UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER INC (EIN 45-4166209)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-11
- IRS object ID
- 202233159349306113
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-11T14:46:37-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 570381582 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ELLIOTT DAVIS LLCPLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE 10TH STREET SUITE 400 | AddressLine1Txt |
| City | AUGUSTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 454166209 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNIVERSITY MCDUFFIE COUNTY REGIONAL | BusinessNameLine1Txt |
| Business Name Line2 | MEDICAL CENTER INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | UNIV | BusinessNameControlTxt |
| Phone | 7067747710 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1350 WALTON WAY | AddressLine1Txt |
| City | AUGUSTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30901 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID BELKOSKI | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 7067747710 | PhoneNum |
| Signature | 2022-11-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | DAVID | PersonFirstNm |
| Person Last | BELKOSKI | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JESSICA C CAIN | PreparerPersonNm |
| PTIN | P01276209 | PTIN |
| Phone | 7067229090 | PhoneNum |
| Preparation | 2022-11-11 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNIVERSITY HOSPITAL MCDUFFIE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JAMES R DAVIS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1350 WALTON WAY | AddressLine1Txt |
| City | AUGUSTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $30,087,839 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.UNIVERSITYHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2012 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION OF THE UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER, INC. IS TO PROVIDE HEALTH CARE SERVICES WITH THE HELP OF OUR COMMUNITIES AND PARTNERS, AND ENRICH THE LIVES WE TOUCH BY PROVIDING COMPASSIONATE QUALITY CARE IN A COST EFFECTIVE MANNER. WE STRIVE TO BE UTILIZED AS THE HEALTHCARE PARTNER OF CHOICE FOR THE COMMUNITIES WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 2 | VotingMembersIndependentCnt |
| Total Employee | 210 | TotalEmployeeCnt |
| Total Volunteers | 15 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,991,134 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,562,189 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $23,951,880 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $26,294,861 | CYProgramServiceRevenueAmt |
| PY Investment Income | $610 | PYInvestmentIncomeAmt |
| CY Investment Income | $229,539 | CYInvestmentIncomeAmt |
| PY Other Revenue | $6,901 | PYOtherRevenueAmt |
| CY Other Revenue | $1,250 | CYOtherRevenueAmt |
| PY Total Revenue | $25,950,525 | PYTotalRevenueAmt |
| CY Total Revenue | $30,087,839 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $7,473,243 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,187,895 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $16,192,240 | PYOtherExpensesAmt |
| CY Other Expenses | $17,071,502 | CYOtherExpensesAmt |
| PY Total Expenses | $23,665,483 | PYTotalExpensesAmt |
| CY Total Expenses | $25,259,397 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,285,042 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,828,442 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $50,983,222 | TotalAssetsBOYAmt |
| Total Assets EOY | $54,263,219 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $37,679,124 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $36,130,679 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $13,304,098 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $18,132,540 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF THE UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER, INC. IS TO PROVIDE HEALTH CARE SERVICES WITH THE HELP OF OUR COMMUNITIES AND PARTNERS, AND ENRICH THE LIVES WE TOUCH BY PROVIDING COMPASSIONATE QUALITY CARE IN A COST EFFECTIVE MANNER. WE STRIVE TO BE UTILIZED AS THE HEALTHCARE PARTNER OF CHOICE FOR THE COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $23,886,918 | ExpenseAmt |
| Revenue | $26,296,111 | RevenueAmt |
| Desc | UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER (UHM), A 25 BED FACILITY, PROVIDES MUCH OF THEIR EDUCATION AND SUPPORT GROUP ACTIVITIES ONLINE SINCE COVID-19. STAFF MEMBERS SERVE ON A VARIETY OF BOARDS AND ARE INVOLVED IN CIVIC ENDEAVORS THAT PROMOTE HEALTH AND WELLNESS. UNCOMPENSATED CARE WAS PROVIDED AS WELL AS IN INDIGENT AND CHARITY CARE. A HOSPITAL BASED PROGRAM ASSISTANCE COUNSELOR IS PROVIDED AT THE HOSPITAL'S EXPENSE IN ORDER TO ASSIST PATIENTS WITH QUALIFYING FOR MEDICARE DISABILITY, MEDICAID, SSI OR OTHER GOVERNMENT FINANCIAL ASSISTANCE PROGRAMS. FOR 2021, THE HOSPITAL HAD A TOTAL OF 2,184 PATIENT DAYS. 183 OF THESE PATIENT DAYS WERE FOR INDIGENT PATIENTS. SWING BEDS WERE 1,652. OBSERVATION STAYS WERE 677 DAYS. OUTPATIENT VISITS WERE 29,171. OF THE TOTAL OUTPATIENT VISITS, 15,514 WERE FOR EMERGENCY CARE. WITHIN THESE INDICATORS ARE THE EFFORTS OF UNIVERSITY HOSPITAL MCDUFFIE TO SERVICE THE NEEDS OF THE COMMUNITY, WHICH INCLUDE THE INDIGENT. IN 2021 THE COST OF INDIGENT AND CHARITY CARE PROVIDED ALONG WITH MEDICAID SHORTFALLS WAS $2,467,601. THE HOSPITAL RECEIVED DISPROPORTIONATE SHARE (DSH) FUNDS OF $1,244,830 AND UPPER PAYMENT LIMIT (UPL) FUNDS OF $141,002 TO HELP OFFSET THESE COSTS. | Desc |
| Total Program Service Expenses | $23,886,918 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 24 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 210 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 2 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | Yes (1) | LocalChaptersInd |
| Policies Reference Chapters | Yes (1) | PoliciesReferenceChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | GA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVID A BELKOSKI CFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7067747710 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1350 WALTON WAY | AddressLine1Txt |
| City | AUGUSTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| WILLIAM P DOUPE | |||||||||
| CHAIRMAN | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| ROBIN S DUDLEY | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| JOHN BIELTZ DO | |||||||||
| DIRECTOR | 2.00 | Yes (X) | $19,500 | $456,453 | $16,028 | 50.00 | |||
| JAMES R DAVIS | |||||||||
| UHCS CEO | 5.00 | Yes (X) | Yes (X) | $0 | $2,343,435 | $17,972 | 50.00 | ||
| EDWARD L BURR | |||||||||
| LEGAL ADVISOR | 5.00 | Yes (X) | Yes (X) | $0 | $1,164,057 | $14,943 | 50.00 | ||
| DAVID A BELKOSKI | |||||||||
| UHCS & UHM CFO | 5.00 | Yes (X) | $0 | $848,041 | $11,442 | 50.00 | |||
| WILLIAM L FARR JR | |||||||||
| CMO | 5.00 | Yes (X) | $0 | $211,210 | $8,976 | 50.00 | |||
| ELIZABETH R GALLUP | |||||||||
| COO ACUTE CARE SERVICES | 5.00 | Yes (X) | $0 | $768,742 | $17,976 | 50.00 | |||
| BARRY J JENKINS | |||||||||
| CMO | 5.00 | Yes (X) | $0 | $435,269 | $9,660 | 50.00 | |||
| ROBERT J KEPSHIRE | |||||||||
| ADMINISTRATIVE CNO | 50.00 | $0 | $195,399 | $10,293 | Yes (X) | ||||
| DANITA T KISER | |||||||||
| NURSE DIRECTOR MED/SERG ED | 50.00 | $118,042 | $0 | $15,671 | Yes (X) | ||||
| MARCIA V RODGERS | |||||||||
| PHARMACY MANAGER | 50.00 | $122,110 | $0 | $12,262 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $259,652 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $6,422,606 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $135,223 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MORRISON HEALTHCARE | |||||
| PO BOX 102289 | ATLANTA | GA | 30368 | FOOD SERVICES | $359,358 |
| AEGIS THERAPIES INC | |||||
| PO BOX 8103 | FORT SMITH | AR | 72902 | THERAPY SERVICES | $261,946 |
| CROTHALL HEALTHCARE | |||||
| 13028 COLLECTION CENTER DRIVE | CHICAGO | IL | 60693 | HOUSEKEEPING SERVICES | $260,960 |
| AMS | |||||
| 28 NORTH PALAFOX STREET | PENSACOLA | FL | 32502 | ANESTHESIA SERVICES | $220,000 |
| CROTHALL LAUNDRY SERVICES INC | |||||
| 13028 COLLECTION CENTER DRIVE | CHICAGO | IL | 60693 | LINEN/LAUNDRY SERVICE | $162,086 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,662,123 | GovernmentGrantsAmt |
| All Other Contributions | $900,066 | AllOtherContributionsAmt |
| Total Contributions | $3,562,189 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $26,294,861 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $26,294,861 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $26,294,861 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $798 | TotalRevenueColumnAmt |
| Exclusion | $798 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $228,741 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $228,741 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $228,741 | TotalRevenueColumnAmt |
| Exclusion | $228,741 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Business | 812900 | BusinessCd |
| Total Revenue Column | $1,250 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,250 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,250 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $30,087,839 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $26,296,111 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $229,539 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,500 | TotalAmt |
| Program Services | $18,983 | ProgramServicesAmt |
| Management And General | $517 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,263,074 | TotalAmt |
| Program Services | $6,097,103 | ProgramServicesAmt |
| Management And General | $165,971 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,638 | TotalAmt |
| Program Services | $54,164 | ProgramServicesAmt |
| Management And General | $1,474 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,356,821 | TotalAmt |
| Program Services | $1,320,865 | ProgramServicesAmt |
| Management And General | $35,956 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $492,862 | TotalAmt |
| Program Services | $479,801 | ProgramServicesAmt |
| Management And General | $13,061 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,464,689 | TotalAmt |
| Program Services | $2,464,689 | ProgramServicesAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,007 | TotalAmt |
| Management And General | $5,007 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,732,787 | TotalAmt |
| Program Services | $2,660,368 | ProgramServicesAmt |
| Management And General | $72,419 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,375 | TotalAmt |
| Management And General | $6,375 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,268 | TotalAmt |
| Program Services | $10,969 | ProgramServicesAmt |
| Management And General | $299 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $163,860 | TotalAmt |
| Program Services | $159,518 | ProgramServicesAmt |
| Management And General | $4,342 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $358,729 | TotalAmt |
| Program Services | $349,223 | ProgramServicesAmt |
| Management And General | $9,506 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92 | TotalAmt |
| Program Services | $90 | ProgramServicesAmt |
| Management And General | $2 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $717,197 | TotalAmt |
| Management And General | $717,197 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,311,900 | TotalAmt |
| Program Services | $1,277,135 | ProgramServicesAmt |
| Management And General | $34,765 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $174,986 | TotalAmt |
| Program Services | $170,349 | ProgramServicesAmt |
| Management And General | $4,637 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT | $3,944,615 | $3,944,615 | |
| MED/SURG SUPPLIES | $3,751,896 | $3,751,896 | |
| REPAIRS & MAINTENANCE | $748,570 | $728,733 | $19,837 |
| TAXES | $270,269 | $270,269 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $409,262 | TotalAmt |
| Program Services | $398,417 | ProgramServicesAmt |
| Management And General | $10,845 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,259,397 | TotalAmt |
| Program Services | $23,886,918 | ProgramServicesAmt |
| Management And General | $1,372,479 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,569,075 | BOYAmt |
| EOY | $10,454,327 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,749,565 | BOYAmt |
| EOY | $4,848,838 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $482,382 | BOYAmt |
| EOY | $592,259 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $192,657 | BOYAmt |
| EOY | $281,153 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $39,438,082 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $14,236,951 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,633,398 | BOYAmt |
| EOY | $25,201,131 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,356,145 | BOYAmt |
| EOY | $12,885,511 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,983,222 | BOYAmt |
| EOY | $54,263,219 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,441,594 | BOYAmt |
| EOY | $11,979,513 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,481,380 | BOYAmt |
| EOY | $23,461,322 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,756,150 | BOYAmt |
| EOY | $689,844 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,679,124 | BOYAmt |
| EOY | $36,130,679 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,304,098 | BOYAmt |
| EOY | $18,132,540 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,304,098 | BOYAmt |
| EOY | $18,132,540 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,983,222 | BOYAmt |
| EOY | $54,263,219 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $4,828,442 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | 0 | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $5,007 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $5,007 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | DESCRIPTION OF LOBBYING ACTIVITY A PART OF VARIOUS ASSOCIATION DUES INCLUDE A PERCENTAGE ALLOCATION FOR EXPENDITURES ON LOBBYING ACTIVITIES. DUES PAID TO THE GEORGIA ALLIANCE OF COMMUNITY HOSPITALS AND THE AMERICAN HOSPITAL ASSOCIATION HAVE A LOBBY COMPONENT. FOR 2021 THESE FEES AMOUNTED TO $5,007. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,683,198 | OtherCostOrOtherBasisAmt |
| Book Value | $1,683,198 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $25,657,962 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,550,118 | DepreciationAmt |
| Book Value | $21,107,844 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $472,974 | OtherCostOrOtherBasisAmt |
| Depreciation | $73,503 | DepreciationAmt |
| Book Value | $399,471 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,341,569 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,613,330 | DepreciationAmt |
| Book Value | $1,728,239 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $282,379 | OtherCostOrOtherBasisAmt |
| Book Value | $282,379 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $25,201,131 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| PHYSICIAN GUARANTEE ASSET | $404,786 |
| DUE FROM UEC | $13,127 |
| DUE FROM UHS | $12,467,598 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $12,885,511 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| LONG-TERM CAPITAL LEASE OBLIGATION | $323,203 |
| DUE TO UNIVERSITY MEDICAL GROUP | $366,641 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $689,844 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | FIN 48 FOOTNOTE ACCOUNTING FOR INCOME TAXES- UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER, INC. IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. ACCORDINGLY, THE ACCOMPANYING FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION OR LIABILITY FOR FEDERAL AND STATE INCOME TAXES. UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER, INC. HAS EVALUATED THEIR TAX POSITION AND DETERMINED THAT THEY DO NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF DECEMBER 31, 2021. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,482,592 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $715,712 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $766,880 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03600 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,734,770 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,019,063 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $715,707 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03360 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,524 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,991 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,218,886 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,736,766 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,482,587 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06950 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,218,886 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,736,766 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,482,587 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06950 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,944,615 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $78,892 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $4,433,622 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $5,986,879 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,553,257 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNIVERSITY MCDUFFIE REGIONAL MEDICAL CENTER DBA UHM | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2460 WASHINGTON ROAD NE | AddressLine1Txt |
| City | THOMSON | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30824 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.UNIVERSITYHEALTHCARE.ORG | WebsiteAddressTxt |
| State License | 097-107 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | SWING-BED CERTIFIED BY MEDICARE 11/15/15 | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDI | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTP://WWW.UNIVERSITYHEALTH.ORG/FULLPANEL/UPLOADS/FILES/CHNA-2019-MCDUFFIE- | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTP://WWW.UNIVERSITYHEALTH.ORG/FULLPANEL/UPLOADS/FILES/CHNA-2019-MCDUFFIE- | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE SCHEDULE H SUPPLEMENTAL INFO | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE SCHEDULE H SUPPLEMENTAL INFO | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE SCHEDULE H SUPPLEMENTAL INFO | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | 0 | NondisEmergencyCarePolicyInd |
| Other Reason | Yes (X) | OtherReasonInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER | PART V, SECTION B, LINE 5: SEE PAGE 8 OF THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT LISTENING SESSIONS WERE HELD IN MCDUFFIE, WARREN, LINCOLN AND COLUMBIA COUNTIES. THOSE AGENCIES WHO PARTICIPATED IN THE SESSIONS ARE: UGA ARCHWAY PARTNERSHIP, CRAWFORD & BREAZEALE DRUG, MCDUFFIE COUNTY HEALTH DEPARTMENT, FAMILY CARE GROUP OF THOMSON, THOMSON DENTAL WELLNESS, FAMILY CONNECTION OF WARREN COUNTY, WARREN COUNTY EXTENSION, LINCOLN COUNTY COMMISSION, LINCOLN COUNTY HEALTH DEPARTMENT, LINCOLN COUNTY OFFICE OF EMERGENCY SERVICES, CITY OF HARLEM, COLUMBIA COUNTY COMMUNITY CONNECTIONS, COLUMBIA COUNTY HEALTH DEPARTMENT, HARLEM MERCHANT'S ASSOCIATION, HOPE HOUSE. THESE AGENCIES REPRESENT THE CITIZENS OF MCDUFFIE WARREN, LINCOLN AND COLUMBIA COUNTIES INCLUDING THE ELDERLY, INDIVIDUALS LIVING IN POVERTY, AS WELL AS THOSE FACING FOOD INSECURITY, MENTAL HEALTH ISSUES OR ADDICTION. THOSE WHO WERE INVITED BUT DID NOT ATTEND WERE FROM THE FOLLOWING ORGANIZATIONS: THOMSON FAMILY YMCA, PARTNERS FOR SUCCESS, SHAW, WARREN COUNTY SENIOR CENTER, HOMETOWN WARRENTON, COMMUNITY HEALTH CARE SYSTEMS, COMMUNITY MEDICAL ASSOCIATES, LINCOLNTON FAMILY DENTISTRY, LINCOLNTON FAMILY MEDICINE, COLUMBIA COUNTY COMMISSION, THE ALZHEIMER'S ASSOCIATION AND CITY OF GROVETOWN. REPRESENTATIVES FROM THESE ORGANIZATIONS WERE SENT AN EMAIL WITH THE LIST OF QUESTIONS FROM THE LISTENING SESSION AND INVITED TO PROVIDE FEEDBACK. |
| UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER | PART V, SECTION B, LINE 7D: CHNA MADE AVAILABLE UPON REQUEST |
| UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER | PART V, SECTION B, LINE 11: SEE IMPLEMENTATION STRATEGY PAGES 3-6 1. LEVERAGE MOBILE PLATFORM TO BRING CARDIOVASCULAR DISEASE SCREENING TO THE COMMUNITY. 2. DEVELOP A DIABETES PREVENTION PROGRAM TO EDUCATE AND ENCOURAGE DIABETICS ABOUT NUTRITION AND PHYSICAL ACTIVITY 3. TEACH EXPECTANT MOTHERS TO RECOGNIZE LIFE THREATENING POST-PARTUM WARNING SIGNS OUR PRIORITIZATION PROCESS IS DETAILED ON PAGE 33. WE CHOSE TO FOCUS ON 3 TOP PRIORITIES WHERE WE FELT WE COULD MAKE THE GREATEST IMPACT. OUR PRIORITIZATION PROCESS IS DETAILED ON PAGE 33. WE CHOSE TO FOCUS ON 3 TOP PRIORITIES WHERE WE FELT WE COULD MAKE THE GREATEST IMPACT. ON PAGE 33 OF THE CHNA, WE IDENTIFY OUR 3 PRIORITIES. THOSE THREE PRIORITIES CORRESPOND TO THE RESULTS OF THE NOMINAL GROUP PROCESS. EMBEDDED IN PRIORITY #1 AND PRIORITY #2 ARE THE TOP FOUR VOTE GETTING ITEMS "HEART DISEASE AND STROKE AS IT PERTAINS TO ACCESS AND "DIABETES AS IT PERTAINS TO NUTRITION, PHYSICAL ACTIVITY, AND WEIGHT STATUS". WE PUT A LIST OF CATEGORIES IN FRONT OF THE NOMINAL GROUP PROCESS. ONE OF THEM WAS CHRONIC KIDNEY DISEASES, BUT IT'S PRETTY CLEARLY A LOW PRIORITY. BEING A CATEGORY DOESN'T MAKE IT A PRIORITY, THE GROUP DISCUSSING THE CATEGORIES CHOOSE WHAT THEY BELIEVE ARE THE PRIORITIES AND WE ADDRESSED WHAT WE PRIORITIZED. |
| UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER | PART V, SECTION B, LINE 16J: WWW.UNIVERSITYHEALTH.ORG/OUR-LOCATIONS/UNIVERSITY-HOSPITAL-MCDUFFIE/PATIENT-INFORMATION/INDEGENT-AND-CHARITY-CARE |
| UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER | PART V, SECTION B, LINE 21D: FAP INCLUDED ER MEDICAL CARE CONDITIONS. IN ADDITION, UHM FOLLOWS EMTALA REGULATIONS. |
| PART V, LINE 16A, FAP WEBSITE: | HTTPS://WWW.UNIVERSITYHEALTH.ORG/INDIGENT-AND-CHARITY-CARE |
| PART V, LINE 16B, FAP WEBSITE: | HTTPS://WWW.UNIVERSITYHEALTH.ORG/FULLPANEL/UPLOADS/FILES/UHM--8310-123-INDIGENT-CARE---ICCP.PDF |
| PART V, LINE 16C, FAP WEBSITE: | HTTPS://WWW.UNIVERSITYHEALTH.ORG/FULLPANEL/UPLOADS/FILES/UHM-PLAIN-LANGUAGE-SUMMARY---2020-00001.PDF |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | MAY USE BOTH FPG AND ASSET TEST |
| PART I, LINE 7: | EXPLANATION OF COSTING METHODOLOGYUSED COST TO CHARGE RATIO CALCULATED USING WORKSHEET 2 --THE OPTIONAL WORKSHEETS PROVIDED TO ASSIST IN PREPARATION OF SCHEDULE H. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | THE COMMUNITY BUILDING ACTIVITIES REPORTED ARE SUPPORT FOR THE VARIOUS CHAMBERS OF COMMERCE FOR THE COMMUNITIES THAT UHM SERVES. IN SUPPORTING THESE ORGANIZATIONS, UHM CAN SUPPORT THE DEVELOPMENT OF OUR COMMUNITY BY BRINGING IN NEW INDUSTRIES, AND JOBS, INCREASING THE AVERAGE HOUSEHOLD INCOME, IMPROVING LIVING CONDITIONS, AND IMPACTING OVERALL GENERAL HEALTH. |
| PART III, LINE 2: | FOR RECEIVABLES ASSOCIATED WITH SELFPAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), UH RECORDS PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. RECOVERIES OF ACCOUNTS PREVIOUSLY WRITTEN OFF ARE RECORDED AS A REDUCTION TO THE PROVISION FOR BAD DEBT EXPENSE WHEN RECEIVED. |
| PART III, LINE 3: | BAD DEBT SHOULD BE INCLUDED AS A COMMUNITY BENEFIT SINCE THE SERVICES THAT INCUR BAD DEBT ARE PROVIDED BY THE HOSPITAL TO PROMOTE THE WELL-BEING OF THE COMMUNITY. THESE SERVICES ARE RENDERED IN CONJUNCTION WITH THE HOSPITAL'S CHARITABLE TAX-EXEMPT PURPOSES. THERE IS NO LOCAL SUPPORT FOR UNINSURED PATIENTS; THEREFORE, THE SERVICES PROVIDED BY THE HOSPITAL RELIEVE THE HEALTH CARE BURDENS OF THE LOCAL GOVERNMENTS. |
| PART III, LINE 4: | BAD DEBT EXPENSEPAGE 10- 12 OF AUDITED FINANCIAL STATEMENT FOR UNIVERSITY HEALTH, INC. |
| PART III, LINE 8: | EXPLANATION OF SHORTFALL AS COMMUNITY BENEFITTHE SERVICES PROVIDED TO THE MEDICARE BENEFICIARIES ARE TO PROMOTE THE WELL-BEING OF THE COMMUNITY WHICH IS PART OF THE HOSPITAL'S CHARITABLE TAX-EXEMPT PURPOSE. THE MEDICARE DIFFERENCE BETWEEN COST AND MEDICARE REIMBURSEMENT SHOULD BE ALLOWED AS COMMUNITY BENEFIT SINCE PROVIDERS CANNOT NEGOTIATE RATES WITH CENTERS FOR MEDICARE/MEDICAID SERVICES (CMS). CMS REGULATES THAT THE REIMBURSEMENT BE FEDERAL BUDGET NEUTRAL THUS PLACING THE COST OF THE CARING FOR MEDICARE BENEFICIARIES AS A COST TO THE HOSPITALS. |
| PART III, LINE 9B: | PROVISIONS ON COLLECTION PRACTICES FOR QUALIFIED PATIENTSAS OUTSTANDING BALANCES AGE, STATEMENT MESSAGES, COLLECTION LETTERS AND/OR TELEPHONE CALLS MAY BE USED AT APPROPRIATE INTERVALS DETERMINED BY THE PATIENT ACCOUNTING/COLLECTION DEPARTMENT. THE PATIENT ACCOUNTING/COLLECTION DEPARTMENT RECOGNIZES THAT THERE ARE OCCASIONS WHEN A PATIENT IS NOT FINANCIALLY ABLE TO PAY HIS OR HER MEDICAL BILL IN FULL AND/OR THE PATIENT IS EXPERIENCING FINANCIAL HARDSHIP. THE HOSPITAL HAS ESTABLISHED A CATASTROPHIC POLICY WHICH ALLOWS FOR THE COLLECTION DEPARTMENT TO APPLY THE INDIGENT CRITERIA AND WRITE-OFF AS MEDICALLY INDIGENT. AND AT ANY POINT DURING THE COLLECTION PROCESS IF A PATIENT STATES OR PATIENT ACCOUNTING/COLLECTIONS BELIEVES THAT THE PATIENT CANNOT AFFORD TO PAY, THEN AN INDIGENT/CHARITY CARE APPLICATION IS BEGUN BY THE COLLECTION DEPARTMENT WHERE DISCOUNTS MAY BE GIVEN. |
| PART VI, LINE 2: | NEEDS ASSESSMENTUHM WORKS WITH ER PERSONNEL AND AREA HEALTH DEPARTMENT DIRECTOR TO IDENTIFY NEEDS BASED ON PATIENTS SEEKING HELP THROUGH THE EMERGENCY ROOM AND HEALTH DEPARTMENT. |
| PART VI, LINE 3: | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEREGISTRARS INFORM PATIENT OF FINANCIAL ASSISTANCE PROGRAMS. ALSO, THERE ARE SIGNS POSTED IN ER AND REGISTRATION AREAS WHICH DENOTE THE AVAILABILITY OF ASSISTANCE WITH HOSPITAL BILLS. IN ADDITION, UHM UTILIZES THE SERVICES OF RCA (RESOURCE CENTER OF AMERICA) WHICH AIDS PATIENTS IN GETTING CERTIFIED FOR SSI AND MEDICAID. |
| PART VI, LINE 4: | SEE COMMUNITY NEEDS ASSESSMENT PAGES 5-7MCDUFFIE COUNTY IS A COUNTY LOCATED IN THE U.S. STATE OF GEORGIA. AS OF THE 2014 CENSUS, THE POPULATION WAS 21,400.[1] THE COUNTY SEAT IS THOMSON.[2] THE COUNTY WAS CREATED ON OCTOBER 18, 1870[3] AND NAMED AFTER THE SOUTH CAROLINA GOVERNOR AND SENATOR GEORGE MCDUFFIE. MCDUFFIE COUNTY IS PART OF THE AUGUSTA-RICHMOND COUNTY, GA-SC METROPOLITAN STATISTICAL AREA. ALSO MCDUFFIE IS IN THE CMS -CORE BUSINESS STATISTICAL AREA FOR WAGE INDEX CALCULATIONS. THE % OF POPULATION THAT IS UNDER 18 YEARS IS 25%; AGE 18-64 IS 61%; OVER 65 IS 14%. THE RACE/ETHNICITY IS MADE UP OF 42% BLACK; 53% WHITE AND HISPANIC IS 3%. |
| PART VI, LINE 5: | COLLABORATION WITH/SUPPORT OF COMMUNITY ORGANIZATIONS THROUGH SEVERAL SURROUNDING CHAMBERS OF COMMERCE. - SEE PART II ABOVE.SEE PAGE 8 OF THE CHNA FOR THE LIST OF AGENCIES THAT UNIVERSITY HOSPITAL MCDUFFIE WORKS WITH TO SUPPORT AND PROMOTE HEALTH IN OUR COMMUNITY. |
| PART VI, LINE 6: | UHM GOVERNING BOARD MEMBERS ARE COMPRISED OF CITZENS WHO RESIDE IN THE UHM'S PRIMARY SERVICE AREA AND ARE NEITHER EMPLOYEES NOR CONTRACTORS OF UHM. UHM BOARD MEMBERS ARE ACTIVE IN THE COMMUNITY AND ARE EAGER TO IMPROVE THE HEALTH AND WELFARE OF THE COMMUNITY. UHM EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN OUR COMMUNITY FOR ALL OF THE UH DEPARTMENTS. UHM AND UHS COLLABORATE ON HEALTH FAIRS AND SCREENINGS |
| PART VI, LINE 7, REPORTS FILED WITH STATES | GA |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | Yes (1) | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAMES R DAVIS | ||||||||||||||
| UHCS CEO | $0 | $822,804 | $0 | $364,951 | $0 | $1,155,680 | $0 | $0 | $0 | $17,972 | $0 | $2,361,407 | $0 | $714,464 |
| EDWARD L BURR | ||||||||||||||
| LEGAL ADVISOR | $0 | $428,561 | $0 | $244,388 | $0 | $491,108 | $0 | $2,710 | $0 | $12,233 | $0 | $1,179,000 | $0 | $0 |
| DAVID A BELKOSKI | ||||||||||||||
| UHCS & UHM CFO | $0 | $489,897 | $0 | $189,830 | $0 | $168,314 | $0 | $0 | $0 | $11,442 | $0 | $859,483 | $0 | $0 |
| ELIZABETH R GALLUP | ||||||||||||||
| COO ACUTE CARE SERVICES | $0 | $493,138 | $0 | $188,100 | $0 | $87,504 | $0 | $1,142 | $0 | $16,834 | $0 | $786,718 | $0 | $0 |
| JOHN BIELTZ DO | ||||||||||||||
| DIRECTOR | $19,500 | $424,402 | $0 | $9,375 | $0 | $22,676 | $0 | $2,469 | $0 | $13,559 | $19,500 | $472,481 | $0 | $0 |
| BARRY J JENKINS | ||||||||||||||
| CMO | $0 | $387,520 | $0 | $0 | $0 | $47,749 | $0 | $0 | $0 | $9,660 | $0 | $444,929 | $0 | $0 |
| WILLIAM L FARR JR | ||||||||||||||
| CMO | $0 | $145,582 | $0 | $54,080 | $0 | $11,548 | $0 | $0 | $0 | $8,976 | $0 | $220,186 | $0 | $0 |
| ROBERT J KEPSHIRE | ||||||||||||||
| ADMINISTRATIVE CNO | $0 | $178,132 | $0 | $0 | $0 | $17,267 | $0 | $2,471 | $0 | $7,822 | $0 | $205,692 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 4B | BENEFITS PAID BY UNIVERSITY HEALTH SERVICES INC. (58-1581103) JAMES R. DAVIS - CAA/SERP REDEMPTION - $714,464, CAA REDEMPTION - $339,489 DAVE BELKOSKI - ROTH IUL - $120,320 ELIZABETH GALLUP - ROTH IUL - $49,500 BARRY JENKINS - SEC. 162 - $7,169, ROTH IUL - $40,000 WILLIAM L. FARR - CAA REDEMPTION - $10,400 EDWARD BURR - CAA REDEMPTION - $109,707 PLEASE NOTE THAT ALL OF THE BENEFITS LISTED ABOVE ARE INCLUDED IN THE TOTALS REPORTED ON FORM 990, SCHEDULE VII, AS REPORTABLE COMPENSATION OR OTHER COMPENSATION FROM RELATED ORGANIZATIONS, AND HAVE BEEN INCLUDED IN THE INDIVIDUAL'S W-2. |
| PART I, LINE 6 | THE BONUS PLAN FOR MANAGEMENT IS CALCULATED BASED ON STRATEGIC INITIATIVES AS DETERMINED BY THE COMPENSATION COMMITTEE. THESE INITIATIVES ARE GOALS THAT MUST BE ACHIEVED DURING THE YEAR IN ORDER FOR BONUS PAYOUT. FOR 2021 THESE INITIATIVES WERE WEIGHTED AS DISPLAYED IN THE FOLLOWING SCHEDULE: UNIVERSITY HEALTH SERVICES, INC 2021 STRATEGIC INITIATIVES WEIGHT QUALITY 20% ACHIEVE OVERALL RATING OF CARE SCORE (RAW SCORE) 20% MINIMIZE HOSPITAL ACQUIRED CONDITIONS PER 1,000 MEDICARE DISCHARGES GROWTH 20% GROW THE NUMBER OF ED VISITS ON THE MAIN CAMPUS PEOPLE 20% ACHIEVE RN TURNOVER RATE FOR UH IN 2021 AFFORDABILITY 20% ACHIEVE OPERATING MARGIN FOR UNIVERSITY HEALTH, INC 100% EACH GOAL THAT WAS ACHIEVED REPRESENTED THAT PERCENTAGE OF BONUS PAYOUT OUT OF A POSSIBLE 100% BASED ON A THRESHOLD LEVEL, TARGET LEVEL, OR AN EXCEED LEVEL. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 REVIEW PROCESS A COPY OF THE FORM 990 AND ALL RELATED SCHEDULES WAS PROVIDED TO THE GOVERNING BOARD BEFORE FILING IN ELECTRONIC FORM. AN EMAIL WAS SENT TO ALL MEMBERS OF THE GOVERNING BODY CONTAINING A LINK TO A PASSWORD-PROTECTED WEBSITE ON WHICH THE ENTIRE 990 COULD BE VIEWED. THE EMAIL EXPLAINED THAT THE FORM 990 WAS AVAILABLE FOR REVIEW ON THE WEBSITE. |
| FORM 990, PART VI, SECTION B, LINE 12C | EXPLANATION OF MONITORING AND ENFORCEMENT CONFLICTS DUTY TO DISCLOSE: IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION ARRANGEMENT. DETERMINING WHETHER A CONFLICT EXISTS: AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, THE INTERESTED PERSON WILL LEAVE THE GOVERNING BOARD OR COMMITTEE MEETING WHILE THE GOVERNING BOARD OR COMMITTEE DISCUSSES AND VOTES ON A DETERMINATION OF WHETHER A CONFLICT OF INTEREST EXISTS. THE REMAINING BOARD OR COMMITTEE MEMBERS WILL DECIDE IF A CONFLICT OF INTEREST EXISTS. PROCEDURES FOR ADDRESSING THE CONFLICT OF INTEREST: AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE GOVERNING BOARD OR COMMITTEE MEETING BUT, AFTER THE PRESENTATION, SUCH INTERESTED PERSON WILL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POSSIBLE CONFLICT OF INTEREST. THE CHAIRPERSON OR THE GOVERNING BOARD OR COMMITTEE WILL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER EXERCISING DUE DILIGENCE, THE GOVERNING BOARD OR COMMITTEE WILL DETERMINE WHETHER THE CORPORATION CAN OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE GOVERNING BOARD OR COMMITTEE WILL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CORPORATION'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IS IT FAIR AND REASONABLE. IN CONFORMITY WITH THE ABOVE DETERMINATION, IT WILL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. VIOLATION OF THE CONFLICT OF INTEREST POLICY: IF THE GOVERNING BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT A MEMBER OF SUCH BOARD OR COMMITTEE HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT WILL INFORM THE MEMBER OF THE BASIS FOR SUCH BELIEF AND AFFORD THE MEMBER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE MEMBER'S RESPONSE AND MAKING FURTHER INVESTIGATIONS AS WARRANTED BY THE CIRCUMSTANCES, THE GOVERNING BOARD OR COMMITTEE DETERMINES THE MEMBER HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT WILL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION REVIEW & APPROVAL PROCESS - OFFICERS & KEY EMPLOYEES THE ORGANIZATION FOLLOWS THE PROCESS DESCRIBED IN TREASURY REGULATION 53.4958-6(C) FOR ESTABLISHING THE REBUTTABLE PRESUMPTION OF REASONABLENESS IN THE REVIEW, APPROVAL, AND DOCUMENTATION OF OFFICER, KEY MANAGEMENT, AND DIRECTOR COMPENSATION. THE CEO AND CFO ARE PAID BY UNIVERSITY HEALTH SERVICES, INC. (58-1581103). ANNUALLY, A COMPENSATION COMMITTEE OF THE UNIVERSITY HEALTH SERVICES (UHS), COMPRISED OF THREE INDEPENDENT BOARD MEMBERS, REVIEWS THE COMPENSATION OF THE CEO AND OTHER SENIOR MANAGEMENT MEMBERS. THE REVIEW IS CONDUCTED IN THE CONTEXT OF A BOARD APPROVED EXECUTIVE COMPENSATION PHILOSOPHY. BOTH THE DEVELOPMENT OF THE COMPENSATION PHILOSOPHY AND THE REVIEWS INVOLVE THE ADVICE AND ASSISTANCE OF AN INDEPENDENT COMPENSATION CONSULTING FIRM. MINUTES OF THE COMPENSATION COMMITTEE ARE RECORDED. THE COMPENSATION COMMITTEE REPORTS TO THE UHS BOARD EXECUTIVE COMMITTEE. |
| FORM 990, PART VI, SECTION C, LINE 19 | OTHER ORGANIZATION DOCUMENTS PUBLICLY AVAILABLE THE IRS FORM 990 IS ALSO AVAILABLE ON WWW.GUIDESTAR.ORG |
| FORM 990, PART VII: COMPENSATION EXPLAINED | JAMES R. DAVIS COMPENSATION PAID BY UNIVERSITY HEALTH SERVICES, INC. (58-1581103) DAVID A. BELKOSKI COMPENSATION PAID BY UNIVERSITY HEALTH SERVICES, INC. (58-1581103) ELIZABETH R. GALLUP COMPENSATION PAID BY UNIVERSITY HEALTH SERVICES, INC. (58-1581103) WILLIAM L. FARR JR. COMPENSATION PAID BY UNIVERSITY HEALTH SERVICES, INC. (58-1581103) EDWARD L. BURR COMPENSATION PAID BY UNIVERSITY HEALTH SERVICES, INC. (58-1581103) JOHN BIELTZ COMPENSATION PAID BY UNIVERSITY MEDICAL GROUP, LLC. (27-4467379) |
| FORM 990, PART IX, LINE 11G | PHYSICIAN: PROGRAM SERVICE EXPENSES 451,815. MANAGEMENT AND GENERAL EXPENSES 12,299. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 464,114. PHYSICIANS-ON CALL: PROGRAM SERVICE EXPENSES 52,569. MANAGEMENT AND GENERAL EXPENSES 1,431. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 54,000. BANKING FEES: PROGRAM SERVICE EXPENSES 30,275. MANAGEMENT AND GENERAL EXPENSES 824. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 31,099. CONSULTING FEES: PROGRAM SERVICE EXPENSES 179,358. MANAGEMENT AND GENERAL EXPENSES 4,882. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 184,240. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,834,557. MANAGEMENT AND GENERAL EXPENSES 49,939. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,884,496. PURCHASED SERVICES - OTHER: PROGRAM SERVICE EXPENSES 15,228. MANAGEMENT AND GENERAL EXPENSES 415. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,643. DUES & MEMBERSHIPS: PROGRAM SERVICE EXPENSES 12,365. MANAGEMENT AND GENERAL EXPENSES 337. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,702. MISCELLANEOUS: PROGRAM SERVICE EXPENSES 33,903. MANAGEMENT AND GENERAL EXPENSES 923. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 34,826. PERSONNEL RECRUITMENT: PROGRAM SERVICE EXPENSES 50,298. MANAGEMENT AND GENERAL EXPENSES 1,369. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 51,667. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR |
| FORM 990, PART XII, LINE 3B: | UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER, INC. SPENT MORE THAN $750,000 IN PROVIDER RELIEF FUNDS IN 2021. HOWEVER, THE SINGLE AUDIT IS NOT DUE UNTIL 2022 BECAUSE THE ENTITY HAS A 12/31 FISCAL YEAR END. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| RICHMOND COUNTY HOSPITAL AUTHORITY | |||||||||||
| 1350 WALTON WAY | AUGUSTA | GA | 30901 | 586001901 | LEASED FACILITIES | GA | 501(C)(3) | LINE 3 | N/A | 0 | |
| UNIVERSITY HEALTH SERVICES INC | |||||||||||
| 1350 WALTON WAY | AUGUSTA | GA | 30901 | 581581103 | HOSPITAL | GA | 501(C)(3) | LINE 3 | 0 | UNIVERSITY HEALTH INC | |
| UNIVERSITY HEALTH CARE FOUNDATION | |||||||||||
| 2260 WRIGHTSBORO ROAD | AUGUSTA | GA | 30904 | 581343550 | PHILANTHROPY | GA | 501(C)(3) | LINE 7 | 0 | UNIVERSITY HEALTH INC | |
| UNIVERSITY HEALTH INC | |||||||||||
| 1350 WALTON WAY | AUGUSTA | GA | 30901 | 581581102 | CONSOLIDATING PARENT | GA | 501(C)(3) | LINE 10 | N/A | 0 | |
| AUGUSTA RESOURCE CENTER ON AGING INC | |||||||||||
| 1350 WALTON WAY | AUGUSTA | GA | 30901 | 581728812 | NONPROFIT LIFE CARE COMMUNITY | GA | 501(C)(3) | LINE 10 | 0 | UNIVERSITY HEALTH INC | |
| UNIVERSITY EXTENDED CARE INC | |||||||||||
| 1350 WALTON WAY | AUGUSTA | GA | 30901 | 581581105 | SKILLED NURSING HOME | GA | 501(C)(3) | LINE 3 | 0 | UNIVERSITY HEALTH INC | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| UNIVERSITY HEALTH RESOURCES I | |||||||||
| 1350 WALTON WAY | AUGUSTA | GA | 30901 | 581601372 | SVCS TO PHY | GA | UNIVERSITY HEALTH INC | C | 0 |
| UNIVERSITY HOSPITAL OF AIKEN INC | |||||||||
| 1350 WALTON WAY | AUGUSTA | GA | 30901 | 472713774 | HOSPITAL | SC | UNIVERSITY HEALTH INC | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |