Ballad Health

“Ballad Health's EVP/CFO reviewed the 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 in an electronic format prior to the review.”

“Ballad Health has a conflict of interest policy for all members of the Board of Directors, the Executive Chair/President, Executive Vice Presidents, Senior Vice Presidents, and Vice Presidents, and applies to all Ballad Health organizations. All persons covered by this policy are required to complete a conflict of interest disclosure form on an annual basis. Should a conflict arise, it is the responsibility of the conflicted individual to update his or her disclosure immediately. All meetings of the board or board committees have a standing agenda item first on the agenda titled Conflicts of Interest. If a member of the board or board committee has a conflict of interest involving any issue on the board agenda, he or she must declare the conflict of interest during the period allotted for disclosure. If any issue arises during a meeting in which the board member has a conflict of interest, he or she must immediately declare the conflict. While each member of the board or board 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.”

“The executive committee serves as the compensation committee of Ballad Health's Board of Directors. The compensation plan for Alan Levine, Ballad Health's President and CEO, was reviewed and approved by the executive committee. An outside and independent compensation consultant was used to determine his compensation and benefits. Studies and surveys were used to ensure his pay is comparable to like positions at similarly situated organizations.”

“The executive committee reviewed and approved compensation for all Ballad Health executives at the vice-president level and above during FY19 using the same methodology used to determine the CEO's compensation.”

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

“Capital Infusion - from controlled entity - MSHA = $XXX-XX-XXXX”

“Capital Infusion - from controlled entity - WHS = $XXX-XX-XXXX”

“Change in Fair Value of interest rate swaps = $8389804”

“Elimination of Intercompany Receivables/Payables = $XXX-XX-XXXX”

“Investment in ISHN = $2488629”

“Minority Interest - Norton Community Hospital = -$45000000”

“Temporarily Restricted Grants = $146491”

“OPENED RURAL HOSPITAL IN UNICOI COUNTY - Ballad Health officially opened the new Unicoi County Hospital in October 2018. The 40,000-square-foot facility includes a 24-hour emergency department with a telemedicine connection to Niswonger Childrens Hospital; 10 inpatient beds; pulmonary, cardiac and acute care services; a chest pain center; standard and advanced diagnostics, including nuclear medicine; and outpatient services. SUPPORTED MILLIGAN COLLEGES ADDICTION COUNSELING CONCENTRATION - With support from Ballad Health, Milligan College announced the expansion of its Master of Science in Counseling program to include a concentration in addictions counseling, beginning in the fall of 2019. Milligans counseling program is a two-year, 60 credit hour program offering concentrations in clinical mental health and school counseling. The addition of addictions counseling is projected to double the number of students in the program.With limited graduate-level options available in the region, the demand for licensed addictions counselors has increased exponentially. Graduates of the new concentration will be qualified for licensure as addictions counselors. Also, current licensed clinical mental health counselors will have an option to add on the addictions subspecialty in as few as two semesters. PARTNERSHIP WITH ETSU TO CREATE FELLOWSHIP PROGRAM IN ADDICTION MEDICINE - Ballad Health and East Tennessee State University formed a partnership to create a new fellowship program in addiction medicine. As part of its commitment to expand education and training in the region, Ballad Health will fund any un-reimbursed costs of the fellowship program which, over a 10-year period, could cost more than $2.5M. Once it seeks accreditation to the Accreditation Council for Graduate Medical Education, ETSU has a goal of accepting its first fellows by July 2020.RECRUITMENT OF NEW PHYSICIANS TO RURAL SOUTHWEST VIRGINIA - Ballad Health provided the necessary resources to recruit more than 140 new specialists to serve our region, many of whom were recruited to private practices not owned by Ballad Health. The addition of specialists is helping to improve access to care in rural communities. For instance, Wise County in Virginia now benefits from an orthopedist, a cardiologist and several other physicians and providers. Wythe County, in Virginia, a community not served by a Ballad Health hospital, benefits from a cardiologist recruited by Ballad Health. Throughout the region, new physicians and advanced practitioners, recruited and funded by Ballad Health, are serving the region from trauma care to pediatrics, from Wythe County Virginia to Hancock County, Tennessee. DONATED EMS SUBSTATION PROPERTY TO GREENE COUNTY - Ballad Health donated the Greene County-Greeneville Emergency Medical Service Substation building to Greene County. The donation involves a two-story brick substation and a nearby building. The substation serves residents within the town limits, but also acts as a backup for the four county-based substations in Mosheim, Tusculum, Baileyton and in the South Greene community. The substation, which functions as EMS headquarters, features three ambulance bays, a kitchen, a lounge, bathrooms, storage areas, and sleeping quarters for up to eight people. The adjacent building will be repurposed in the near future for offices, meeting space and training classrooms. DONATED EMS SUBSTATION PROPERTY TO GREENE COUNTY - Ballad Health donated the Greene County-Greeneville Emergency Medical Service Substation building to Greene County. The donation involves a two-story brick substation and a nearby building. The substation serves residents within the town limits, but also acts as a backup for the four county-based substations in Mosheim, Tusculum, Baileyton and in the South Greene community. The substation, which functions as EMS headquarters, features three ambulance bays, a kitchen, a lounge, bathrooms, storage areas, and sleeping quarters for up to eight”

“ACCOUNTABLE CARE COMMUNITY ACHIEVEMENTS - A leadership committee representing 24 regional organizations, along with more than 250 community stakeholder groups, has created the regions first accountable care community a collaborative group whose goal is to transform the health of a region spanning 21 counties in Northeast Tennessee and Southwest Virginia. A formalized partnership of Ballad Health, Healthy Kingsport and the United Way of Southwest Virginia serves as the backbone of the accountable care community, which uses the collective impact model to align the efforts of all sectors of a community or region to accomplish shared objectives.The accountable care community will focus on supportive systems, programs and environments that nurture strong children and families to help them develop the key characteristics that will lead to success in life. The 250 community stakeholder groups identified the concept of personal resiliency as being a primary differentiator between those who succeed in life and overcome adverse experiences and those who do not, which is especially critical to our regions children.CREATION OF NEW BALLAD HEALTH BEHAVIORAL SERVICES DIVISION - To achieve success in a value-based healthcare environment and to achieve the goals for improved access to behavioral services for the region, Ballad Health created the Behavioral Health Services Division. This new division will oversee all inpatient and outpatient services, including Overmountain Recovery and 186 behavioral service beds throughout the health system, including the 84 beds at Woodridge Hospital, the only dedicated inpatient behavioral health hospital in the region. Already, the new division is taking lead on establishing a residential facility for women who are pregnant and homeless, or drug addicted a meaningful step toward reducing the abuse, neglect and challenges that plague our region due to the addiction epidemic. PROGRAMS TO IMPROVE CHILD LITERACY - Since 2014, Niswonger Childrens Hospital has reached outside the hospital walls and into the community to improve child literacy through the B.E.A.R. Buddies reading program, which pairs volunteer mentors with elementary school students who need a boost in their reading skills. When five new schools recently requested to join the program, Ballad Health Chairman and CEO Alan Levine issued a call to Ballad Health team members to help fill the gap. To date, 100 volunteers for the 2020 school year have signed up. Ballad Health also partnered with seven United Way organizations in a pilot initiative to increase grade-level reading and improve reading proficiency for the regions children. The program is supported by a $300,000 investment, which includes $100,000 from Ballad Health Foundation and $100,000 from contributions made by Ballad Health team members during the health systems 2018 team member campaign. The program is piloting the following initiatives: Tutoring and educational programming designed to raise childrens reading level scores in school systems; training on trauma-informed care for teachers and caregivers; United WE READ, which engages, empowers and equips all children and families using tools and strategies to build a literacy-rich culture; reading volunteers brought digitally into the classroom through a computer program called Vello; and a region-wide chronic absence initiative offering mini-grants and a regionally-focused online attendance toolkit across 17 school districts in Southwest Virginia.In April 2019, Ballad Health donated 3,000 books to schools in Smyth County, Virginia, allowing each student in the school system to take home a free book.STRONG KIDS INTIATIVE - Ballad Health is participating in a new initiative called STRONG Kids, which stands for Striving Toward Resiliency and Opportunities for the Next Generation, that brings together and assists regional organizations that support children. The program will enable Ballad Health, Niswonger Childrens Hospital and the Bristol”

“COMMON ELECTRONIC HEALTH RECORD - Ballad Health made progress in FY19 toward establishing a common clinical platform and electronic health record (EHR). An implementation plan was developed to include infrastructure enhancements to support the expansion. A common EHR across the new health system will allow patient information to be shared immediately at the point of service regardless of where a patient enters the Ballad system, providing clinical staff with information to better manage patients in the emergency room, clinics, acute and post-acute settings. MOVE TO IMPLEMENT COMPREHENSIVE REGIONAL TRAUMA AND EMERGENCY SYSTEM - To reduce the number of duplicative services and better align the health systems resources, Ballad Health made progress towards implementing a comprehensive regional trauma and emergency system to better meet the needs of the Appalachian Highlands region. As part of creating a fully-integrated and highly-coordinated trauma and emergency system, Ballad Health successfully moved to realign the status of Holston Valley Medical Centers trauma center from a Level I to a Level III, and expects to realign Bristol Regional Medical Centers trauma center from a Level II to a Level III within the coming year. This move closely follows evidence-based best practices, which indicates the highest-acuity services are best provided in a higher-volume setting where staff and physician coverage is consistent, and quality is improved.Ballad Health serves as the Official Healthcare Trauma and Emergency Services Provider for Bristol Motor Speedway (BMS). The partnership pledges Ballad Healths trauma and emergency teams will be ready and equipped to handle any medical emergency situations during BMS events with service provided to both guests and participants. Medical services delivered to guests and participants at the speedway is provided at no cost to the patient or community. ENHANCED PEDIATRIC TRAUMA AND PEDIATRIC EMERGENCY ROOMS - Ballad Health is seeking to improve pediatric care by investing in additional pediatric specialties which will support the pediatric trauma program at Niswonger Childrens Hospital, and plans have been announced to add new pediatric emergency rooms in Kingsport and Bristol. Already, the Board has acted to fund both pediatric emergency departments. These plans have been so exciting, that Ballad Health received a $1.2 million pledge from a family which has long supported childrens services in the region. The pediatric emergency room at Bristol Regional Medical Center will be named the J.D. Niswonger Family Pediatric Emergency Department, which will be affiliated with the Niswonger Childrens Hospital. This comprehensive proposal involves realigning the Level III neonatal intensive care unit (NICU) at Holston Valley Medical Center and focusing those services at Niswonger Childrens Hospital, the regions state-designated perinatal center. These pediatric enhancements also involve investing in new pediatric subspecialties and connecting all of Ballad Healths hospitals to Niswonger through telemedicine.SUPPORTED COMMUNITY INITIATIVES AND ORGANIZATIONS- During the year, Ballad Health supported more than 300 organizations in the Appalachian Highlands of Northeast Tennessee and Southwest Virginia. That support totaled more than $5 million in the form of sponsorships, non-cash contributions, community education and direct community benefit. Ballad Health donated 30 advanced cardiac monitors to Sullivan County Emergency Medical Services to enhance Ballad Healths regional trauma network by enabling EMS to transmit patients vital signs to hospital emergency departments and cardiac catheterization labs while still en route. The new monitors also allow emergency providers to monitor oxygen and pulmonary issues in addition to the EKG, which can improve treatment for patients with emphysema, chronic obstructive pulmonary disease (COPD) and asthma. The donation saved Sullivan County approximately $1.2 million, as t”

“Ballad Health, along with American Cancer Society, was one of the sponsors for the Making Strides Against Breast Cancer event.Ballad Health hosted a Food Drive to support Second Harvest Food Bank of Northeast Tennessee and Feeding America of Southwest Virginia. The food drive coincided with National Food Bank Day. People struggle with having enough to eat throughout the year, so this drive was to help eliminate hunger in our community. The donations go to local food pantries and a Senior Grocery Program.Ballad Healths Project Employment Hope has been honored by Disability Rights Tennessee with a Freedom Award for corporate employment leadership. Project Employment Hope is an employment assistance program offered by Ballad Healths human resources (HR) department. The program helps people in need those who are chronically unemployed, underemployed, disabled, living below the poverty line and/or homeless by providing, at no cost to the individual, access to employment counseling, guidance, training and job opportunities with Ballad Health. Members of the Ballad Health HR team work closely with a state program, Vocational Rehabilitation (part of Tennessee Department of Human Services), to assist with job placement of people with disabilities throughout the hospital system. Project Employment Hope includes providing referral candidates assistance with overcoming barriers to finding a job. Ballad Health was recognized for the successful integration of retirement plans after merger of Mountain States and Wellmont Health System:1.Pensions & Investments: 2019 Eddy Award 1st place, Plan Transitions2.Plan Sponsor Council of America (PSCA) a.2019 Signature Award Winner for excellence in employee communications b.2nd place Ballad Health with Lincoln Financial Group, Plan ChangesBallad Healths security, safety & emergency management force has been recognized by Security magazine as part of the 2018 Security 500 rankings. Security magazine remarked: We are recognizing your organization for your safety and security policies and efforts to keep patients, staff and visitors safe. Our team has been monitoring your work in this area, and we wanted to recognize you.Lynn Krutak, chief financial officer for Ballad Health, has been recognized on the prestigious list of 10 Women Leaders to Watch in Healthcare in 2019 by Modern Healthcare. The publication is a leading source of healthcare business and policy news, research and information across the nation. Each year Modern Healthcare selects Top 25 Women Leaders, accompanied by 10 to Watch accomplished, rising women executives who are advancing healthcare. MedAxiom (the nations leading cardiovascular community) selected Dr. Jerry Blackwell to serve as its president. The nations leading community of cardiovascular providers, thought leaders and innovators, MedAxiom is a subsidiary of the American College of Cardiology. Blackwell, who has practiced cardiology in Kingsport since 1995, and previously served as chief executive officer of the Wellmont CVA Heart Institute, served as chief clinical officer of Ballad Health during FY2019. Trish Tanner, assistant vice president and chief pharmacy officer, was honored by the Tennessee Hospital Association (THA) with a 2018 Award of Excellence for Patient Safety Leadership. This award recognizes an individual who has taken extraordinary and innovative steps to make patient safety and quality a top priority in their organization. Tanner serves as chairperson for Ballad Healths Opioid Taskforce and has been a leading voice in the fight against opioid addiction.”

“Ballad Health (Ballad) is a tax-exempt entity and the parent corporation of both Mountain States Health Alliance (MSHA) and Wellmont Health System (WHS). The two healthcare systems came together on February 1, 2018 as a result of a merger approved by both Tennessee and Virginia Departments of Health. Ballad operates under a Certificate of Public Advantage (COPA) in Tennessee and a Cooperative Agreement (CA) in Virginia. Pursuant to the COPA and CA, MSHA and WHS are required to fulfill the obligations, commitments and covenants set forth in the COPA. Such obligations include that Ballad Health shall meet, over the ten-year period beginning July 1, 2018, established minimum spending criteria on initiatives for expanded access to healthcare services, health research and graduate medical education, population health improvement, and a region-wide health information exchange. The full text of the COPA can be found on the Tennessee Department of Health's website, while the CA can be found on the Virginia Department of Health's website.Ballad Health is a healthcare delivery system serving 1.2 million residents from 29 counties in Northeast Tennessee, Southwest Virginia, Northwest North Carolina, and Southeastern Kentucky. Ballad operates 3,162 licensed beds in 21 hospitals, including a dedicated children's hospital, community hospitals, three critical access hospitals, a behavioral health hospital, an addiction treatment facility, long-term care facilities, home care and hospice services, retail pharmacies, outpatient services and a comprehensive medical management corporation. Form 990 for MSHA includes seven wholly-owned hospitals including a childrens hospital and a behavioral health hospital; four others, majority owned by MSHA, each file a separate return. Laughlin Memorial Hospital, wholly-owned by MSHA, also files a separate return. Form 990 for WHS includes five wholly-owned hospitals; two others, also wholly-owned, each file a separate return.”