APPALACHIAN EMERGENCY PHYSICIANS: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- APPALACHIAN EMERGENCY PHYSICIANS (EIN 80-0592504)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2017-11-06
- IRS object ID
- 201733109349300698
- Schema version
- 2016v3.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-06T10:28:33-05:00 | ReturnTs |
| Tax Period End | 2017-06-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 800592504 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | APPALACHIAN EMERGENCY PHYSICIANS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | APPA | BusinessNameControlTxt |
| Phone | 4232326995 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1021 W OAKLAND AVE SUITE 207 | AddressLine1Txt |
| City | JOHNSON CITY | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37604 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOSH PUHR MD | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 4232326995 | PhoneNum |
| Signature | 2017-10-31 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparation | 2017-11-06 | PreparationDt |
Filing Security Information FilingSecurityInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| At Submission Creation Device Id | EBA7F521928E27B6E9DB4326061FED7B51503225 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | EBA7F521928E27B6E9DB4326061FED7B51503225 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JOSH PUHR MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1021 W OAKLAND AVENUE STE 207 | AddressLine1Txt |
| City | JOHNSON CITY | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37604 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $23,506,110 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2010 | FormationYr |
| Legal Domicile State | VA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE EMERGENCY PHYSICIANS SERVICES TO ACUTE CARE HOSPITAL FACILITIES IN SOUTHWEST VIRGINIA AND NORTHEAST TENNESSEE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 3 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $29,638,857 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $23,506,110 | CYProgramServiceRevenueAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $29,638,857 | PYTotalRevenueAmt |
| CY Total Revenue | $23,506,110 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $815,888 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $796,623 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $28,822,969 | PYOtherExpensesAmt |
| CY Other Expenses | $22,709,495 | CYOtherExpensesAmt |
| PY Total Expenses | $29,638,857 | PYTotalExpensesAmt |
| CY Total Expenses | $23,506,118 | CYTotalExpensesAmt |
| CY Revenues Less Expenses | -$8 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,095,819 | TotalAssetsBOYAmt |
| Total Assets EOY | $875,572 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,131,852 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $911,613 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$36,033 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$36,041 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | APPALACHIAN EMERGENCY PHYSICIANS IS ORGANIZED AND OPERATED FOR CHARITABLE PURPOSES, WHICH INCLUDE THE PROVISION OF EMERGENCY PHYSICIAN SERVICES TO ACUTE CARE HOSPITAL FACILITIES IN SOUTHWEST VIRGINIA AND NORTHEAST TENNESSEE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $23,402,004 | ExpenseAmt |
| Revenue | $23,506,110 | RevenueAmt |
| Desc | APPALACHIAN EMERGENCY PHYSICIANS ("AEP") IS A VIRGINIA NONSTOCK CORPORATION THAT IS ORGANIZED AND OPERATED FOR CHARITABLE PURPOSES, WHICH INCLUDE THE PROVISION OF EMERGENCY PHYSICIAN SERVICES TO ACUTE CARE HOSPITAL FACILITIES IN SOUTHWEST VIRGINIA AND NORTHEAST TENNESSEE. AEP HAS NO MEMBERS AND IS GOVERNED BY ITS BOARD OF DIRECTORS. (CONTINUED ON SCHEDULE O) APPALACHIAN EMERGENCY PHYSICIANS HELPS TO FULFILL A NEED IN SOUTHWEST VIRGINIA AND NORTHEAST TENNESSEE FOR ACUTE CARE FACILITIES THAT HAVE ENCOUNTERED PROBLEMS IN SECURING COMPREHENSIVE PHYSICIAN COVERAGE WITHIN THE FIELD OF EMERGENCY MEDICINE. AEP WILL ENSURE THAT PATIENTS ARE TREATED FOR MEDICALLY NECESSARY CONDITIONS REGARDLESS OF RACE, RELIGION, ETHNICITY OR ABILITY TO PAY, IN A MANNER CONSISTENT WITH THE PATIENT FINANCIAL ASSISTANCE PROGRAM APPLICABLE FOR EACH RESPECTIVE HOSPITAL WHERE AEP PROVIDES EMERGENCY SERVICES. IN RECOGNIZING THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES, AEP WILL NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY FOR PATIENT FINANCIAL ASSISTANCE. THE FINANCIAL ASSISTANCE POLICY FOR EACH RESPECTIVE HOSPITAL FACILITY SERVICED BY AEP HAS BEEN ADOPTED BY THE AEP BOARD WITH RESPECT TO SERVICES AT THE RESPECTIVE FACILITY. AEP IS ORGANIZED AND OPERATED AS AN EMERGENCY PHYSICIAN DEVELOPMENT SERVICE. SPECIFICALLY, AEP WILL (I) RECRUIT AND CONTRACT WITH A STABLE BASE OF PHYSICIANS AND MID-LEVEL PROVIDERS (E.G. NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS) TO SUPPORT THE LEVEL OF EMERGENCY MEDICAL CARE REQUIRED FOR MSHA ACUTE CARE HOSPITAL FACILITIES; (II) CREATE A VEHICLE FOR COLLABORATION BETWEEN MSHA HOSPITALS AND THEIR MEDICAL STAFFS; AND (III) STABILIZE THE PROVISION OF EMERGENCY CARE THROUGH EXISTING PHYSICIAN PRACTICES IN SOUTHWEST VIRGINIA AND NORTHEAST TENNESSEE. AEP PROVIDES EMERGENCY MEDICINE PROFESSIONAL COVERAGE BY CONTRACT FOR THE FOLLOWING HOSPITALS: JOHNSON CITY MEDICAL CENTER (TN) FRANKLIN WOODS COMMUNITY HOSPITAL (TN) NISWONGER CHILDREN'S HOSPITAL (TN) INDIAN PATH MEDICAL CENTER (TN) SYCAMORE SHOALS HOSPITAL (TN) JOHNSON COUNTY COMMUNITY HOSPITAL (TN) UNICOI COUNTY MEMORIAL HOSPITAL (TN) NORTON COMMUNITY HOSPITAL (VA), AND DICKENSON COMMUNITY HOSPITAL (VA) EACH OF THESE HOSPITAL FACILITIES IS EITHER WHOLLY OR PARTIALLY OWNED BY MOUNTAIN STATES HEALTH ALLIANCE (MSHA). MSHA IS A NONPROFIT HEALTH SYSTEM BASED IN JOHNSON CITY, TN. MSHA IS TAX-EXEMPT UNDER IRC SECTION 501(C)(3). WHILE SOME MSHA REPRESENTATIVES ARE ON AEP'S GOVERNING BOARD, MSHA AND ITS AFFILIATES DO NOT CONTROL AEP'S BOARD OR THE MANNER IN WHICH AEP IS OPERATED, MANAGED, OR GOVERNED. MEDICAL SERVICES ARE PROVIDED TO INDIVIDUALS PRESENTING TO THE EMERGENCY DEPARTMENT OF ONE OF THE AFOREMENTIONED HOSPITAL FACILITIES AND ARE BASED UPON EMERGENCY MEDICAL NEED. AEP FOLLOWS THE PATIENT FINANCIAL ASSISTANCE POLICIES AND PROCEDURES ADOPTED BY EACH OF THE AFOREMENTIONED HOSPITAL FACILITIES FOR THE TREATMENT OF PATIENTS WITHOUT REGARD TO THE ABILITY TO PAY. AS SUCH SERVICES ARE MADE AVAILABLE TO THE GENERAL PUBLIC, AEP MAY INCIDENTALLY PROVIDE EMERGENCY SERVICES TO OFFICERS, DIRECTORS, AND INDEPENDENT CONTRACTORS. HOWEVER, SUCH INDIVIDUALS WOULD NOT BE TREATED DIFFERENTLY THAN OTHER PATIENTS AND SUCH SERVICES WOULD ONLY BE MADE AVAILABLE IN THE NORMAL COURSE OF AEP'S BUSINESS OPERATIONS. | Desc |
| Total Program Service Expenses | $23,402,004 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 103 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 3 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | VA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KEVIN JIA | PersonNm |
| Phone | 4239155102 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1021 W OAKLAND AVENUE STE 207 | AddressLine1Txt |
| City | JOHNSON CITY | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37604 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|
| MARVIN EICHORN MSHA EVPCOO | |||||||
| DIRECTOR | 1.00 | 54.00 | Yes (X) | $0 | $590,395 | $23,064 | |
| MORRIS SELIGMAN MD MSHA EVPCMO | |||||||
| DIRECTOR | 0.50 | 54.50 | Yes (X) | $0 | $535,274 | $75,391 | |
| MELISSA POWELL MD | |||||||
| DIRECTOR | 0.80 | 40.00 | Yes (X) | $0 | $468,092 | $1,650 | |
| JOSH PUHR MD | |||||||
| PRESIDENT | 46.50 | Yes (X) | $447,776 | $0 | $0 | Yes (X) | |
| MATT MOODY DO | |||||||
| DIRECTOR | 35.00 | Yes (X) | $390,451 | $0 | $0 | ||
| CLAY RUNNELS MD MSHA VP | |||||||
| DIRECTOR | 1.00 | 44.00 | Yes (X) | $0 | $356,888 | $27,234 | |
| SHANE HILTON MSHA VPCFO MKT OPER | |||||||
| DIRECTOR | 1.00 | 44.00 | Yes (X) | $0 | $339,387 | $46,282 | |
| TODD JONES | |||||||
| SECRETARY | 0.60 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| STEVE GOODSON | |||||||
| CHAIR | 3.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| BILL MILLER | |||||||
| DIRECTOR | 0.30 | Yes (X) | $0 | $0 | $0 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $838,227 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,290,036 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $173,621 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MTN STATES EMERGENCY PHYSICIANS LLP | |||||
| PO BOX 677979 | DALLAS | TX | 752677979 | MGMT. SERVICES | $3,510,618 |
| SYMMETRIC REVENUE SOLUTIONS | |||||
| PO BOX 674579 | DETROIT | MI | 482674579 | BILLING/CODING | $1,763,221 |
| SW VA EMERGENCY PHYSICIANS LLP | |||||
| PO BOX 677979 | DALLAS | TX | 752677979 | MGMT. SERVICES | $912,504 |
| WEATHERBY LOCUMS INC | |||||
| PO BOX 972633 | DALLAS | TX | 753972633 | PHYSICIAN SVCS. | $827,405 |
| SMITH CHRISTOPHER MD | |||||
| 1233 RESERVE PLACE | JOHNSON CITY | TN | 37615 | PHYSICIAN SVCS. | $575,843 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 61 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 621110 | $16,525,434 | $16,525,434 |
| HOSPITAL SUBSIDIES | 621110 | $6,542,706 | $6,542,706 |
| HOSPITAL MED. DIRECTOR FEES | 621110 | $437,970 | $437,970 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $23,506,110 | TotalProgramServiceRevenueAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $23,506,110 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $23,506,110 | RelatedOrExemptFuncIncomeAmt |
| 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 | $796,623 | TotalAmt |
| Program Services | $796,623 | ProgramServicesAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,097,401 | TotalAmt |
| Program Services | $2,079,842 | ProgramServicesAmt |
| Management And General | $17,559 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,941 | TotalAmt |
| Management And General | $4,941 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,025 | TotalAmt |
| Management And General | $13,025 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,899,199 | TotalAmt |
| Program Services | $19,899,199 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,327 | TotalAmt |
| Program Services | $2,450 | ProgramServicesAmt |
| Management And General | $66,877 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94 | TotalAmt |
| Management And General | $94 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $577,138 | TotalAmt |
| Program Services | $577,138 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| LICENSES AND PERMITS | $26,194 | $26,194 | |
| PHYSICIAN CEU | $16,817 | $16,817 | |
| PHYSICIAN DUES | $2,898 | $2,898 | |
| FOOD/MEALS | $1,395 | $1,395 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,066 | TotalAmt |
| Program Services | $843 | ProgramServicesAmt |
| Management And General | $223 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,506,118 | TotalAmt |
| Program Services | $23,402,004 | ProgramServicesAmt |
| Management And General | $104,114 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,508,917 | BOYAmt |
| EOY | $10,549 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,718,904 | BOYAmt |
| EOY | $215,023 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $217,998 | BOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $650,000 | BOYAmt |
| EOY | $650,000 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,095,819 | BOYAmt |
| EOY | $875,572 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,596,272 | BOYAmt |
| EOY | $832,050 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $535,580 | BOYAmt |
| EOY | $79,563 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,131,852 | BOYAmt |
| EOY | $911,613 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$36,033 | BOYAmt |
| EOY | -$36,041 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$36,033 | BOYAmt |
| EOY | -$36,041 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,095,819 | BOYAmt |
| EOY | $875,572 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$8 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $29,434,006 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $30,084,214 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $28,762,811 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $29,638,857 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $23,506,110 | CurrentTaxYearAmt |
| Total | $141,425,998 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $29,434,006 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $30,084,214 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $28,762,811 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $29,638,857 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $23,506,110 | CurrentTaxYearAmt |
| Total | $141,425,998 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,799,266 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,997,059 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,796,967 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,534,073 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,316,933 | CurrentTaxYearAmt |
| Total | $32,444,298 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,799,266 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,997,059 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,796,967 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,534,073 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,316,933 | CurrentTaxYearAmt |
| Total | $32,444,298 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $108,981,700 | PublicSupportTotal509Amt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $29,434,006 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $30,084,214 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $28,762,811 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $29,638,857 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $23,506,110 | CurrentTaxYearAmt |
| Total | $141,425,998 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.77060 | PublicSupportCY509Pct |
| Public Support PY509 | 0.78830 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule D IRS990ScheduleD
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO RELATED ORGANIZATIONS | Desc |
| Amt | $79,563 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $79,563 | TotalLiabilityAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|---|---|---|---|---|
| MARVIN EICHORN MSHA EVPCOO | |||||||||
| DIRECTOR | $558,459 | $31,936 | $1,518 | $24,493 | $613,459 | ||||
| MORRIS SELIGMAN MD MSHA EVPCMO | |||||||||
| DIRECTOR | $505,996 | $29,278 | $58,651 | $19,687 | $610,665 | ||||
| MELISSA POWELL MD | |||||||||
| DIRECTOR | $420,000 | $8,092 | $1,650 | $469,742 | $40,000 | ||||
| JOSH PUHR MD | |||||||||
| PRESIDENT | $396,047 | $51,729 | $447,776 | ||||||
| MATT MOODY DO | |||||||||
| DIRECTOR | $322,355 | $68,096 | $390,451 | ||||||
| CLAY RUNNELS MD MSHA VP | |||||||||
| DIRECTOR | $352,463 | $4,425 | $5,904 | $24,257 | $384,122 | ||||
| SHANE HILTON MSHA VPCFO MKT OPER | |||||||||
| DIRECTOR | $322,719 | $4,103 | $24,304 | $24,815 | $385,669 | $12,565 | |||
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PAGE 1, PART I, LINE 4 | MORRIS SELIGMAN, M.D., MSHA EVP/CMO 0 53,381 0 SHANE HILTON, MSHA VP/CFO MKT. OPER. 0 17,247 0 |
| SCHEDULE J, PART III | PART I, LINE 4B: EXPLANATION: THE FOLLOWING EXECUTIVES LISTED IN SCHEDULE J, PART II PARTICIPATED IN A 457(F) RETIREMENT PLAN PROVIDED BY MOUNTAIN STATES HEALTH ALLIANCE ("MSHA"): MORRIS SELIGMAN, M.D. AND SHANE HILTON. THE 457(F) RETIREMENT PLAN IS A NONQUALIFIED TAX-DEFERRED COMPENSATION PLAN AVAILABLE TO A SELECT GROUP OF KEY EXECUTIVES FOR THE INTENT OF SUPPORTING RETENTION AND TO OFFER A COMPETITIVE TOTAL RETIREMENT PROGRAM. ACCOUNT BALANCES HAVE A "SUBSTANTIAL RISK OF FORFEITURE". IN ADDITION TO CREDITOR RISK, SUBSTANTIAL RISK OF FORFEITURE IS CREATED THROUGH DEFAULT RISK IF THE PARTICIPANT'S EMPLOYMENT WITH MSHA IS TERMINATED PRIOR TO AGE 65. HOWEVER, THE 457(F) PLAN CONTAINS A NON-COMPETE PROVISION THAT PROVIDES THE ACCOUNT BALANCE TO BE PAID IN A LUMP SUM AFTER THE EXECUTIVE SATISFIES THE TWO-YEAR NON-COMPETE PERIOD. THIS PROVISION APPLIES TO EMPLOYER CONTRIBUTIONS IF THE EXECUTIVE HAS PROVIDED ELIGIBLE SERVICE FOR SIX OR MORE YEARS. (ELIGIBLE SERVICE IS OFFICER SERVICE THAT PERMITTED THE EXECUTIVE TO PARTICIPATE IN THE PLAN). THE EXECUTIVE WILL RECEIVE THE ENTIRE ACCOUNT BALANCE IF HE/SHE BECOMES DISABLED, DIES OR IF THE EXECUTIVE TERMINATES FOR "GOOD REASON- OR IS INVOLUNTARILY TERMINATED WITHOUT "GOOD CAUSE" WITHIN A 24 MONTH PERIOD AFTER A CHANGE-OF-CONTROL OCCURS. DISTRIBUTIONS FROM THIS PLAN ARE SUBJECT TO FEDERAL, STATE, AND LOCAL TAXES ON THE ENTIRE ACCOUNT BALANCE UPON DISTRIBUTION. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | APPALACHIAN EMERGENCY PHYSICIANS IS ORGANIZED AND OPERATED FOR CHARITABLE PURPOSES, WHICH INCLUDE THE PROVISION OF EMERGENCY PHYSICIAN SERVICES TO ACUTE CARE HOSPITAL FACILITIES IN SOUTHWEST VIRGINIA AND NORTHEAST TENNESSEE. |
| FORM 990, PAGE 2, PART III, LINE 4A | APPALACHIAN EMERGENCY PHYSICIANS HELPS TO FULFILL A NEED IN SOUTHWEST VIRGINIA AND NORTHEAST TENNESSEE FOR ACUTE CARE FACILITIES THAT HAVE ENCOUNTERED PROBLEMS IN SECURING COMPREHENSIVE PHYSICIAN COVERAGE WITHIN THE FIELD OF EMERGENCY MEDICINE. AEP WILL ENSURE THAT PATIENTS ARE TREATED FOR MEDICALLY NECESSARY CONDITIONS REGARDLESS OF RACE, RELIGION, ETHNICITY OR ABILITY TO PAY, IN A MANNER CONSISTENT WITH THE PATIENT FINANCIAL ASSISTANCE PROGRAM APPLICABLE FOR EACH RESPECTIVE HOSPITAL WHERE AEP PROVIDES EMERGENCY SERVICES. IN RECOGNIZING THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES, AEP WILL NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY FOR PATIENT FINANCIAL ASSISTANCE. THE FINANCIAL ASSISTANCE POLICY FOR EACH RESPECTIVE HOSPITAL FACILITY SERVICED BY AEP HAS BEEN ADOPTED BY THE AEP BOARD WITH RESPECT TO SERVICES AT THE RESPECTIVE FACILITY. AEP IS ORGANIZED AND OPERATED AS AN EMERGENCY PHYSICIAN DEVELOPMENT SERVICE. SPECIFICALLY, AEP WILL (I) RECRUIT AND CONTRACT WITH A STABLE BASE OF PHYSICIANS AND MID-LEVEL PROVIDERS (E.G. NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS) TO SUPPORT THE LEVEL OF EMERGENCY MEDICAL CARE REQUIRED FOR MSHA ACUTE CARE HOSPITAL FACILITIES; (II) CREATE A VEHICLE FOR COLLABORATION BETWEEN MSHA HOSPITALS AND THEIR MEDICAL STAFFS; AND (III) STABILIZE THE PROVISION OF EMERGENCY CARE THROUGH EXISTING PHYSICIAN PRACTICES IN SOUTHWEST VIRGINIA AND NORTHEAST TENNESSEE. AEP PROVIDES EMERGENCY MEDICINE PROFESSIONAL COVERAGE BY CONTRACT FOR THE FOLLOWING HOSPITALS: JOHNSON CITY MEDICAL CENTER (TN) FRANKLIN WOODS COMMUNITY HOSPITAL (TN) NISWONGER CHILDREN'S HOSPITAL (TN) INDIAN PATH MEDICAL CENTER (TN) SYCAMORE SHOALS HOSPITAL (TN) JOHNSON COUNTY COMMUNITY HOSPITAL (TN) UNICOI COUNTY MEMORIAL HOSPITAL (TN) NORTON COMMUNITY HOSPITAL (VA), AND DICKENSON COMMUNITY HOSPITAL (VA) EACH OF THESE HOSPITAL FACILITIES IS EITHER WHOLLY OR PARTIALLY OWNED BY MOUNTAIN STATES HEALTH ALLIANCE (MSHA). MSHA IS A NONPROFIT HEALTH SYSTEM BASED IN JOHNSON CITY, TN. MSHA IS TAX-EXEMPT UNDER IRC SECTION 501(C)(3). WHILE SOME MSHA REPRESENTATIVES ARE ON AEP'S GOVERNING BOARD, MSHA AND ITS AFFILIATES DO NOT CONTROL AEP'S BOARD OR THE MANNER IN WHICH AEP IS OPERATED, MANAGED, OR GOVERNED. MEDICAL SERVICES ARE PROVIDED TO INDIVIDUALS PRESENTING TO THE EMERGENCY DEPARTMENT OF ONE OF THE AFOREMENTIONED HOSPITAL FACILITIES AND ARE BASED UPON EMERGENCY MEDICAL NEED. AEP FOLLOWS THE PATIENT FINANCIAL ASSISTANCE POLICIES AND PROCEDURES ADOPTED BY EACH OF THE AFOREMENTIONED HOSPITAL FACILITIES FOR THE TREATMENT OF PATIENTS WITHOUT REGARD TO THE ABILITY TO PAY. AS SUCH SERVICES ARE MADE AVAILABLE TO THE GENERAL PUBLIC, AEP MAY INCIDENTALLY PROVIDE EMERGENCY SERVICES TO OFFICERS, DIRECTORS, AND INDEPENDENT CONTRACTORS. HOWEVER, SUCH INDIVIDUALS WOULD NOT BE TREATED DIFFERENTLY THAN OTHER PATIENTS AND SUCH SERVICES WOULD ONLY BE MADE AVAILABLE IN THE NORMAL COURSE OF AEP'S BUSINESS OPERATIONS. |
| FORM 990, PAGE 6, PART VI, LINE 11B | AEP'S TAX PREPARER REVIEWED THE FORM 990 WITH AEP'S BOARD MEMBERS PRIOR TO FILING THE RETURN WITH THE IRS. BOARD MEMBERS RECEIVED A COPY OF THE FORM 990 PRIOR TO THE REVIEW. |
| FORM 990, PAGE 6, PART VI, LINE 12C | EXPLANATION: EVERY COVERED PERSON AS DEFINED BY THE CONFLICT OF INTEREST POLICY ADOPTED BY THE BOARD OF DIRECTORS SHALL BE SUBJECT TO THAT POLICY. AS PART OF SAID POLICY, EVERY COVERED PERSON SHALL COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT IN ACCORDANCE WITH THE REQUIREMENT OF THE CONFLICT OF INTEREST POLICY. |
| FORM 990, PAGE 6, PART VI, LINE 15A | EXPLANATION: AEP HAS ENTERED INTO PROFESSIONAL SERVICE CONTRACTS WITH PHYSICIANS TO ASSIST AEP IN PROVIDING EMERGENCY SERVICE COVERAGE TO HOSPITALS. THESE AGREEMENTS MAY INCLUDE FIXED RATES AND BONUSES BASED ON PRODUCTIVITY OR ACHIEVING QUALITY,PATIENT SATISFACTION SCORES OR OTHER QUALITY METRICS. THE METHODOLOGY OR AMOUNT OF THE BONUS IS FIXED AND SET IN ADVANCE WITHIN EACH CONTRACT. BONUS FORMULAS ARE BASED UPON REACHED PRE- DETERMINED AND OBJECTIVELY VERIFIABLE PERFORMANCE METRICS. IN ADDITION TO ADDRESSING EXCESS BENEFIT, PRIVATE INUREMENT AND PRIVATE BENEFIT CONCERNS, AEP'S COMPENSATION ARRANGEMENTS ARE STRUCTURED IN A MANNER TO COMPLY WITH APPLICABLE FRAUD AND ABUSE LAWS THAT APPLY TO HEALTH CARE PROVIDERS. AEP HAS NEGOTIATED EACH OF ITS COMPENSATION ARRANGEMENTS AT ARM'S LENGTH. THE AGREEMENTS INCLUDE COMMERCIALLY REASONABLE TERMS AND CONDITIONS WITH A COMPENSATION ARRANGEMENT THAT IS CONSISTENT WITH FAIR MARKET VALUE FOR THE SERVICES RENDERED. THE TERMS AND CONDITIONS OF SUCH ARRANGEMENTS HAVE BEEN, ARE AND WILL CONTINUE TO BE SET THROUGH GOOD FAITH NEGOTIATIONS AMONG THE RELEVANT PARTIES IN AN EFFORT TO BE CONSISTENT WITH SIMILAR ARRANGEMENTS FOR OTHER HEALTH CARE PROVIDERS PROVIDING SIMILAR SERVICES IN SIMILAR SPECIALTIES WITHIN SOUTHWESTERN VIRGINIA AND NORTHEASTERN TENNESSEE. NATIONAL PHYSICIAN COMPENSATION SURVEY DATA (E.G. MGMA PHYSICIAN COMPENSATION SURVEY) AND OTHER OBJECTIVE COMPARABLE DATA HAS BEEN AND WILL CONTINUE TO BE USED AS THE BASIS FOR SETTING PHYSICIAN COMPENSATION ARRANGEMENTS. AEP ALSO UTILIZES THE SERVICES OF NATIONALLY-RECOGNIZED VALUATION FIRMS TO EVALUATE CERTAIN PROPOSED COMPENSATION ARRANGEMENTS TO ENSURE THAT THEY ARE CONSISTENT WITH FAIR MARKET VALUE AND ARE COMMERCIALLY REASONABLE. IN ADDITION TO COMPENSATION RECEIVED FOR PROVISION OF PHYSICIAN SERVICES, AEP'S PRESIDENT, JOSH PUHR, RECEIVES PAY AS AN INDEPENDENT CONTRACTOR FOR HIS DUTIES AND RESPONSIBILITIES AS PRESIDENT. BECAUSE HIS DUTIES DID NOT MATERIALLY CHANGE FROM THE PRIOR YEAR AND BECAUSE A REVIEW WAS PERFORMED/APPROVED LAST YEAR, ANOTHER REVIEW WAS NOT NEEDED DURING 2016. |
| FORM 990, PAGE 6, PART VI, LINE 15B | EXPLANATION: DIRECTOR MOODY RECEIVES COMPENSATION FROM AEP AS AN INDEPENDENT CONTRACTOR FOR PROVISION OF PHYSICIAN SERVICES TO HOSPITALS SERVICED BY AEP. HIS CONTRACT, SIMILAR TO PUHR'S, FOLLOWS THE SAME PROCESS USED FOR ALL AEP PHYSICIAN CONTRACTS THAT IS DESCRIBED FOR PART VI, LINE 15A. |
| FORM 990, PAGE 6, PART VI, LINE 19 | EXPLANATION: THE CONFLICT OF INTEREST POLICY, IN ADDITION TO OTHER GOVERNING POLICIES, IS AVAILABLE UPON REQUEST. ALL CORPORATE POLICIES AND CORPORATE FINANCIAL STATEMENTS ARE ALSO AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A - COMPENSATION OF DIRECTORS AND OFFICERS EXPLANATION: AEP DOES NOT COMPENSATE ITS OFFICERS AND DIRECTORS EXCEPT AS FOLLOWS: PRESIDENT/DIRECTOR PUHR AND DIRECTOR MOODY ARE PAID BY AEP FOR PHYSICIAN SERVICES THEY PROVIDE TO HOSPITALS. IN ADDITION, PUHR RECEIVES ADDITIONAL COMPENSATION, AS APPROVED BY THE BOARD, FOR HIS SERVICES TO THE ORGANIZATION AS PRESIDENT. |
| FORM 990, PART IX, LINE 11G | PHYSICIAN FEES 18,561,863 0 0 MANAGEMENT & BILLING SERVICES 1,337,336 0 0 TOTAL 19,899,199 0 0 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| MOUNTAIN STATES HEALTH ALLIANCE | ||||||||||
| 400 N STATE OF FRANKLIN ROAD | JOHNSON CITY | TN | 37604 | 620476282 | HOSP. SYS. | TN | 501C3 | 3 | NA | false |
| DICKENSON COMMUNITY HOSPITAL | ||||||||||
| ONE HOSPTIAL DRIVE | CLINTWOOD | VA | 24228 | 770599553 | HOSPITAL | VA | 501C3 | 3 | NCH | false |
| SMYTH COUNTY COMMUNITY HOSPITAL | ||||||||||
| 245 MEDICAL PARK DRIVE | MARION | VA | 24354 | 540794913 | HOSPITAL | VA | 501C3 | 3 | MSHA | false |
| NORTON COMMUNITY HOSPITAL | ||||||||||
| 100 15TH STREET NW | NORTON | VA | 24273 | 540566029 | HOSPITAL | VA | 501C3 | 3 | NA | false |
| JOHNSTON MEMORIAL HOSPITAL | ||||||||||
| 16000 JOHNSTON MEMORIAL DRIVE | ABINGDON | VA | 24211 | 540544705 | HOSPITAL | VA | 501C3 | 3 | NA | false |
| ABINGDON PHYSICIAN PARTNERS | ||||||||||
| 16000 JOHNSTON MEMORIAL DRIVE | ABINGDON | VA | 24211 | 205485346 | MED. SERV. | VA | 501C3 | 3 | JMH | false |
| MOUNTAIN STATES HEALTH ALLIANCE AUX | ||||||||||
| 400 N STATE OF FRANKLIN ROAD | JOHNSON CITY | TN | 37604 | 581418345 | SUPP. ORG. | TN | 501C3 | 12A | MSHA | false |
| MOUNTAIN STATES FOUNDATION | ||||||||||
| 2335 KNOB CREEK ROAD STE 101 | JOHNSON CITY | TN | 37604 | 581418862 | FUNDRAISER | TN | 501C3 | 12A | MSHA | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| EMMAUS COMMUNITY HEALTHCARE LLC | |||||||||
| 6070 HWY 11E | PINEY FLATS | TN | 37686 | 200577483 | MED. SERV. | TN | NA | false | false |
| MEDICAL SPECIALISTS OF JOHNSON CITY | |||||||||
| 2528 WESLEY STREET STE 2 | JOHNSON CITY | TN | 37601 | 272199037 | MED. SERV. | TN | NA | false | false |
| EAST TN AMBULATORY SURGERY CENTER | |||||||||
| 701 MED TECH PARKWAY STE 100 | JOHNSON CITY | TN | 37604 | 621787537 | MED. SERV. | TN | NA | false | false |
| INTEGRATED SOLUTIONS HEALTH NETWORK | |||||||||
| 509 MED TECH PARKWAY STE 100 | JOHNSON CITY | TN | 37604 | 621711997 | INVESTMENT | TN | NA | false | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| BLUE RIDGE MEDICAL MANAGEMENT CORP | |||||||||
| 1021 W OAKLAND AVENUE STE 207 | JOHNSON CITY | TN | 37604 | 621490616 | MED. SERV. | TN | NA | C CORP | false |
| MEDISERVE MEDICAL EQUIPMENT | |||||||||
| 1021 W OAKLAND AVENUE STE 207 | JOHNSON CITY | TN | 37604 | 621212286 | DME | TN | NA | C CORP | false |
| MOUNTAIN STATES PROPERTIES | |||||||||
| 1021 W OAKLAND AVENUE STE 207 | JOHNSON CITY | TN | 37604 | 621845895 | PROP. MGMT | TN | NA | C CORP | false |
| MOUNTAIN STATES PHYSICIAN GROUP | |||||||||
| 1021 W OAKLAND AVENUE STE 207 | JOHNSON CITY | TN | 37604 | 621700412 | MED. SERV. | TN | NA | C CORP | false |
| COMMUNITY HOME CARE INC | |||||||||
| 1460 PARK AVENUE | NORTON | VA | 24273 | 541453810 | DME | VA | NA | C CORP | false |
| WILSON PHARMACY INC | |||||||||
| PO BOX 5289 | JOHNSON CITY | TN | 37604 | 620329587 | PHARMACY | TN | NA | C CORP | false |
| CRESTPOINT HEALTH INSURANCE COMPANY | |||||||||
| 509 MED TECH PARKWAY STE 100 | JOHNSON CITY | TN | 37604 | 620381170 | INSURANCE | TN | NA | C CORP | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |