2025-05-08T12:36:07-05:00 2024-06-30 990 2023-07-01 815475903 East Tennessee Healthcare Holdings Inc EAST 4234672854 311 Princeton Road Suite 1 Johnson City TN 376012080 Brooke Graham OMR President 4234672854 2025-05-08 1 Non-Paid Preparer P03077501 2023 2025-03-06 01:10:19Z Overmountain Recovery Brooke Graham 701 Med Tech Prkwy 200 Johnson City TN 37604 5483315 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 1223663 951239 2553995 4526085 0 0 1785 5991 3779443 5483315 0 0 0 0 1375316 1942106 0 0 0 1652006 2577832 3027322 4519938 752121 963377 2239370 3236013 2007695 2040961 231675 1195052 X See Schedule O 0 0 4136819 0 4526085 See Schedule O 4136819 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 Luis Isaza MD Director, Start April 2024 0.10 40.00 X 0 0 0 Allison Rogers BH Chief Strategic O Director, Vice Chair 0.10 54.90 X X 0 482972 85419 Jon Smith PhD Director, Secretary 0.10 40.00 X X 0 0 0 Ken Olive MD Director, End April 2024 0.10 40.00 X 0 0 0 Brooke Graham BH COO Behav Hlth President 15.00 30.00 X X 0 183768 36392 Robert Pack PhD Director, Chair 0.20 40.00 X X 0 0 0 Sarah Thomason PHARMD Director 0.10 40.00 X 0 0 0 Joshua McFall CFO Corp Retail Director, Treasurer 0.10 54.90 X X 0 477101 87670 Mark Wilkinson MD BH CMO Dig Hlth Director 0.10 54.90 X 0 564821 93190 Michael Deitschmann OMR Executive Director 35.20 4.80 X 0 308613 38245 Brooke Davis OMR CFO 1.50 43.50 X 0 122182 16982 Laurie Street OMR Exec. Director, End Sept. 2024 40.00 X 0 127659 7856 Lynn Krutak BH EVPCFO Former Officer 0.00 65.00 X 0 994595 120642 Tony Keck BH EVPCPHO Former Officer 0.00 65.00 X 0 716765 102173 0 3978476 588569 0 1 1 0 0 951239 951239 Patient Revenue 621400 4526085 4526085 4526085 Vending Machines 900099 5491 5491 Medical Records 900099 500 500 5991 5483315 4526085 0 5991 X 123484 123484 1548709 1548709 27875 27875 117615 117615 124423 124423 1507067 1507067 465 465 111729 70732 40997 82511 82511 13872 13872 71013 71013 28878 28878 44889 44889 Medical Supplies 334412 334412 Support Services 173749 173749 Grant-Funded Expenses 133417 133417 Maintenance 51369 51369 24461 24461 4519938 4136819 383119 0 1237586 2107840 373624 234184 758631 759029 389487 393976 369542 2239370 3236013 285976 334768 1600000 1320000 121719 386193 2007695 2040961 X 231675 1195052 231675 1195052 2239370 3236013 963377 0 X 0 1 X 1 1 1 X 1002333 1465660 1243727 1223663 951239 5886622 638217 838098 1815616 2553995 4526085 10372011 2634 1726 1785 5991 12136 1640550 2306392 3061069 3779443 5483315 16270769 0 0 0 16270769 2000 2000 1642550 2306392 3061069 3779443 5483315 16272769 0.99990 0.99970 0.00000 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 425889 116281 309608 333140 273206 59934 369542 Due to Affiliates 386193 386193 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, 2024 and 2023. Tax returns for 2021 through 2023 are subject to examination by the Internal Revenue Service." 0 1 0 0 0 0 0 0 0 Lynn Krutak BH EVPCFO Former Officer 0 751346 0 230794 0 12455 0 90747 0 29895 0 1115237 0 0 Tony Keck BH EVPCPHO Former Officer 0 540176 0 163908 0 12681 0 71915 0 30258 0 818938 0 0 Mark Wilkinson MD BH CMO Dig Hlth Director 0 451190 0 100949 0 12682 0 65158 0 28032 0 658011 0 0 Allison Rogers BH Chief Strategic O Director, Vice Chair 0 376079 0 100091 0 6802 0 57175 0 28244 0 568391 0 0 Joshua McFall CFO Corp Retail Director, Treasurer 0 375615 0 100420 0 1066 0 57934 0 29736 0 564771 0 0 Michael Deitschmann OMR Executive Director 0 235550 0 65833 0 7230 0 14496 0 23749 0 346858 0 0 Brooke Graham BH COO Behav Hlth President 0 151276 0 31678 0 814 0 9625 0 26767 0 220160 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 $70,942 Tony Keck $52,137 Mark Wilkinson $44,571 Joshua McFall $38,555 Allison Rogers $38,429 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 "2022 Tennessee Drug Overdose Deaths and "2022 Drug Overdose Hospital Discharges in Tennessee", in 2022, there were 3,073 overdose deaths involving opioids in Tennessee-an age-adjusted rate for all opioid overdose deaths of 45.7 per 100,000 residents. Over the five-year period from 2018-2022, 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 in the Tennessee Department of Health's report "Neonatal Abstinence Syndrome in Tennessee 2022", the rate of cases of NAS per 1,000 live births reported to the Tennessee Department of Health increased from 9.3 in 2021 to 9.8 in 2022. Since 2019, there have been fluctuations in the number of cases reported but there has not been a meaningful trend during those years. 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 serves approximately 14,000 undergraduate, graduate, medical and pharmacy students each year. 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. The average monthly census increased from 546 patients in FY23 to 685 in FY24, which is an increase of 25%. OMR provided food for over 100 individuals for Thanksgiving in 2023 and plans are underway to provide warm coats to families in need for Thanksgiving 2024. 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 FY24, 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 FY24 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 has a representative from Appalachian Highlands Care Network present three days a week receiving referrals from internal providers and working directly with patients to access community resources, including specialty care. OMR has plans to provide access to an on-site Mobile Health Unit in FY25. 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 2025. 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. Form 990, Part V, line 1a 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 1,392,937. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,392,937. Environmental Services: Program service expenses 43,144. Management and general expenses 0. Fundraising expenses 0. Total expenses 43,144. Other: Program service expenses 70,986. Management and general expenses 0. Fundraising expenses 0. Total expenses 70,986. Mountain States Health Alliance 303 Med Tech Parkway Suite 300 Johnson City TN 37604 620476282 Hospital System TN 501C3 Line 3 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