2021-02-26T16:47:41-06:00 2019-12-31 621046406 JOHNSON HICKEY & MURCHISON PC 2215 OLAN MILLS DRIVE CHATTANOOGA TN 37421 990 2019-07-16 825388429 UNITY MEDICAL CENTER INC UNIT 6153088800 481 INTERSTATE DRIVE MANCHESTER TN 37355 PAM JERNIGAN CFO 9317283856 2021-02-26 Barry R Huggins P00627334 4237560052 2019 2022-09-23 18:48:47Z X PAM JERNIGAN 481 INTERSTATE DRIVE MANCHESTER TN 37355 21711610 0 X UNITYMEDICALMANCHESTER.COM X 2018 TN TO PROVIDE IMPROVED HEALTHCARE TO LOCAL RESIDENTS.PROVIDE LEADERSHIP AND DEVELOPMENT OF ADDITIONAL SUPPORTIVE ACTIVITIES THAT WILL IMPROVE THE HEALTHCARE OF THE COMMUNITY. 9 4 292 5 0 0 0 21711595 15 0 21711610 0 0 5537872 0 0 14918418 20456290 1255320 49121492 47866172 1255320 TO IMPROVE HEALTHCARE TO LOCAL RESIDENTS AND PROVIDE SUPPORTIVE SERVICES TO IMPROVE THE HEALTHCARE OF THE COMMUNITY. 0 0 18064117 21711595 HOSPITAL SERVICES INCLUDING HASEMEIER GROUP NURSING HOME VISITS 28,500, LAB TEST/PROCEDURES 51,400 AND EMERGENCY ROOM VISITS OF 5050. 18064117 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 1 0 1 0 1 0 0 0 0 1 0 0 0 0 1 87 0 292 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 4 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 0 1 0 X The Organization 6153088800 481 INTERSTATE DRIVE MANCHESTER TN 37355 ASHOKE MUKHERJI CHAIRMAN CHIEF BUSINESS MANAGER 40.00 X X 258820 0 0 MARTHA MCCORMICK CEO 40.00 X X 262276 0 0 BOBBY COUCH COO 40.00 X X 391791 0 17736 ERIC BURCH BOARD MEMBER 0.65 X 0 0 0 LESLIE TRUSSLER BOARD MEMBER 0.65 X 0 0 0 KIM ROBERTS BOARD MEMBER 0.65 X 0 0 0 MIKE NIEDERHAUSER BOARD MEMBER 0.65 X 0 0 0 JAMES VANWINKLE BOARD MEMBER 0.65 X 0 0 0 JOEY VAUGHN BOARD MEMBER 0.65 X 0 0 0 PAMELA JERNIGAN CFO 40.00 X 239553 0 20880 JAMES BARMES SR FINANCE OFFICER 40.00 X 143984 0 0 ALBERT BRANDON PHYSICIAN 40.00 X 347484 0 0 ELIZABETH CRAIN DIRECTOR 40.00 X 152327 0 14555 DENNY DANIEL PHYSICIAN 40.00 X 338762 0 20880 GLENN DAVIS PHYSICIAN 40.00 X 221226 0 0 2356223 0 74051 15 0 1 0 DR HASEMEIER & ASSOCIATES PO BOX 1010 DANDRIDGE TN 37725 STAFFING NURSING HOME VISITS 4070207 HOUSECALL TODAY INC 5221 RAVENS GLEN NASHVILLE TN 37211 STAFFING NURSING HOME VISITS 2686414 RAPHA CENTRE 482 INTERSTATE DRIVE SUITE D MANCHESTER TN 37355 STAFFING ADDICTION CLINIC VISITS 2015031 SENIOR HEALTH PARTNERS 5221 RAVENS GLEN NASHVILLE TN 37211 STAFFING NURSING HOME VISITS 817174 EMCARE INC HCA EMCARE HOLDINGS LLC DALLAS TX 75240 STAFFING FOR ER PHYSICIANS 584099 14 NET PATIENT SERVICE RE 621990 21641654 21641654 OTHER REVENUE 621990 69941 69941 21711595 15 15 21711610 21711595 0 15 X 1191056 994532 196524 3569110 3337035 232075 484471 436069 48402 293235 275009 18226 36979 36979 8159171 7440452 718719 1848 1848 82529 72293 10236 422481 352772 69709 13933 11600 2333 14249 13374 875 803558 746227 57331 1043364 200238 843126 184918 154407 30511 BAD DEBT 2397014 2397014 SUPPLIES AND DRUGS 1231156 1224991 6165 UTILITIES 201152 167962 33190 REPAIRS AND MAINTENANCE 155942 130212 25730 170124 109930 60194 20456290 18064117 2392173 0 280852 9745266 15039 529043 168888 15663328 11984490 0 3678838 0 34703566 0 49121492 11514081 15845780 19174788 0 1331523 0 47866172 X 1255320 0 1255320 0 49121492 1255320 0 X 0 1 X 1 0 X 1 1677 1677 0 Part II-B, Line 1: PORTION OF HOSPITAL ASSOCIATION MEMBERSHIP DUES THAT ARE USED FOR LOBBYING. 1079741 1079741 4576026 3049747 1526279 9653533 8907245 746288 354028 27498 326530 3678838 GOODWILL 34637286 DEPOSITS 66280 34703566 ESTIMATED THIRD PARTY SETTLEMENTS 1331523 1331523 X 21711610 0 21711610 0 21711610 20456290 0 20456290 0 20456290 Part X, Line 2: 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. 1 1 1 X 1 X 0 1 0 0 7605 191404 0 0.00000 6720038 21725271 0 0.00000 6727643 21916675 0 0.00000 2187 2187 0.00010 3400 3400 0.00020 5587 5587 0.00030 6733230 21916675 5587 0.00030 1 2397014 871554 4592039 3309723 1282316 X 1 1 UNITY MEDICAL CENTER 481 INTERSTATE DR MANCHESTER TN 37355 0000000017 X X X UNITY MEDICAL CENTER INC 1 1 1 X X X X X X X X X 19 1 0 0 1 X 1 19 1 www.unitymedicalmanchester.com 0 0 0 0 0 1 X X 1 X X X X 0 X 0 0 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. 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. X X 0 0 0 0 0 0 0 0 0 ASHOKE MUKHERJI CHAIRMAN CHIEF BUSINESS MANAGER 258820 0 0 0 0 0 0 0 0 0 258820 0 0 0 MARTHA MCCORMICK CEO 262276 0 0 0 0 0 0 0 0 0 262276 0 0 0 BOBBY COUCH COO 391791 0 0 0 0 0 0 0 17736 0 409527 0 0 0 PAMELA JERNIGAN CFO 239553 0 0 0 0 0 0 0 20880 0 260433 0 0 0 ALBERT BRANDON PHYSICIAN 347484 0 0 0 0 0 0 0 0 0 347484 0 0 0 ELIZABETH CRAIN DIRECTOR 152327 0 0 0 0 0 0 0 14555 0 166882 0 0 0 DENNY DANIEL PHYSICIAN 338762 0 0 0 0 0 0 0 20880 0 359642 0 0 0 GLENN DAVIS PHYSICIAN 221226 0 0 0 0 0 0 0 0 0 221226 0 0 0 MEDICAL ASSOCIATES DEVELOPMENT LLC ROBERT COUCH THE COO IS A 20% OWNER OF MEDICAL ASSOCIATES DEVELOPMENT HOSPITAL FINANCING ACCOUNTS PAYABLE X 8171074 8171074 0 1 1 ASHOKE BAPPA MUKHERJI ASHOKE MUKHERJI IS THE BUSINESS MANAGER OF THE HOSPITAL HOSPITAL FINANCING ACCOUNTS PAYABLE X 555973 555973 0 1 1 MCARTHUR 23 MUKHERJI BUSINESS MANAGER OWNS 25.5% OF MCARTHUR 23 HOSPITAL FINANCING X 328886 328886 0 1 1 UNITED REGIONAL INVESTORS GROUP OWNED 7.69% BY MUKHERJI BUSINESS MANAGER 7.69% OWNED BY MCCORMICK CEO HOSPITAL FINANCING X 4109775 4109775 0 1 1 RURAL HEALTH ASSOCIATES OWNED 100% BY BOBBY COUCH HOSPITAL FINANCING X 61370 61370 0 1 1 MJM LEASING 99% OWNERSHIP ASHOKE MUKHERJI PAM JERNIGAN MARTHA MCCORMICK HOSPITAL FINANCING X 400000 400000 0 1 1 MARTHA MCCORMICK HOSPITAL CEO HOSPITAL FINANCING ACCRUED INTEREST X 532467 532467 0 1 1 ROBERT COUCH HOSPITAL COO HOSPITAL FINANCING X 118154 118154 0 1 1 PAM JERNIGAN HOSPITAL CFO HOSPITAL FINANCING X 970812 970812 0 1 1 MIKE NIEDERHAUSER BOARD MEMBER HOSPITAL FINANCING X 30000 30000 0 1 1 JAMES VANWINKLE BOARD MEMBER HOSPITAL FINANCING X 246000 246000 0 1 1 RAPHA MEDICAL BUSINESS MANAGER ASHOKE MUKHERJI IS 60% OWNER HOSPITAL FINANCING X 321269 321269 0 1 1 15845780 PAM JERNIGAN CFO OFFICER OF UNITY MEDICAL CENTER 970812 HOSPITAL FINANCING ACCOUNTS PAYABLE 0 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. COFFEE MEDICAL GROUP LLC 481 INTERSTATE DRIVE MANCHESTER TN 37355 460485169 HOSPITAL MEDICAL CARE TN