2024-05-03T13:49:38-05:00 2023-06-30 621517792 PYA P C 2220 SUTHERLAND AVE KNOXVILLE TN 37919 990 2022-07-01 581594191 BALLAD HEALTH FOUNDATION BALL 4233023131 1019 W OAKLAND AVE SUITE 2 JOHNSON CITY TN 376042357 JACK SIMPSON PRESIDENT 4232308550 2024-05-03 1 JACK SIMPSON 999009999 0 DEBORAH O ERNSBERGER P00364912 8656730844 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z TODD NORRIS 1019 W OAKLAND AVE SUITE 2 JOHNSON CITY TN 376042357 7956050 0 X BALLADHEALTH.ORG X 1984 TN BALLAD HEALTH FOUNDATION'S PRIMARY PURPOSE IS TO BUILD RELATIONSHIPS WITH OTHERS TO FULFILL THE MISSION AND VISION OF BALLAD HEALTH THROUGH PHILANTHROPY. WORKING TOGETHER AROUND A COMMON SET OF OBJECTIVES, WE CAN TRANSFORM OUR COMMUNITY'S HEALTH AND WELL-BEING. 14 10 6 172 0 0 11715022 6316780 0 0 2034599 1401132 45594 8448 13795215 7726360 5197989 17282947 0 0 682250 835095 0 0 158813 582011 593925 6462250 18711967 7332965 -10985607 62092613 67442232 8673935 22739416 53418678 44702816 BALLAD HEALTH FOUNDATION'S PRIMARY PURPOSE IS TO BUILD RELATIONSHIPS WITH OTHERS TO FULFILL THE MISSION AND VISION OF BALLAD HEALTH THROUGH PHILANTHROPY. WORKING TOGETHER AROUND A COMMON SET OF OBJECTIVES, WE CAN TRANSFORM OUR COMMUNITY'S HEALTH AND WELL-BEING. 0 0 17282947 17282947 DURING THE FISCAL YEAR ENDING JUNE 30, 2023, THE FOUNDATION AWARDED A TOTAL OF $17,257,947 IN GRANTS TO SUPPORT THE CHARITABLE PROGRAMS OF BALLAD HEALTH. $15.1 MILLION WAS DESIGNATED FOR NISWONGER CHILDREN'S HOSPITAL & PEDIATRIC SERVICES, WITH $14.9 MILLION FUNDING THE PLANNING AND CONSTRUCTION OF A NEW NICU AND PEDIATRIC SUBSPECIALTY CLINICS. THE FOUNDATION ALSO PROVIDED GRANTS FOR CARDIOVASCULAR SERVICES ($188,000), CANCER SERVICES AND PATIENT SUPPORT ($176,000), AND HOSPICE CARE, INCLUDING RENOVATIONS TO THE HOSPICE HOUSE ($133,000). ADDITIONALLY, GRANTS SUPPORTED EDUCATIONAL PROGRAMMING FOR STAFF ($125,358), PATIENT ASSISTANCE PROGRAMS ($276,911), AND TEAM MEMBER EMERGENCY SUPPORT ($130,000). 17282947 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 32 0 1 6 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 14 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 TN X SAMANTHA BRUCE 4233023131 1019 W OAKLAND AVE SUITE 2 JOHNSON CITY TN 376042357 TED FIELDS CHAIRPERSON 1.00 X X 0 0 0 LYNN KRUTAK TRUSTEE / BH EVP & CFO 0.50 64.50 X X 0 1209478 109728 JACK SIMPSON PRESIDENT / EX-OFFICIO 45.00 X X 317625 0 37919 GREG COX SECRETARY / TREASURER 1.00 X X 0 0 0 JEFF BEDARD TRUSTEE 0.50 X 0 0 0 MARK COX TRUSTEE 0.50 X 0 0 0 ELIZABETH GARTNER TRUSTEE 0.50 X 0 0 0 JOANNE HAIRSTON TRUSTEE 0.50 X 0 0 0 CARLA KARST TRUSTEE 0.50 X 0 0 0 ANTHONY KECK TRUSTEE 0.50 64.50 X 0 837512 91471 MICHELE KING TRUSTEE 0.50 X 0 0 0 JULIE LICH TRUSTEE 0.50 X 0 0 0 TODD NORRIS TRUSTEE 0.50 54.50 X 0 595211 70410 DAWN TUELL TRUSTEE 0.50 X 0 0 0 317625 2642201 309528 1 0 1 0 0 341567 111783 5863430 6316780 1115424 1115424 285708 0 285708 285708 285708 84290 341567 169874 -85584 -85584 153848 59816 94032 94032 7726360 0 0 1409580 17144616 17144616 138331 138331 355544 355544 479551 479551 41952 41952 134858 125983 8875 34965 20914 14051 126178 126178 17451 17451 CHILDREN'S MIRACLE NETW 93035 93035 BAD DEBT EXPENSE 63850 63850 DONOR RECOGNITION 41567 41567 OTHER 30485 29200 1285 9584 9584 18711967 17282947 1270207 158813 21036155 22817216 4571995 4377607 164971 311243 79697 137466 140526 133393 44345 7133 34240353 37697171 1955097 2094396 62092613 67442232 10099 6183 252500 323126 8411336 22410107 8673935 22739416 X 9542223 11774620 43876455 32928196 53418678 44702816 62092613 67442232 -10985607 2269745 0 X 0 1 X 1 0 X 3793058 4900227 3536748 11694439 6231198 30155670 3793058 4900227 3536748 11694439 6231198 30155670 30155670 1080704 830542 951376 1031944 1115424 5009990 94336 94336 35259996 0.85520 0.84980 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1328687 1328687 1328687 1328687 1326617 2070 1328687 1840295 -513678 1326617 1308437 531858 1840295 1.00000 0 0 4780 4780 1145 1145 0 134601 132248 2353 7133 DUE TO AFFILIATES 22258506 ANNUITY PAYABLE 151601 22410107 X 10805439 2269745 621596 229690 3121031 7684408 41952 41952 7726360 19521301 621596 229690 851286 18670015 41952 41952 18711967 PART X, LINE 2: THE FOUNDATION IS CLASSIFIED AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3). ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN INCLUDED IN THE ACCOMPANYING FINANCIAL STATEMENTS. IN ADDITION, THE FOUNDATION HAS BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE (IRS) NOT TO BE A "PRIVATE FOUNDATION" WITHIN THE MEANING OF SECTION 509(A) OF THE IRC. THE FOUNDATION HAS NO UNCERTAIN TAX POSITIONS AT JUNE 30, 2023 OR 2022 THAT WOULD REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. INFORMATIONAL TAX RETURNS FOR 2020 THROUGH 2022 ARE SUBJECT TO EXAMINATION BY THE IRS. PART XI, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES NETTED WITH REVENUES 169,874. GAMING EXPENSES NETTED WITH REVENUES 59,816. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES NETTED WITH REVENUES 169,874. GAMING EXPENSES NETTED WITH REVENUES 59,816. WINE, WOMEN, AND SHOES 178698 138245 40453 5173 10039 15524 50558 NOHM 2022 247159 203322 43837 6761 26376 6000 44348 1 5095 425857 341567 84290 5173 16800 41900 6000 100001 169874 -85584 153848 35000 24816 1 1.00000 153848 35000 24816 59816 94032 TN 1 0 1 0 1.00000 SAMANTHA BRUCE 1019 W OAKLAND AVENUE SUITE 2 JOHNSON CITY TN 37604 0 JACK SIMPSON THE RAFFLE IS A MINIMAL PART OF THE FOUNDATION'S ACTIVITIES AND DOES NOT HAVE AN OUTSIDE GAMING MANAGER. MR. SIMPSON, AS PRESIDENT OF THE FOUNDATION DURING THE YEAR ENDED JUNE 30, 2023, PROVIDED GENERAL OVERSIGHT AND SUPERVISION OF THE EVENT. HIS INVOLVEMENT IS NOT SIGNIFICANT ENOUGH TO ALLOW FOR ANY PART OF HIS COMPENSATION TO BE ALLOCATED TO GAMING ACTIVITIES. X 1 1 BALLAD HEALTH 1019 W OAKLAND AVE STE 1 JOHNSON CITY TN 37604 611771290 501(C)(3) 17119616 0 $16,332,601 FOR CAPITAL NEEDS AND $787,015 FOR MISCELLANEOUS OTHER PROJECTS EMORY & HENRY COLLEGE PO BOX 947 EMORY VA 24327 540505892 501(C)(3) 25000 0 FUNDING FOR NURSING AND HEALTH SCIENCE PROFESSIONS 2 0 EMPLOYEE ASSSISTANCE 170 138331 PART I, LINE 2: 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. 0 0 0 0 0 0 0 0 0 LYNN KRUTAK TRUSTEE / BH EVP & CFO 0 682629 0 520077 0 6772 0 82332 0 27396 0 1319206 0 0 JACK SIMPSON PRESIDENT / EX-OFFICIO 193559 0 121434 0 2632 0 11758 0 26161 0 355544 0 0 0 ANTHONY KECK TRUSTEE 0 477287 0 347573 0 12652 0 63501 0 27970 0 928983 0 0 TODD NORRIS TRUSTEE 0 344428 0 245595 0 5188 0 46937 0 23473 0 665621 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE BUSINESS AND AFFAIRS OF BALLAD HEALTH FOUNDATION ARE OVERSEEN BY THE BOARD OF TRUSTEES. THE FOUNDATION'S BOARD OF TRUSTEES IS APPOINTED BY BALLAD HEALTH, THE SOLE MEMBER OF THIS CORPORATION. IN ADDITION TO SUCH RIGHTS OF APPROVAL AND CONSENT AS MAY BE RESERVED TO THE SOLE MEMBER OF THE FOUNDATION PURSUANT TO APPLICABLE LAW, TRANSACTIONS OF THE FOLLOWING MATTERS BY THE FOUNDATION SHALL REQUIRE THE PRIOR APPROVAL OF BALLAD HEALTH: (A) IMPLEMENTATION OF FOUNDATION'S ANNUAL BUDGET, (B) INCURRING ANY LOAN OR OTHER INDEBTEDNESS FOR BORROWED MONEY, (C) ACQUISITION OF ANY EQUIPMENT OR PERSONAL PROPERTY FOR A PURCHASE PRICE IN EXCESS OF $50,000 OR THE ACQUISITION OF ANY REAL ESTATE, REGARDLESS OF PURCHASE PRICE, (D) THE UNDERTAKING OF CERTAIN CONTRACTUAL COMMITMENTS, (E) ENTERING INTO ANY PLAN OR MERGER OR CONSOLIDATION, (F) ACQUISITION OF SUBSTANTIALLY ALL OF THE ASSETS OF ANY OTHER LEGAL ENTITY, AND (G) INSTITUTION OF ANY LITIGATION BY OR ON BEHALF OF THE FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7A BALLAD HEALTH IS BALLAD HEALTH FOUNDATION'S SOLE MEMBER. THE BOARD OF DIRECTORS OF BALLAD HEALTH IS RESPONSIBLE FOR APPOINTING THE DIRECTORS OF THE FOUNDATION'S BOARD. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS SUBJECT TO APPROVAL OF MEMBERS SEE FORM 990, PART VI, SECTION A, LINE 6 FOR EXPLANATION. FORM 990, PART VI, SECTION B, LINE 11B THE BALLAD HEALTH FOUNDATION PRESIDENT REVIEWED THE BALLAD HEALTH FOUNDATION FORM 990 PRIOR TO FILING. A COPY OF THE RETURN WAS MADE AVAILABLE TO EACH BOARD MEMBER IN AN ELECTRONIC FORMAT PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE FOUNDATION IS PART OF BALLAD HEALTH WHICH 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 CIRCUMSTANCE SHALL A MEMBER VOTE ON A MATTER THAT GIVES RISE TO A POTENTIAL CONFLICT. FORM 990, PART VI, SECTION B, LINE 15A ON AN ANNUAL BASIS, BALLAD HEALTH'S HUMAN RESOURCES (H/R) DEPARTMENT EVALUATES COMPENSATION FOR ALL EXECUTIVES AT A POSITION LEVEL OF ASSISTANT VICE PRESIDENT AND ABOVE. H/R'S EVALUATION IS BASED ON MARKET DATA OBTAINED FROM INDEPENDENT THIRD-PARTY CONSULTANTS FOR POSITIONS WITH SIMILAR RESPONSIBILITIES AT SIMILARLY SITUATED ORGANIZATIONS. BASED ON THIS COMPARABLE DATA, BALLAD HEALTH'S PRESIDENT & CEO EVALUATES THE DATA AND SUBMITS HIS RECOMMENDATIONS TO BALLAD HEALTH'S BOARD OF DIRECTORS FOR THEIR FINAL REVIEW AND APPROVAL. IN ADDITION, BALLAD HEALTH OFFERS AN INCENTIVE PLAN TO EXECUTIVES BASED ON TARGETED ACHIEVEMENT METRICS SET IN ADVANCE OF THE PAY YEAR. ESTABLISHED METRICS INCLUDE: QUALITY AND ACCESS MEASURES, EVIDENCE-BASED CARE SCORES, AND VALUE BASED PURCHASING, ETC. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND THE 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. 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