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Mountain States Health Alliance

EIN 62-0476282 · Johnson City, TN

Public records show a registered, tax-exempt organization in good standing.

LegitimacyPassesRegistration and standingFinancial healthGood71 out of 100GovernanceGood75 out of 100Impact evidenceDescribes programsHow well its results are evidenced

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
$1.3 billion
Spending
$1.2 billion
Spent on programs
85%
Reserves
1.9 months of spending
Largest source of income
fees for its services, 96%
Employees
7,188
Volunteers
298
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 61% of charities in its peer group (health care, over $100m).

  • Reserves

    10 of 35

    Spendable reserves would cover 1.9 months of spending.

  • Debt

    16 of 20

    It owes 27% of what it owns.

  • Living within its means

    15 of 15

    Income exceeded spending by 7% of income.

  • Income trend

    15 of 15

    Income rose 22% on the year before.

  • Spending floor

    15 of 15

    85% 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 7% of charities in its peer group (health care, over $100m).

  • Independent board

    5 of 25

    0 of 4 voting board members are independent.

  • Conflict of interest policy

    15 of 15

    Has a written conflict of interest policy.

  • Whistleblower policy

    8 of 8

    Has a written whistleblower policy.

  • Record keeping policy

    7 of 7

    Has a written policy on keeping and destroying records.

  • Board minutes

    5 of 5

    Keeps minutes of board meetings.

  • Board sees the tax return

    10 of 10

    Gave the board a copy of this return before filing it.

  • Pay set independently

    0 of 5

    Reports no independent review process for its chief executive's pay.

  • Independent check of accounts

    15 of 15

    Its accounts were audited by an independent accountant.

  • No reported misuse

    10 of 10

    Reports 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)
  1. $1.0 billion spent. See Schedule O
  2. 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/. Form 990 for Mountain States Health Alliance (MSHA) includes eight wholly owned hospitals including a tertiary hospital, a children's hospital and a behavioral health hospital; two others, wholly owned by MSHA, each file a separate return. MSHA is sole shareholder of Blue Ridge Medical Management Corporation (BRMMC), a for-profit entity that owns and manages physician practices and real estate and provides other health care services to patients in Tennessee and Virginia. MSHA is the sole member of Integrated Solutions Health Network, LLC (ISHN). ISHN, also included in this Form 990, is a regional health solutions company headquartered in Johnson City, Tennessee. ISHN is an expansive network of providers serving residents of Northeast Tennessee and Southwest Virginia and consists of provider groups, primary care physicians, specialists, and allied health providers. Specific to the hospitals included in this Form 990, services were provided to: 42,447 inpatients 617,000 outpatient visits 174,227 emergency visits 3,627 deliveries 27,291 surgeries 98,447 home health visits

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

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. How long has it been tax-exempt? Passed.

    Recognized by the IRS since April 1954.

    Source: Exempt Organizations Business Master File, Internal Revenue Service, file dated September 7, 2026.

  6. 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.

Ratings and checks are our reading of public records, using the published method. They are not a statement about anyone's honesty. If you work for this organization, you can send corrections or results, confirm you want gifts through Veridonate, or ask to be removed from giving.