Smyth County Community Hospital

“Mountain states health alliance is the 80% member of smyth county community hospital. Smyth county community hospital foundation is the 20% member of smyth county community hospital.”

“There are two classes of members, and each class is entitled to elect a specified number of directors to the board. The mountain states health alliance (msha) class is elected by the msha board of directors and the smyth county community hospital class is elected by the smyth county community hospital foundation board of directors. Neither side can veto an appointment.”

“Certain decisions of the board are, pursuant to charter and virginia statute, subject to approval of the members. These decisions include: dissolution of the corporation; merger of the corporation; non-ordinary course of business sale of assets; etc. No ordinary, day-to-day decisions are subject to member approval.”

“The cfo reviewed the form 990 with the board of directors prior to filing with the irs and the return was made available to each board member in an electronic format prior to the review.”

“Annually, the corporate audit and compliance department of msha forwards the conflict of interest policy and disclosure form to all msha management team members and board members, including those at scch. Employees and board members must note any conflicts or attest they have "none", and return the form to the audit and compliance department. Any noted disclosures are forwarded to the appropriate management or board personnel to evaluate and utilize when a transaction involving a conflicted person arises. Additionally, personnel who have a conflict arise between the annual distribution of the policy and forms are required to disclose the conflict and would be disciplined in any instance where they have not disclosed and engaged in a conflicted transaction.”

“The compensation of scch's ceo is initially determined by mountain states health alliance's human resource department based on market data of comparable positions in similar settings. Executive salaries are evaluated on an annual or near-annual basis. Msha offers an incentive plan to executives based on targeted achievement metrics set in advance of the pay year. Established metrics include: communication with patients, patient evidence-based care scores and patient safety, value-based purchasing, etc. These same metrics are used for all employees within msha, with a small number of exceptions for companies that do not provide direct patient care. Msha uses an outside and independent compensation consulting firm to establish reasonable compensation.”

“Compensation for scch's cfo is established the same way as the ceo's, described in 15a above.”

“Governing documents and our conflict of interest policy are made available upon request to appropriate parties requesting them. Financial statements are made available to those parties who own indebtedness of the company on a quarterly basis.”

“Form 990, part vii - related organizations trustee compensation: hospital board of trustees members john jeter, sean mcmurray, and eric sacknoff, m.d. Have form 990 reportable compensation derived from services they provide to related organizations and to scch. They do not receive compensation for their service as a board trustee.”

“Part i, line i - organization's mission: smyth county community hospital (scch) is committed to bringing loving care to health care. We exist to identify and respond to the health care needs of individuals and communities in our region and to assist them in attaining their highest possible level of health.”

“As a not-for-profit hospital, all of scch's surpluses are invested in improving healthcare in the community. With a strong commitment to quality patient care and a heritage of services, scch continues to meet the healthcare needs of smyth and the adjoining counties. For the year ending june 30, 2015, scch recorded 1,596 inpatient admissions, and provided for 81,804 outpatient visits. There were 17,949 emergency visits, 13,685 home health visits and 366 nursing home admissions. Scch serves as a clinical training facility for health professional education students. We have dedicated staff to work with regional colleges and universities to coordinate the placement of healthcare professional students as part of their educational curriculum. In addition to clinical training, the health care students entering our system are required to have orientation and computer training. Participants receiving clinical experience at scch during fy15 included 60 nursing students from various colleges, universities and programs. This nursing clinical experience required extensive scch nursing staff involvement. The clinical setting and hands-on instruction cost scch 119,438. Scch provided a clinical setting for another 17 students training in health-related programs such as radiology, pharmacy, physical therapy, emt/paramedic and other allied-health disciplines. These additional clinical students cost scch 16,352. In furtherance of our commitment to area schools with health professions programs, scch donated 15,000 this year to virginia highlands community college to support its nursing program. Scch partnered with the companies firstsource solutions usa and advanced patient advocacy to work with self-paying patients who have limited financial resources. Representatives were able to determine governmental medical assistance (medicaid) eligibility, and to help with the application process and follow-up. During fy15, 435 patients were approved for coverage. Once a person is approved for medicaid through this program offered through scch, they retain coverage for future medical care. Scch's cost for this program was 36,375. Smyth county's first urgent care facility was opened in september 2014 to offer the community access to local primary care providers after normal business hours. The state-of-the-art facility is located on the scch grounds and offers treatment of minor illnesses and injuries in a setting that is both convenient and cost effective. Lab and x-ray services are available on-site. Premier healthcare alliance's 2014 award winners included smyth county community hospital. Our hospital earned the highest honor by achieving top performance in all of the six areas measured in premier's quest collaborative. Scch, along with sycamore shoals hospital (another mountain states health alliance hospital) were among only 18 hospitals nationwide to receive the quest award for high-value healthcare. The high-value healthcare awards are determined based on six measures: cost of care, evidence-based care; mortality; potential harm; patient experience; and, readmissions. For many years, scch has provided assistance to local non-profit lifesaving organizations such as ambulance services and rescue squads. Scch donates free medications and pharmaceutical supplies to these organizations. The cost of donated medications to rescue organizations during fy15 was more than 6,000. A variety of screenings, support groups, health education, and health fairs were provided on an ongoing basis throughout the year. Some of the services provided during the year include: lab services for a free public clinic and a health fair, cpr training to the public, and first aid classes. Scch offers a support group for people with diabetes. Every other month a scch team member provides education regarding self-care, including nutrition counseling. Scch hosts an annual advanced directives day to educate community members about legal documents they may wish to have in order to expre”

“Part v, line 2a msha, scch's majority owner, processes payroll for scch. Scch reimburses msha for all salary and benefits. The salary and benefits are recorded on scch's books. Scch operates a rural health clinic. Under current centers for medicare and medicaid services (cms) regulations governing staffing at a rural health clinic, at least one midlevel provider (nurse practitioner, physician assistant, etc.) must be a w-2 employee of the clinic. Therefore, scch pays one midlevel provider directly (rather than msha paying this team member's salary, and scch reimbursing msha, as it does for all other scch employees).”

“Hospital supported clinics 4,132,132 0 0 physician fees 1,370,437 0 0 dietary fees 1,374,037 0 0 laundry services 231,130 0 0 environmental services 147,583 0 0 laboratory services 136,184 0 0 other 1,663,155 10,187 0”

“Part iv, line 24a and part x, line 20 - tax exempt bond liability the tax exempt bond liability reflects the portion of bonds issued by mountain states health alliance, scch's majority owner, on behalf of scch for capital needs. Scch pays all costs related to this portion of the bond issue.”

“Capital contribution from subsidiary 738,177 temporarily restricted grants -693 total to form 990, part xi, line 9 737,484”