Smyth County Community Hospital
Public records show a registered, tax-exempt organization in good standing.
What it says it does
Honor those we serve by delivering the best possible care.Ballad Health is dedicated to improving the health of the 29-county Appalachian Highlands region.
- Income
- $57.2 million
- Spending
- $49.5 million
- Spent on programs
- 84%
- Reserves
- 1.3 months of spending
- Largest source of income
- fees for its services, 88%
- Employees
- 4
- Volunteers
- 30
- Highest pay
- $4.1 million, director, chair
Source: Form 990 for the year ending June 30, 2025, filed with the Internal Revenue Service. Rating method 2026.2. How we rate
Financial health
Good: 71 out of 100. Higher than 59% of charities in its peer group (health care, $10m to $100m).
Reserves
10 of 35Spendable reserves would cover 1.3 months of spending.
Debt
16 of 20It owes 30% of what it owns.
Living within its means
15 of 15Income exceeded spending by 14% of income.
Income trend
15 of 15Income rose 13% on the year before.
Spending floor
15 of 1584% of spending went to programs and raising each dollar of donations cost 0 cents.
Source: Form 990 for the year ending June 30, 2025, filed with the Internal Revenue Service. Rating method 2026.2. How we rate
Governance
Good: 75 out of 100. Higher than 8% of charities in its peer group (health care, $10m to $100m).
Independent board
5 of 250 of 4 voting board members are independent.
Conflict of interest policy
15 of 15Has a written conflict of interest policy.
Whistleblower policy
8 of 8Has a written whistleblower policy.
Record keeping policy
7 of 7Has a written policy on keeping and destroying records.
Board minutes
5 of 5Keeps minutes of board meetings.
Board sees the tax return
10 of 10Gave the board a copy of this return before filing it.
Pay set independently
0 of 5Reports no independent review process for its chief executive's pay.
Independent check of accounts
15 of 15Its accounts were audited by an independent accountant.
No reported misuse
10 of 10Reports no diversion of assets, excess benefits or loans to insiders.
Source: Form 990 for the year ending June 30, 2025, filed with the Internal Revenue Service. Rating method 2026.2. How we rate
Impact evidence
Describes programs. Its tax return describes what it does but we have found no measurable results in it.
Programs described in its return (2)
- $37.3 million spent. Smyth County Community Hospital's (SCCH) membership consists of Mountain States Health Alliance. SCCH is also a member of the Ballad Health network. Ballad Health (Ballad) is an integrated healthcare delivery system consisting of 20 hospitals in Northeast Tennessee and Southwest Virginia, including a Level 1 Trauma Center, dedicated children's hospital, several community hospitals, four 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. 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. Ballad is a Tennessee non-profit corporation and is the main provider of healthcare services in Northeast Tennessee and Southwest Virginia. Ballad Health is a tax-exempt entity and the parent corporation of both Mountain States Health Alliance (MSHA) and Wellmont Health System (WHS). On February 1, 2018, Ballad was formed through a merger of two legacy systems, Mountain States Health Alliance and Wellmont Health System. Ballad was formed under state-action immunity in compliance with federal antitrust law, to create a healthier region and keep healthcare local. The action approving the merger was officially taken through the agreements made between Ballad and the State of Tennessee in the Certificate of Public Advantage (the "COPA") and the Letter Authorizing the Cooperative Agreement (the "CA") in Virginia. Pursuant to the COPA and CA, Ballad must fulfill certain obligations, commitments, and covenants. Tennessee and Virginia, through their respective health departments, supervise specific aspects of Ballad's operations under certain conditions of the COPA and the CA. The COPA and amendments are publicly available on the website of the Tennessee Department of Health, at https://www.tn.gov/health/copa.html. The Cooperative Agreement is available on the website of the Virginia Department of Health, at https://www.vdh.virginia.gov/licensure-and- certification/cooperative-agreement/. Located in Marion, Virginia, Smyth County Community Hospital (SCCH) is a 44-bed hospital dedicated to bringing quality healthcare to Southwest Virginia. As a community hospital, SCCH offers a wide range of services including surgery, rehabilitation, home health, skilled nursing, orthopedics and more. The hospital has achieved a "Five Star" overall rating by the Centers for Medicare & Medicaid Services, one of only 8 hospitals in Virginia, as well as a "Five Star" patient experience rating - one of 266 nationwide, and the only hospital in Virginia to receive this rating. Specific to the hospitals included in this Form 990, services were provided to: 1,117 hospital inpatients 64,196 outpatient visits 16,791 emergency visits 28 nursing home admissions SCCH subsidizes the Glade Springs Family Medicine Rural Health Clinic and the Family Medicine Practice in Rural Retreat, Virginia. These practices are located in rural, medically underserved areas and allow residents to receive quality care without having to travel outside of their home area. This is especially important for elderly residents and others that require family or friends to provide transportation to physician appointments. Ballad Health is in its seventh full year of operation under active supervision by the State of Tennessee and the Commonwealth of Virginia. Fiscal Year 2025 was marked by resilience, innovation, and a deepened commitment to improving health outcomes across Northeast Tennessee and Southwest Virginia. Throughout the period, Ballad Health continued to maintain and expand access to essential care and services, delivering high quality care, and reducing the cost of care for the people we are entrusted to serve. Over the past seven years, Ballad Health has made significant strides in regional healthcare. The organization successfully reopened a previously closed hospital in Southwest Virginia, invested capital in critical infrastructure, expanded services where needed, and consolidated others where appropriate. We met the challenges of a global pandemic that claimed thousands of lives in our region and severely disrupted hospital operations. We coordinated care in the wake of Hurricane Helene and its devastating aftermath and worked closely with both the Tennessee Department of Health and Virginia Department of Health to respond to the evolving needs of the region. Notable examples include investments in mental health services, the opening of high-quality childcare centers, the creation of the Quillen Center for Urological Services, and the launch of a new dental clinic that has served thousands of uninsured Virginians. Ballad Health has achieved these milestones while navigating national challenges, often responding faster and more effectively than other well-regarded hospitals and health systems. Similarly, our emergency department performance outpaces other peer hospitals on publicly reported metrics. Furthermore, a recent independent evaluation of physician access revealed that, while the rest of the nation has experienced a decline in physician supply, Ballad Health's rural region has either maintained or improved access in many specialties. In FY25, Ballad Health continued to demonstrate its commitment to improving the health of the Appalachian Highlands region through investments in its people, COPA Plan spending commitments, and capital. These investments included: - Partnering with the Tennessee Center for Nursing Advancement, the ETSU Research Corporation, East Tennessee State University (ETSU) College of Nursing, and StoryCollab on the Nursing Narrative Initiative. This project highlights the voices and experiences of nurse
- $4.2 million spent. See Schedule O
Source: Form 990 for the year ending June 30, 2025, filed with the Internal Revenue Service. Rating method 2026.2. How we rate
Legitimacy checks
Is it registered with the IRS? Passed.
Listed in the IRS master file of tax-exempt organizations as a 501(c)(3) charitable organization.
Source: Exempt Organizations Business Master File, Internal Revenue Service, file dated September 7, 2026.
Has the IRS revoked its tax-exempt status? Passed.
Not on the IRS automatic revocation list.
Source: Automatic revocation of exemption list, Internal Revenue Service, file dated September 30, 2026.
Are donations tax-deductible? Passed.
On the IRS list of organizations eligible to receive tax-deductible contributions.
Source: Publication 78 data: organizations eligible for tax-deductible contributions, Internal Revenue Service, file dated September 10, 2026.
Is it keeping up with its IRS filings? Passed.
Most recent return on file covers the year ending June 2025.
Source: Exempt Organizations Business Master File, Internal Revenue Service, file dated September 7, 2026.
How long has it been tax-exempt? Passed.
Recognized by the IRS since June 1965.
Source: Exempt Organizations Business Master File, Internal Revenue Service, file dated September 7, 2026.
Is it in good standing with state regulators? Passed.
Not on California's list of charities barred from soliciting. Other states are not yet checked.
Source: May Not Operate or Solicit for Charitable Purposes list, California Attorney General, Registry of Charities and Fundraisers, file dated October 7, 2026.
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