2024-05-07T11:30:21-05:00 2023-06-30 990 2022-07-01 815475903 East Tennessee Healthcare Holdings Inc EAST 4234672854 311 Princeton Road Suite 1 Johnson City TN 376012080 Brooke Graham OMR President 4234672854 2024-05-07 Brooke Graham 999009999 1 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z Overmountain Recovery Brooke Graham 701 Med Tech Prkwy 200 Johnson City TN 37604 3779443 0 X OVERMOUNTAINRECOVERY.ORG X 2016 TN To operate an outpatient opioid treatment program to treat opioid use disorder and provide recovery for each and every patient. All Overmountain Recovery personnel, from its program leadership to staff members, aim to reduce the burden of addiction on the region it serves. Overmountain Recovery is focused not just on providing a service, but on making the community a healthier and safer place to live, work, learn and do business. 8 0 0 0 0 0 1243727 1223663 1815616 2553995 0 0 1726 1785 3061069 3779443 0 0 0 0 916793 1375316 0 0 0 1375446 1652006 2292239 3027322 768830 752121 2584511 2239370 3104004 2007695 -519493 231675 X See Schedule O 0 0 2843488 0 2553995 See Schedule O 2843488 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 8 0 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 TN X Shane Hilton 4233023467 303 Med Tech Parkway Suite 300 Johnson City TN 37604 Allison Rogers BH Chief Strategic O Vice Chair 0.10 54.90 X X 0 642339 80982 Jon Smith PhD Secretary 0.10 40.00 X X 0 143112 33306 Ken Olive MD Director 0.10 40.00 X 0 286938 49143 Brooke Graham BH COO Behav Hlth President 15.00 30.00 X X 0 162809 32800 Robert Pack PhD Chairman 0.30 40.00 X X 0 242978 74961 Sarah Thomason PHARMD Director 0.10 40.00 X 0 164362 29695 Joshua McFall BH CFO - Acute Svcs Treasurer 0.10 44.90 X X 0 455393 61297 Mark Wilkinson MD BH CMO Dig Hlth Director 0.10 44.90 X 0 548999 44284 Michael Deitschmann OMR Executive Director, Prev. CFO 1.50 43.50 X 0 296397 35477 Laurie Street OMR Exec. Director 40.00 X 126301 0 7710 Lynn Krutak BH EVPCFO Former Officer OMR 0.00 65.00 X 0 1209478 109728 Tony Keck BH EVPCPHO Former Officer OMR 0.00 65.00 X 0 837512 91471 Melissa Carr BH Sr Dir Treasury Former Officer OMR 0.00 40.00 X 0 169955 15901 126301 5160272 666755 1 1 1 0 0 1223663 1223663 Patient Revenue 621400 2444330 2444330 CARES Act Revenue 900099 109665 109665 2553995 Vending Machines 900099 1785 1785 1785 3779443 2553995 0 1785 X 1191666 1191666 16921 16921 85416 85416 81313 81313 926022 926022 3036 3036 37073 30727 6346 13466 13466 141 141 102956 102956 43218 43218 36556 36556 Medical Supplies 279741 279741 Support Services 140932 140932 Maintenance 48812 48812 Clinical Training Affil 8000 8000 12053 12053 3027322 2843488 183834 0 1905758 1237586 94569 373624 151644 234184 785580 391604 432540 393976 2584511 2239370 315788 285976 2380000 1600000 408216 121719 3104004 2007695 X -519493 231675 -519493 231675 2584511 2239370 752121 -953 0 X 0 1 X 1 1 1 X 161010 1002333 1465660 1243727 1223663 5096393 718609 638217 838098 1815616 2553995 6564535 2634 1726 1785 6145 879619 1640550 2306392 3061069 3779443 11667073 0 0 0 11667073 1598 2000 3598 881217 1642550 2306392 3061069 3779443 11670671 0.99970 0.99950 0.00000 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 425889 99225 326664 359691 292379 67312 393976 Due to Affiliates 121719 121719 X Part X, Line 2: East Tennessee Healthcare Holdings, Inc. is included in the audited consolidated financial statements of Ballad Health. The footnote explanation relative to income taxes reads: "Ballad is classified as an organization exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code. As such, no provision for federal income taxes is included in the accompanying consolidated financial statements. Taxable subsidiaries are discussed in Note K. No significant uncertain tax positions exist at June 30, 2023 and 2022. Tax returns for 2020 through 2022 are subject to examination by the Internal Revenue Service." 0 1 0 0 0 0 0 0 0 Lynn Krutak BH EVPCFO Former Officer OMR 0 682629 0 520077 0 6772 0 82332 0 27396 0 1319206 0 0 Tony Keck BH EVPCPHO Former Officer OMR 0 477287 0 347573 0 12652 0 63501 0 27970 0 928983 0 0 Allison Rogers BH Chief Strategic O Vice Chair 0 361874 0 273693 0 6772 0 55335 0 25647 0 723321 0 0 Mark Wilkinson MD BH CMO Dig Hlth Director 0 424870 0 108231 0 15898 0 18150 0 26134 0 593283 0 0 Joshua McFall BH CFO - Acute Svcs Treasurer 0 359547 0 94810 0 1036 0 34586 0 26711 0 516690 0 0 Ken Olive MD Director 0 286538 0 0 0 400 0 30503 0 18640 0 336081 0 0 Michael Deitschmann OMR Executive Director, Prev. CFO 0 230609 0 60876 0 4912 0 14227 0 21250 0 331874 0 0 Robert Pack PhD Chairman 0 242978 0 0 0 0 0 52471 0 22490 0 317939 0 0 Brooke Graham BH COO Behav Hlth President 0 132714 0 29410 0 685 0 8529 0 24271 0 195609 0 0 Sarah Thomason PHARMD Director 0 164362 0 0 0 0 0 16696 0 12999 0 194057 0 0 Melissa Carr BH Sr Dir Treasury Former Officer OMR 0 110226 0 52898 0 6831 0 7224 0 8677 0 185856 0 0 Jon Smith PhD Secretary 0 143112 0 0 0 0 0 14683 0 18623 0 176418 0 0 Part I, Line 4b The following executives listed in Schedule J, Part II participated in a 457(f) retirement plan provided by Ballad Health (BH). The 457(f) plan is a nonqualified tax-deferred compensation plan available to a select group of key executives for the intent of supporting retention and to offer a competitive total retirement program. Account balances have a "substantial risk of forfeiture". In addition to creditor risk, substantial risk of forfeiture is created through default risk if the participant's employment with Ballad Health is terminated prior to age 65. However, the 457(f) plan contains a non-compete provision that provides the account balance to be paid in a lump sum after the executive satisfies the two-year non-compete period. This provision applies to employer contributions if the executive has provided eligible service for six or more years. The executive will receive the entire account balance if he/she becomes disabled, dies or if the executive terminates for "good reason or is involuntarily terminated without "good cause" within a 24-month period after a change-of-control occurs. Distributions from this plan are subject to federal, state, and local taxes on the entire account balance upon distribution. Lynn Krutak $64,932 Tony Keck $45,581 Allison Rogers $36,552 Joshua McFall $18,615 Form 990, Part III, Line 1 - Organization Mission To provide quality treatment for those qualified persons who are addicted to opiates and related chemicals. Overmountain Recovery's philosophy is the goal of treatment should be to assist these individuls in attaining the highest level of functioning possible in physical, emotional, vocational and social domains. Form 990, Part III, Line 4a - Program Service Accomplishments East Tennessee Healthcare Holdings, Inc. d/b/a Overmountain Recovery (OMR) is a not-for-profit outpatient opioid treatment, drug rehabilitation program in Johnson City, Tennessee. In 2016, Mountain States Health Alliance (MSHA) and East Tennessee State University Research Foundation (ETSU) formed OMR to treat people in its service area with heroin, morphine and prescription opioid addictions, including high-acuity individuals with co-occurring mental and physical health conditions, as well as vulnerable populations such as women with substance-exposed pregnancies. The service area consists of 39 cities and 11 counties including: Carter, Greene, Hancock, Hawkins, Johnson, Sullivan, Unicoi and Washington in Tennessee and Lee, Scott and Washington in Virginia, including the City of Bristol, Virginia. According to the Tennessee Department of Health's report "2021 Tennessee Drug Overdose Deaths and "2021 Drug Overdose Hospital Discharges in Tennessee", in 2021, there were 3,043 overdose deaths involving opioids in Tennessee-an age-adjusted rate for all opioid overdose deaths of 45.7 per 100,000 persons. Over the five-year period from 2017-2021, the percentage of decedents who filled an opioid prescription in the Controlled Substance Monitoring Database in the 60 days before death decreased continually. These trends reflect the decrease of deaths involving prescription opioids and increase in deaths involving illicit opioids, such as fentanyl, the current driving force of the epidemic of overdose deaths. Neonatal Abstinence Syndrome (NAS) or Neonatal Opioid Withdrawal Syndrome (NOWS) may occur when a woman uses opioids during pregnancy. As stated by the Tennessee Department of Health's report "Neonatal Abstinence Syndrome Surveillance Annual Report 2021", the rate of cases of NAS per 1,000 live births reported to the Tennessee Department of Health decreased slightly from 10.2 in 2020 to 9.1 in 2021. The decrease follows a slight increase in the prior year and consistent decrease from 2017 to 2019. This may emphasize the negative impact that COVID-19 had on both the consistency and timeliness of hospital reporting and the efforts made to reduce drug use in Tennessee. OMR's Opioid Treatment Program represents a unique comprehensive, innovative, holistic model of care for this patient population by bringing together the local academic and research resources of ETSU; coupled with the medical care expertise and capital resources of MSHA. These two entities have also contracted with Frontier Health to provide therapeutic and recovery-based services. OMR is only one component of a larger focus to incorporate education, outreach, research, and evaluation, all aimed at making a significant difference in the management of the chronic disease of addiction. OMR is an entity that emphasizes evidence-based, long-term treatment that addresses substance abuse disorder (SUD) as a chronic, relapsing disease. Overmountain is focused not just on providing a service, but on making the community a healthier and safer place to live, work, learn and do business by reducing the burden of addiction plaguing its service area. Both ETSU and MSHA have long-time roots in the community. ETSU, founded in 1911, is a state-supported, coeducational institution. ETSU currently has a student population of nearly 14,000 undergraduate, graduate, medical and pharmacy students. Although most students are from Tennessee and the surrounding southeastern region, all 50 states and 71 countries are also represented. The main campus is in Johnson City, Tennessee with off campus sites in Kingsport and Sevierville in Tennessee, Abingdon in Virginia, and Asheville in North Carolina. ETSU has a strong health care focus with colleges of pharmacy, clinical and rehabilitative health sciences, nursing, public health, and medicine. Mountain States Health Alliance, founded in 1998, is part of a large, integrated, not-for-profit health care system based in Johnson City, Tennessee. On February 1, 2018, Mountain States Health Alliance (MSHA) and Wellmont Health System (WHS) merged to form Ballad Health (Ballad), a tax-exempt entity and parent company of MSHA and WHS. Ballad is an integrated healthcare delivery system consisting of 21 hospitals in Northeast Tennessee and Southwest Virginia, including a Level 1 Trauma Center, dedicated children's hospital, several community hospitals, three critical access hospitals, a behavioral health hospital, long-term care facilities, home care and hospice services, retail pharmacies, outpatient services and a comprehensive medical management corporation. Ballad works closely with an active independent medical community and community stakeholders to improve the health and well-being of over one million people in 29 counties of the Appalachian Highlands in Northeast Tennessee, Southwest Virginia, Northwest North Carolina, and Southeast Kentucky. OMR is committed to its patients' recovery. OMR provides care that is customized to their patients' personal needs and takes into consideration housing, education, employment, legal issues, security, transportation and other areas in order to gain a complete picture of the individual. Another key facet of patient-centric approach to care is to have a reliable way of getting input from patients. OMR convenes focus groups of patients who meet quarterly with the director. In FY22, OMR admitted 278 patients into their program. During FY23, OMR admitted a record breaking 368 patients. This was an increase in the monthly intake average by 32.4%. The average monthly census increased from 463 patients in FY22 to 546 in FY23, which is an increase of almost 18%. OMR provided food for over 100 patients and their families for Thanksgiving in 2022 and plans are underway to provide food for more families than ever before for Thanksgiving 2023. The team at OMR donated all the items provided in the food boxes. PROMOTE COMMUNITY HEALTH: OMR's Community Advisory Committee meets quarterly to keep the community abreast of what is happening at OMR. This committee is comprised of members who reside in the community, as well as churches, businesses, and Ballad leadership. ETSU has an addiction medicine fellowship and OMR is a participating site. During FY23, two fellows spent time at OMR. This program will assist in preparing physicians to treat persons with substance use and behavioral disorders in OMR's service area. OMR also has a Clinical Affiliation Agreement with ETSU to provide clinical experience to students enrolled in the Clinical Psychology program of ETSU. The agreement runs for one year and is a paid position. One student was at OMR during FY23 as part of this paid Clinical Affiliation Agreement. A doctoral student from the College of Public Health at ETSU completed an internship at OMR. OMR continues to contract with the Department of Health to provide Hepatitis C rapid testing. OMR participated in several community events throughout the year. This included hosting an event to educate patients on resources available to them. OMR also participated in an event at the Gray Fairgrounds in Gray, TN offering free services to the community such as dental and vision. We are collaborating with a group called Partnership to End Addiction. Their goal is to transform how our nation addresses addiction by empowering families, advancing effective care, shaping public policy, and changing culture. AWARDS AND RECOGNITIONS: Overmountain regularly measures and reports on the performance of its program. OMR tracks both efficiency and effectiveness measures. Because of this dedication to quality, OMR earned its first three-year accreditation from CARF (the Commission on the Accreditation of Rehabilitation Facilities) in August 2018. CARF three-year accreditation is the highest accreditation level awarded to organizations like Overmountain. OMR was resurveyed in July of 2021 and again received a three-year accreditation. To receive three-year accreditation from CARF, organizations are put through a rigorous ongoing process that includes, among other requirements, live on-site surveys. These requirements ensure OMR's program meets CARF's high standards of quality and accountability. Overmountain Recovery was also awarded the State Opioid Response (SOR) grant which was renewed in September 2022 and extended through fiscal year 2023. The SOR grant is a hub and spoke model with Overmountain being the first hub out of four across the state of TN. Spokes include Families Free, Frontier Health, Appalachian Counseling, CCS, and Red Legacy. This has allowed OMR to help many patients who could not otherwise afford treatment. The grant includes funding that allows patients assistance with transportation, social services, help pay utility bills, provide clothes for an interview, and community awareness of the services OMR provides for treatment of opioid addiction. A third-party research agency, "Evaluation, Management, and Training Associates", is conducting research on the State Opioid Response Grant at Overmountain Recovery. This research is sponsored by the Substance Abuse and Mental Health Services Administration (SAMSHA). The research project is titled "Evaluation of the Tennessee Strategic Opioid Response (TN SOR): Changing Behavior, Coordinating Care, and Restoring Lives". These assessments are conducted at intake, at 6-month review and at discharge from the grant. Throughout the fiscal year, these data were used to track trends in opioid use and effectiveness of treatment under the SOR grant. All data and reports are provided directly to SAMSHA and to the Tennessee Department of Mental Health and Substance Abuse Services. Form 990, Part V, line 1a For CY22 Ballad Health (BH), the parent organization of both East Tennessee Healthcare Holdings, Inc. (OMR) and one of its members Mountain States Health Alliance, filed Form 1096 on a consolidated basis for all subsidiaries that were required to file Forms 1099-MISC/NEC. OMR reimburses BH for all expenses related to vendor payments and the expenses are recorded on OMR's books. Form 990, Part V, Line 2a Mountain States Health Alliance (MSHA) along with East Tennessee State University Research Foundation are the sole members of East Tennessee Healthcare Holdings, Inc. MSHA and its parent organization, Ballad Health, Inc. have entered into a management services agreement which includes performance of purchasing functions, inclusive of payment of salaries and benefits as well as the ability to contract for clinical service staff. East Tennessee Healthcare Holdings, Inc. reimburses Ballad Health for all salary and benefits related to its team members and the contracted clinical staffing arrangements. These expenses are recorded on East Tennessee Healthcare Holdings Inc.'s books. Form 990, Part VI, Section A, line 6 The organization has two members: Mountain States Health Alliance and East Tennessee State University Research Foundation both of which are 501(c)(3) public charities. Form 990, Part VI, Section A, line 7a Mountain States Health Alliance and East Tennessee State University Research Foundation each have the power to elect four of the eight voting board members. 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 organization'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 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. Form 990, Part IX, line 11g Medical Professional Services: Program service expenses 800,092. Management and general expenses 0. Fundraising expenses 0. Total expenses 800,092. Contract Labor: Program service expenses 19,092. Management and general expenses 0. Fundraising expenses 0. Total expenses 19,092. Environmental Services: Program service expenses 41,254. Management and general expenses 0. Fundraising expenses 0. Total expenses 41,254. Other: Program service expenses 65,584. Management and general expenses 0. Fundraising expenses 0. Total expenses 65,584. Mountain States Health Alliance 303 Med Tech Parkway Suite 300 Johnson City TN 37604 620476282 Hospital System TN 501C3 Line_3_Hospital_Coop BALLAD 0 East Tennessee State University Research Foundation 2109 West Market Street Johnson City TN 37604 550788917 Research Foundation TN 501C3 12A N/A 0 0 0 0 0 1 0 0 0 0 0 1 0 1 0 1 1 0 0 0