Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| (A)
Mountain States Health Alliance |
620476282 | 3 | No | 0 | 12,104 | |
| (B)
Smyth County Community Hospital |
540794913 | 3 | No | 0 | 3,148 | |
| (C)
Johnston Memorial Hospital |
540544705 | 3 | No | 0 | 0 | |
| (D)
Dickenson Community Hospital |
770599553 | 3 | No | 0 | 0 | |
| (E)
Wellmont Health System |
621636465 | 3 | No | 0 | 0 | |
| (F)
Takoma Regional Hospital |
510603966 | 3 | No | 0 | 7,368 | |
| (G)
Wellmont Hawkins Co Memorial Hosp |
621816368 | 3 | No | 0 | 0 | |
|
Total 7
|
0 | 22,620 | ||||
Calendar year
(or fiscal year beginning in)
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(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (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. | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal
year beginning in) ![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year
(or fiscal year beginning in)
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(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (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 on line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 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 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2023 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2023 |
(iii) Distributable Amount for 2023 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2023 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2023: | ||||
| a From 2018....... | ||||
| b From 2019....... | ||||
| c From 2020....... | ||||
| d From 2021....... | ||||
| e From 2022....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2023 distributable amount | ||||
|
i
Carryover from 2018 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2023 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2023 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2023, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2023. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2024. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2019..... | ||||
| b Excess from 2020..... | ||||
| c Excess from 2021..... | ||||
| d Excess from 2022..... | ||||
| e Excess from 2023..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Part I, Line 12g - Column vi | The auxiliary raises money for Ballad Health hospitals to help fund needed projects and assist with patient needs. |
| Part IV, Sec. A, Line 1 - Supported Orgs Not Listed By Name | The auxiliary's Bylaws do not list each supported organization by name. However, Article II ("Purpose") of the Bylaws states "The Auxiliary is organized exclusively for charitable, religious, educational and scientific purposes within the meaning of Section 501(c)(3) of the Internal Revenue Code of 1986, as the same may be amended from time to time. Specifically, the Auxiliary is organized to render service to Ballad Health hospitals and their patients, and to assist Ballad Health in promoting the health and welfare of the community in accordance with the objectives estblished by the institution." Article VI ("Auxiliary Divisions") of the Bylaws states "The Auxiliary's Board of Directors, in its sole discretion, shall operate seperate divisions for the various healthcare facilities affiliated with or operated by Ballad Health (each an "Auxiliary Division.")" |
| Part IV, Sec. A, Line 5a - Supported Orgs Added | The Mountain States Health Alliance Auxiliary's Bylaws and Charter were amended during the tax year to change the name to Ballad Health Auxiliary. The amended Bylaws and Charter state that the auxiliary renders services to Ballad Health and its related hospitals. Two hospitals not included under the previous Bylaws and Charter were added to the list of supported organizations: Johnston Memorial Hospital FEIN: 54-0544705 Wellmont Hawkins County Memorial Hospital FEIN: 62-1816368 |
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| Return Reference | Explanation |
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| Form 990, Part III, Line 4a - Program Service Accomplishments | In November 2023, Mountain States Health Alliance Auxiliary amended our Bylaws and Charter to change our name to Ballad Health Auxiliary. The auxiliary continues to render services to Ballad Health and its related hospitals; its patients, guests, and team members, while assisting Ballad Health in promoting the health and welfare of the communities served, and functions as an advisory board to the Ballad Health Corporate Volunteer/Auxiliary Department. In addition to the volunteers reflected in our "active" volunteer count reported on Line 6 of Part I, home volunteers continue to crochet or knit baby blankets and caps, quilt or sew lap blankets for patients, hats for cancer patients, large Christmas stockings for babies born in December, and other items for cancer patients, as well as perform clerical work from home. Each volunteer helps to ensure that every patient at a Ballad Health facility receives the best possible care. There are many service and special project opportunities for volunteers throughout Ballad Health's service areas. The leadership within Ballad Health volunteer and auxiliary resources departments work very closely with volunteers to ensure appropriate volunteer placement. This allows volunteers to provide service in an area that matches their passions, interests, and abilities. There has been an increase in the number of applications received for student volunteers, many of which are interested in pursuing a career in healthcare. Volunteering at a Ballad Health facility enables students to gain practical hands-on experience and helps develop vital skills that can be applied to their careers. It is the auxiliary's responsibility to support these students and educate them on the integration of empathy into the patient experience. This allows these volunteers to create a healthier region by accelerating healthy outcomes for patients, caregivers and communities as current students and as future clinicians. Auxiliary volunteers have the same onboarding process as paid team members; including, but not limited to, required immunizations, orientation, competencies, and unit/department training where they will serve. Annual self-evaluations and educational opportunities are conducted to ensure a consistent provision of quality service to patients, visitors, and team members. Volunteers are also one of the best ways to gain feedback from the communities Ballad Health serves. This input is used to continually improve the care offered at all Ballad Health facilities. Volunteers play a key role in a variety of departments, including business offices, reception desks, gift shops, blood banks, and many others. They work throughout the year to assist hospital staff, patients, and patient families. Some services provided by auxiliary volunteers during FY24 included: The Pet Therapy Program, active throughout the health system, brings specially trained dogs in to lift the spirits of patients and create a healing environment. Studies have confirmed therapy dogs help people physically, emotionally, and socially by providing greater comfort and happiness; decreasing stress, anxiety, blood pressure, and heart rates; and by providing patients with unconditional love. Each dog in the program is trained and certified by a nationally recognized therapy dog program. Auxiliary pet therapy volunteers are also called to local colleges such as East Tennessee State University, Emory & Henry College, and Milligan University to assist students with destressing. Additionally, they are present at Camp Firefly, a free, one-day camp designed for children and teenagers who have experienced the death of a loved one. Therapy dogs are there for children who need one-on-one comfort or a few minutes to decompress. The Pet Therapy program has extended to Greeneville Community Hospital, Norton Community Hospital, Bristol Regional Medical Center, Indian Path Community Hospital and will be extending to all Ballad facilities. Volunteers currently staff Johnson City Medical Center's (JCMC) ICU, which is the region's only Level I trauma center. Volunteers also staff JCMC's information desk and surgery waiting room desks. The addition of a new director of volunteers at the Washington County Tennessee hospitals has resulted in an increase of 300% in volunteers and 100% in areas served. Volunteers at Bristol Regional Medical Center and Johnson City Medical Center have begun rounding on patients, which has significantly improved the number of patients surveyed. The Regional Cancer Center of Kingsport located by Indian Path Community Hospital (IPCH) currently has volunteers serving there. The volunteers provide support for the patients, families, and staff by offering drinks, snacks, blankets, and pillows as well as serving lunches. They also provide a Courtesy Cart program which helps facilitate transportation of patients. Most volunteers are cancer survivors who are genuinely interested in the patients as individuals, making the Center's oncology visits less stressful. High school and college students were welcomed into participating here as volunteers and interacting with patients. The students, the patients and the staff proclaimed this program as a success. At Greeneville Community Hospital, volunteers service the outpatient desk, laboratory, radiation oncology, women's center/breast health awareness, and volunteer office. With delivery of gift shop flowers, cards, and newspapers daily, the volunteers strive to make a difference in the lives of patients and their families. The auxiliary has placed a family surgical lounge volunteer in the lounge and in our medical office buildings. Smyth County Community Hospital Auxiliary is continuing to provide Cancer Bags for patients. Bags are filled with items that are appropriate for these patients such as chap stick, lotion, CD's, blankets, water, and other items. This has been very well received by patients. A gift shop volunteer won the servants heart award this year. Fresh baked cookies are served in waiting rooms to the visitors at IPCH. Auxiliary-operated gift shops, which are in most Ballad Health hospitals, provide merchandise for patients, visitors, and team members. The gift shop volunteers not only sell merchandise; but provide a listening ear to family members needing to verbalize concerns about their hospitalized family members. Vendor sales are slowly coming back to Ballad Health hospitals after COVID-19. The auxiliary is also continuing to offer virtual sales which allows team members to order items online and receive their purchases by mail to their home. Volunteer Chaplains: The staff of the Spiritual and Pastoral Care Department endeavors to affirm and respect each person, to be inclusive of all, and to approach diverse religious convictions with sensitivity. Employed chaplains are supplemented by a high-quality core of volunteer chaplains composed of representatives of various denominations in the area. In selecting these persons, the auxiliary seeks people who will adhere to its Code of Ethics and will attempt to relate to each patient's particular religious/spiritual understanding and not proselytize or coerce. Each volunteer chaplain participating in the Ballad Health Spiritual and Pastoral Care Department goes through a rigorous interview and training regimen found in its Guide to Clinical Practice. This 57-page document orients individuals to Pastoral Care at Ballad Health facilities. Volunteer chaplains work in hospitals throughout Ballad Health. They provide pastoral care visitation and support to patients, families of patients and team members. Where implemented, chaplain programs are on-call, 24 hours a day, 7 days a week. At larger hospitals, there are spiritual care volunteers who provide scheduled coverage and daily visitations for added support and presence. In addition to the many volunteer hours provided to the hospitals, the auxiliary raises money for the hospitals to help fund needed projects. Individual Ballad Health hospitals request donations from the auxiliary. Funding is made to a hospital only after the auxiliary board has reviewed and approved a request. Most often, donations fund small capital items such as a piece of medical equipment or items directed toward improved patient care or comfort. In summary, not only was a new volunteer director hired for the Washington County, Tennessee hospital, but new volunteer managers will soon be hired for the Kingsport Market Volunteer Department and for Greeneville Community Hospitals. |
| Form 990, Part V, Line 1a | For Calendar Year 2023, Ballad Health, the parent organization of Ballad Health Auxiliary, filed Form 1096 on a consolidated basis for all subsidiaries that were required to file Forms 1099-MISC/NEC. The auxiliary reimburses Ballad Health for all expenses related to vendor payments and the expenses are recorded on the auxiliary's books. |
| Form 990, Part VI, Section A, line 4 | In November 2023, Mountain States Health Alliance Auxiliary amended our Bylaws and Charter to change our name to Ballad Health Auxiliary. The auxiliary continues to render services to Ballad Health and its related hospitals; its patients, guests, and team members. |
| Form 990, Part VI, Section A, line 7a | The auxiliary President is an employee of Ballad Health. Her continued employment is subject to approval by the Ballad Health Board of Directors. |
| Form 990, Part VI, Section A, line 7b | Governance decisions of the auxiliary are subject to approval by Ballad Health's Board of Directors. |
| Form 990, Part VI, Section B, line 11b | The Ballad Health Tax Department prepares and reviews the Form 990. During preparation other functional areas within the organization provide information and support to complete an accurate return. The return is reviewed by the auxiliary's President and is provided in electronic form to all members of the Board of Directors prior to being filed with the IRS. |
| Form 990, Part VI, Section B, line 12c | Ballad Health policy requires Board of Directors and Board Committee members, the Executive Chair/President, and Executive Vice Presidents to complete a conflict of interest disclosure statement on an annual basis. Ballad Health policy also requires team members to complete an annual acknowledgement that they have read and understand the conflict of interest policy and they will complete a conflict of interest disclosure statement if they have a conflict of interest. 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 committee 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. This applies to all Ballad Health organizations. |
| Form 990, Part VI, Section B, line 15 | Form 990, Part VI, Line 15a - Compensation Process for Top Official: The auxiliary is led by a corporate director of Ballad Health and undergoes the same employment requirements of any director level team member. Since the director is not a Vice-President or in a senior leadership position, her compensation and benefits are consistent with other non-executive positions. |
| Form 990, Part VI, Section C, line 19 | Governing documents and conflict of interest policy are made available upon request to appropriate parties requesting them. Financial statements are made available upon request to appropriate parties requesting them, and they are made available to those parties who own indebtedness of the company on a quarterly basis. |
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