Form 990, Part VI, Section A, Line 6
“Msha is considered a member of the foundation because it approves the appointment of the foundation board and also approves any significant capital campaigns.”
Mountain States Foundation
990 • Fiscal year 2018 • EIN 58-1418862
Siviq Scores
Scores are not available for this record yet.
Balance Sheet
Assets
Down$0
Down $15,712,146 (-100%) from 2017
Net Assets
Down$0
Down $14,914,035 (-100%) from 2017
Liabilities
Down$0
Down $798,111 (-100%) from 2017
Revenue And Expenses
Revenue
Down$536,579
Down $1,507,366 (-74%) from 2017
Expenses
Down$187,149
Down $2,225,703 (-92%) from 2017
Net Income
Up$349,430
Up $718,337 (+195%) from 2017
Historical Trend
Jump To
Filing Snapshot
- Filing Period
- Jul 1, 2018 to Sep 30, 2018
- Signed
- Aug 14, 2019
- Return Version
- 2018v3.1
- Gross Receipts
- $843,058
Mission and Program Overview
Mission
Mountain states foundation ("msf") supports mountain states health alliance in healthcare and bringing loving care to healthcare. Msf's vision is to generate public support and awareness, encourage financial support, build endowments, and enlist the philanthropic efforts of other organizations. Through the efforts of friends, volunteers, and team members, msf provides support to a number of causes that are important to the people of northeast tennessee. Helping bring health to life, mountain states foundation advances quality healthcare in the northeast tennessee region by linking friends with mountain states health alliance and creating a difference through giving.
To support mountain states health alliance ("msha") in bringing loving care to healthcare.
Balance Sheet Detail
| Line | Beginning | End | Change |
|---|---|---|---|
| Assets | |||
| Savings and Temporary Cash Investments | $10,292,998 | $0 | ▼ $10,292,998 |
| Investments in Publicly Traded Securities | $1,900,430 | $0 | ▼ $1,900,430 |
| Pledges and Grants Receivable | $932,375 | $0 | ▼ $932,375 |
| Accounts Receivable | $106,804 | $0 | ▼ $106,804 |
| Prepaid Expenses and Deferred Charges | $9,477 | $0 | ▼ $9,477 |
| Cash and Non-Interest-Bearing Accounts | - | $0 | - |
| Other Notes and Loans Receivable, Net | - | $0 | - |
| Receivable From Disqualified Prsn | - | $0 | - |
| Receivables From Officers Etc | - | $0 | - |
| Investments Other Securities | - | $0 | - |
| Investments Program Related | - | $0 | - |
| Land, Buildings, and Equipment, Net | - | $0 | - |
| Intangible Assets | - | $0 | - |
| Inventories for Sale or Use | - | $0 | - |
| Total Assets | $15,499,241 | $0 | ▼ $15,499,241 |
| Other Assets Total | $2,257,157 | $0 | ▼ $2,257,157 |
| Liabilities | |||
| Other Liabilities | $475,034 | $0 | ▼ $475,034 |
| Deferred Revenue | $305,000 | - | - |
| Accounts Payable and Accrued Expenses | $25,426 | - | - |
| Total Liabilities | $805,460 | $0 | ▼ $805,460 |
| Net Assets / Fund Balance | |||
| Temporarily Rstr Net Assets | $12,506,340 | $0 | ▼ $12,506,340 |
| Unrestricted Net Assets | $2,160,309 | $0 | ▼ $2,160,309 |
| Permanently Rstr Net Assets | $27,132 | $0 | ▼ $27,132 |
| Total Net Assets Fund Balance | $14,693,781 | $0 | ▼ $14,693,781 |
| Total Liabilities and Net Assets / Fund Balance | $15,499,241 | $0 | ▼ $15,499,241 |
Endowment Activity
| Period | Beginning | Contrib. | Gain/Loss | Other Uses | End |
|---|---|---|---|---|---|
| 2018 | $127,132 | - | - | - | - |
| 2017 | $127,132 | - | - | - | $127,132 |
| 2016 | $127,132 | - | - | - | $127,132 |
| 2015 | $127,132 | - | - | - | $127,132 |
| 2014 | $127,132 | - | - | - | $127,132 |
Compensation and Service Providers
Employees
| Name | Title | Other | Total |
|---|---|---|---|
| Heidi Dulebohn | Trustee | $23,060 | $23,060 |
Board Members and Trustees
| Name | Title |
|---|---|
| Bob Cantler | Chairperson |
| Greg Cox | Trustee |
| John Williams | Trustee |
| Kay Bunn | Trustee |
| Michele King | Trustee |
| Norrris Sneed | Trustee |
| Ted Fields | Trustee |
| Lynn Krutak | Evp & CFO Ballad/treasurer |
| Todd Norris | SVP Comm. Health & Syst. Adv. Ballad |
| Anthony Keck | SVP/chief Dev. Officer Ballad |
Revenue and Support
Revenue Composition
- Contributions and Grants
- $745,531
- Program Service Revenue
- $0
- Investment Income
- $8,293
- Other Revenue
- $-217,245
- All Other Contributions
- $321,753
- Change in Net Assets
- $349,430
Expenses and Functional Allocation
Major Expense Lines
| Line Item | Amount |
|---|---|
| Grants and Similar Amounts Paid | $175,891 |
| Other Expenses | $11,258 |
| Professional Fundraising Fees | $0 |
| Salaries, Compensation, and Employee Benefits | $0 |
| Total Fundraising Expense | $0 |
Functional Expense Allocation
| Line Item | Program | Management | Fundraising | Total |
|---|---|---|---|---|
| Grants to Domestic Orgs | $175,891 | - | - | $175,891 |
| Fees for Service Investment Mgmnt Fees | - | $4,187 | - | $4,187 |
| Other Expenses | - | $2,225 | - | $2,225 |
| Total Functional Expenses | $175,891 | $11,258 | $0 | $187,149 |
International Activity
Grant and Assistance Recipients
| Recipient | Location | Category | Purpose | Amount |
|---|---|---|---|---|
| Mountain States Health Alliance | Johnson City, TN | 501(c)(3) | NISWONGER CHILDREN'S HOSPITAL, PARISH NURSING, HOSPICE, CIRCLE OF HOPE, HELPING HANDS, PEDIATRIC ONCOLOGY | - |
Fundraising, Events, and Gaming
- Fundraising activities
- Yes
- Gaming activities
- No
- Professional fundraiser used
- No
Fundraising and Gaming Totals
| Line Item | Amount |
|---|---|
| Fundraising Direct Expenses | $306,479 |
| Fundraising Gross Income | $89,234 |
| Professional Fundraising Fees | $0 |
Fundraising Events
| Event | Gross Receipts | Gross Revenue | Direct Expenses | Net Income |
|---|---|---|---|---|
| Golf Tournament | $505,021 | $89,234 | $304,863 | $-215,629 |
| The Beast Bike Ride | $1,888 | - | $153 | - |
| Total Events | $507,913 | $89,234 | $306,479 | $-217,245 |
Political and Lobbying Activity
- Political campaign activity
- No
- Lobbying activity
- No
- Subject to proxy tax
- No
Insider Transactions and Loans
Loans and Receivables
| Line Item | Beginning | End | Change |
|---|---|---|---|
| Receivables from Disqualified Persons | - | $0 | - |
| Receivables from Officers, Directors, Trustees, and Key Employees | - | $0 | - |
Governance and Compliance
Governance Checklist
- Compiled or reviewed by an accountant
- No
- Annual disclosure for covered persons
- Yes
- Backup withholding compliance
- Yes
- Business relationship with family members
- No
- Business relationship with organization members
- No
- Material changes to governing documents
- No
- Compensation from other sources disclosed
- No
- CEO compensation reviewed
- No
- Other officer compensation reviewed
- No
- Conflict-of-interest policy
- Yes
- Audited financial statements prepared
- No
- Key decisions subject to board approval
- Yes
- Management duties delegated
- No
Governance Explanations
Form 990, Part VI, Section A, Line 7A
“Msha is considered a member of the foundation because it approves the appointment of the foundation board and also approves any significant capital campaigns.”
Form 990, Part VI, Section A, Line 7B
“Mountain states health alliance board approves mountain states foundation board of trustees and approves any capital campaigns.”
Form 990, Part VI, Section B, Line 11B
“The tax return is prepared by an unrelated, independent accounting firm and then submitted to senior management within accounting for internal review. Paper copies are then provided to the entire board for review.”
Form 990, Part VI, Section B, Line 12C
“Board members are required to update and submit a new conflict of interest statement by january 31 of each year. The chairman of the board, msha president and chief executive officer and the msha corporate ethics and compliance officer shall become familiar with the statements of the board members in order to guide their conduct should a conflict arise. At such time as any matter comes before the board that may potentially result in a conflict of interest, the affected board member shall make known the potential conflict, whether or not disclosed in a written statement. The affected board member may make a presentation to the board or a committee meeting, but after such presentation, he or she must leave the meeting during the discussion of and the vote on the transaction or arrangement considered to be a conflict of interest.”
Form 990, Part VI, Section C, Line 19
“The governing documents of the organization are held as public records of the state of tennessee secretary of state office. As such, these documents are open to the public. The conflict of interest policies and financial statements are not available to the public as this is not a requirement.”
Filing and Contact Details
Filer
- Filer Name
- Mountain States Foundation
- EIN
- 58-1418862
- Phone
- 4239523110
- Address
- 1019 W OAKLAND AVENUE SUITE 2, JOHNSON CITY, TN 37604
Signing Officer
- Name
- Jack Simpson
- Title
- President
- Phone
- 4239523110
- Signed
- 2019-08-14
- Discuss with paid preparer
- Yes
Organization Details
- Principal Officer
- Todd Norris
- Formed
- 1980
- Legal Domicile
- Tn
- Voting Board Members
- 11
- Independent Board Members
- 7
- Employees
- 0
- Volunteers
- 99
Preparer
- Firm
- Pya P C
- Address
- 2220 SUTHERLAND AVE, KNOXVILLE, TN 37919
- Preparer
- Deborah O Ernsberger
- Phone
- 8656730844
Supplemental Narrative
Additional Explanations
Form 990, Part III, Line 3
“Mountain states foundation ("msf") merged into ballad health foundation, effective october 1, 2018. Though the mission and activities of ballad health foundation closely align with those of msf, msf was no longer a legal entity as of that merger date.”
FORM 990, PART XI, LINE 9:
“Transfer to ballad health foundation -15,076,934.”
Financial Statement Notes
PART V, LINE 4:
“The endowment, along with all of the other assets of mountain states foundation, was transferred to ballad health foundation as of september 30, 2018.”
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| IRS990/Desc | 0 | MOUNTAIN STATES FOUNDATION ("MSF") IS A 501(C)(3) NOT-FOR-PROFIT ORGANIZATION THAT SUPPORTS MOUNTAIN STATES HEALTH ALLIANCE ("MSHA"), A 501(C)(3) ORGANIZATION INVOLVED IN HEALTHCARE AND HEALTHCARE RELATED SERVICES. MSF'S VISION IS TO GENERATE PUBLIC SUPPORT AND AWARENESS, ENCOURAGE FINANCIAL SUPPORT, BUILD ENDOWMENTS, AND ENLIST THE PHILANTHROPIC EFFORTS OF OTHER ORGANIZATIONS. THIS IS ESSENTIAL TO HELP ASSURE CONTINUED EXCELLENCE IN HEALTHCARE AND TO HELP LESSEN THE BURDEN ON PATIENT CHARGES FOR THE FUNDING OF NEW FACILITIES, EQUIPMENT, SERVICES, MEDICAL EDUCATION AND INDIGENT CARE. THROUGH THE EFFORTS OF FRIENDS, VOLUNTEERS, AND STAFF MEMBERS, MSF PROVIDES SUPPORT TO A NUMBER OF CAUSES THAT ARE VERY IMPORTANT TO THE PEOPLE OF NORTHEAST TENNESSEE AND SOUTHWEST VIRGINIA.THE WASHINGTON COUNTY FOUNDATIONTHE WASHINGTON COUNTY FOUNDATION CONTINUES TO PROVIDE SUPPORT FOR THE SURROUNDING HOSPITALS IN THE FOLLOWING CAPACITIES: JOHNSON CITY MEDICAL CENTER - THE FOUNDATION IS CURRENTLY SEEKING SUPPORT FOR A NEW ICU HEALING GARDEN. FRANKLIN WOODS COMMUNITY HOSPITAL AND WOODRIDGE HOSPITAL - THE FOUNDATION CONTINUES TO SUPPORT THEM THROUGH OUR HELPING HANDS PROGRAM.THE NISWONGER CHILDREN'S HOSPITALNISWONGER CHILDREN'S HOSPITAL SERVES A POPULATION OF MORE THAN 200,000 CHILDREN IN A 29-COUNTY REGION. THE HOSPITAL WAS DESIGNED TO PROVIDE FOR THE UNIQUE NEEDS OF CHILDREN AND COMBINES COMPASSIONATE, PERSONALIZED CARE WITH STATE-OF-THE-ART TECHNOLOGY. THE FOUNDATION PROVIDES FUNDING TO THE NISWONGER CHILDREN'S HOSPITAL EACH YEAR FOR VARIOUS NEEDS SUCH AS THE CHILDREN'S RESOURCE CENTER, CHILDLIFE PROGRAM, PEDIATRIC ONCOLOGY, AND THE FAMILIES THRIVE PROGRAM, TO NAME A FEW.THE FOUNDATION CONTINUES TO PROVIDE ADDITIONAL PIECES OF EQUIPMENT AND OTHER HEALTH-RELATED NEEDS IN ITS ONGOING EFFORT TO PROVIDE PATIENT-CENTERED CARE TO THE PEDIATRIC PATIENTS.OTHER PROGRAMS SUPPORTED BY THE FOUNDATION:PARISH NURSING PROGRAMTHE PARISH NURSES PROVIDE INDIVIDUAL/FAMILY HEALTH COUNSELING SESSIONS, HEALTH EDUCATIONAL PROGRAMS AND MAKE REFERRALS TO THE HEALTH/SOCIAL COMMUNITY. THE NURSES ALSO ASSIST THE PARISHIONERS IN NAVIGATING A COMPLICATED HEALTHCARE SYSTEM, AS WELL AS BEING AN ADVOCATE TO THEM.TEAM MEMBER EMERGENCY FUNDTHE TEAM MEMBER EMERGENCY FUND IS A PROGRAM SUPPORTED BY MSHA EMPLOYEES TO SUPPORT OTHER TEAM MEMBERS WHO MAY SUFFER FAMILY TRAGEDIES AND NEED SHORT-TERM SUPPORT. MSHA HAS CREATED A FUND TO PROVIDE FOR THESE NEEDS.PROGRAMS OF HOPETHE PROGRAMS OF HOPE INCLUDE THE CIRCLE OF HOPE, HELPING HANDS, HOSPICE, CANCER AND HEART PROGRAMS.CIRCLE OF HOPETHE CIRCLE OF HOPE PROGRAM WAS CREATED IN 1987 AND PROVIDES FINANCIAL SUPPORT TO CANCER CARE PATIENTS. THE PROGRAM FUNDS EXPENSES SUCH AS GAS VOUCHERS, TAXI FARES, NON-COVERED MEDICATIONS, NUTRITIONAL EXPENSES AND PERSONAL CARE ITEMS. THE PROGRAM ALSO HAS PAID FOR OTHER ESSENTIALS - SUCH AS ELECTRIC BILLS - DEPENDING ON THE PATIENTS' GREATEST NEEDS. THE HELPING HANDS PROGRAMTHE HELPING HANDS PROGRAM WAS STARTED IN 2008 AFTER DISCOVERING THAT MANY OF OUR CAREGIVERS WERE TAKING MONEY OUT OF THEIR POCKETS TO HELP PATIENTS WITH A CAB RIDE HOME, A MEAL IN THE CAFETERIA FOR A FAMILY MEMBER, OR PRESCRIPTION ASSISTANCE. THE PROGRAM CURRENTLY OPERATES IN ALL 14 OF OUR HOSPITALS AND IS GENEROUSLY SUPPORTED BY OUR TEAM MEMBERS.OTHER PROGRAMSHOSPICE IS A SERVICE DESIGNED TO HELP TERMINALLY ILL PATIENTS AND THEIR FAMILIES DEAL WITH SUCH AN ILLNESS AT HOME AND IN THE HOSPITAL. THE CANCER AND HEART PROGRAMS PROVIDE PREVENTION, DIAGNOSIS, AND TREATMENT SERVICES AT VARIOUS MSHA FACILITIES. MSF SUPPORTS THE PROGRAMS THROUGH EDUCATION, EQUIPMENT, AND OTHER RESOURCE NEEDS.MOUNTAIN STATES FOUNDATION ALSO DEVELOPED A PEDIATRIC STORYTELLING PROGRAM TO BE USED WITHIN MOUNTAIN STATES HEALTH ALLIANCE. IT IS DESIGNED TO PROVIDE THE MSHA FACILITIES IMPROVED PATIENT HEALING AND PATIENT SATISFACTION THROUGH A HEALTHCARE STORYTELLING PROGRAM. THIS PROGRAM IS SHOWCASED IN THE DEDICATED STORYTELLING CHANNEL WITH PROFESSIONAL STORYTELLERS.JO |
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| IRS990/Form990PartVIISectionAGrp/TitleTxt | 8 | SVP COMM. HEALTH & SYST. ADV. BALLAD |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 9 | TRUSTEE |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 10 | TRUSTEE |
| IRS990/Form990ProvidedToGvrnBodyInd | 0 | 1 |
| IRS990/FormationYr | 0 | 1980 |
| IRS990/FormerOfcrEmployeesListedInd | 0 | 0 |
| IRS990/FSAuditedInd | 0 | 0 |
| IRS990/FundraisingActivitiesInd | 0 | 1 |
| IRS990/FundraisingAmt | 0 | 418679 |
| IRS990/FundraisingDirectExpensesAmt | 0 | 306479 |
| IRS990/FundraisingGrossIncomeAmt | 0 | 89234 |
| IRS990/GamingActivitiesInd | 0 | 0 |
| IRS990/GoverningBodyVotingMembersCnt | 0 | 11 |
| IRS990/GovernmentGrantsAmt | 0 | 5099 |
| IRS990/GrantAmt | 0 | 175891 |
| IRS990/GrantsToDomesticOrgsGrp/ProgramServicesAmt | 0 | 175891 |
| IRS990/GrantsToDomesticOrgsGrp/TotalAmt | 0 | 175891 |
| IRS990/GrantsToIndividualsInd | 0 | 0 |
| IRS990/GrantsToOrganizationsInd | 0 | 1 |
| IRS990/GrantToRelatedPersonInd | 0 | 0 |
| IRS990/GrossReceiptsAmt | 0 | 843058 |
| IRS990/GroupReturnForAffiliatesInd | 0 | 0 |
| IRS990/IncludeFIN48FootnoteInd | 0 | 0 |
| IRS990/IndependentAuditFinclStmtInd | 0 | 0 |
| IRS990/IndependentVotingMemberCnt | 0 | 7 |
| IRS990/IndivRcvdGreaterThan100KCnt | 0 | 0 |
| IRS990/IndoorTanningServicesInd | 0 | 0 |
| IRS990/InfoInScheduleOPartIIIInd | 0 | X |
| IRS990/InfoInScheduleOPartVIInd | 0 | X |
| IRS990/InfoInScheduleOPartXIInd | 0 | X |
| IRS990/IntangibleAssetsGrp/EOYAmt | 0 | 0 |
| IRS990/InventoriesForSaleOrUseGrp/EOYAmt | 0 | 0 |
| IRS990/InvestmentIncomeGrp/ExclusionAmt | 0 | 8293 |
| IRS990/InvestmentIncomeGrp/TotalRevenueColumnAmt | 0 | 8293 |
| IRS990/InvestmentInJointVentureInd | 0 | 0 |
| IRS990/InvestmentsOtherSecuritiesGrp/EOYAmt | 0 | 0 |
| IRS990/InvestmentsProgramRelatedGrp/EOYAmt | 0 | 0 |
| IRS990/InvestmentsPubTradedSecGrp/BOYAmt | 0 | 1900430 |
| IRS990/InvestmentsPubTradedSecGrp/EOYAmt | 0 | 0 |
| IRS990/IRPDocumentCnt | 0 | 0 |
| IRS990/IRPDocumentW2GCnt | 0 | 0 |
| IRS990/LandBldgEquipBasisNetGrp/EOYAmt | 0 | 0 |
| IRS990/LegalDomicileStateCd | 0 | TN |
| IRS990/LoanOutstandingInd | 0 | 0 |
| IRS990/LobbyingActivitiesInd | 0 | 0 |
| IRS990/LocalChaptersInd | 0 | 0 |
| IRS990/MaterialDiversionOrMisuseInd | 0 | 0 |
| IRS990/MembersOrStockholdersInd | 0 | 1 |
| IRS990/MethodOfAccountingAccrualInd | 0 | X |
| IRS990/MinutesOfCommitteesInd | 0 | 1 |
| IRS990/MinutesOfGoverningBodyInd | 0 | 1 |
| IRS990/MissionDesc | 0 | MOUNTAIN STATES FOUNDATION ("MSF") SUPPORTS MOUNTAIN STATES HEALTH ALLIANCE ("MSHA") IN HEALTHCARE AND BRINGING LOVING CARE TO HEALTHCARE. MSF'S VISION IS TO GENERATE PUBLIC SUPPORT AND AWARENESS, ENCOURAGE FINANCIAL SUPPORT, BUILD ENDOWMENTS, AND ENLIST THE PHILANTHROPIC EFFORTS OF OTHER ORGANIZATIONS. THROUGH THE EFFORTS OF FRIENDS, VOLUNTEERS, AND TEAM MEMBERS, MSF PROVIDES SUPPORT TO A NUMBER OF CAUSES THAT ARE IMPORTANT TO THE PEOPLE OF NORTHEAST TENNESSEE AND SOUTHWEST VIRGINIA. HELPING BRING HEALTH TO LIFE, MOUNTAIN STATES FOUNDATION ADVANCES QUALITY HEALTHCARE IN THE REGION BY LINKING FRIENDS WITH MSHA AND CREATING A DIFFERENCE THROUGH GIVING. |
| IRS990/MoreThan5000KToIndividualsInd | 0 | 0 |
| IRS990/MoreThan5000KToOrgInd | 0 | 0 |
| IRS990/NetAssetsOrFundBalancesBOYAmt | 0 | 14693781 |
| IRS990/NetAssetsOrFundBalancesEOYAmt | 0 | 0 |
| IRS990/NetIncmFromFundraisingEvtGrp/ExclusionAmt | 0 | -217245 |
| IRS990/NetIncmFromFundraisingEvtGrp/TotalRevenueColumnAmt | 0 | -217245 |
| IRS990/NetUnrelatedBusTxblIncmAmt | 0 | 0 |
| IRS990/NetUnrlzdGainsLossesInvstAmt | 0 | 33723 |
| IRS990/NondeductibleContributionsInd | 0 | 0 |
| IRS990/OfficerMailingAddressInd | 0 | 0 |
| IRS990/OperateHospitalInd | 0 | 0 |
| IRS990/Organization501c3Ind | 0 | X |
| IRS990/OrganizationFollowsSFAS117Ind | 0 | X |
| IRS990/OtherAssetsTotalGrp/BOYAmt | 0 | 2257157 |
| IRS990/OtherAssetsTotalGrp/EOYAmt | 0 | 0 |
| IRS990/OtherChangesInNetAssetsAmt | 0 | -15076934 |
| IRS990/OtherExpensesGrp/Desc | 0 | FOUNDATION EXPENSE |
| IRS990/OtherExpensesGrp/Desc | 1 | BANK CHARGES |
| IRS990/OtherExpensesGrp/ManagementAndGeneralAmt | 0 | 4846 |
| IRS990/OtherExpensesGrp/ManagementAndGeneralAmt | 1 | 2225 |
| IRS990/OtherExpensesGrp/TotalAmt | 0 | 4846 |
| IRS990/OtherExpensesGrp/TotalAmt | 1 | 2225 |
| IRS990/OtherLiabilitiesGrp/BOYAmt | 0 | 475034 |
| IRS990/OtherLiabilitiesGrp/EOYAmt | 0 | 0 |
| IRS990/OthNotesLoansReceivableNetGrp/EOYAmt | 0 | 0 |
| IRS990/PartialLiquidationInd | 0 | 0 |
| IRS990/PayPremiumsPrsnlBnftCntrctInd | 0 | 0 |
| IRS990/PermanentlyRstrNetAssetsGrp/BOYAmt | 0 | 27132 |
| IRS990/PermanentlyRstrNetAssetsGrp/EOYAmt | 0 | 0 |
| IRS990/PledgesAndGrantsReceivableGrp/BOYAmt | 0 | 932375 |
| IRS990/PledgesAndGrantsReceivableGrp/EOYAmt | 0 | 0 |
| IRS990/PoliticalCampaignActyInd | 0 | 0 |
| IRS990/PrepaidExpensesDefrdChargesGrp/BOYAmt | 0 | 9477 |
| IRS990/PrepaidExpensesDefrdChargesGrp/EOYAmt | 0 | 0 |
| IRS990/PrincipalOfficerNm | 0 | TODD NORRIS |
| IRS990/ProfessionalFundraisingInd | 0 | 0 |
| IRS990/ProhibitedTaxShelterTransInd | 0 | 0 |
| IRS990/PYBenefitsPaidToMembersAmt | 0 | 0 |
| IRS990/PYContributionsGrantsAmt | 0 | 1257204 |
| IRS990/PYExcessBenefitTransInd | 0 | 0 |
| IRS990/PYGrantsAndSimilarPaidAmt | 0 | 1331553 |
| IRS990/PYInvestmentIncomeAmt | 0 | 91766 |
| IRS990/PYOtherExpensesAmt | 0 | 115239 |
| IRS990/PYOtherRevenueAmt | 0 | -227962 |
| IRS990/PYProgramServiceRevenueAmt | 0 | 0 |
| IRS990/PYRevenuesLessExpensesAmt | 0 | -325784 |
| IRS990/PYSalariesCompEmpBnftPaidAmt | 0 | 0 |
| IRS990/PYTotalExpensesAmt | 0 | 1446792 |
| IRS990/PYTotalProfFndrsngExpnsAmt | 0 | 0 |
| IRS990/PYTotalRevenueAmt | 0 | 1121008 |
| IRS990/QuidProQuoContributionsInd | 0 | 0 |
| IRS990/RcvblFromDisqualifiedPrsnGrp/EOYAmt | 0 | 0 |
| IRS990/RcvFndsToPayPrsnlBnftCntrctInd | 0 | 0 |
| IRS990/ReceivablesFromOfficersEtcGrp/EOYAmt | 0 | 0 |
| IRS990/ReconcilationRevenueExpnssAmt | 0 | 349430 |
| IRS990/RegularMonitoringEnfrcInd | 0 | 1 |
| IRS990/RelatedEntityInd | 0 | 1 |
| IRS990/RelatedOrganizationCtrlEntInd | 0 | 0 |
| IRS990/ReportInvestmentsOtherSecInd | 0 | 0 |
| IRS990/ReportLandBuildingEquipmentInd | 0 | 0 |
| IRS990/ReportOtherAssetsInd | 0 | 0 |
| IRS990/ReportOtherLiabilitiesInd | 0 | 0 |
| IRS990/ReportProgramRelatedInvstInd | 0 | 0 |
| IRS990/SavingsAndTempCashInvstGrp/BOYAmt | 0 | 10292998 |
| IRS990/SavingsAndTempCashInvstGrp/EOYAmt | 0 | 0 |
| IRS990ScheduleA/Form990SchASupportingOrgGrp/Contribution35ControlledInd | 0 | 0 |
| IRS990ScheduleA/Form990SchASupportingOrgGrp/ContributionControllerInd | 0 | 0 |
| IRS990ScheduleA/Form990SchASupportingOrgGrp/ContributionFamilyInd | 0 | 0 |
| IRS990ScheduleA/Form990SchASupportingOrgGrp/ControlledDisqualifiedPrsnInd | 0 | 0 |
| IRS990ScheduleA/Form990SchASupportingOrgGrp/DisqualifiedPrsnControllIntInd | 0 | 0 |
| IRS990ScheduleA/Form990SchASupportingOrgGrp/DisqualifiedPrsnOwnrIntInd | 0 | 0 |
| IRS990ScheduleA/Form990SchASupportingOrgGrp/ExcessBusinessHoldingsRulesInd | 0 | 0 |
| IRS990ScheduleA/Form990SchASupportingOrgGrp/ListedByNameGoverningDocInd | 0 | 1 |
| IRS990ScheduleA/Form990SchASupportingOrgGrp/LoanDisqualifiedPersonInd | 0 | 0 |
| IRS990ScheduleA/Form990SchASupportingOrgGrp/OrganizationChangeSuprtOrgInd | 0 | 0 |
| IRS990ScheduleA/Form990SchASupportingOrgGrp/PaymentSubstantialContribtrInd | 0 | 0 |
| IRS990ScheduleA/Form990SchASupportingOrgGrp/SupportedOrgNotOrganizedUSInd | 0 | 0 |
| IRS990ScheduleA/Form990SchASupportingOrgGrp/SupportedOrgSectionC456Ind | 0 | 0 |
| IRS990ScheduleA/Form990SchASupportingOrgGrp/SupportNonSupportedOrgInd | 0 | 0 |
| IRS990ScheduleA/Form990SchASupportingOrgGrp/SuprtOrgNoIRSDeterminationInd | 0 | 0 |
| IRS990ScheduleA/Form990SchAType1SuprtOrgGrp/OperateBenefitNonSuprtOrgInd | 0 | 0 |
| IRS990ScheduleA/Form990SchAType1SuprtOrgGrp/PowerAppointMajorityDirTrstInd | 0 | 1 |
| IRS990ScheduleA/OtherSupportSumAmt | 0 | 0 |
| IRS990ScheduleA/SupportedOrganizationsCnt | 0 | 1 |
| IRS990ScheduleA/SupportedOrganizationsTotalCnt | 0 | 1 |
| IRS990ScheduleA/SupportedOrgInformationGrp/EIN | 0 | 620476282 |
| IRS990ScheduleA/SupportedOrgInformationGrp/GoverningDocumentListedInd | 0 | 1 |
| IRS990ScheduleA/SupportedOrgInformationGrp/OrganizationTypeCd | 0 | 3 |
| IRS990ScheduleA/SupportedOrgInformationGrp/OtherSupportAmt | 0 | 0 |
| IRS990ScheduleA/SupportedOrgInformationGrp/SupportAmt | 0 | 152106 |
| IRS990ScheduleA/SupportedOrgInformationGrp/SupportedOrganizationName/BusinessNameLine1Txt | 0 | MOUNTAIN STATES HEALTH ALLIANCE |
| IRS990ScheduleA/SupportingOrganization509a3Ind | 0 | X |
| IRS990ScheduleA/SupportingOrgType1Ind | 0 | X |
| IRS990ScheduleA/SupportSumAmt | 0 | 152106 |
| IRS990/ScheduleBRequiredInd | 0 | 1 |
| IRS990ScheduleD/CYEndwmtFundGrp/BeginningYearBalanceAmt | 0 | 127132 |
| IRS990ScheduleD/CYMinus1YrEndwmtFundGrp/BeginningYearBalanceAmt | 0 | 127132 |
| IRS990ScheduleD/CYMinus1YrEndwmtFundGrp/EndYearBalanceAmt | 0 | 127132 |
| IRS990ScheduleD/CYMinus2YrEndwmtFundGrp/BeginningYearBalanceAmt | 0 | 127132 |
| IRS990ScheduleD/CYMinus2YrEndwmtFundGrp/EndYearBalanceAmt | 0 | 127132 |
| IRS990ScheduleD/CYMinus3YrEndwmtFundGrp/BeginningYearBalanceAmt | 0 | 127132 |
| IRS990ScheduleD/CYMinus3YrEndwmtFundGrp/EndYearBalanceAmt | 0 | 127132 |
| IRS990ScheduleD/CYMinus4YrEndwmtFundGrp/BeginningYearBalanceAmt | 0 | 127132 |
| IRS990ScheduleD/CYMinus4YrEndwmtFundGrp/EndYearBalanceAmt | 0 | 127132 |
| IRS990ScheduleD/EndowmentsHeldRelatedOrgInd | 0 | 0 |
| IRS990ScheduleD/EndowmentsHeldUnrelatedOrgInd | 0 | 0 |
| IRS990ScheduleD/SupplementalInformationDetail/ExplanationTxt | 0 | THE ENDOWMENT, ALONG WITH ALL OF THE OTHER ASSETS OF MOUNTAIN STATES FOUNDATION, WAS TRANSFERRED TO BALLAD HEALTH FOUNDATION AS OF SEPTEMBER 30, 2018. |
| IRS990ScheduleD/SupplementalInformationDetail/FormAndLineReferenceDesc | 0 | PART V, LINE 4: |
| IRS990ScheduleD/TotalBookValueLandBuildingsAmt | 0 | 0 |
| IRS990ScheduleG/FundraisingEventInformationGrp/CharitableContributionsTotAmt | 0 | 418679 |
| IRS990ScheduleG/FundraisingEventInformationGrp/CharitableContriEvent1Amt | 0 | 415787 |
| IRS990ScheduleG/FundraisingEventInformationGrp/CharitableContriEvent2Amt | 0 | 1888 |
| IRS990ScheduleG/FundraisingEventInformationGrp/CharitableContriOtherEventsAmt | 0 | 1004 |
| IRS990ScheduleG/FundraisingEventInformationGrp/DirectExpenseSummaryEventsAmt | 0 | 306479 |
| IRS990ScheduleG/FundraisingEventInformationGrp/Event1Nm | 0 | GOLF TOURNAMENT |
| IRS990ScheduleG/FundraisingEventInformationGrp/Event2Nm | 0 | THE BEAST BIKE RIDE |
| IRS990ScheduleG/FundraisingEventInformationGrp/GrossReceiptsEvent1Amt | 0 | 505021 |
| IRS990ScheduleG/FundraisingEventInformationGrp/GrossReceiptsEvent2Amt | 0 | 1888 |
| IRS990ScheduleG/FundraisingEventInformationGrp/GrossReceiptsOtherEventsAmt | 0 | 1004 |
| IRS990ScheduleG/FundraisingEventInformationGrp/GrossReceiptsTotalAmt | 0 | 507913 |
| IRS990ScheduleG/FundraisingEventInformationGrp/GrossRevenueEvent1Amt | 0 | 89234 |
| IRS990ScheduleG/FundraisingEventInformationGrp/GrossRevenueTotalEventsAmt | 0 | 89234 |
| IRS990ScheduleG/FundraisingEventInformationGrp/NetIncomeSummaryAmt | 0 | -217245 |
| IRS990ScheduleG/FundraisingEventInformationGrp/OthDirectExpnssOtherEventsAmt | 0 | 1463 |
| IRS990ScheduleG/FundraisingEventInformationGrp/OthDirectExpnssTotalEventsAmt | 0 | 306479 |
| IRS990ScheduleG/FundraisingEventInformationGrp/OtherDirectExpensesEvent1Amt | 0 | 304863 |
| IRS990ScheduleG/FundraisingEventInformationGrp/OtherDirectExpensesEvent2Amt | 0 | 153 |
| IRS990ScheduleG/FundraisingEventInformationGrp/OtherEventsTotalCnt | 0 | 7 |
| IRS990ScheduleI/GrantRecordsMaintainedInd | 0 | 1 |
| IRS990ScheduleI/RecipientTable/IRCSectionDesc | 0 | 501(C)(3) |
| IRS990ScheduleI/RecipientTable/NonCashAssistanceAmt | 0 | 152106 |
| IRS990ScheduleI/RecipientTable/PurposeOfGrantTxt | 0 | NISWONGER CHILDREN'S HOSPITAL, PARISH NURSING, HOSPICE, CIRCLE OF HOPE, HELPING HANDS, PEDIATRIC ONCOLOGY |
| IRS990ScheduleI/RecipientTable/RecipientBusinessName/BusinessNameLine1Txt | 0 | MOUNTAIN STATES HEALTH ALLIANCE |
| IRS990ScheduleI/RecipientTable/RecipientEIN | 0 | 620476282 |
| IRS990ScheduleI/RecipientTable/USAddress/AddressLine1Txt | 0 | 400 N STATE OF FRANKLIN ROAD |
| IRS990ScheduleI/RecipientTable/USAddress/CityNm | 0 | JOHNSON CITY |
| IRS990ScheduleI/RecipientTable/USAddress/StateAbbreviationCd | 0 | TN |
| IRS990ScheduleI/RecipientTable/USAddress/ZIPCd | 0 | 37604 |
| IRS990ScheduleI/SupplementalInformationDetail/ExplanationTxt | 0 | THE ORGANIZATION HAS GUIDELINES IN PLACE THAT ARE TO BE USED IN REVIEWING THE ELIGIBILITY OF GRANTEES. VARIOUS PROCEDURES ARE IN PLACE DEPENDING ON GRANT TYPE, INCLUDING REQUIREMENTS TO SUBMIT APPLICATIONS FOR REVIEW AND APPROVAL. ALL GRANTS REQUIRE WRITTEN DOCUMENTATION AND APPROPRIATE LEVELS OF APPROVAL. |
| IRS990ScheduleI/SupplementalInformationDetail/FormAndLineReferenceDesc | 0 | PART I, LINE 2: |
| IRS990ScheduleI/Total501c3OrgCnt | 0 | 1 |
| IRS990ScheduleI/TotalOtherOrgCnt | 0 | 0 |
| IRS990ScheduleJ/AnyNonFixedPaymentsInd | 0 | 0 |
| IRS990ScheduleJ/CompBasedOnRevenueOfFlngOrgInd | 0 | 0 |
| IRS990ScheduleJ/CompBsdNetEarnsFlngOrgInd | 0 | 0 |
| IRS990ScheduleJ/CompBsdNetEarnsRltdOrgsInd | 0 | 0 |
| IRS990ScheduleJ/CompBsdOnRevRelatedOrgsInd | 0 | 0 |
| IRS990ScheduleJ/EquityBasedCompArrngmInd | 0 | 0 |
| IRS990ScheduleJ/InitialContractExceptionInd | 0 | 0 |
| IRS990/ScheduleJRequiredInd | 0 | 1 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BaseCompensationFilingOrgAmt | 0 | 0 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BaseCompensationFilingOrgAmt | 1 | 0 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BaseCompensationFilingOrgAmt | 2 | 0 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BonusFilingOrganizationAmount | 0 | 0 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BonusFilingOrganizationAmount | 1 | 0 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BonusFilingOrganizationAmount | 2 | 0 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BonusRelatedOrganizationsAmt | 0 | 192790 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BonusRelatedOrganizationsAmt | 1 | 250000 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/BonusRelatedOrganizationsAmt | 2 | 25501 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompensationBasedOnRltdOrgsAmt | 0 | 413343 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompensationBasedOnRltdOrgsAmt | 1 | 585707 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompensationBasedOnRltdOrgsAmt | 2 | 313551 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompReportPrior990FilingOrgAmt | 0 | 0 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompReportPrior990FilingOrgAmt | 1 | 0 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompReportPrior990FilingOrgAmt | 2 | 0 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompReportPrior990RltdOrgsAmt | 0 | 0 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompReportPrior990RltdOrgsAmt | 1 | 0 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompReportPrior990RltdOrgsAmt | 2 | 0 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/DeferredCompensationFlngOrgAmt | 0 | 0 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/DeferredCompensationFlngOrgAmt | 1 | 0 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/DeferredCompensationFlngOrgAmt | 2 | 0 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/DeferredCompRltdOrgsAmt | 0 | 54026 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/DeferredCompRltdOrgsAmt | 1 | 71047 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/DeferredCompRltdOrgsAmt | 2 | 12458 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/NontaxableBenefitsFilingOrgAmt | 0 | 0 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/NontaxableBenefitsFilingOrgAmt | 1 | 0 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/NontaxableBenefitsFilingOrgAmt | 2 | 0 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/NontaxableBenefitsRltdOrgsAmt | 0 | 13819 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/NontaxableBenefitsRltdOrgsAmt | 1 | 17645 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/NontaxableBenefitsRltdOrgsAmt | 2 | 4757 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/OtherCompensationFilingOrgAmt | 0 | 0 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/OtherCompensationFilingOrgAmt | 1 | 0 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/OtherCompensationFilingOrgAmt | 2 | 0 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/OtherCompensationRltdOrgsAmt | 0 | 6777 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/OtherCompensationRltdOrgsAmt | 1 | 18316 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/OtherCompensationRltdOrgsAmt | 2 | 1420 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm | 0 | ANTHONY KECK |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm | 1 | LYNN KRUTAK |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm | 2 | TODD NORRIS |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt | 0 | SVP/CHIEF DEV. OFFICER BALLAD |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt | 1 | EVP & CFO BALLAD/TREASURER |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt | 2 | SVP COMM. HEALTH & SYST. ADV. BALLAD |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationFilingOrgAmt | 0 | 0 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationFilingOrgAmt | 1 | 0 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationFilingOrgAmt | 2 | 0 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationRltdOrgsAmt | 0 | 680755 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationRltdOrgsAmt | 1 | 942715 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationRltdOrgsAmt | 2 | 357687 |
| IRS990ScheduleJ/SeverancePaymentInd | 0 | 0 |
| IRS990ScheduleJ/SupplementalNonqualRtrPlanInd | 0 | 0 |
| IRS990ScheduleN/AssetsDistributedInd | 0 | 1 |
| IRS990ScheduleN/AttorneyGeneralNotifiedInd | 0 | 1 |
Document Assets
No mirrored PDF or thumbnail assets are attached yet.
Filings
Displayed year
2018 • Form 990Detailed filing. Detailed filing data is available for this year.
- Assets
- $0
- Liabilities
- $0
- Net assets
- $0
- Revenue
- $536,579
- Expenses
- $187,149
- Net income
- $349,430