UNITY MEDICAL CENTER INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- UNITY MEDICAL CENTER INC (EIN 82-5388429)
- Tax period
- 2019-07-16 to 2019-12-31
- Filed
- 2021-02-26
- IRS object ID
- 202100579349301510
- Schema version
- 2019v5.2
- 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 C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-02-26T16:47:41-06:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 621046406 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHNSON HICKEY & MURCHISON PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2215 OLAN MILLS DRIVE | AddressLine1Txt |
| City | CHATTANOOGA | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37421 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-07-16 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 825388429 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNITY MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | UNIT | BusinessNameControlTxt |
| Phone | 6153088800 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 481 INTERSTATE DRIVE | AddressLine1Txt |
| City | MANCHESTER | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37355 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PAM JERNIGAN | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 9317283856 | PhoneNum |
| Signature | 2021-02-26 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Barry R Huggins | PreparerPersonNm |
| PTIN | P00627334 | PTIN |
| Phone | 4237560052 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Initial Return | Yes (X) | InitialReturnInd |
| Principal Officer | PAM JERNIGAN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 481 INTERSTATE DRIVE | AddressLine1Txt |
| City | MANCHESTER | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37355 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $21,711,610 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | UNITYMEDICALMANCHESTER.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2018 | FormationYr |
| Legal Domicile State | TN | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE IMPROVED HEALTHCARE TO LOCAL RESIDENTS.PROVIDE LEADERSHIP AND DEVELOPMENT OF ADDITIONAL SUPPORTIVE ACTIVITIES THAT WILL IMPROVE THE HEALTHCARE OF THE COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 292 | TotalEmployeeCnt |
| Total Volunteers | 5 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $21,711,595 | CYProgramServiceRevenueAmt |
| CY Investment Income | $15 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| CY Total Revenue | $21,711,610 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $5,537,872 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| CY Other Expenses | $14,918,418 | CYOtherExpensesAmt |
| CY Total Expenses | $20,456,290 | CYTotalExpensesAmt |
| CY Revenues Less Expenses | $1,255,320 | CYRevenuesLessExpensesAmt |
| Total Assets EOY | $49,121,492 | TotalAssetsEOYAmt |
| Total Liabilities EOY | $47,866,172 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances EOY | $1,255,320 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO IMPROVE HEALTHCARE TO LOCAL RESIDENTS AND PROVIDE SUPPORTIVE SERVICES TO IMPROVE THE HEALTHCARE OF THE COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $18,064,117 | ExpenseAmt |
| Revenue | $21,711,595 | RevenueAmt |
| Desc | HOSPITAL SERVICES INCLUDING HASEMEIER GROUP NURSING HOME VISITS 28,500, LAB TEST/PROCEDURES 51,400 AND EMERGENCY ROOM VISITS OF 5050. | Desc |
| Total Program Service Expenses | $18,064,117 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | 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 | Yes (1) | 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 | Yes (1) | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | Yes (1) | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | 0 | 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 | 87 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 292 | 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 | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | 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 | 0 | LocalChaptersInd |
| 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 | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | The Organization | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6153088800 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 481 INTERSTATE DRIVE | AddressLine1Txt |
| City | MANCHESTER | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37355 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| ASHOKE MUKHERJI | |||||||
| CHAIRMAN CHIEF BUSINESS MANAGER | 40.00 | Yes (X) | Yes (X) | $258,820 | $0 | $0 | |
| MARTHA MCCORMICK | |||||||
| CEO | 40.00 | Yes (X) | Yes (X) | $262,276 | $0 | $0 | |
| BOBBY COUCH | |||||||
| COO | 40.00 | Yes (X) | Yes (X) | $391,791 | $0 | $17,736 | |
| ERIC BURCH | |||||||
| BOARD MEMBER | 0.65 | Yes (X) | $0 | $0 | $0 | ||
| LESLIE TRUSSLER | |||||||
| BOARD MEMBER | 0.65 | Yes (X) | $0 | $0 | $0 | ||
| KIM ROBERTS | |||||||
| BOARD MEMBER | 0.65 | Yes (X) | $0 | $0 | $0 | ||
| MIKE NIEDERHAUSER | |||||||
| BOARD MEMBER | 0.65 | Yes (X) | $0 | $0 | $0 | ||
| JAMES VANWINKLE | |||||||
| BOARD MEMBER | 0.65 | Yes (X) | $0 | $0 | $0 | ||
| JOEY VAUGHN | |||||||
| BOARD MEMBER | 0.65 | Yes (X) | $0 | $0 | $0 | ||
| PAMELA JERNIGAN | |||||||
| CFO | 40.00 | Yes (X) | $239,553 | $0 | $20,880 | ||
| JAMES BARMES | |||||||
| SR FINANCE OFFICER | 40.00 | $143,984 | $0 | $0 | Yes (X) | ||
| ALBERT BRANDON | |||||||
| PHYSICIAN | 40.00 | $347,484 | $0 | $0 | Yes (X) | ||
| ELIZABETH CRAIN | |||||||
| DIRECTOR | 40.00 | $152,327 | $0 | $14,555 | Yes (X) | ||
| DENNY DANIEL | |||||||
| PHYSICIAN | 40.00 | $338,762 | $0 | $20,880 | Yes (X) | ||
| GLENN DAVIS | |||||||
| PHYSICIAN | 40.00 | $221,226 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,356,223 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $74,051 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 15 | 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 |
|---|---|---|---|---|---|
| DR HASEMEIER & ASSOCIATES | |||||
| PO BOX 1010 | DANDRIDGE | TN | 37725 | STAFFING NURSING HOME VISITS | $4,070,207 |
| HOUSECALL TODAY INC | |||||
| 5221 RAVENS GLEN | NASHVILLE | TN | 37211 | STAFFING NURSING HOME VISITS | $2,686,414 |
| RAPHA CENTRE | |||||
| 482 INTERSTATE DRIVE SUITE D | MANCHESTER | TN | 37355 | STAFFING ADDICTION CLINIC VISITS | $2,015,031 |
| SENIOR HEALTH PARTNERS | |||||
| 5221 RAVENS GLEN | NASHVILLE | TN | 37211 | STAFFING NURSING HOME VISITS | $817,174 |
| EMCARE INC | |||||
| HCA EMCARE HOLDINGS LLC | DALLAS | TX | 75240 | STAFFING FOR ER PHYSICIANS | $584,099 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 14 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE RE | 621990 | $21,641,654 | $21,641,654 |
| OTHER REVENUE | 621990 | $69,941 | $69,941 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $21,711,595 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15 | TotalRevenueColumnAmt |
| Exclusion | $15 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,711,610 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $21,711,595 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $15 | 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 | $1,191,056 | TotalAmt |
| Program Services | $994,532 | ProgramServicesAmt |
| Management And General | $196,524 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,569,110 | TotalAmt |
| Program Services | $3,337,035 | ProgramServicesAmt |
| Management And General | $232,075 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $484,471 | TotalAmt |
| Program Services | $436,069 | ProgramServicesAmt |
| Management And General | $48,402 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $293,235 | TotalAmt |
| Program Services | $275,009 | ProgramServicesAmt |
| Management And General | $18,226 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,979 | TotalAmt |
| Management And General | $36,979 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,159,171 | TotalAmt |
| Program Services | $7,440,452 | ProgramServicesAmt |
| Management And General | $718,719 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,848 | TotalAmt |
| Management And General | $1,848 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,529 | TotalAmt |
| Program Services | $72,293 | ProgramServicesAmt |
| Management And General | $10,236 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $422,481 | TotalAmt |
| Program Services | $352,772 | ProgramServicesAmt |
| Management And General | $69,709 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,933 | TotalAmt |
| Program Services | $11,600 | ProgramServicesAmt |
| Management And General | $2,333 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,249 | TotalAmt |
| Program Services | $13,374 | ProgramServicesAmt |
| Management And General | $875 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $803,558 | TotalAmt |
| Program Services | $746,227 | ProgramServicesAmt |
| Management And General | $57,331 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,043,364 | TotalAmt |
| Program Services | $200,238 | ProgramServicesAmt |
| Management And General | $843,126 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $184,918 | TotalAmt |
| Program Services | $154,407 | ProgramServicesAmt |
| Management And General | $30,511 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT | $2,397,014 | $2,397,014 | |
| SUPPLIES AND DRUGS | $1,231,156 | $1,224,991 | $6,165 |
| UTILITIES | $201,152 | $167,962 | $33,190 |
| REPAIRS AND MAINTENANCE | $155,942 | $130,212 | $25,730 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $170,124 | TotalAmt |
| Program Services | $109,930 | ProgramServicesAmt |
| Management And General | $60,194 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,456,290 | TotalAmt |
| Program Services | $18,064,117 | ProgramServicesAmt |
| Management And General | $2,392,173 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $280,852 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $9,745,266 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $15,039 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $529,043 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $168,888 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $15,663,328 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $11,984,490 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $3,678,838 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $34,703,566 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $49,121,492 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $11,514,081 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $15,845,780 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $19,174,788 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,331,523 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $47,866,172 | 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) |
|---|---|---|
| EOY | $1,255,320 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,255,320 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $49,121,492 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,255,320 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| 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 | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $1,677 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $1,677 | 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 | PORTION OF HOSPITAL ASSOCIATION MEMBERSHIP DUES THAT ARE USED FOR LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,079,741 | OtherCostOrOtherBasisAmt |
| Book Value | $1,079,741 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,576,026 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,049,747 | DepreciationAmt |
| Book Value | $1,526,279 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,653,533 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,907,245 | DepreciationAmt |
| Book Value | $746,288 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $354,028 | OtherCostOrOtherBasisAmt |
| Depreciation | $27,498 | DepreciationAmt |
| Book Value | $326,530 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,678,838 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| GOODWILL | $34,637,286 |
| DEPOSITS | $66,280 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $34,703,566 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ESTIMATED THIRD PARTY SETTLEMENTS | Desc |
| Amt | $1,331,523 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,331,523 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $21,711,610 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $21,711,610 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $21,711,610 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $20,456,290 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $20,456,290 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $20,456,290 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | The Medical Center adopted professional guidance which clarifies the accounting for uncertainty in income taxes on the Medical Center's consolidated financial statements and prescribes a recognition and measurement of a tax position taken or expected to be taken in a tax return. It also provides guidance on derecognition and measurement of a tax position taken or expected to be taken in a tax return. The Medical Center did not have any uncertain tax positions as of December 31, 2019, and does not expect this to change significantly over the next 12 months. As of December 31, 2019, the Medical Center has not accrued interest or penalties related to uncertain tax positions. | 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 | 0 | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,605 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $191,404 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,720,038 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $21,725,271 | 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 | $6,727,643 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $21,916,675 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,187 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,187 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,400 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,400 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,587 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,587 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,733,230 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $21,916,675 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,587 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,397,014 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $871,554 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $4,592,039 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $3,309,723 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $1,282,316 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | UNITY MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 481 INTERSTATE DR | AddressLine1Txt |
| City | MANCHESTER | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37355 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | 0000000017 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNITY MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Licensed CY Or PY | Yes (1) | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | Yes (1) | 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 |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.unitymedicalmanchester.com | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | 0 | EligCriteriaExplainedInd |
| Explained Basis | 0 | ExplainedBasisInd |
| App Financial Asst Expln | 0 | AppFinancialAsstExplnInd |
| Includes Publicity Measures | 0 | IncludesPublicityMeasuresInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Permit Legal Judicial Process | Yes (X) | PermitLegalJudicialProcessInd |
| Collection Activities | Yes (1) | CollectionActivitiesInd |
| Reporting To Credit Agency | Yes (X) | ReportingToCreditAgencyInd |
| Other Actions | Yes (X) | OtherActionsInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Nondis Emergency Care Policy | 0 | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| UNITY MEDICAL CENTER INC. | Part V, Section B, Line 3j: THE NONPROFIT HOSPITAL BEGAN OPERATIONS IN 2019. |
| UNITY MEDICAL CENTER INC. | Part V, Section B, Line 5: WITH A FOCUS ON THE DEMOGRAPHIC HEALTH INDICATORS, A COMMUNITY HEALTH COMMITTEE WAS FORMED BY UNITY MEDICAL CENTER TO REPRESENT THE BROAD INTEREST OF THE COMMUNITY TO WEIGH IN ON THE HEALTH ISSUES IMPACTING THE COMMUNITY. A SURVEY WAS GENERATED TO INQUIRE ABOUT THE COMMUNITY AND PRIORITIZE ISSUES THAT IMPACT HEALTH. THIS SURVEY WAS POSTED ONLINE AND DISTRIBUTED WITHIN THE COMMUNITY THROUGH AVENUES SUCH AS THE HOSPITAL, CHAMBER OF COMMERCE, PUBLIC SCHOOL BOARD, LOCAL CHURCH, EMERGENCY RESPONDERS, AND OTHER CIVIC GROUP EMAIL SERVICES.THE METHODOLOGY UTILIZED IN THIS ASSESSMENT INCORPORATED BOTH QUANTITIVE AND QUALITATIVE SOURCES. QUANTITIVE DATA INCLUDED THE PRIMARY RESEARCH (THE SURVEY) AND SECONDARY RESEARCH (VITAL STATISTICS AND EXISTING HEALTH-RELATED DATA). QUALITATIVE INCLUDE PRIMARY RESEARCH GATHERED THROUGH THE ONLINE SURVEY IN ADDITION TO THE EXPERTISE PROVIDED BY THE COMMUNITY HEALTH COMMITTEE THAT WAS FORMED BY THE HOSPITAL. |
| UNITY MEDICAL CENTER INC. | Part V, Section B, Line 11: THE COMMUNTIY HEALTH NEEDS COMMITTEE WAS PRESENTED THE TOP TEN MOST SIGNIFICANT HEALTH ISSUES. THE 2019 COMMUNITY HEALTH PRIORITIES IDENTIFED BY THE COMMITTEE AND APPROVED BY THE HOSPITAL BOARD OF DIRECTORS ARE: CANCER, HEART DISEASE AND STROKE. THE COMMUNITY HEALTH NEEDS COMMITTEE ELIMINATED HEALTH INSURANCE AND PRESCRIPTION DRUG AFFORDABILITY BECAUSE THEY ARE NATIONAL HEALTH CONCERNS AND WOULD BE LIKELY BE MET WITH MINIMAL POSITIVE RESULTS. |
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Ln 7 Col(f): | The Medical Center's estimate of the allowance for doubtful accounts is based primarily on the type and age of the patient's accounts receivable. The policy is to reserve a portion of all self-pay accounts, including amounts due from uninsured patients and amounts related to co-payments and deductibles. On a monthly basis, the Medical Center reviews its estimate and performs analytical procedures, including review of the accounts receivable aging and payor mix. The Medical Center also performs retrospective reviews of write-offs and collections to ensure the estimate is reasonable going forward. |
| Part III, Line 2: | THE MEDICAL CENTER'S ESTIMATE OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED PRIMARILY ON THE TYPE AND AGE OF THE PATIENT'S ACCOUNTS RECEIVABLE. THE POLICY IS TO RESERVE A PORTION OF ALL SELF-PAY ACCOUNTS INCLUDING AMOUNTS DUE FROM UNINSURED PATIENTS AND AMOUNTS RELATED TO CO-PAYMENTS AND DEDUCTIBLES. ON A MONTHLY BASIS, THE MEDICAL CENTER REVIEWS ITS ESTIMATE AND PERFORMS ANALYTICAL PROCEDURES, INCLUDING REVIEW OF THE ACCOUNTS RECEIVABLE AND PAYOR MIX. THE MEDICAL CENTER ALSO PERFORS RETROSPECTIVE REVIEWS OF WRITE-OFFS AND COLLECTIONS TO ENSURE THE ESTIMATE IS REASONABLE GOING FORWARD. |
| Part III, Line 3: | THE COST OF BAD DEBT IS DETERMINED BY APPLYING THE RATIO OF PATIENT CARE COST TO CHARGES TO THE TOTAL BAD DEBT. |
| Part III, Line 4: | The Medical Center's estimate of the allowance for doubtful accounts is based primarily on the type and age of the patient's accounts receivable. The policy is to reserve a portion of all self-pay accounts, including amounts due from uninsured patients and amounts related to co-payments and deductibles. On a monthly basis, the Medical Center reviews its estimate and performs analytical procedures, including review of the accounts receivable aging and payor mix. The Medical Center also performs retrospective reviews of write-offs and collections to ensure the estimate is reasonable going forward. |
| Part VI, Line 2: | THE HOSPITAL ANALYZES DATA RECEIVED FROM LOCAL, REGIONAL, AND STATE AGENCIES IN ORDER TO ACCURATELY AND ADEQUATELY INDENTIFY THE NEEDS OF THE COMMUNITY THROUGH SERVICES PROVIDED BY UNITY HOSPITAL. |
| Part VI, Line 3: | INFORMATION TO INFORM AND EDUCATE PATIENTS REGARDING ASSISTANCE UNDER FEDERAL, STATE OR LOCAL PROGRAMS AND UNITY POLICIES IS AVAILABLE UPON ADMISSION AND IS POSTED IN PATIENT ROOMS. HOSPITAL BUSINESS OFFICE REPRESENTATIVES ARE AVAILABLE BEFORE, DURING AND FOLLOWING PATIENT STAYS TO DISCUSS PAYMENT ARRANGEMENTS, FINANCIAL ASSISTANCE, AND QUESTIONS ABOUT BILLING. FOR INPATIENT AND SUBACUTE REFERRALS, THE NURSE LIASONS ARE THE FIRST POINT OF CONTACT FOR INFORMATION DISSEMINATION TO PROSPECTIVE PATIENTS REGARDING AVAILABILITY OF ASSISTANCE, ELIGIBILITY CRITERIA AND APPLICATION INFORMATION. |
| Part VI, Line 4: | UNITY SERVES MIDDLE TENNESSEE. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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 | 0 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ASHOKE MUKHERJI | ||||||||||||||
| CHAIRMAN CHIEF BUSINESS MANAGER | $258,820 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $258,820 | $0 | $0 | $0 |
| MARTHA MCCORMICK | ||||||||||||||
| CEO | $262,276 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $262,276 | $0 | $0 | $0 |
| BOBBY COUCH | ||||||||||||||
| COO | $391,791 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $17,736 | $0 | $409,527 | $0 | $0 | $0 |
| PAMELA JERNIGAN | ||||||||||||||
| CFO | $239,553 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $20,880 | $0 | $260,433 | $0 | $0 | $0 |
| ALBERT BRANDON | ||||||||||||||
| PHYSICIAN | $347,484 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $347,484 | $0 | $0 | $0 |
| ELIZABETH CRAIN | ||||||||||||||
| DIRECTOR | $152,327 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $14,555 | $0 | $166,882 | $0 | $0 | $0 |
| DENNY DANIEL | ||||||||||||||
| PHYSICIAN | $338,762 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $20,880 | $0 | $359,642 | $0 | $0 | $0 |
| GLENN DAVIS | ||||||||||||||
| PHYSICIAN | $221,226 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $221,226 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (12 entries)
| Relationship With OrgRelationshipWithOrgTxt | Loan PurposeLoanPurposeTxt | Loan To OrganizationLoanToOrganizationInd | Original PrincipalOriginalPrincipalAmt | Balance DueBalanceDueAmt | DefaultDefaultInd | Board Or Committee ApprovalBoardOrCommitteeApprovalInd | Written AgreementWrittenAgreementInd |
|---|---|---|---|---|---|---|---|
| MEDICAL ASSOCIATES DEVELOPMENT LLC | |||||||
| ROBERT COUCH THE COO IS A 20% OWNER OF MEDICAL ASSOCIATES DEVELOPMENT | HOSPITAL FINANCING ACCOUNTS PAYABLE | Yes (X) | $8,171,074 | $8,171,074 | 0 | Yes (1) | Yes (1) |
| ASHOKE BAPPA MUKHERJI | |||||||
| ASHOKE MUKHERJI IS THE BUSINESS MANAGER OF THE HOSPITAL | HOSPITAL FINANCING ACCOUNTS PAYABLE | Yes (X) | $555,973 | $555,973 | 0 | Yes (1) | Yes (1) |
| MCARTHUR 23 | |||||||
| MUKHERJI BUSINESS MANAGER OWNS 25.5% OF MCARTHUR 23 | HOSPITAL FINANCING | Yes (X) | $328,886 | $328,886 | 0 | Yes (1) | Yes (1) |
| UNITED REGIONAL INVESTORS GROUP | |||||||
| OWNED 7.69% BY MUKHERJI BUSINESS MANAGER 7.69% OWNED BY MCCORMICK CEO | HOSPITAL FINANCING | Yes (X) | $4,109,775 | $4,109,775 | 0 | Yes (1) | Yes (1) |
| RURAL HEALTH ASSOCIATES | |||||||
| OWNED 100% BY BOBBY COUCH | HOSPITAL FINANCING | Yes (X) | $61,370 | $61,370 | 0 | Yes (1) | Yes (1) |
| MJM LEASING | |||||||
| 99% OWNERSHIP ASHOKE MUKHERJI PAM JERNIGAN MARTHA MCCORMICK | HOSPITAL FINANCING | Yes (X) | $400,000 | $400,000 | 0 | Yes (1) | Yes (1) |
| MARTHA MCCORMICK | |||||||
| HOSPITAL CEO | HOSPITAL FINANCING ACCRUED INTEREST | Yes (X) | $532,467 | $532,467 | 0 | Yes (1) | Yes (1) |
| ROBERT COUCH | |||||||
| HOSPITAL COO | HOSPITAL FINANCING | Yes (X) | $118,154 | $118,154 | 0 | Yes (1) | Yes (1) |
| PAM JERNIGAN | |||||||
| HOSPITAL CFO | HOSPITAL FINANCING | Yes (X) | $970,812 | $970,812 | 0 | Yes (1) | Yes (1) |
| MIKE NIEDERHAUSER | |||||||
| BOARD MEMBER | HOSPITAL FINANCING | Yes (X) | $30,000 | $30,000 | 0 | Yes (1) | Yes (1) |
| JAMES VANWINKLE | |||||||
| BOARD MEMBER | HOSPITAL FINANCING | Yes (X) | $246,000 | $246,000 | 0 | Yes (1) | Yes (1) |
| RAPHA MEDICAL | |||||||
| BUSINESS MANAGER ASHOKE MUKHERJI IS 60% OWNER | HOSPITAL FINANCING | Yes (X) | $321,269 | $321,269 | 0 | Yes (1) | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $15,845,780 | TotalBalanceDueAmt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PAM JERNIGAN | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | CFO OFFICER OF UNITY MEDICAL CENTER | RelationshipDescriptionTxt |
| Transaction | $970,812 | TransactionAmt |
| Transaction | HOSPITAL FINANCING ACCOUNTS PAYABLE | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section B, line 11b | THE BOARD WILL REVIEW THE TAX RETURN BEFORE THE RETURN IS FILED. |
| Form 990, Part VI, Section B, line 12c | CONFLICT ON INTEREST IS MONITORED BY COMPLIANCE OFFICER |
| Form 990, Part VI, Section B, line 15b | ALL CONTRACTS ARE REVIEWED BY THE CHIEF COMPLIANCE OFFICER AND OUTSIDE COUNSEL. |
| Form 990, Part VI, Section C, line 19 | DOCUMENTS ARE AVAILABLE UPON REQUEST |
| Form 990, Part IX, line 11g | PURCHASED SERVICES: Program service expenses 7440452. Management and general expenses 718719. Fundraising expenses 0. Total expenses 8159171. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COFFEE MEDICAL GROUP LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 481 INTERSTATE DRIVE | AddressLine1Txt |
| City | MANCHESTER | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37355 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 460485169 | EIN |
| Primary Activities | HOSPITAL MEDICAL CARE | PrimaryActivitiesTxt |
| Legal Domicile State | TN | LegalDomicileStateCd |