791,871	-------------
3MARK PATTERSON MD LMH COMM BRD DIR	(i) (ii)	356,162 -------------	118,802 -------------	-------------	13,500 -------------	6,236 -------------	494,700 -------------	-------------
4MARK COMPTON LMH CFO	(i) (ii)	195,657 -------------	84,061 -------------	1,802 -------------	10,059 -------------	13,816 -------------	305,395 -------------	-------------
5BRENDA CANNON LMH CNO LMH CNO	(i) (ii)	109,440 -------------	1,327 -------------	108,336 -------------	5,740 -------------	15,734 -------------	240,577 -------------	-------------
6BILLY PARSLEY MD PHYSICIAN	(i) (ii)	576,479 -------------	50,000 -------------	-------------	13,500 -------------	14,881 -------------	654,860 -------------	-------------
7RICHARD PECTOL MD PHYSICIAN	(i) (ii)	585,578 -------------	-------------	1,926 -------------	13,750 -------------	3,636 -------------	604,890 -------------	-------------
8ROBERT NORTHRUP MD PHYSICIAN	(i) (ii)	296,798 -------------	169,386 -------------	-------------	13,500 -------------	14,445 -------------	494,129 -------------	-------------
9KYLE BOREN MD PHYSICIAN	(i) (ii)	437,805 -------------	-------------	-------------	10,491 -------------	-------------	448,296 -------------	-------------
10NATALIE SCOTT MD PHYSICIAN	(i) (ii)	296,362 -------------	48,222 -------------	-------------	13,500 -------------	14,881 -------------	372,965 -------------	-------------

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, PAGE 1, PART I, LINE 4	CHARLES WHITFIELD, LMH CEO 500,000 221,852 0 BRENDA CANNON, LMH CNO 0 107,527 0
SCHEDULE J, PART III	CHARLES WHITFIELD RECEIVED A CHANGE OF CONTROL PAYMENT OF 500,000, PURSUANT TO HIS EMPLOYMENT AGREEMENT. MR. WHITFIELD AND MS. CANNON RECEIVED 457(F) DISTRIBUTIONS DUE TO THE PLAN BEING TERMINATED. ALL PAYMENTS WERE REPORTED AS TAXABLE INCOME WITH APPROPRIATE TAX WITHHELD AND REMITTED TO THE IRS.

Schedule J (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
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

LAUGHLIN MEMORIAL HOSPITAL INC

Employer identification number

62-0701119

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e) Original principal amount	(f) Balance due	(g) In default?		(h) Approved by board or committee?		(i) Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2019

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) SUSAN COMPTON	FAMILY MEMBER	86,044	SEE PART V		No
(2) SUZANNE WILHOIT	FAMILY MEMBER	90,514	SEE PART V		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation
SCHEDULE L, PART V	(1) MARK COMPTON, LMH CFO, IS A FAMILY MEMBER OF SUSAN COMPTON, AN EMPLOYEE OF LMH. (2) BRENDA CANNON, LMH CNO, IS A FAMILY MEMBER OF SUZANNE WILHOIT, AN EMPLOYEE OF LMH.

Schedule L (Form 990 or 990-EZ) 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

LAUGHLIN MEMORIAL HOSPITAL INC

Employer identification number

62-0701119

Return Reference	Explanation
FORM 990, PAGE 2, PART III, LINE 4A	ON JUNE 30, 2017, MOUNTAIN STATES HEALTH ALLIANCE (MSHA) BECAME THE SOLE MEMBER OF LAUGHLIN MEMORIAL HOSPITAL. MOUNTAIN STATES HEALTH ALLIANCE IS A TAX-EXEMPT ENTITY WITH OPERATIONS PRIMARILY LOCATED IN WASHINGTON, SULLIVAN, UNICOI, GREENE, AND CARTER COUNTIES OF TENNESSEE AND SMYTH, WISE, DICKENSON, RUSSELL AND WASHINGTON COUNTIES OF VIRGINIA. OUR HOSPITAL AND MSHA HAVE ENJOYED A DECADES-LONG RELATIONSHIP AND THE MERGER ALLOWS LMH TO EXPAND SERVICES INTO AREAS WHERE THEY ARE MOST NEEDED. LMH REMAINS A SEPARATE LEGAL ENTITY; THUS FILING A SEPARATE FORM 990 RETURN. SHORTLY FOLLOWING LMH'S MERGER WITH MOUNTAIN STATES, THE TWO ORGANIZATIONS OFFICIALLY OPENED A NEW URGENT CARE CENTER IN GREENEVILLE. THE FACILITY'S OPENING REPRESENTS MOUNTAIN STATES' FIRST MAJOR INVESTMENT IN GREENE COUNTY FOLLOWING LMH JOINING MSHA. URGENT CARE PLAYS A VERY IMPORTANT ROLE IN HEALTH CARE. FREQUENTLY, AN ILLNESS OR INJURY MAY OCCUR AFTER PHYSICIAN OFFICES' NORMAL OFFICE HOURS, OR DURING A TIME WHEN A PERSON'S PRIMARY CARE PHYSICIAN DOESN'T HAVE AN AVAILABLE APPOINTMENT. URGENT CARE PROVIDES A COST-EFFECTIVE ALTERNATIVE TO THE EMERGENCY ROOM. PATIENTS CAN WALK INTO AN URGENT CARE CENTER WITHOUT AN APPOINTMENT, QUICKLY SEE A PROVIDER, AND RECEIVE MEDICAL CARE IN A CONVENIENT SETTING. THE URGENT CARE CENTER ALSO SERVES AS LIAISON BETWEEN THE PATIENT AND THEIR PRIMARY CARE PROVIDER BY INFORMING THE PATIENT'S PHYSICIAN THAT THEIR PATIENT IS BEING TREATED AND HOW THE PATIENT WAS TREATED SO THE PATIENT'S PHYSICIAN CAN FOLLOW UP IF NEEDED. THE NEW FACILITY HAS EXTENDED HOURS AND OFFERS URGENT CARE FOR ALL AGES. CARE IS PROVIDED BY PHYSICIANS, PHYSICIAN ASSISTANTS, NURSE PRACTITIONERS, NURSES, RADIOLOGY TECHS AND OTHER MEDICAL PROFESSIONALS. THE CENTER ALSO HAS SEAMLESS CONNECTIVITY TO LAUGHLIN MEMORIAL HOSPITAL AS WELL AS JOHNSON CITY MEDICAL CENTER, MOUNTAIN STATES' FLAGSHIP HOSPITAL, FOR CONDITIONS THAT REQUIRE A HIGHER LEVEL OF CARE. LMH ENGAGES WITH NUMEROUS COMMUNITY GROUPS TO IMPROVE THE OVERALL HEALTH, EDUCATION AND ECONOMY OF THE COMMUNITIES WE SERVE. A FEW OF THE SERVICE LINES UNIQUE TO LMH THAT ARE NOT OFFERED BY ANY OTHER PROVIDER IN THE COMMUNITY INCLUDE A CANCER CARE PROGRAM THAT IS ACCREDITED BY THE AMERICAN COLLEGE OF SURGEON'S COMMISSION ON CANCER, A DEDICATED CARDIAC CATHETERIZATION LAB, RADIATION ONCOLOGY SERVICES, A BARIATRIC SURGERY PROGRAM AND THE AREA'S ONLY DEDICATED WHEELCHAIR CLINIC. LMH ROUTINELY PROVIDES EDUCATIONAL OPPORTUNITIES FOR A LOCAL SENIOR CENTER, THE LOCAL YMCA, THE BOYS AND GIRLS CLUB, AND VARIOUS COMMUNITY AND CIVIC GROUPS. THROUGH FUNDING PROVIDED BY OUR FOUNDATION, WE SPONSOR EVENTS THROUGHOUT THE YEAR TO RAISE FUNDS FOR WORTHY CAUSES SUCH AS SECOND HARVEST FOOD BANK, RAM EYE CLINIC, VARIOUS SUPPORT GROUPS, AND A MEDICATION PROGRAM TO ASSIST WITH FILLING PRESCRIPTIONS FOR DISCHARGED PATIENTS WHO CANNOT AFFORD TO FILL THEIR PRESCRIPTIONS. UTILIZING STAFF MEMBERS, LMH PROMOTED PROPER HAND HYGIENE AT LOCAL SCHOOLS AND A LOCAL PARENTING FAIR, TYPICALLY ATTENDED BY 3,000 - 5,000. DURING THESE EVENTS, HAND SANITIZERS WERE DISTRIBUTED AND GLOGERM WAS UTILIZED TO GRAPHICALLY DEMONSTRATE TO PARTICIPANTS HOW GERMS ARE SPREAD. GLOGERM IS A LOTION OR POWDER THAT LETS STUDENTS AND OTHER PARTICIPANTS SEE HOW MANY "GERMS" ARE LEFT ON THEIR HANDS. USING AN ULTRAVIOLET LIGHT, THE PARTICIPANT IS ABLE TO SEE THE FLUORESCENT "GERMS" REMAINING ON THEIR HANDS AFTER WASHING AS THEY NORMALLY DO. THE HOSPITAL'S PHARMACY PROVIDED THE LOCAL EMS AGENCY WITH IV SETS AT NO CHARGE, A VALUE EXCEEDING 7,000. OUR DIABETES EDUCATOR PRESENTED THREE COMMUNITY PROGRAMS THAT PROVIDED GUIDANCE AND INFORMATIVE MATERIALS TO COMMUNITY MEMBERS REGARDING THE PREVALENCE OF DIABETES, THE RISK FACTORS FOR DIABETES, AND DIABETES PREVENTION AND BASIC CARE. APPROXIMATELY SIXTY COMMUNITY MEMBERS PARTICIPATED. A LMH NURSE EDUCATOR TAUGHT A "HEART SAVER CPR" CLASS AT A LOCAL CHURCH. LMH PROVIDED MANIKINS AND DISPOSABLE SUPPLIES FOR THE CLASS, WHICH WAS PROVIDED FREE OF CHARGE TO PARTICIPANTS, EXCEPT FOR THOSE INDIVIDUALS WANTING AN OFFICIAL AHA CARD ISSUED TO THEM. FOR THOSE NEEDING THE CARD, THE STANDARD FEE FOR THE CARD AND BOOKS WAS ASSESSED. THE HOSPITAL PROVIDES A MEETING SPACE AND FOOD EACH MONTH FOR A LOCAL CANCER SUPPORT GROUP. ON AVERAGE, NINE PEOPLE ATTEND THIS MONTHLY MEETING. THE HOSPITAL OFTEN PROVIDES MEETING SPACE FOR OTHER COMMUNITY GROUPS/CIVIC ORGANIZATIONS AT NO CHARGE. A HOSPITAL DIETITIAN PARTICIPATED IN NUMEROUS EVENTS THROUGHOUT THE YEAR TO PROMOTE HEALTHY EATING/HEALTHY CHOICES. A SAMPLING OF EVENTS: -BARIATRIC SUPPORT GROUP MEETINGS. THE DIETITIAN TEACHES PATIENTS HOW TO PREPARE FOR THEIR SURGERY AND HOW TO MAINTAIN THEIR WEIGHT LOSS POST- SURGERY. SHE PROVIDES INFORMATION ON PROTEIN BARS/POWDERS, VITAMIN AND MINERAL SUPPLEMENTS, DISCUSSES CALORIE-DENSE AND NUTRIENT-DENSE FOODS AND HOW TO AVOID WEIGHT GAIN DURING THE HOLIDAYS. SHE ALSO CONDUCTS A GROCERY STORE TOUR TO EDUCATE PARTICIPANTS ON MAKING HEALTHY CHOICES. DURING FY18, APPROXIMATELY SIXTY-EIGHT PEOPLE ATTENDED THE MEETINGS. -SHE PARTICIPATED IN A LOCAL COMPANY'S EMPLOYEE/SPOUSE HEALTH FAIR AND PROVIDED "LUNCH AND LEARN" EVENTS FOR THE SAME COMPANY. A TOTAL OF 365 PEOPLE ATTENDED. -SHE CONDUCTED "LUNCH AND LEARN" EVENTS FOR THE EMPLOYEES OF THE TOWN OF GREENEVILLE; 30 EMPLOYEES ATTENDED. -THE DIETICIAN PROVIDED EDUCATION TO A LOCAL STROKE SUPPORT GROUP CONCERNING HEALTHY EATING, HOW TO REDUCE SODIUM AND SUGAR INTAKE, HEALTHY DESSERTS AND HEALTHY PICNIC TIPS - 24 PEOPLE ATTENDED THE SESSION. -SHE SPOKE TO A LOCAL CIVIC CLUB ABOUT PRE-DIABETES/DIABETES AND HEALTHY EATING. LMH TEAM MEMBERS FROM THE RADIATION ONCOLOGY DEPARTMENT PARTICIPATED IN NUMEROUS EDUCATION/SUPPORT OPPORTUNITIES THROUGHOUT THE YEAR. THE FOLLOWING IS A PARTIAL LIST OF ACTIVITIES DURING FY18: -WITH FUNDING PROVIDED BY OUR FOUNDATION, TRANSPORTATION ASSISTANCE WAS PROVIDED FOR LOW INCOME RADIATION ONCOLOGY PATIENTS. -WITH FUNDING PROVIDED BY OUR FOUNDATION, THE DEPARTMENT WAS ABLE TO PROVIDE ASSISTANCE FOR SOME LOW-INCOME PATIENTS' UTILITIES. -THE DEPARTMENT PROVIDED NUTRITION DRINKS AND SUPPLEMENTS TO RADIATION ONCOLOGY PATIENTS. -AN ORAL CANCER SCREENING EVENT OPEN TO THE COMMUNITY WAS HELD. -A COLORECTAL CANCER PREVENTION EDUCATIONAL SESSION FOR MEMBERS OF A LOCAL CHURCH WAS HELD, PARTNERING WITH A LMH ONCOLOGIST. -A PROGRAM WAS OFFERED AT A LOCAL CIVIC CLUB ON THE IMPORTANCE OF PSA SCREENING; A LMH ONCOLOGIST CONDUCTED THE PRESENTATION. END OF LIFE ADVANCE CARE PLANNING WORKSHOPS WERE OFFERED THROUGHOUT THE YEAR TO EDUCATE PATIENTS AND COMMUNITY MEMBERS. THE WORKSHOPS COVERED THE IMPORTANCE OF APPOINTING A HEALTHCARE AGENT, UNDERSTANDING THE VARIOUS FORMS THE STATE OF TENNESSEE PROVIDES (ADVANCED DIRECTIVE FORMS, ETC.), AND PROVIDED OTHER RESOURCES. A LMH CERTIFIED WOUND CARE NURSE ROUTINELY PROVIDES SERVICES AT NO COST TO PATIENTS FOR WOUND CARE, BOTH FOR LMH'S PATIENTS AND FOR PATIENTS THAT CANNOT AFFORD THESE SERVICES WHO HAVE BEEN REFERRED BY THEIR PRIVATE PHYSICIANS. WHEN APPROPRIATE, THE HOSPITAL DISTRIBUTES FREE SAMPLES AND SUPPLIES TO THESE PATIENTS. IN OCTOBER, LMH'S OB DEPARTMENT WAS RECOGNIZED BY THE STATE OF TENNESSEE AS ONE OF SEVEN HOSPITALS STATEWIDE TO RECEIVE THE FIRST EVER "BEST FOR BABIES" AWARD. THIS AWARD CELEBRATES HOSPITALS' EFFORTS TO REDUCE INFANT DEATHS AND GIVE BABIES AND THEIR FAMILIES THE BEST POSSIBLE START. THE "BEST" AWARD STANDS FOR BREASTFEEDING, EARLY ELECTIVE DELIVERY REDUCTION AND SAFE SLEEP FOR TENNESSEE BABIES. OUR OB DEPARTMENT HAD PREVIOUSLY BEEN RECOGNIZED BY CRIBS FOR KIDS AS A GOLD SAFE SLEEP CHAMPION. THIS RECOGNITION WAS A RESULT OF LMH'S COMMITMENT TO COMMUNITY LEADERSHIP FOR BEST PRACTICES AND EDUCATION FOR INFANT SLEEP ACHIEVED THROUGH DEVELOPMENT OF HOSPITAL POLICY, STAFF TRAINING, PARENT EDUCATION, MODELING THROUGH A WEARABLE BLANKET PROGRAM AND AN AFFILIATION WITH THE CRIBS FOR KIDS PROGRAM. FOLLOWING MSHA AND WHS'S MERGER THIS YEAR TO FORM THE BALLAD HEALTH HEALTHCARE SYSTEM, TEAM MEMBERS FROM ALL OF BALLAD HEALTH'S HOSPITALS TRANSITIONED TO STANDARD SCRUB COLORS, WHICH MEANT TEAM MEMBERS' SCRUBS THROUGHOUT OUR MANY HOSPITALS AND CLINICS HAD TO BE REPLACED. A TEAM MEMBER FROM FRANKLIN WOODS COMMUNITY HOSPITAL RECOGNIZED AN OPPORTUNITY TO HELP OTHERS BY ORGANIZING A "SAVE OUR SCRUBS" PROGRAM TO COLLECT USED SCRUBS FOR DONATION TO A GLOBAL CHARITY. THE CHARITY IS A MEDICAL RELIEF ORGANIZATION THAT COLLECTS USED SCRUBS AND DONATES THEM TO HEALTHCARE WORKERS IN RESOURCE-POOR AREAS, INCLUDING COUNTRIES SUCH AS NICARAGUA, GUATEMALA, HAITI AND GUYANA, WHERE HOSPITALS OFTEN HAVE A SHORTAGE OF UNIFORMS. PROVIDING SCRUBS TO THESE HOSPITALS ALLOWS OTHER CRITICAL MEDICAL NEEDS, SUCH AS MEDICINES AND SURGICAL SUPPLIES, TO BE MORE EASILY FUNDED. IN ADDITION TO GENTLY USED SCRUBS, OUR TEAM MEMBERS DONATED JACKETS, LAB COATS, HEALTHCARE SHOES, AND OTHER MEDICAL APPAREL. THE PROGRAM WAS A GREAT SUCCESS ACROSS OUR BALLAD HEALTH SYSTEM: OUR TEAM MEMBERS DONATED MORE THAN 2 TONS OF SCRUB
FORM 990, PAGE 6, PART VI, LINE 4	IN FEBRUARY OF 2017, A REORGANIZATION AGREEMENT WAS ENTERED INTO BETWEEN LAUGHLIN MEMORIAL HOSPITAL (LMH) AND MOUNTAIN STATES HEALTH ALLIANCE (MSHA). THE AGREEMENT RECORDED LMH'S DESIRE TO REORGANIZE ITS GOVERNANCE STRUCTURE TO ESTABLISH MSHA AS THE SOLE MEMBER OF LMH. THE AGREEMENT FURTHER STATED THAT LMH'S GOVERNING DOCUMENTS WOULD BE AMENDED AT CLOSING TO ACCOMPLISH THE FOLLOWING: - MSHA AS SOLE MEMBER - ESTABLISH MSHA BOARD OF DIRECTORS AS THE NEW BOARD OF DIRECTORS FOR LMH - ESTABLISH A COMMUNITY BOARD OF TRUSTEES IN ACCORDANCE WITH THE AMENDED AND RESTATED BYLAWS OF LMH AND THE COMMUNITY BOARD BYLAWS - ESTABLISH THE BOARD OF DIRECTORS AUTHORITY CLOSING TOOK PLACE ON JUNE 30, 2017 AND LMH COMMUNITY BOARD BYLAWS WERE ADOPTED JULY 1, 2017.
FORM 990, PAGE 6, PART VI, LINE 6	THE CORPORATION IS ORGANIZED AS A TENNESSEE NON-STOCK, NONPROFIT CORPORATION WITH MOUNTAIN STATES HEALTH ALLIANCE AS ITS SOLE MEMBER. MOUNTAIN STATES HEALTH ALLIANCE'S BOARD OF DIRECTORS ASSUMED THE FUNCTIONS OF LMH'S BOARD OF DIRECTORS WHEN LMH MERGED WITH MOUNTAIN STATES JUNE 30, 2017. SEVEN MONTHS LATER ON FEBRUARY 1, 2018, MOUNTAIN STATES AND WELLMONT HEALTH SYSTEM MERGED TO FORM BALLAD HEALTH, A NONPROFIT 21-HOSPITAL HEALTHCARE SYSTEM. CONCURRENT WITH THE MOUNTAIN STATES-WELLMONT MERGER, THE NEW BALLAD HEALTH BOARD OF DIRECTORS REPLACED THE MOUNTAIN STATES AND WELLMONT BOARDS. BOTH MOUNTAIN STATES HEALTH ALLIANCE AND WELLMONT HEALTH SYSTEM STILL EXIST AS ACTIVE LEGAL ENTITIES AND MOUNTAIN STATES REMAINS THE SOLE MEMBER OF LMH. WHEN LMH MERGED WITH MOUNTAIN STATES, A LMH COMMUNITY BOARD WAS ESTABLISHED CONSISTING OF INDIVIDUALS WHO HAVE RESPONSIBILITIES AND SPECIFIC COAPPROVAL RIGHTS WITH LMH'S GOVERNING BODY (BALLAD HEALTH'S BOARD OF DIRECTORS). THE COMMUNITY BOARD WAS ESTABLISHED FOR FIVE YEARS AT WHICH TIME THE BOARD OF DIRECTORS MAY CONTINUE OR DISSOLVE THE COMMUNITY BOARD. DURING A TWO-YEAR TRANSITION PERIOD FROM JULY 1, 2017 THROUGH JUNE 30, 2019, THE FOLLOWING DECISIONS ARE SUBJECT TO CONCURING APPROVAL BY THE COMMUNITY BOARD: 1) SALE OF ALL OR SUBSTANTIALLY ALL OF THE CORPORATION'S ASSETS; 2) MERGER OR CONSOLIDATION OF THE CORPORATION WITH ANOTHER ENTITY; 3) DISSOLUTION AND LIQUIDATION OF THE CORPORATION; 4) A DECISION TO DISCONTINUE EXISTING HEALTH CARE SERVICE PROVIDED BY CERTAIN PROVIDERS, PROVIDED THAT SUCH ARRANGEMENT IS COMPLIANT WITH APPLICABLE LEGAL REQUIREMENTS FOR SUCH ARRANGEMENTS; 5) AMENDMENT OF THE CHARTER AND BYLAWS OF THE CORPORATION; 6) SELECTION AND REMOVAL OF THE INDIVIDUAL WHO IS THE PRESIDENT/CEO OF THE CORPORATION AND HOSPITAL; 7) DEVELOPMENT OF COMMUNITY OUTREACH PROGRAMS; AND 8) A DECISION TO APPROVE CAPITAL EXPENDITURES BY THE CORPORATION PURSUANT TO PROVISIONS OF THE REORGANIZATION AGREEMENT BETWEEN THE CORPORATION AND THE SOLE MEMBER.
FORM 990, PAGE 6, PART VI, LINE 7A	LAUGHLIN MEMORIAL HOSPITAL MERGED WITH MOUNTAIN STATES HEALTH ALLIANCE (MSHA) ON JUNE 30, 2017, WITH MSHA AS THE SOLE MEMBER OF LMH. AT MERGER DATE, MSHA'S BOARD OF DIRECTORS BECAME THE GOVERNING BODY OF LMH. ON FEBRUARY 1, 2018, MOUNTAIN STATES MERGED WITH WELLMONT HEALTH SYSTEM, WITH BALLAD HEALTH BECOMING THE SOLE MEMBER OF BOTH MOUNTAIN STATES AND WELLMONT. AT MERGER, BALLAD HEALTH'S BOARD OF DIRECTORS BECAME THE GOVERNING BODY FOR MOUNTAIN STATES (INCLUDING LMH) AND WELLMONT. THE BALLAD HEALTH BOARD HAS THE SOLE VOTE ON ALL MATTERS REQUIRING A VOTE OF THE SOLE MEMBER, SUBJECT ONLY TO THE TRANSITIONAL APPROVAL AUTHORITY GRANTED TO LMH'S COMMUNITY BOARD (AS DISCUSSED ON FORM 990, PART VI, LINE 6). THE SOLE MEMBER'S VOTING RIGHTS INCLUDE THE POWER (WITH AN AFFIRMATIVE VOTE OF A MAJORITY OF THE DIRECTORS AT A MEETING AT WHICH A QUORUM IS PRESENT) TO: (I) AMEND THE CHARTER OR BYLAWS OF BALLAD HEALTH; (II) SELL OR CLOSE ANY OF THE BALLAD HEALTH HOSPITALS; (III) ADOPT A PLAN OF DISSOLUTION FOR BALLAD HEALTH; (IV) SELL OR TRANSFER ALL OR SUBSTANTIALLY ALL OF BALLAD HEALTH'S ASSETS; (V) ENTER INTO A PLAN OF MERGER OR CONSOLIDATION OF BALLAD HEALTH WITH OR INTO AN UNRELATED ENTITY; (VI) INCURRENCE OF ANY INDEBTEDNESS, GUARANTEES, OR CAPITAL LEASE OBLIGATIONS EXCEEDING 100 MILLION IN THE AGGREGATE DURING ANY FISCAL YEAR, OTHER THAN TRADE PAYABLES AND OTHER SHORT-TERM LIABILITIES IN THE ORDINARY COURSE OF BUSINESS; (VII) DICONTINUE MAJOR SERVICE LINES WHERE ANY SUCH DISCONTINUATION WOULD RENDER THE SERVICE UNAVAILABLE IN THAT COMMUNITY; AND (VIII) FILE A PETITION REQUESTING OR CONSENTING TO AN ORDER FOR RELIEF UNDER THE FEDERAL BANKRUPTCY LAWS, OR OTHER ACTIONS WITH RESPECT TO BALLAD HEALTH OR ANY MEMBER OF ITS OBLIGATED GROUP AS A RESULT OF INSOLVENCY OR THE INABILITY TO PAY DEBTS GENERALLY AS SUCH DEBTS BECOME DUE.
FORM 990, PAGE 6, PART VI, LINE 11B	THE EXECUTIVE VICE PRESIDENT/CFO OF THE BALLAD HEALTH HEALTHCARE SYSTEM REVIEWED LAUGHLIN MEMORIAL HOSPITAL'S FORM 990 WITH THE BOARD OF DIRECTORS PRIOR TO THE RETURN BEING FILED WITH THE IRS. THE RETURN WAS MADE AVAILABLE TO EACH BOARD MEMBER PRIOR TO THE REVIEW.
FORM 990, PAGE 6, PART VI, LINE 12C	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, WHICH APPLIES TO ALL BALLAD HEALTH ORGANIZATIONS, INCLUDING LAUGHLIN MEMORIAL HOSPITAL. ALL PERSONS COVERED BY THIS POLICY ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM ON AN ANNUAL BASIS. SHOULD A CONFLICT ARISE, IT IS THE RESPONSIBILITY OF THE CONFLICTED INDIVIDUAL TO UPDATE HIS OR HER DISCLOSURE IMMEDIATELY. ALL MEETINGS OF THE BOARD OR BOARD COMMITTEES HAVE A STANDING AGENDA ITEM FIRST ON THE AGENDA TITLED "CONFLICTS OF INTEREST". IF A MEMBER OF THE BOARD OR BOARD COMMITTEE HAS A CONFLICT OF 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 IS RESPONSIBLE FOR DISCLOSING CONFLICTS OF INTEREST, IT IS ALSO THE RESPONSIBILITY OF ANY BOARD MEMBER AWARE OF A CONFLICT WHICH HAS NOT BEEN DISCLOSED TO ENSURE THE BOARD IS MADE AWARE. THE PRESIDING OFFICER OF A BOARD OR BOARD COMMITTEE MEETING 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	LMH'S CEO'S CALENDAR YEAR 2017 COMPENSATION, REPORTED ON THIS FORM 990, WAS REVIEWED AND APPROVED BY LMH'S GOVERNING BODY PRIOR TO THE ORGANIZATION MERGING WITH MOUNTAIN STATES HEALTH ALLIANCE. THE CEO'S CALENDAR YEAR 2017 COMPENSATION INCLUDED A CHANGE OF CONTROL PAYMENT AS WELL AS PAYOUT OF THE TERMINATED 457(F) PLAN. LMH'S CEO BECAME AN EMPLOYEE OF MOUNTAIN STATES JULY, 2018. EXECUTIVE COMPENSATION (VICE-PRESIDENT LEVEL AND ABOVE) WAS REVEIWED AND APPROVED DURING FY18 BY THE BOARD OF DIRECTORS FOR ALL BALLAD HEALTH ORGANIZATIONS. DATA OBTAINED BY AN INDEPENDENT, OUTSIDE CONSULTING FIRM WAS USED TO DETERMINE EXECUTIVE PAY SO THAT OUR EXECUTIVE COMPENSATION AND BENEFIT STRUCTURE IS COMPARABLE TO LIKE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS.
FORM 990, PAGE 6, PART VI, LINE 19	GOVERNING DOCUMENTS AND OUR CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE UPON REQUEST TO APPROPRIATE PARTIES REQUESTING THEM. FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST TO APPROPRIATE PARTIES REQUESTING THEM, AND THEY ARE MADE AVAILABLE TO THOSE PARTIES WHO OWN INDEBTEDNESS OF THE COMPANY.
FORM 990, PART IX, LINE 11G	PHYSICIAN FEES 914,188 0 0 LINEN SERVICES 445,145 0 0 COLLECTION FEES 0 584,320 0 PURCHASED SERVICES 4,475,961 1,801,676 0 TOTAL 5,835,294 2,385,996 0
FORM 990, PART XI, LINE 9	INVESTMENT TERMINATED IN A PRIOR YR. 7,704 PPE ADJUSTMENT AT MERGER -29,489,336 P/S ORDINARY INCOME NOT ON BOOKS -103,971 P/S INTEREST INCOME NOT ON BOOKS -2,365 PARKING - UBI -18,603 TOTAL -29,606,571
FORM 990, PAGE 12, PART XII, LINE 2C	LAUGHLIN MEMORIAL HOSPITAL DID NOT ENGAGE AN INDEPENDENT ACCOUNTANT TO AUDIT ITS FINANCIAL STATEMENTS FOR THE TAX YEAR ENDING JUNE 30, 2017. LMH MERGED WITH MOUNTAIN STATES HEALTH ALLIANCE (MSHA) ON JUNE 30, 2017 WITH MSHA BECOMING THE SOLE MEMBER OF LMH. ON FEBRUARY 1, 2018, MSHA MERGED WITH WELLMONT HEALTH SYSTEM (WHS) TO FORM BALLAD HEALTH HEALTH SYSTEM. BALLAD HEALTH IS THE PARENT CORPORATION OF MSHA AND WHS. AT THE TIME OF MERGER, BALLAD'S BOARD OF DIRECTORS BECAME THE BOARD OF DIRECTORS FOR MSHA AND WHS. BALLAD HEALTH'S AUDIT COVERED THE PERIOD FEBRUARY 1, 2018 (THE DATE OF MERGER) THROUGH JUNE 30, 2018. ALL BALLAD HEALTH ORGANIZATIONS WERE INCLUDED IN THE THE JUNE 30, 2018 CONSOLIDATED AUDITED FINANCIAL STATEMENTS. BALLAD'S AUDIT COMMITTEE IS RESPONSIBLE FOR OVERSIGHT OF AUDITED FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR.

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

LAUGHLIN MEMORIAL HOSPITAL INC

Employer identification number

62-0701119

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)MOUNTAIN STATES HEALTH ALLIANCE 303 MED TECH PARKWAY SUITE 220 JOHNSON CITY,TN37604 62-0476282	HOSP. SYS.	TN	501C3	3	BALLAD		No
(2)MOUNTAIN STATES FOUNDATION 2335 KNOB CREEK ROAD SUITE 101 JOHNSON CITY,TN37604 58-1418862	FUNDRAISER	TN	501C3	12A	MSHA		No
(3)MSHA AUXILIARY 400 N STATE OF FRANKLIN ROAD JOHNSON CITY,TN37604 58-1418345	SUPP. ORG.	TN	501C3	12A	MSHA		No
(4)SMYTH COUNTY COMMUNITY HOSPITAL 245 MEDICAL PARK DRIVE MARION,VA24354 54-0794913	HOSPITAL	VA	501C3	3	MSHA		No
(5)NORTON COMMUNITY HOSPITAL 100 15TH STREET NW NORTON,VA24273 54-0566029	HOSPITAL	VA	501C3	3	NA		No
(6)DICKENSON COMMUNITY HOSPITAL 312 HOSPITAL DRIVE CLINTWOOD,VA24228 77-0599553	HOSPITAL	VA	501C3	3	NCH		No
(7)JOHNSTON MEMORIAL HOSPITAL 16000 JOHNSTON MEMORIAL DRIVE ABINGDON,VA24211 54-0544705	HOSPITAL	VA	501C3	3	NA		No
(8)ABINGDON PHYSICIAN PARTNERS 16000 JOHNSTON MEMORIAL DRIVE ABINGDON,VA24211 20-5485346	MED. SERV.	VA	501C3	12A	JMH		No
(9)BALLAD HEALTH 303 MED TECH PARKWAY SUITE 220 JOHNSON CITY,TN37604 61-1771290	SUPP. ORG.	TN	501C3	12B	NA		No
(10)EAST TN HEALTHCARE HOLDINGS INC 203 GRAY COMMONS CIRCLE GRAY,TN37615 81-5475903	OPIOID TRT	TN	501C3	3	MSHA		No
(11)WELLMONT HEALTH SYSTEM 1905 AMERICAN WAY KINGSPORT,TN37660 62-1636465	HOSP. SYS.	TN	501C3	3	BALLAD		No
(12)WELLMONT HAWKINS CO MEMORIAL HOSP 851 LOCUST STREET ROGERSVILLE,TN37857 62-1816368	HOSPITAL	TN	501C3	3	WHS		No
(13)TAKOMA REGIONAL HOSPITAL INC 401 TAKOMA AVENUE GREENEVILLE,TN37743 51-0603966	HOSPITAL	TN	501C3	3	WHS		No
(14)TAKOMA REGIONAL HOSPITAL FDN INC 1905 AMERICAN WAY KINGSPORT,TN37660 47-1334302	FUNDRAISER	TN	501C3	7	WHS		No
(15)WELLMONT CARDIOLOGY SERVICES 1905 AMERICAN WAY KINGSPORT,TN37660 26-3557623	MED. SERV.	TN	501C3	10	WHS		No
(16)WELLMONT MEDICAL ASSOCIATES 1905 AMERICAN WAY KINGSPORT,TN37660 27-0898372	MED. SERV.	TN	501C3	7	WHS		No
(17)WELLMONT FOUNDATION 1905 AMERICAN WAY KINGSPORT,TN37660 58-1594191	FUNDRAISER	TN	501C3	7	WHS		No
(18)WELLMONT MADISON HOUSE 1905 AMERICAN WAY KINGSPORT,TN37660 62-1308216	ASST. LIV.	TN	501C3	10	WHS		No
(19)WELLMONT WEXFORD HOUSE 1905 AMERICAN WAY KINGSPORT,TN37660 58-1859039	NSG. HOME	TN	501C3	10	WHS		No
(20)WELLMONT IMAGING SERVICES INC 1905 AMERICAN WAY KINGSPORT,TN37660 86-1103148	HEALTHCARE	TN	501C3	12A	WHS		No
(21)WELLMONT SLEEP SERVICES 1905 AMERICAN WAY KINGSPORT,TN37660 27-3777167	MED. SERV.	TN	501C3	3	WHS		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	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(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?		(k) Percentage ownership
(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) EMMAUS COMMUNITY HEALTHCARE PLLC 6070 HWY 11E PINEY FLATS,TN37686 20-0577483	MED. SERV.	TN	N/A					No			No
(2) MEDICAL SPECIALISTS OF JC LLC 2528 WESLEY STREET SUITE 2 JOHNSON CITY,TN37601 27-2199037	MED. SERV.	TN	N/A					No			No
(3) EAST TN AMBULATORY SURGERY CNTR 701 MED TECH PARKWAY SUITE 100 JOHNSON CITY,TN37604 62-1787537	MED. SERV.	TN	N/A					No			No
(4) GREENEVILLE PHYSICIAN SERVICES LLC 1905 AMERICAN WAY KINGSPORT,TN37660 45-5070419	MED. SERV.	TN	LMH	RELATED	-3,816	237,805		No			No	75.000 %

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	(h) Percentage ownership	(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) BLUE RIDGE MEDICAL MANAGEMENT CORP 1905 AMERICAN WAY KINGSPORT,TN37660 62-1490616	MED. SERV.	TN	NA	C CORP					No
(2) MEDISERVE MEDICAL EQUIPMENT 1905 AMERICAN WAY KINGSPORT,TN37660 62-1212286	DME	TN	NA	C CORP					No
(3) MOUNTAIN STATES PROPERTIES 1905 AMERICAN WAY KINGSPORT,TN37660 62-1845895	PROP. MGMT	TN	NA	C CORP					No
(4) MOUNTAIN STATES PHYSICIAN GROUP 1905 AMERICAN WAY KINGSPORT,TN37660 62-1700412	MED. SERV.	TN	NA	C CORP					No
(5) COMMUNITY HOME CARE INC 1490 PARK AVENUE NW SUITE B NORTON,VA24273 54-1453810	DME	VA	NA	C CORP					No
(6) WILSON PHARMACY INC PO BOX 5289 JOHNSON CITY,TN37604 62-0329587	PHARMACY	TN	NA	C CORP					No
(7) CRESTPOINT HEALTH INSURANCE COMPANY 509 MED TECH PARKWAY SUITE 100 JOHNSON CITY,TN37604 62-0381170	INSURANCE	TN	NA	C CORP					No
(8) INTEGRATED SOLUTIONS HEALTH NETWORK 509 MED TECH PARKWAY SUITE 100 JOHNSON CITY,TN37604 62-1711997	HLTH NETWK	TN	NA	C CORP					No
(9) WELLMONT INC 1905 AMERICAN WAY KINGSPORT,TN37660 62-1320035	MED. SERV.	TN	NA	C CORP					No
(10) MCOT INC 1905 AMERICAN WAY KINGSPORT,TN37660 62-1325938	BUS. SERV.	TN	NA	C CORP					No
(11) MEDICAL MALL PHARMACY INC 1905 AMERICAN WAY KINGSPORT,TN37660 62-1565006	MED. SERV.	TN	NA	C CORP					No
(12) WELLMONT PHYSICIAN SERVICES 1905 AMERICAN WAY KINGSPORT,TN37660 62-1567353	MED. SERV.	TN	NA	C CORP					No
(13) WPS PROVIDERS INC 1905 AMERICAN WAY KINGSPORT,TN37660 20-5564642	MED. SERV.	TN	NA	C CORP					No
(14) WELLMONT HEALTH SERVICES INC 1905 AMERICAN WAY KINGSPORT,TN37660 62-1254373	MED. SERV.	TN	NA	C CORP					No
(15) WELLMONT INSURANCE CO SPC LTD 1905 AMERICAN WAY KINGSPORT,TN37660 98-1195624	INSURANCE		N/A						No
(16) NOLICHUCKEY MANAGEMENT SVCS INC 1420 TUSCULUM BOULEVARD GREENEVILLE,TN37745 62-1776681	MED. SERV.	TN	LMH	C CORP	4,161,858	801,596	100.000 %	Yes

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 .....................

Yes

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

Yes

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) .......................

Yes

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

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

Yes

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) ...................

Yes

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) ............................

Yes

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
(1) NOLICHUCKEY MANAGEMENT SVCS INC	A	179,504	FMV
(2) LAUGHLIN HEALTHCARE FOUNDATION	C	54,124	FMV
(3) NOLICHUCKEY MANAGEMENT SVCS INC	B	111,661	FMV
(4) NOLICHUCKEY MANAGEMENT SVCS INC	R	1,908,301	FMV

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: OUR MISSION: HONOR THOSE WE SERVE BY DELIVERING THE BEST POSSIBLE CARE OUR 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	21
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	17
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	979
6	Total number of volunteers (estimate if necessary) .............	6	53
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	23,950
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	20,655

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	206,759	54,125
9	Program service revenue (Part VIII, line 2g) .........	63,152,246	64,100,922
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	269,092	1,679,331
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	759,371	784,485
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	64,387,468	66,618,863
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...		55,845
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)	43,838,627	37,356,108
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 340,122
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	33,757,396	31,734,114
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	77,596,023	69,146,067
19	Revenue less expenses. Subtract line 18 from line 12.......	-13,208,555	-2,527,204
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	102,776,886	78,576,820
21	Total liabilities (Part X, line 26).............	12,487,635	12,420,425
22	Net assets or fund balances. Subtract line 21 from line 20.....	90,289,251	66,156,395

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 63,161,481 including grants of $ 55,845 ) (Revenue $ 64,104,622 )
	LAUGHLIN MEMORIAL HOSPITAL (LMH) IS LOCATED IN GREENEVILLE, TENNESSEE. IN ADDITION TO OUR 140-BED ACUTE CARE HOSPITAL, WE OPERATE LAUGHLIN HEALTHCARE CENTER, A 90-BED SKILLED NURSING FACILITY, AND A HOME HEALTH AGENCY. LMH IS ALSO THE SOLE OWNER OF NOLICHUCKEY MANAGEMENT SERVICES, A PHYSICIAN MEDICAL PRACTICE. LAUGHLIN HEALTH CARE FOUNDATION IS A SUPPORTING ORGANIZATION ORGANIZED FOR THE BENEFIT OF LMH. (CONTINUED ON SCHEDULE O) ON JUNE 30, 2017, MOUNTAIN STATES HEALTH ALLIANCE (MSHA) BECAME THE SOLE MEMBER OF LAUGHLIN MEMORIAL HOSPITAL. MOUNTAIN STATES HEALTH ALLIANCE IS A TAX-EXEMPT ENTITY WITH OPERATIONS PRIMARILY LOCATED IN WASHINGTON, SULLIVAN, UNICOI, GREENE, AND CARTER COUNTIES OF TENNESSEE AND SMYTH, WISE, DICKENSON, RUSSELL AND WASHINGTON COUNTIES OF VIRGINIA. OUR HOSPITAL AND MSHA HAVE ENJOYED A DECADES-LONG RELATIONSHIP AND THE MERGER ALLOWS LMH TO EXPAND SERVICES INTO AREAS WHERE THEY ARE MOST NEEDED. LMH REMAINS A SEPARATE LEGAL ENTITY; THUS FILING A SEPARATE FORM 990 RETURN. SHORTLY FOLLOWING LMH'S MERGER WITH MOUNTAIN STATES, THE TWO ORGANIZATIONS OFFICIALLY OPENED A NEW URGENT CARE CENTER IN GREENEVILLE. THE FACILITY'S OPENING REPRESENTS MOUNTAIN STATES' FIRST MAJOR INVESTMENT IN GREENE COUNTY FOLLOWING LMH JOINING MSHA. URGENT CARE PLAYS A VERY IMPORTANT ROLE IN HEALTH CARE. FREQUENTLY, AN ILLNESS OR INJURY MAY OCCUR AFTER PHYSICIAN OFFICES' NORMAL OFFICE HOURS, OR DURING A TIME WHEN A PERSON'S PRIMARY CARE PHYSICIAN DOESN'T HAVE AN AVAILABLE APPOINTMENT. URGENT CARE PROVIDES A COST-EFFECTIVE ALTERNATIVE TO THE EMERGENCY ROOM. PATIENTS CAN WALK INTO AN URGENT CARE CENTER WITHOUT AN APPOINTMENT, QUICKLY SEE A PROVIDER, AND RECEIVE MEDICAL CARE IN A CONVENIENT SETTING. THE URGENT CARE CENTER ALSO SERVES AS LIAISON BETWEEN THE PATIENT AND THEIR PRIMARY CARE PROVIDER BY INFORMING THE PATIENT'S PHYSICIAN THAT THEIR PATIENT IS BEING TREATED AND HOW THE PATIENT WAS TREATED SO THE PATIENT'S PHYSICIAN CAN FOLLOW UP IF NEEDED. THE NEW FACILITY HAS EXTENDED HOURS AND OFFERS URGENT CARE FOR ALL AGES. CARE IS PROVIDED BY PHYSICIANS, PHYSICIAN ASSISTANTS, NURSE PRACTITIONERS, NURSES, RADIOLOGY TECHS AND OTHER MEDICAL PROFESSIONALS. THE CENTER ALSO HAS SEAMLESS CONNECTIVITY TO LAUGHLIN MEMORIAL HOSPITAL AS WELL AS JOHNSON CITY MEDICAL CENTER, MOUNTAIN STATES' FLAGSHIP HOSPITAL, FOR CONDITIONS THAT REQUIRE A HIGHER LEVEL OF CARE. LMH ENGAGES WITH NUMEROUS COMMUNITY GROUPS TO IMPROVE THE OVERALL HEALTH, EDUCATION AND ECONOMY OF THE COMMUNITIES WE SERVE. A FEW OF THE SERVICE LINES UNIQUE TO LMH THAT ARE NOT OFFERED BY ANY OTHER PROVIDER IN THE COMMUNITY INCLUDE A CANCER CARE PROGRAM THAT IS ACCREDITED BY THE AMERICAN COLLEGE OF SURGEON'S COMMISSION ON CANCER, A DEDICATED CARDIAC CATHETERIZATION LAB, RADIATION ONCOLOGY SERVICES, A BARIATRIC SURGERY PROGRAM AND THE AREA'S ONLY DEDICATED WHEELCHAIR CLINIC. LMH ROUTINELY PROVIDES EDUCATIONAL OPPORTUNITIES FOR A LOCAL SENIOR CENTER, THE LOCAL YMCA, THE BOYS AND GIRLS CLUB, AND VARIOUS COMMUNITY AND CIVIC GROUPS. THROUGH FUNDING PROVIDED BY OUR FOUNDATION, WE SPONSOR EVENTS THROUGHOUT THE YEAR TO RAISE FUNDS FOR WORTHY CAUSES SUCH AS SECOND HARVEST FOOD BANK, RAM EYE CLINIC, VARIOUS SUPPORT GROUPS, AND A MEDICATION PROGRAM TO ASSIST WITH FILLING PRESCRIPTIONS FOR DISCHARGED PATIENTS WHO CANNOT AFFORD TO FILL THEIR PRESCRIPTIONS. UTILIZING STAFF MEMBERS, LMH PROMOTED PROPER HAND HYGIENE AT LOCAL SCHOOLS AND A LOCAL PARENTING FAIR, TYPICALLY ATTENDED BY 3,000 - 5,000. DURING THESE EVENTS, HAND SANITIZERS WERE DISTRIBUTED AND GLOGERM WAS UTILIZED TO GRAPHICALLY DEMONSTRATE TO PARTICIPANTS HOW GERMS ARE SPREAD. GLOGERM IS A LOTION OR POWDER THAT LETS STUDENTS AND OTHER PARTICIPANTS SEE HOW MANY "GERMS" ARE LEFT ON THEIR HANDS. USING AN ULTRAVIOLET LIGHT, THE PARTICIPANT IS ABLE TO SEE THE FLUORESCENT "GERMS" REMAINING ON THEIR HANDS AFTER WASHING AS THEY NORMALLY DO. THE HOSPITAL'S PHARMACY PROVIDED THE LOCAL EMS AGENCY WITH IV SETS AT NO CHARGE, A VALUE EXCEEDING 7,000. OUR DIABETES EDUCATOR PRESENTED THREE COMMUNITY PROGRAMS THAT PROVIDED GUIDANCE AND INFORMATIVE MATERIALS TO COMMUNITY MEMBERS REGARDING THE PREVALENCE OF DIABETES, THE RISK FACTORS FOR DIABETES, AND DIABETES PREVENTION AND BASIC CARE. APPROXIMATELY SIXTY COMMUNITY MEMBERS PARTICIPATED. A LMH NURSE EDUCATOR TAUGHT A "HEART SAVER CPR" CLASS AT A LOCAL CHURCH. LMH PROVIDED MANIKINS AND DISPOSABLE SUPPLIES FOR THE CLASS, WHICH WAS PROVIDED FREE OF CHARGE TO PARTICIPANTS, EXCEPT FOR THOSE INDIVIDUALS WANTING AN OFFICIAL AHA CARD ISSUED TO THEM. FOR THOSE NEEDING THE CARD, THE STANDARD FEE FOR THE CARD AND BOOKS WAS ASSESSED. THE HOSPITAL PROVIDES A MEETING SPACE AND FOOD EACH MONTH FOR A LOCAL CANCER SUPPORT GROUP. ON AVERAGE, NINE PEOPLE ATTEND THIS MONTHLY MEETING. THE HOSPITAL OFTEN PROVIDES MEETING SPACE FOR OTHER COMMUNITY GROUPS/CIVIC ORGANIZATIONS AT NO CHARGE. A HOSPITAL DIETITIAN PARTICIPATED IN NUMEROUS EVENTS THROUGHOUT THE YEAR TO PROMOTE HEALTHY EATING/HEALTHY CHOICES. A SAMPLING OF EVENTS: -BARIATRIC SUPPORT GROUP MEETINGS. THE DIETITIAN TEACHES PATIENTS HOW TO PREPARE FOR THEIR SURGERY AND HOW TO MAINTAIN THEIR WEIGHT LOSS POST- SURGERY. SHE PROVIDES INFORMATION ON PROTEIN BARS/POWDERS, VITAMIN AND MINERAL SUPPLEMENTS, DISCUSSES CALORIE-DENSE AND NUTRIENT-DENSE FOODS AND HOW TO AVOID WEIGHT GAIN DURING THE HOLIDAYS. SHE ALSO CONDUCTS A GROCERY STORE TOUR TO EDUCATE PARTICIPANTS ON MAKING HEALTHY CHOICES. DURING FY18, APPROXIMATELY SIXTY-EIGHT PEOPLE ATTENDED THE MEETINGS. -SHE PARTICIPATED IN A LOCAL COMPANY'S EMPLOYEE/SPOUSE HEALTH FAIR AND PROVIDED "LUNCH AND LEARN" EVENTS FOR THE SAME COMPANY. A TOTAL OF 365 PEOPLE ATTENDED. -SHE CONDUCTED "LUNCH AND LEARN" EVENTS FOR THE EMPLOYEES OF THE TOWN OF GREENEVILLE; 30 EMPLOYEES ATTENDED. -THE DIETICIAN PROVIDED EDUCATION TO A LOCAL STROKE SUPPORT GROUP CONCERNING HEALTHY EATING, HOW TO REDUCE SODIUM AND SUGAR INTAKE, HEALTHY DESSERTS AND HEALTHY PICNIC TIPS - 24 PEOPLE ATTENDED THE SESSION. -SHE SPOKE TO A LOCAL CIVIC CLUB ABOUT PRE-DIABETES/DIABETES AND HEALTHY EATING. LMH TEAM MEMBERS FROM THE RADIATION ONCOLOGY DEPARTMENT PARTICIPATED IN NUMEROUS EDUCATION/SUPPORT OPPORTUNITIES THROUGHOUT THE YEAR. THE FOLLOWING IS A PARTIAL LIST OF ACTIVITIES DURING FY18: -WITH FUNDING PROVIDED BY OUR FOUNDATION, TRANSPORTATION ASSISTANCE WAS PROVIDED FOR LOW INCOME RADIATION ONCOLOGY PATIENTS. -WITH FUNDING PROVIDED BY OUR FOUNDATION, THE DEPARTMENT WAS ABLE TO PROVIDE ASSISTANCE FOR SOME LOW-INCOME PATIENTS' UTILITIES. -THE DEPARTMENT PROVIDED NUTRITION DRINKS AND SUPPLEMENTS TO RADIATION ONCOLOGY PATIENTS. -AN ORAL CANCER SCREENING EVENT OPEN TO THE COMMUNITY WAS HELD. -A COLORECTAL CANCER PREVENTION EDUCATIONAL SESSION FOR MEMBERS OF A LOCAL CHURCH WAS HELD, PARTNERING WITH A LMH ONCOLOGIST. -A PROGRAM WAS OFFERED AT A LOCAL CIVIC CLUB ON THE IMPORTANCE OF PSA SCREENING; A LMH ONCOLOGIST CONDUCTED THE PRESENTATION. END OF LIFE ADVANCE CARE PLANNING WORKSHOPS WERE OFFERED THROUGHOUT THE YEAR TO EDUCATE PATIENTS AND COMMUNITY MEMBERS. THE WORKSHOPS COVERED THE IMPORTANCE OF APPOINTING A HEALTHCARE AGENT, UNDERSTANDING THE VARIOUS FORMS THE STATE OF TENNESSEE PROVIDES (ADVANCED DIRECTIVE FORMS, ETC.), AND PROVIDED OTHER RESOURCES. A LMH CERTIFIED WOUND CARE NURSE ROUTINELY PROVIDES SERVICES AT NO COST TO PATIENTS FOR WOUND CARE, BOTH FOR LMH'S PATIENTS AND FOR PATIENTS THAT CANNOT AFFORD THESE SERVICES WHO HAVE BEEN REFERRED BY THEIR PRIVATE PHYSICIANS. WHEN APPROPRIATE, THE HOSPITAL DISTRIBUTES FREE SAMPLES AND SUPPLIES TO THESE PATIENTS. IN OCTOBER, LMH'S OB DEPARTMENT WAS RECOGNIZED BY THE STATE OF TENNESSEE AS ONE OF SEVEN HOSPITALS STATEWIDE TO RECEIVE THE FIRST EVER "BEST FOR BABIES" AWARD. THIS AWARD CELEBRATES HOSPITALS' EFFORTS TO REDUCE INFANT DEATHS AND GIVE BABIES AND THEIR FAMILIES THE BEST POSSIBLE START. THE "BEST" AWARD STANDS FOR BREASTFEEDING, EARLY ELECTIVE DELIVERY REDUCTION AND SAFE SLEEP FOR TENNESSEE BABIES. OUR OB DEPARTMENT HAD PREVIOUSLY BEEN RECOGNIZED BY CRIBS FOR KIDS AS A GOLD SAFE SLEEP CHAMPION. THIS RECOGNITION WAS A RESULT OF LMH'S COMMITMENT TO COMMUNITY LEADERSHIP FOR BEST PRACTICES AND EDUCATION FOR INFANT SLEEP ACHIEVED THROUGH DEVELOPMENT OF HOSPITAL POLICY, STAFF TRAINING, PARENT EDUCATION, MODELING THROUGH A WEARABLE BLANKET PROGRAM AND AN AFFILIATION WITH THE CRIBS FOR KIDS PROGRAM. FOLLOWING MSHA AND WHS'S MERGER THIS YEAR TO FORM THE BALLAD HEALTH HEALTHCARE SYSTEM, TEAM MEMBERS FROM ALL OF BALLAD HEALTH'S HOSPITALS TRANSITIONED TO STANDARD SCRUB COLORS, WHICH MEANT TEAM MEMBERS' SCRUBS THROUGHOUT OUR MANY HOSPITALS AND CLINICS HAD TO BE REPLACED. A TEAM MEMBER FROM FRANKLIN WOODS COMMUNITY HOSPITAL RECOGNIZED AN OPPORTUNITY TO HELP OTHERS BY ORGANIZING A "SAVE OUR SCRUBS" PROGRAM TO COLLECT USED SCRUBS FOR DONATION TO A GLOBAL CHARITY. THE CHARITY IS A MEDICAL RELIEF ORGANIZATION THAT COLLECTS USED SCRUBS AND DONATES THEM TO HEALTHCARE WORKERS IN RESOURCE-POOR AREAS, INCLUDING COUNTRIES SUCH AS NICARAGUA, GUATEMALA, HAITI AND GUYANA

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 expenses63,161,481

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	4,367,006	966,706	263,295

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	54,125
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.......		54,125

		Business Code
2a	PATIENT REVENUE	622110	63,778,290	63,778,290
b	WELLNESS PROGRAMS	622110	224,008	224,008
c	P/S BUSINESS INCOME	541900	98,624	98,624
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		64,100,922

3 Investment income (including dividends, interest, and othersimilar amounts) ......			289,470			289,470
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		1,246,653	6a
b	Less: rental expenses		1,006,715	6b
c	Rental income or (loss)		239,938	6c
d	Net rental income or (loss).......			239,938			239,938
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	3,700	1,386,161	7a
b	Less: cost or other basis and sales expenses			7b
c	Gain or (loss)	3,700	1,386,161	7c
d	Net gain or (loss).........			1,389,861	3,700		1,386,161
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	CAFETERIA SALES		722514	374,246			374,246
b	GIFT SHOP		453000	85,295			85,295
c	MEDICAL RECORDS COPIES		900099	15,327			15,327
d	All other revenue ....			69,679		23,950	45,729
e	Total. Add lines 11a–11d ......			544,547
12	Total revenue. See instructions.....			66,618,863	64,104,622	23,950	2,436,166

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	55,845	55,845
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 ...........	1,794,068	735,432	1,058,636
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........	27,663,784	27,127,200	368,549	168,035
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	1,138,990	1,087,578	44,728	6,684
9	Other employee benefits .......	4,605,292	4,359,698	209,605	35,989
10	Payroll taxes ...........	2,153,974	2,026,996	114,597	12,381
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	198,227		198,227
c	Accounting ...........	17,841		17,841
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	55,308		55,308
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	8,221,290	5,835,294	2,385,996
12	Advertising and promotion ....	276,425	34,006	130,999	111,420
13	Office expenses .......	582,665	561,982	20,683
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	1,458,284	980,826	477,458
17	Travel ............	43,522	43,522
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	90,755	83,045	7,318	392
20	Interest ...........	19,447		19,447
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	3,904,096	3,824,039	80,030	27
23	Insurance ...	363,781	337,726	26,055
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	MEDICAL SUPPLIES AND DRUG	11,974,663	11,973,703		960
b	REPAIRS AND MAINTENANCE	3,664,630	3,532,282	128,874	3,474
c	DUES & SUBSCRIPTIONS	163,370	102,071	61,299
d	RETENTION & RECRUITMENT	107,131	7,577	99,554
e	All other expenses	592,679	452,659	139,260	760
25	Total functional expenses. Add lines 1 through 24e	69,146,067	63,161,481	5,644,464	340,122
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 ........			671,943	1	1,887,366
2	Savings and temporary cash investments .........				2	156,959
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			10,133,069	4	13,790,403
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 ...........			250,081	7	168,567
8	Inventories for sale or use ............			2,632,979	8	2,533,612
9	Prepaid expenses and deferred charges ......			1,288,318	9	1,117,964
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	32,225,788
b	Less: accumulated depreciation	10b	3,207,815	60,113,615	10c	29,017,973
11	Investments—publicly traded securities .			24,934,767	11	15,121,054
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13	1,554,840
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			2,752,114	15	13,228,082
16	Total assets. Add lines 1 through 15 (must equal line 33)...			102,776,886	16	78,576,820

17	Accounts payable and accrued expenses .....	7,222,398	17	7,151,663
18	Grants payable ...		18
19	Deferred revenue .........		19	297,513
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 ..	880,969	23	325,613
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	4,384,268	25	4,645,636
26	Total liabilities. Add lines 17 through 25..	12,487,635	26	12,420,425

	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 ...........	90,289,251	32	66,156,395
33	Total liabilities and net assets/fund balances ........	102,776,886	33	78,576,820