2021-11-08T13:50:58-06:00 2020-12-31 621046406 JOHNSON HICKEY & MURCHISON PC 2215 OLAN MILLS DRIVE CHATTANOOGA TN 37421 990 2020-01-01 825388429 UNITY MEDICAL CENTER INC UNIT 6153088800 481 INTERSTATE DRIVE MANCHESTER TN 37355 PAM JERNIGAN CFO 9317283856 2021-11-08 PAM JERNIGAN XXX-XX-XXXX Sharon Brooks P01553065 4237560052 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z PAM JERNIGAN 481 INTERSTATE DRIVE MANCHESTER TN 37355 54133034 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 4 293 5 0 0 0 9225206 21711595 44907789 15 39 0 0 21711610 54133034 0 0 0 0 5537872 13967611 0 0 0 14918418 34538788 20456290 48506399 1255320 5626635 49121492 60435359 47866172 53553402 1255320 6881957 TO IMPROVE HEALTHCARE TO LOCAL RESIDENTS AND PROVIDE SUPPORTIVE SERVICES TO IMPROVE THE HEALTHCARE OF THE COMMUNITY. 0 0 42518615 44907789 HOSPITAL SERVICES INCLUDING HASEMEIER GROUP NURSING HOME VISITS - 76,17., LAB TESTS AND/OR PROCEDURES - 25,150. HOUSECALL TODAY VISITS - 45,927. EMERGENCY ROOM VISITS - 9,477. 42518615 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 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 1 110 0 293 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 MA 40.00 X X 422045 0 0 MARTHA MCCORMICK CEO 40.00 X X 398011 0 1082 BOBBY COUCH COO 40.00 X X 546196 0 12222 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 409393 0 22989 JAMES BARMES SR FINANCE OFFICER 40.00 X 154669 0 0 KENNETH WARE CHIEF CLINICAL OFFICER 40.00 X 131130 0 13353 ARTHUR BURNS CHIEF COMP. OFFICER 40.00 X 122592 0 0 ALBERT BRANDON PHYSICIAN 40.00 X 341066 0 9863 ELIZABETH CRAIN DIRECTOR 40.00 X 159331 0 0 DENNY DANIEL PHYSICIAN 40.00 X 338762 0 22989 GLENN DAVIS PHYSICIAN 40.00 X 218297 0 0 SUE RICHARDSON NURSE PRACTITIONER 40.00 X 120732 0 23154 3362224 0 105652 16 0 1 0 DR HASEMEIER & ASSOCIATES PO BOX 1010 DANDRIDGE TN 37725 STAFFING NURSING HOME VISITS 6047503 HOUSECALL TODAY INC 5221 RAVENS GLEN NASHVILLE TN 37211 STAFFING NURSING HOME VISITS 3754058 RAPHA CENTRE 482 INTERSTATE DRIVE SUITE D MANCHESTER TN 37355 STAFFING ADDICTION CLINIC VISITS 2094991 EMCARE INC HCA EMCARE HOLDINGS LLC DALLAS TX 75240 STAFFING FOR ER PHYSICIANS 985145 SENIOR HEALTH PARTNERS 5221 RAVENS GLEN NASHVILLE TN 37211 STAFFING NURSING HOME VISITS 752312 5 9204495 20711 9225206 NET PATIENT SERVICE RE 621990 42739645 42739645 OTHER REVENUE 621990 2168144 2168144 44907789 39 39 54133034 44907789 0 39 X 2256857 2004745 252112 9806611 8711119 1095492 1120877 968341 152536 783266 723091 60175 22588 22588 19341427 18225090 1116337 3460 3460 123937 103606 20331 1066970 890920 176050 26177 20646 5531 31398 28177 3221 994557 994557 2328992 480771 1848221 470513 392878 77635 BAD DEBT 4632450 4632450 SUPPLIES AND DRUGS 3572801 3568854 3947 MISCELLANEOUS 997326 997326 UTILITIES 430516 359480 71036 495676 413890 81786 48506399 42518615 5987784 0 280852 13341959 9745266 6727772 15039 5542 529043 617967 168888 158821 19142006 12560266 3678838 6581740 34703566 33001558 49121492 60435359 11514081 11335010 15845780 3112200 19174788 28024728 1331523 11081464 47866172 53553402 X 1255320 6881957 1255320 6881957 49121492 60435359 X 5626635 2 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1845 1845 0 Part II-B, Line 1: PORTION OF HOSPITAL ASSOCIATION MEMBERSHIP DUES THAT ARE USED FOR LOBBYING. 1079741 1079741 5115385 3657196 1458189 11521481 8861218 2660263 1425399 41852 1383547 6581740 GOODWILL 32884068 DEPOSITS 61130 RELATED PARTY RECIEVABLE 56360 33001558 ESTIMATED THIRD PARTY SETTLEMENTS 9791478 REFUNDABLE ADVANCE - CARES PROVIDER RELIEF FUNDS 1289986 11081464 X 49500584 0 49500584 4632450 4632450 54133034 43873949 0 43873949 4632450 4632450 48506399 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, 2020, and does not expect this to change significantly over the next 12 months. As of December 31, 2020, the Medical Center has not accrued interest or penalties related to uncertain tax positions. 1 1 1 X 1 X 0 1 0 0 739414 475307 264107 0.00600 4972495 4285502 686993 0.01570 5711909 4760809 951100 0.02170 5711909 4760809 951100 0.02170 1 4632450 2045312 2358260 1428285 929975 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 1 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: Generally, patients who are covered by third-party payers are responsible for related deductibles and coinsurance, which vary in amount. The Organization also provides services to uninsured patients who do not qualify for charity care, and offers those uninsured patients a discount, either by policy or law, from standard charges. The Organization estimates the transaction price for patients with deductibles and coinsurance and from those who are uninsured based on historical experience and current market conditions. The initial estimate of the transaction price is determined by reducing the standard charge by any contractual adjustments, discounts, and implicit price concessions. Subsequent changes to the estimate of the transaction price are generally recorded as adjustments to patient service revenue in the period of the change. For the year ended December 31, 2020, additional revenue of $159,431 was recognized due to changes in its estimates of implicit price concessions for performance obligations satisfied in prior years. Subsequent changes that are determined to be the result of an adverse change in the patient's ability to pay are recorded as bad debt expense. Bad debt expense for the year ended December 31, 2020 was not significant. 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 BOBBY COUCH COO 546196 0 0 0 0 0 0 0 12222 0 558418 0 0 0 PAMELA JERNIGAN CFO 409393 0 0 0 0 0 0 0 22989 0 432382 0 0 0 ASHOKE MUKHERJI CHAIRMAN CHIEF BUSINESS MA 422045 0 0 0 0 0 0 0 0 0 422045 0 0 0 MARTHA MCCORMICK CEO 398011 0 0 0 0 0 0 0 1082 0 399093 0 0 0 DENNY DANIEL PHYSICIAN 338762 0 0 0 0 0 0 0 22989 0 361751 0 0 0 ALBERT BRANDON PHYSICIAN 341066 0 0 0 0 0 0 0 9863 0 350929 0 0 0 GLENN DAVIS PHYSICIAN 218297 0 0 0 0 0 0 0 0 0 218297 0 0 0 ELIZABETH CRAIN DIRECTOR 159331 0 0 0 0 0 0 0 0 0 159331 0 0 0 JAMES BARMES SR FINANCE OFFICER 154669 0 0 0 0 0 0 0 0 0 154669 0 0 0 ROBERT COUCH OFFICER HOSPITAL FINANCING X 118154 111000 0 1 1 ASHOKE BAPPA MUKHERJI OFFICER HOSPITAL FINANCING X 555973 553500 0 1 1 MARTHA MCCORMICK OFFICER HOSPITAL FINANCING X 532467 504000 0 1 1 PAMELA JERNIGAN OFFICER HOSPITAL FINANCING X 970812 686700 0 1 1 MIKE NIEDERHAUSER BOARD MEMBER HOSPITAL FINANCING X 30000 30000 0 1 1 JAMES VANWINKLE BOARD MEMBER HOSPITAL FINANCING X 0 246000 0 1 1 EVELYN CASE TRUST FAMILY MEMBER OF CHAIRMAN HOSPITAL FINANCING X 0 261000 0 1 1 IMMEDIATE RELATIVES OF A MUKHERJI FAMILY OF CHAIRMAN HOSPITAL FINANCING X 0 720000 0 1 1 3112200 RAPHA BUSINESS MANAGER ASHOKE MUKHERJI IS 60% OWNER 2319665 CLINIC ADDICTION PROGRAM 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 18225090. Management and general expenses 1116337. Fundraising expenses 0. Total expenses 19341427. Form 990, Part XI, line 9: ROUNDING 2. COFFEE MEDICAL GROUP LLC 481 INTERSTATE DRIVE MANCHESTER TN 37355 460485169 HOSPITAL MEDICAL CARE TN