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UVMC NURSING CARE INC: Form 990, tax year 2024

View the entire original 990 at ProPublica ↗

Organization
UVMC NURSING CARE INC (EIN 31-1224064)
Tax period
2024-01-01 to 2024-12-31
Filed
2025-11-06
IRS object ID
202503109349303095
Schema version
2024v5.2
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 ReturnHeader

FieldValueIRS element (for citing)
Return2025-11-06T13:44:16-06:00ReturnTs
Tax Period End2024-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2024-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN311224064EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1UVMC NURSING CARE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlUVMCBusinessNameControlTxt
Phone9374999942PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1110 N MAIN ST 200AddressLine1Txt
CityDAYTONCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45402ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJ MICHAEL SIMSPersonNm
Person TitleSYSTEM VP & CORP. CONTROLLERPersonTitleTxt
Phone9374999942PhoneNum
Signature2025-11-06SignatureDt
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd
Tax2024TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKEVIN HARLANPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line13130 N COUNTY ROAD 25AAddressLine1Txt
CityTROYCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45373ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$59,857,702GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PREMIERHEALTH.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1987FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or MissionSEE PART III, LINE 1ActivityOrMissionDesc
Contract TerminationYes (X)ContractTerminationInd
Voting Members Governing Body3VotingMembersGoverningBodyCnt
Voting Members Independent3VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$24,806,859PYProgramServiceRevenueAmt
CY Program Service Revenue$21,171,513CYProgramServiceRevenueAmt
PY Investment Income-$339,634PYInvestmentIncomeAmt
CY Investment Income$19,956,900CYInvestmentIncomeAmt
PY Other Revenue$1,226,918PYOtherRevenueAmt
CY Other Revenue$1,786,055CYOtherRevenueAmt
PY Total Revenue$25,694,143PYTotalRevenueAmt
CY Total Revenue$42,914,468CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$24,884,339PYOtherExpensesAmt
CY Other Expenses$26,416,365CYOtherExpensesAmt
PY Total Expenses$24,884,339PYTotalExpensesAmt
CY Total Expenses$26,416,365CYTotalExpensesAmt
PY Revenues Less Expenses$809,804PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$16,498,103CYRevenuesLessExpensesAmt
Total Assets BOY$29,514,195TotalAssetsBOYAmt
Total Assets EOY$5,021,936TotalAssetsEOYAmt
Total Liabilities BOY$12,044,921TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,253,452TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$17,469,274NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$3,768,484NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionWE CARE. WE TEACH. WE INNOVATE. WE SERVE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant ChangeYes (1)SignificantChangeInd
Expense$22,998,676ExpenseAmt
Revenue$19,720,043RevenueAmt
DescTHE PRIMARY EXEMPT PURPOSE OF UVMC NURSING CARE, INC. (UVMCN) IS TO PROVIDE SKILLED NURSING AND REHABILITATIVE SERVICES IN A LONG-TERM HEALTHCARE SETTING TO INDIVIDUALS IN THE COMMUNITY SERVED BY UPPER VALLEY MEDICAL CENTER, A RELATED TAX-EXEMPT HOSPITAL. AS A PART OF THE UVMC HEALTH SYSTEM, UVMCN IS COMMITTED TO PRESERVING LONG-TERM ACCESS TO QUALITY HEALTH CARE SERVICES FOR MIAMI COUNTY AND THE SURROUNDING AREA. THIS ORGANIZATION WAS FORMED IN 1987 TO ASSURE ACCESS TO APPROPRIATE CARE AT AN ACCEPTABLE COST FOR PATIENTS IN A MANAGED CARE ENVIRONMENT. IN JUNE OF 1989, IT WAS GRANTED TAX EXEMPT STATUS.KOESTER PAVILION IS A 150-BED NURSING HOME PROVIDING LONG-TERM CARE FOR SKILLED AND INTERMEDIATE CARE PATIENTS AS WELL AS FREEDOM COURT, A SPECIALIZED ALZHEIMER'S UNIT.SPRINGMEADE HEALTH CENTER IS A 99-BED NURSING HOME OFFERING A RECUPERATIVE, REHABILITATIVE HEALTH CENTER AND CONVALESCENT AND EXTENDED CARE SERVICES INCLUDING FREEDOM COURT, A DEDICATED ALZHEIMER'S UNIT. BOTH NURSING HOMES CARE FOR MEDICAID, MEDICARE, INSURANCE AND PRIVATE PAY PATIENTS.PATIENT DAYS FOR 2024 WERE:KOESTER PAVILION 39,328SPRINGMEADE 32,315 TOTAL 71,643THE MAJORITY OF THE EXPENDITURES FOR UVMC NURSING CARE, INC. RELATES TO THE COSTS OF THE PROFESSIONAL AND NURSING SERVICES NEEDED TO SERVE THOSE ENTRUSTED TO OUR CARE.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$1,571,867ExpenseAmt
Revenue$1,451,470RevenueAmt
DescSPRINGMEADE RESIDENCE, LOCATED ON THE SAME CAMPUS AS THE HEALTH CENTER, OFFERS TWO- AND THREE-BEDROOM RETIREMENT LIVING COACH HOMES. SPRINGMEADE COACH HOMES ARE SITUATED TO OFFER A VIEW OF THE NATURAL BEAUTY AND VISUAL AMENITIES WHICH SURROUND THE AREA. SERVICES ARE DESIGNED TO ENHANCE THE LIVES OF THE RESIDENTS BY PROVIDING:1) ALL PROPERTY TAXES AND INSURANCE ON THE STRUCTURES2) YEAR-ROUND INTERIOR AND EXTERIOR MAINTENANCE AND GROUNDS KEEPING3) SPRINGMEADE SPONSORED SPECIAL EVENTS AND SOCIAL FUNCTIONS4) ELECTRONIC CONTACT SYSTEM THAT PROVIDES NOTIFICATION FOR RAPID RESPONSE TO HEALTH EMERGENCIES.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$24,570,543TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit CounselingYes (1)CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial LiquidationYes (1)PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document56IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members3GoverningBodyVotingMembersCnt
Independent Voting Member3IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1J MICHAEL SIMSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9374999942PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1110 N MAIN ST SUITE 200AddressLine1Txt
CityDAYTONCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45402ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (6 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
STEVEN STALEY
BOARD CHAIR0.501.00Yes (X)Yes (X)$0$0$0
LISA SHOCKLEY
BOARD VICE-CHAIR0.501.00Yes (X)$0$0$0
NICOLE ERNST
TRUSTEE0.501.00Yes (X)$0$0$0
DIANNE RUHENKAMP
BOARD TREASURER0.5039.50Yes (X)$0$178,175$28,450
ELIZABETH D WILFONG
BOARD SECRETARY0.5039.50Yes (X)$0$187,502$1,609
KEVIN W HARLAN
FORMER TRUSTEE & OFFICER0.0040.00$0$834,770$20,947Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,200,447TotReportableCompRltdOrgAmt
Total Other Compensation$51,006TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
CONCEPT REHAB INC
7150 GRANITE CIRTOLEDOOH43617THERAPY SERVICES$2,484,891
VANCREST MANAGEMENT
120 W MAIN ST STE 200VAN WERTOH45891MANAGEMENT SERVICES$1,600,324
OTTERBEIN SENIOR LIFE
4375 S CO RD 25ATROYOH45373MANAGEMENT SERVICES$1,402,956
TREASURER STATE OF OHIO MEDICAID
OHIO DEPARTMENT OF MEDICAID L-3669COLUMBUSOH432603669HEALTHCARE SERVICES$1,192,062
REMEDI SENIORCARE OF OHIO LLC
PO BOX 715744PHILADELPHIAPA191715744HEALTHCARE SERVICES$698,757
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K22CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT REVENUE (NURSING HOME624100$19,720,043$19,720,043
RETIREMENT COMMUNITY FEES531390$1,451,470$1,451,470
FieldValueIRS element (for citing)
Total Program Service Revenue$21,171,513TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$665,264TotalRevenueColumnAmt
Exclusion$665,264ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$13,984,870SecuritiesAmt
Other$22,250,000OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$14,016,719SecuritiesAmt
Other$2,926,515OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$31,849SecuritiesAmt
Other$19,323,485OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$19,291,636TotalRevenueColumnAmt
Exclusion$19,291,636ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
OTHER FEES900099$1,778,060$1,778,060
BEAUTY SHOP900099$7,705$7,705

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$290TotalRevenueColumnAmt
Exclusion$290ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$1,786,055OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$42,914,468TotalRevenueColumnAmt
Related Or Exempt Func Income$21,171,513RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$21,742,955ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$1,142,466TotalAmt
Program Services$1,034,617ProgramServicesAmt
Management And General$107,849ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$23,775TotalAmt
Program Services$21,531ProgramServicesAmt
Management And General$2,244ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,371,014TotalAmt
Program Services$3,371,014ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$75,905TotalAmt
Program Services$75,905ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$329,542TotalAmt
Program Services$298,433ProgramServicesAmt
Management And General$31,109ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$771,877TotalAmt
Program Services$699,012ProgramServicesAmt
Management And General$72,865ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$57,467TotalAmt
Program Services$52,042ProgramServicesAmt
Management And General$5,425ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$96TotalAmt
Program Services$96ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$978,252TotalAmt
Program Services$885,905ProgramServicesAmt
Management And General$92,347ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$91,969TotalAmt
Program Services$83,287ProgramServicesAmt
Management And General$8,682ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PURCHASED PERSONNEL$16,060,784$14,544,646$1,516,138
OPERATING SUPPLIES$1,994,739$1,994,739
BED OCCUPANCY TAX$1,386,191$1,386,191
DUES & SUBSCRIPTIONS$35,224$35,224

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$97,064TotalAmt
Program Services$87,901ProgramServicesAmt
Management And General$9,163ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$26,416,365TotalAmt
Program Services$24,570,543ProgramServicesAmt
Management And General$1,845,822ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$7,250BOYAmt
EOY$0EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$3,529,103BOYAmt
EOY$2,033,108EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,361,713BOYAmt
EOY$1,431,290EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$86,220BOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$8,228,399LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$6,670,861LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$8,641,071BOYAmt
EOY$1,557,538EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$12,879,505BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$9,333BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$29,514,195BOYAmt
EOY$5,021,936EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,250,097BOYAmt
EOY$879,395EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$2,871,657BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$150,803BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,772,364BOYAmt
EOY$374,057EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$12,044,921BOYAmt
EOY$1,253,452EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$17,469,274BOYAmt
EOY$3,768,484EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$17,469,274BOYAmt
EOY$3,768,484EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$29,514,195BOYAmt
EOY$5,021,936EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$16,498,103ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$30,198,893OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,974CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,126CurrentTaxYearMinus3YearsAmt
Total$8,100TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$18,993,383CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$21,970,563CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$23,183,422CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$24,806,859CurrentTaxYearMinus1YearAmt
Current Tax Year$21,171,513CurrentTaxYearAmt
Total$110,125,740TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$18,999,357CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$21,972,689CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$23,183,422CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$24,806,859CurrentTaxYearMinus1YearAmt
Current Tax Year$21,171,513CurrentTaxYearAmt
Total$110,133,840TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$110,133,840PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$288,793CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$210,613CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$173,546CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$392,269CurrentTaxYearMinus1YearAmt
Current Tax Year$665,264CurrentTaxYearAmt
Total$1,730,485TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$288,793CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$210,613CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$173,546CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$392,269CurrentTaxYearMinus1YearAmt
Current Tax Year$665,264CurrentTaxYearAmt
Total$1,730,485TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,568,045CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$624,962CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,196,083CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,226,918CurrentTaxYearMinus1YearAmt
Current Tax Year$1,786,055CurrentTaxYearAmt
Total$7,402,063TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$21,856,195CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$22,808,264CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$24,553,051CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$26,426,046CurrentTaxYearMinus1YearAmt
Current Tax Year$23,622,832CurrentTaxYearAmt
Total$119,266,388TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.92340PublicSupportCY509Pct
Public Support PY5090.94080PublicSupportPY509Pct
Investment Income CY0.01450InvestmentIncomeCYPct
Investment Income PY0.01060InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (1)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$119,970OtherCostOrOtherBasisAmt
Book Value$119,970BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,165,025OtherCostOrOtherBasisAmt
Depreciation$5,032,019DepreciationAmt
Book Value$1,133,006BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,943,404OtherCostOrOtherBasisAmt
Depreciation$1,638,842DepreciationAmt
Book Value$304,562BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,557,538TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescAFFILIATES PAYABLEDesc
Amt$374,057Amt
FieldValueIRS element (for citing)
Total Liability$374,057TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART IV, LINE 2B:THE LONG-TERM CARE FACILITIES ARE MANAGED BY AN OUTSIDE COMPANY. THE ESCROW LIABILITY ON FORM 990, PART X, LINE 21 REPRESENTS FUNDS HELD BY EACH NURSING HOME FOR USE BY THE RESIDENTS AND "GOOD FAITH" DEPOSITS ON PURCHASES OF COTTAGES. MEDICAID RESIDENTS ARE ABLE TO KEEP A PORTION OF THEIR BENEFITS AND ARE RESPONSIBLE FOR PERSONAL CARE ITEMS SUCH AS HAIR CARE, TOILETRIES, DINING OUT, ETC. THE NURSING HOME HOLDS THE FUNDS FOR THE RESIDENTS, AND THE RESIDENTS ARE ABLE TO ACCESS THEIR FUNDS WHEN THEY ARE NEEDED. DEPOSITS ON THE PURCHASES OF COTTAGES ARE GENERALLY REFUNDABLE UNDER THE TERMS OF THE RESIDENCY AGREEMENT BETWEEN THE BUYER AND UVMC NURSING CARE, INC. (UVMCN).
PART X, LINE 2:THE FOLLOWING FOOTNOTE IS FROM THE 2024 CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR PREMIER HEALTH (PHP) AND AFFILIATES. PHP IS THE SOLE MEMBER OF UPPER VALLEY MEDICAL CENTER NURSING CARE (UVMCN). PHP HAS BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE TO BE A TAX-EXEMPT NON-PROFIT CORPORATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS A TAX-EXEMPT ORGANIZATION, ITS INCOME IS EXEMPT FROM FEDERAL INCOME TAX EXCEPT TO THE EXTENT OF ANY UNRELATED BUSINESS ACTIVITIES. PHP CONSOLIDATES CERTAIN SUBSIDIARIES WHICH ARE FOR-PROFIT CORPORATIONS SUBJECT TO FEDERAL INCOME TAXES. THESE ARE: * PREMIER HEALTH HOLDING COMPANY (PHHC) (WHOLLY OWNED SUBSIDIARY OF PHP) * MVHE, INC., (AND ITS WHOLLY OWNED SUBSIDARY EXTENDED CARE), SAMARITAN FAMILY CARE, INC., PREMIER HEALTH SPECIALISTS, INC. AND PREMIER HEALTH URGENT CARE, INC. (WHOLLY OWNED SUBSIDIARIES OF PHHC) MANAGEMENT ANNUALLY REVIEWS THE TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
KEVIN W HARLAN
FORMER TRUSTEE & OFFICER$0$514,770$0$240,926$0$79,074$0$11,274$0$9,673$0$855,717$0$0
DIANNE RUHENKAMP
BOARD TREASURER$0$135,603$0$41,375$0$1,197$0$10,729$0$17,721$0$206,625$0$0
ELIZABETH D WILFONG
BOARD SECRETARY$0$174,677$0$12,500$0$325$0$707$0$902$0$189,111$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART 1, LINE 4B:FormAndLineReferenceDesc
ExplanationDUE TO RESTRICTIONS IMPOSED BY THE INTERNAL REVENUE CODE, CERTAIN PERSONS ARE LIMITED IN THE AMOUNT OF BENEFIT THAT CAN BE EARNED UNDER A QUALIFIED RETIREMENT PLAN. LIKE MANY EMPLOYERS, UVMC NURSING CARE (UVMCN) AND ITS AFFILIATED ORGANIZATIONS COMPENSATE FOR THIS LIMITATION AND SUPPLEMENT THE AFFECTED EXECUTIVES' QUALIFIED PENSION THROUGH CERTAIN NONQUALIFIED PLANS. UVMCN SUPPLEMENTS THE AFFECTED EXECUTIVES THROUGH A PENSION RESTORATION PLAN OR A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE BENEFITS UNDER THESE SUPPLEMENTAL NONQUALIFIED PLANS ARE SUBJECT TO MULTI-YEAR VESTING AND A PARTICIPANT CAN FORFEIT BENEFITS EARNED IF VESTING REQUIREMENTS ARE NOT SATISFIED. UNDER THE TERMS OF THE SUPPLEMENTAL PLANS, AND BECAUSE OF TAX RULES PERTAINING TO TAXATION OF THE EARNED BENEFITS UPON VESTING, CERTAIN INDIVIDUALS RECEIVED A PAYOUT OF THE CUMULATIVE VESTED BENEFITS UNDER THEIR SUPPLEMENTAL PLAN DURING 2024. THE INDIVIDUAL LISTED BELOW HAS MET THE MULTI-YEAR VESTING REQUIREMENT UNDER THE PENSION RESTORATION PLAN AND RECEIVED THE ASSOCIATED PAYMENT IN 2024: KEVIN HARLAN $47,900. BASED ON THE GUIDANCE PROVIDED IN THE INSTRUCTIONS TO THE FORM 990, ANY PAYMENTS TO THE PARTICIPANTS RELATED TO THESE PLANS THAT WERE MADE WITHIN 2-1/2 MONTHS AFTER THE END OF THE ORGANIZATION'S TAX YEAR ARE NOT TREATED AS DEFERRED COMPENSATION FOR PURPOSES OF SCHEDULE J. SUCH AMOUNTS ARE PROPERLY REPORTED AS COMPENSATION FOR FORM 990 PURPOSES WHEN INCLUDED IN THE PARTICIPANTS' FORM W-2 WAGES.ExplanationTxt

Schedule N IRS990ScheduleN

Disposition Of Assets Detail DispositionOfAssetsDetail (2 entries)

Assets Distri Or Expnss PaidAssetsDistriOrExpnssPaidDescDistributionDistributionDtFair Market Value Of AssetFairMarketValueOfAssetAmtMethod Of FMV DeterminationMethodOfFMVDeterminationTxtEINEINAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdIRC SectionIRCSectionTxt
UPPER VALLEY MEDICAL CENTER
INVESTMENTS2024-12-31$14,994,893BOOK VALUE310537095110 N MAIN ST STE 200DAYTONOH45402501(C)(3)
UPPER VALLEY MEDICAL CENTER
CASH2024-12-31$15,204,001BOOK VALUE310537095110 N MAIN ST STE 200DAYTONOH45402501(C)(3)
FieldValueIRS element (for citing)
Director Of Successor20DirectorOfSuccessor2Ind
Employee Of Successor20EmployeeOfSuccessor2Ind
Owner Of Successor20OwnerOfSuccessor2Ind
Receive Compensation20ReceiveCompensation2Ind

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 3PREMIER HEALTH DECIDED TO SELL SPRINGMEADE HEALTH CENTER, SPRINGMEADE RESIDENCE, AND KOESTER PAVILION TO ALLOW IT TO FOCUS ON ITS CORE BUSINESS IN OTHER AREAS OF HEALTH CARE, INCLUDING ITS HOSPITALS.
PART V, QUESTION 2A:UVMCN DOES NOT HAVE DIRECT EMPLOYEES. VANCREST MANAGEMENT CORP AND OTTERBEIN SENIOR LIFE PROVIDE ALL NURSING, ADMINISTRATIVE, AND FINANCIAL SERVICES TO PERFORM THE DAY-TO-DAY OPERATION OF THE NURSING HOMES. ALLOCATED PERSONNEL EXPENSES ARE REPORTED ON PART IX, LINE 24A OF FORM 990.
FORM 990, PART VI, SECTION A, LINE 3ADCARE HEALTH SYSTEMS, INC., UNDER THE DIRECTION OF THE EXECUTIVE MANAGEMENT TEAM OF UVMC, PROVIDES ALL ADMINISTRATIVE, NURSING, AND FINANCIAL SERVICES TO PERFORM THE DAY-TO-DAY OPERATIONS OF THE NURSING HOMES.
FORM 990, PART VI, SECTION A, LINE 6UVMCN HAS ONE CORPORATE MEMBER: PREMIER, AN OHIO NON-PROFIT CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7APREMIER HAS THE SOLE AUTHORITY TO ELECT THE BOARD OF TRUSTEES FOR UVMCN. PREMIER AS THE OPERATOR OF UVMCN DEVELOPS AND OVERSEES THE IMPLEMENTATION OF THE STRATEGIC PLAN FOR UVMCN, WHICH INCLUDES (BUT IS NOT LIMITED TO) SUCH MATTERS AS LOCATION OF CLINICAL AND ADMINISTRATIVE SERVICES AND THE CONSOLIDATION OF SUCH SERVICES. UVMCN SHALL COMPLY WITH AND IMPLEMENT THIS PLAN AND SHALL NOT TAKE ANY ACTION THAT MATERIALLY DEPARTS FROM THIS PLAN WITHOUT PREMIER'S APPROVAL. UVMCN SHALL IMPLEMENT THE CAPITAL AND OPERATING BUDGET SO APPROVED AND/OR REVISED FOR IT BY PREMIER. UVMCN SHALL IMPLEMENT ANY BUSINESS PLAN APPROVED BY PREMIER. UVMCN MUST HAVE APPROVAL FROM PREMIER TO BORROW IN ANY FISCAL YEAR, GUARANTEE IN ANY YEAR, OR INCUR ANY LIEN OR OTHER ENCUMBRANCE ON ANY PROPERTY IN AN AMOUNT EQUAL TO OR GREATER THAN $1,000,000. UVMCN MUST SEEK PREMIER'S APPROVAL FOR ANY ACQUISITIONS, SALE OR TRANSFER OF ANY MATERIAL ASSET USED IN UVMCN'S ACTIVITIES.
FORM 990, PART VI, SECTION A, LINE 7BSEE EXPLANATION FOR FORM 990, PART VI, SECTION A, LINE 7A.
FORM 990, PART VI, SECTION B, LINE 11BTHIS 990 FILING AND ATTACHED SCHEDULES (THE RETURN) ARE PREPARED BY A STAFF MEMBER IN THE TAX DEPARTMENT OF PREMIER, WITH WHICH UVMCN IS AFFILIATED. THE RETURN IS REVIEWED BY THE MANAGER AND DIRECTOR OF TAX COMPLIANCE OF PREMIER. AFTER ALL CHANGES FROM THE ABOVE PERSONS ARE MADE, THE RETURN IS REVIEWED BY THE VICE PRESIDENT/CONTROLLER OF PREMIER. A FINAL VERSION OF THE RETURN IS PROVIDED TO THE BOARD OF TRUSTEES FOR REVIEW. AT A BOARD OF TRUSTEES MEETING, THE VICE PRESIDENT/CONTROLLER OF PREMIER (OR DESIGNEE) SHARES DETAILED INFORMATION ON COMPENSATION AND OTHER KEY AREAS, AS WELL AS ADDRESSES ANY OTHER QUESTIONS FROM THE BOARD OF TRUSTEES, PENDING THEIR REVIEW. THE 990 FILING IS ALSO SHARED WITH THE AUDIT COMMITTEE OF PREMIER.
FORM 990, PART VI, SECTION B, LINE 12CPREMIER, WITH WHICH UVMCN IS AN AFFILIATE, REQUIRES ALL BOARD MEMBERS, BOARD COMMITTEE MEMBERS, MEDICAL DIRECTORS, SUPPLY CHAIN DIVISION MEMBERS, AUTHORIZED SIGNERS, DIRECTORS, EXECUTIVES, MEDICAL EXECUTIVE COMMITTEE MEMBERS, MEDICAL DEPARTMENT AND SECTION CHAIRS, PHYSICIAN PARTNERSHIP COMMITTEE MEMBERS, PHYSICIAN GUIDANCE GROUP MEMBERS, AND ALL EMPLOYED PHYSICIANS TO ANNUALLY REVIEW THE PREMIER COMPREHENSIVE CONFLICT OF INTEREST STATEMENT, AN EXPLANATORY MEMORANDUM, THE ANTITRUST COMPLIANCE POLICY, AND COMPLETE AN INDIVIDUAL QUESTIONNAIRE DISCLOSING ANY POTENTIAL CONFLICTS AS DEFINED IN THE CONFLICT OF INTEREST POLICY. THIS IS ACCOMPLISHED EITHER BY WAY OF AN ELECTRONIC COMMUNICATION SENT OUT DIRECTLY BY THE CORPORATE COMPLIANCE DEPARTMENT OR BY WAY OF A MEMO SENT OUT FROM THE CHAIRMAN OF THE BOARD AND CHIEF EXECUTIVE OFFICER OF PREMIER. IT ALSO INCLUDES AN EXPLANATORY MEMORANDUM OF SPECIFIC ACTIVITIES THAT MIGHT GIVE CAUSE TO A CONFLICT AND AN INDIVIDUAL QUESTIONNAIRE TO DISCLOSE ALL SUCH ACTIVITIES. THIS QUESTIONNAIRE MUST BE COMPLETED AND SIGNED BY THE INDIVIDUAL. THIS CORRESPONDENCE INCLUDES A COPY OF THE ANTITRUST COMPLIANCE POLICY THAT MUST BE SIGNED BY THE INDIVIDUAL. ALL OF THESE DOCUMENTS ARE SENT TO THE CORPORATE COMPLIANCE DEPARTMENT. THE CORPORATE COMPLIANCE DEPARTMENT ENSURES ALL FORMS ARE RETURNED AND RETAINS THE DOCUMENTS FOR FIVE YEARS. IN ADDITION, AT EACH MEETING OF THE BOARD OR ANY BOARD COMMITTEE, FOLLOWING APPROVAL OF THE PREVIOUS MEETING'S MINUTES, THE BOARD OR COMMITTEE CHAIR SHALL REQUEST ANY BOARD MEMBER WHO PERCEIVES A POTENTIAL CONFLICT OF INTEREST ON ANY OF THE MEETING'S AGENDA ITEMS TO DISCLOSE THE POTENTIAL CONFLICT. ADDITIONALLY, AT ANY BOARD OR BOARD COMMITTEE MEETING WHERE THE SUBJECT OF CONFLICT OF INTEREST IS DISCUSSED, THE MINUTES SHALL CONTAIN THE NAME OF THE PARTY DISCUSSING A POTENTIAL CONFLICT OF INTEREST, THE NATURE OF THE POTENTIAL CONFLICT OF INTEREST AND WHETHER A CONFLICT OF INTEREST WAS FOUND TO EXIST. IF A CONFLICT OF INTEREST IS DETERMINED BY THE BOARD TO EXIST, THE MEMBER WILL BE EXCUSED FROM PARTICIPATING IN ANY DISCUSSION OR VOTING ON THE PARTICULAR AGENDA ITEM. THE CHIEF COMPLIANCE AND ENTERPRISE RISK OFFICER REPORTS THE RESULTS OF THE PREMIER CONFLICT OF INTEREST QUESTIONNAIRES NO LESS THAN ANNUALLY TO THE BOARD OF TRUSTEES BY WAY OF THE COMPLIANCE AND AUDIT COMMITTEE. THIS REVIEW IS DOCUMENTED IN THE MINUTES OF THE MEETING. PERIODICALLY, THE INTERNAL AUDIT DEPARTMENT WILL REVIEW A SAMPLE OF COMPLETED CONFLICT OF INTEREST QUESTIONNAIRES AND REPORT THE RESULTS TO THE COMPLIANCE AND AUDIT COMMITTEE. THE ANNUAL CONFLICT OF INTEREST QUESTIONNAIRES ARE INDIVIDUALLY SUMMARIZED IN A DOCUMENT AND SENT ELECTRONICALLY TO THE FINANCE DEPARTMENT FOR ANY NECESSARY DISCLOSURES REQUIRED ON THE 990 FILING.
FORM 990, PART VI, SECTION C, LINE 19THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC WHEN REQUIRED BY LAW OR FOR ACCREDITATION PURPOSES. THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST.
FORM 990, PART IX, LINE 11GCONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 3,335,875. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,335,875. MEDICAL DIRECTOR: PROGRAM SERVICE EXPENSES 24,754. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 24,754. BANK FEES: PROGRAM SERVICE EXPENSES 10,385. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,385.
FORM 990, PART XI, LINE 9:TRANSFER TO RELATED ENTITY -14,994,892. TRANSFER OF INVESTMENTS TO RELATED ENTITY -15,204,001.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (15 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
PREMIER HEALTH
110 N MAIN ST 200DAYTONOH45402311446699PARENTOH501(C)(3)12BN/A0
MEDAMERICA HEALTH SYSTEMS CO
110 N MAIN ST 200DAYTONOH45402311040228SUPPORT ORGOH501(C)(3)12BN/A0
MIAMI VALLEY HOSPITAL
110 N MAIN ST 200DAYTONOH45402310537504HOSPITALOH501(C)(3)30PREMIER HEALTH
MIAMI VALLEY HOSPITAL FOUNDATION
110 N MAIN ST 200DAYTONOH45402311040231FOUNDATIONOH501(C)(3)70PREMIER HEALTH
FIDELITY HEALTH CARE INC
110 N MAIN ST 200DAYTONOH45402311075381HOME HEALTHOH501(C)(3)100PREMIER HEALTH
PREMIER COMMUNITY HEALTH
110 N MAIN ST 200DAYTONOH45402311122883HEALTH EDUCATIONOH501(C)(3)100FIDELITY HEALTH CARE
GOOD SAMARITAN FOUNDATION - DAYTON
110 N MAIN ST 200DAYTONOH45402237296923FOUNDATIONOH501(C)(3)70PREMIER HEALTH
SAMARITAN BEHAVIORAL HEALTH INC
110 N MAIN ST 200DAYTONOH45402020633634BEHAVIORAL HEALTHOH501(C)(3)70PREMIER HEALTH
ATRIUM HEALTH SYSTEM
110 N MAIN ST 200DAYTONOH45402310537492SUPPORT ORGOH501(C)(3)12BN/A0
ATRIUM MEDICAL CENTER
110 N MAIN ST 200DAYTONOH45402311079309HOSPITALOH501(C)(3)30PREMIER HEALTH
UVMC
110 N MAIN ST 200DAYTONOH45402341850683SUPPORT ORGOH501(C)(3)12BN/A0
UPPER VALLEY MEDICAL CENTER
110 N MAIN ST 200DAYTONOH45402310537095HOSPITALOH501(C)(3)30PREMIER HEALTH
UPPER VALLEY PROFESSIONAL CORP
110 N MAIN ST 200DAYTONOH45402311400963HEALTH CAREOH501(C)(3)100PREMIER HEALTH HOLDING CO
UVPC SPECIALISTS INC
110 N MAIN ST 200DAYTONOH45402203687536HEALTH CAREOH501(C)(3)100PREMIER HEALTH HOLDING CO
COMPUNET CLINICAL LABORATORIES LLC
110 N MAIN ST 200DAYTONOH45402311258010LABOH501(C)(3)12B0PREMIER HEALTH

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerInd
SWEITZER STREET LLC
110 N MAIN ST 200DAYTONOH45402454700417REAL ESTATEOHMVHE INCEXCLUDED00
SWEITZER MOB LLC
110 N MAIN ST 200DAYTONOH45402474554657REAL ESTATEOHMVHE INCEXCLUDED00

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (12 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdForeign PostalForeignAddress/ForeignPostalCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
MVHE INC
110 N MAIN ST 200DAYTONOH45402311185270PHYSICIAN SVCSOHPREMIER HEALTH HOLDING COC0
PREMIER HEALTH SPECIALISTS
110 N MAIN ST 200DAYTONOH45402061744704PHYSICIAN SVCSOHPREMIER HEALTH HOLDING COC0
SAMARITAN FAMILY CARE
110 N MAIN ST 200DAYTONOH45402311299450PHYSICIAN SVCSOHPREMIER HEALTH HOLDING COC0
AFTER HOURS FAMILY CARE
110 N MAIN ST 200DAYTONOH45402311269483HEALTH CAREOHUPPER VALLEY PROFESSIONAL CORPC0
UVMC MANAGEMENT CORP
110 N MAIN ST 200DAYTONOH45402311360489MANAGEMENT COMPANYOHPREMIER HEALTHC0
PREMIER HEALTH URGENT CARE INC
110 N MAIN ST 200DAYTONOH45402822079409URGENT CAREOHPREMIER HEALTH HOLDING COC0
PREMIER HEALTH INT'L INSURANCE
980548485INSURANCEPREMIER HEALTHC0BUTTERFIELD BANK BLDG 6TH FLOOR 6HAMILTONBDHM12BD
PREMIER HEALTH PLAN INC
110 N MAIN ST 200DAYTONOH45402463024049HEALTH INSURANCEOHPREMIER HEALTH INSURING COC0
GOOD SAMARITAN HOSPITAL
110 N MAIN ST 200DAYTONOH45402310536981HOSPITALOHPREMIER HEALTHC0
PREMIER HEALTH ACO OF OHIO
110 N MAIN ST 200DAYTONOH45402474049773MEDICARE ACOOHPREMIER HEALTHC0
PREMIER HEALTH HOLDING CO
110 N MAIN ST 200DAYTONOH45402812419110HOLDING COOHPREMIER HEALTHC0
PREMIER HEALTH INSURING CO
110 N MAIN ST 200DAYTONOH45402464766841HEALTH INSURANCEOHPREMIER HEALTHC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd