UPPER VALLEY MEDICAL CENTER: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- UPPER VALLEY MEDICAL CENTER (EIN 31-0537095)
- Tax period
- 2014-01-01 to 2014-12-31
- Filed
- 2015-11-13
- IRS object ID
- 201533179349308738
- Schema version
- 2014v5.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule F
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-11-13T16:08:21-06:00 | ReturnTs |
| Tax Period End | 2014-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 YARD STREET SUITE 200 | AddressLine1Txt |
| City | GRANDVIEW HEIGHTS | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43212 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 310537095 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Upper Valley Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % J MICHAEL SIMS | InCareOfNm |
| Business Name Control | UPPE | BusinessNameControlTxt |
| Phone | 9374999942 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 N Main St Suite 500 | AddressLine1Txt |
| City | Dayton | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45402 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TIMOTHY D SNIDER | PersonNm |
| Person Title | VP-CFO | PersonTitleTxt |
| Phone | 6142245678 | PhoneNum |
| Signature | 2015-11-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Diane L bean | PreparerPersonNm |
| PTIN | P00104972 | PTIN |
| Phone | 6142245678 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-04-25 22:37:26Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Rebecca Rice | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3130 N County Rd 25 A | AddressLine1Txt |
| City | Troy | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45373 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $165,718,217 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.premierhealth.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1926 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | See Schedule O. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 1434 | TotalEmployeeCnt |
| Total Volunteers | 154 | TotalVolunteersCnt |
| Total Gross UBI | $253,711 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$8,858 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $178,614 | PYContributionsGrantsAmt |
| CY Contributions Grants | $85,580 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $130,298,278 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $132,638,850 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,513,361 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,478,084 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,270,429 | PYOtherRevenueAmt |
| CY Other Revenue | $1,195,415 | CYOtherRevenueAmt |
| PY Total Revenue | $135,260,682 | PYTotalRevenueAmt |
| CY Total Revenue | $136,397,929 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $574,010 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $749,788 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $77,177,058 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $71,524,918 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $50,138,772 | PYOtherExpensesAmt |
| CY Other Expenses | $57,224,086 | CYOtherExpensesAmt |
| PY Total Expenses | $127,889,840 | PYTotalExpensesAmt |
| CY Total Expenses | $129,498,792 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $7,370,842 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $6,899,137 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $157,678,217 | TotalAssetsBOYAmt |
| Total Assets EOY | $182,859,293 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $93,218,464 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $102,184,144 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $64,459,753 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $80,675,149 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE O | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $113,827,865 | ExpenseAmt |
| Grant | $749,788 | GrantAmt |
| Revenue | $132,638,850 | RevenueAmt |
| Desc | See Schedules H and O. | Desc |
| Total Program Service Expenses | $113,827,865 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | 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 | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (true) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | Yes (true) | 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 | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| 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 | Yes (true) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (true) | 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 | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | Yes (true) | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 123 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 1434 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| 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 | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | 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 | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OH | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | J MICHAEL SIMS | PersonNm |
| Phone | 9374999942 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 N MAIN ST SUITE 500 | AddressLine1Txt |
| City | Dayton | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (38 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 | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Douglas R Murray | ||||||||||
| Trustee | 0.5 | 3.0 | Yes (X) | $0 | $0 | $0 | ||||
| Rowan R Nickol MD | ||||||||||
| Chair | 0.5 | 2.5 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| Craig C Bundschuh | ||||||||||
| Secretary | 0.5 | 3.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| Daniel P French | ||||||||||
| Trustee | 0.5 | 1.0 | Yes (X) | $0 | $0 | $0 | ||||
| Gail Haddad RN | ||||||||||
| Trustee | 0.5 | 1.0 | Yes (X) | $0 | $0 | $0 | ||||
| William E Lukens | ||||||||||
| Trustee | 0.5 | 3.5 | Yes (X) | $0 | $0 | $0 | ||||
| Peter E Nims MD | ||||||||||
| Trustee | 0.5 | 3.0 | Yes (X) | $0 | $0 | $0 | ||||
| James R Pancoast | ||||||||||
| Premier President & CEO | 8.0 | 7.0 | Yes (X) | $0 | $0 | $0 | ||||
| Michael R Tinkler DDS | ||||||||||
| Trustee | 0.5 | 1.5 | Yes (X) | $0 | $0 | $0 | ||||
| Joel H Walker | ||||||||||
| Trustee | 0.5 | 1.0 | Yes (X) | $625 | $0 | $0 | ||||
| Mary Patricia Wampler RN | ||||||||||
| Trustee (TO MAR) | 0.5 | 1.0 | Yes (X) | $0 | $0 | $0 | ||||
| Steven Staley | ||||||||||
| Trustee | 0.5 | 1.0 | Yes (X) | $0 | $0 | $0 | ||||
| Rebecca Rice | ||||||||||
| President & CEO | 32.0 | 8.0 | Yes (X) | $309,563 | $0 | $46,312 | Yes (X) | |||
| Arthur R Disbrow | ||||||||||
| Vice Chair | 0.5 | 3.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| Ronal Manis MD | ||||||||||
| Trustee/ Medical Staff 1st VP | 0.5 | 1.0 | Yes (X) | $62,750 | $0 | $0 | ||||
| Christopher Grove MD | ||||||||||
| TRUSTEE | 0.5 | 1.0 | Yes (X) | $0 | $330,664 | $28,633 | ||||
| Tim D Snider | ||||||||||
| Vice President/CFO (See Sch O) | 16.0 | 4.0 | $230,534 | $0 | $36,855 | Yes (X) | ||||
| Jenna M Downey Esq | ||||||||||
| Recording Secretary | 0.5 | 2.5 | $0 | $0 | $0 | Yes (X) | ||||
| Thomas Parker | ||||||||||
| Sys VP - Service Lines | 8.0 | 32.0 | $454,750 | $0 | $28,492 | Yes (X) | ||||
| James Hurak | ||||||||||
| Vice President - Operations | 40.0 | 0.0 | $190,140 | $0 | $47,309 | Yes (X) | ||||
| Dale E Creech | ||||||||||
| Sys VP - CLO | 8.0 | 32.0 | $0 | $576,691 | $155,680 | Yes (X) | ||||
| MARK W SHAW | ||||||||||
| Sys VP - MANAGED CARE | 8.0 | 32.0 | $0 | $388,917 | $99,374 | Yes (X) | ||||
| RENEE P GEORGE | ||||||||||
| Sys VP-Rev Cycle (to Sep) | 8.0 | 32.0 | $0 | $262,907 | $21,843 | Yes (X) | ||||
| Thomas R Curtin | ||||||||||
| Sys VP-Rev Cycle (from Sep) | 8.0 | 32.0 | $0 | $232,395 | $53,830 | Yes (X) | ||||
| Gary G Ginter | ||||||||||
| Sys VP - CIO | 8.0 | 32.0 | $0 | $338,708 | $41,276 | Yes (X) | ||||
| Barbara A Johnson | ||||||||||
| Sys VP - Human Resources | 8.0 | 32.0 | $0 | $462,639 | $21,525 | Yes (X) | ||||
| Tammy S Lundstrom MD | ||||||||||
| Sys VP - CMO | 8.0 | 32.0 | $0 | $614,198 | $9,696 | Yes (X) | ||||
| Sylvain TREPANIER | ||||||||||
| Sys VP - CNO | 8.0 | 32.0 | $0 | $354,001 | $13,675 | Yes (X) | ||||
| Scott Shelton | ||||||||||
| Sys VP - CPO (from Sep) | 8.0 | 32.0 | $0 | $435,366 | $38,447 | Yes (X) | ||||
| Thomas Bigley | ||||||||||
| Director of Pharmacy | 40.0 | 0.0 | $171,440 | $0 | $22,191 | Yes (X) | ||||
| Danny Bailey DPM | ||||||||||
| Chief Medical Officer | 40.0 | 0.0 | $325,495 | $0 | $33,167 | Yes (X) | ||||
| Kathleen J Scarbrough | ||||||||||
| President, UVMC Foundation | 24.0 | 16.0 | $78,169 | $57,200 | $40,479 | Yes (X) | ||||
| Terry R Fry | ||||||||||
| VP - CNO (UVMC) | 40.0 | 0.0 | $178,120 | $0 | $21,117 | Yes (X) | ||||
| Delores A Mullen | ||||||||||
| DIR-EMERGENCY SVS-UVMC | 40.0 | 0.0 | $128,404 | $0 | $40,766 | Yes (X) | ||||
| Michael Maiberger | ||||||||||
| SYSTEM SR VP - CSO | 8.0 | 32.0 | $0 | $564,224 | $46,894 | Yes (X) | ||||
| Thomas A Nash | ||||||||||
| Sys VP - CPO | 8.0 | 32.0 | $0 | $284,206 | $111,206 | Yes (X) | ||||
| David Meckstroth | ||||||||||
| Former President & CEO | 0.0 | 0.0 | $0 | $165,509 | $0 | Yes (X) | ||||
| Nick Lair | ||||||||||
| Former Key Employee | 0.0 | 40.0 | $0 | $291,654 | $60,819 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,129,990 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $5,359,279 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,019,586 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 30 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | 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 |
|---|---|---|---|---|---|
| Cerner Corporation | |||||
| 2800 Rockcreek Pkwy | KANSAS CITY | MO | 64117 | Medical Services | $954,021 |
| Community Blood Center | |||||
| 349 S Main St | DAYTON | OH | 45402 | Medical services | $839,352 |
| Valley Anesthesia | |||||
| PO Box 63437 | CINCINNATI | OH | 45263 | Medical Services | $1,994,153 |
| CareFusion Solutions | |||||
| 3750 Torrey View Court | SAN DIEGO | CA | 92310 | Medical Services | $1,323,944 |
| GE Medical Systems | |||||
| 5517 Collections Center | CHICAGO | IL | 60693 | Medical Services | $2,663,206 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 48 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $85,580 | RelatedOrganizationsAmt |
| Total Contributions | $85,580 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET MEDICARE / MEDICAID | 621110 | $62,178,492 | $62,178,492 | |
| NET PATIENT CARE SERVICES | 621110 | $68,448,593 | $68,194,882 | $253,711 |
| FRANCHISE TAX RECOVERIES | 900099 | $1,945,014 | $1,945,014 | |
| OTHER | 900099 | $66,751 | $66,751 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $132,638,850 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $796,375 | TotalRevenueColumnAmt |
| Exclusion | $796,375 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $282,025 | TotalRevenueColumnAmt |
| Exclusion | $282,025 | ExclusionAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $361,049 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $66,374 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $294,675 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $294,675 | TotalRevenueColumnAmt |
| Exclusion | $294,675 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $29,635,092 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $28,092,289 | SecuritiesAmt |
| Other | $143,119 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,542,803 | SecuritiesAmt |
| Other | -$143,119 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,399,684 | TotalRevenueColumnAmt |
| Exclusion | $1,399,684 | ExclusionAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $1,153,028 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $1,018,506 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $134,522 | TotalRevenueColumnAmt |
| Exclusion | $134,522 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA SALES | 721210 | $679,442 | $679,442 |
| INTEREST RATE SWAP | 523920 | $50,015 | $50,015 |
| ALL OTHER REVENUE | 900099 | $36,761 | $36,761 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $766,218 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $136,397,929 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $132,385,139 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $253,711 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,673,499 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $749,788 | TotalAmt |
| Program Services | $749,788 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,273,636 | TotalAmt |
| Program Services | $1,092,399 | ProgramServicesAmt |
| Management And General | $181,237 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,258,261 | TotalAmt |
| Program Services | $46,537,310 | ProgramServicesAmt |
| Management And General | $7,720,951 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,065,388 | TotalAmt |
| Program Services | $2,629,183 | ProgramServicesAmt |
| Management And General | $436,205 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,040,198 | TotalAmt |
| Program Services | $7,753,778 | ProgramServicesAmt |
| Management And General | $1,286,420 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,887,435 | TotalAmt |
| Program Services | $3,334,253 | ProgramServicesAmt |
| Management And General | $553,182 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,000 | TotalAmt |
| Program Services | $16,296 | ProgramServicesAmt |
| Management And General | $2,704 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $555,305 | TotalAmt |
| Program Services | $476,285 | ProgramServicesAmt |
| Management And General | $79,020 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,197 | TotalAmt |
| Management And General | $43,197 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,730 | TotalAmt |
| Program Services | $11,730 | ProgramServicesAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $115,174 | TotalAmt |
| Management And General | $115,174 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $509,935 | TotalAmt |
| Program Services | $509,935 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $649,637 | TotalAmt |
| Program Services | $649,637 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $942,692 | TotalAmt |
| Program Services | $808,547 | ProgramServicesAmt |
| Management And General | $134,145 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,316,061 | TotalAmt |
| Program Services | $3,701,886 | ProgramServicesAmt |
| Management And General | $614,175 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,641,529 | TotalAmt |
| Program Services | $1,407,939 | ProgramServicesAmt |
| Management And General | $233,590 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $145,038 | TotalAmt |
| Program Services | $124,399 | ProgramServicesAmt |
| Management And General | $20,639 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $661 | TotalAmt |
| Program Services | $567 | ProgramServicesAmt |
| Management And General | $94 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,378,915 | TotalAmt |
| Program Services | $2,378,915 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,692,261 | TotalAmt |
| Program Services | $8,313,052 | ProgramServicesAmt |
| Management And General | $1,379,209 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $355,752 | TotalAmt |
| Program Services | $305,128 | ProgramServicesAmt |
| Management And General | $50,624 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| OPERATING SUPPLIES/EQUIP | $16,027,381 | $16,027,381 | |
| JOINT OPERATING AGREEMENT | $5,275,000 | $4,524,367 | $750,633 |
| PURCHASED SERVICES | $9,899,937 | $8,491,176 | $1,408,761 |
| HOSPITAL FRANCHISE TAX | $2,081,685 | $1,785,461 | $296,224 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,563,196 | TotalAmt |
| Program Services | $2,198,453 | ProgramServicesAmt |
| Management And General | $364,743 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $129,498,792 | TotalAmt |
| Program Services | $113,827,865 | ProgramServicesAmt |
| Management And General | $15,670,927 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,750 | BOYAmt |
| EOY | $3,110 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,703,608 | BOYAmt |
| EOY | $16,549,780 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,355,287 | BOYAmt |
| EOY | $18,916,002 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $426,436 | BOYAmt |
| EOY | $139,333 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $685,168 | BOYAmt |
| EOY | $747,916 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,101,888 | BOYAmt |
| EOY | $2,454,126 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $183,289,933 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $97,889,707 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,969,080 | BOYAmt |
| EOY | $85,400,226 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,510,522 | BOYAmt |
| EOY | $38,612,803 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,502,968 | BOYAmt |
| EOY | $11,785,627 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,421,510 | BOYAmt |
| EOY | $8,250,370 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $157,678,217 | BOYAmt |
| EOY | $182,859,293 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,175,351 | BOYAmt |
| EOY | $15,441,507 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $145,545 | BOYAmt |
| EOY | $193,850 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $72,018 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,224,934 | BOYAmt |
| EOY | $41,671,466 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,667,875 | BOYAmt |
| EOY | $2,268,545 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,004,759 | BOYAmt |
| EOY | $42,536,758 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $93,218,464 | BOYAmt |
| EOY | $102,184,144 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,459,753 | BOYAmt |
| EOY | $80,675,149 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,459,753 | BOYAmt |
| EOY | $80,675,149 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $157,678,217 | BOYAmt |
| EOY | $182,859,293 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $6,899,137 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$498,960 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $9,815,219 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (true) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $9,030 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $2,700 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $11,730 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1F & 1I: | FormAndLineReferenceDesc |
| Explanation | Amounts include a portion of membership dues paid to Ohio Hospital Association and Greater Dayton Area Hospital Association that were used for lobbying purposes. Also includes payments to a contracted lobbyist for health care related issues. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,928,963 | OtherCostOrOtherBasisAmt |
| Book Value | $2,928,963 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $111,615,145 | OtherCostOrOtherBasisAmt |
| Depreciation | $58,503,605 | DepreciationAmt |
| Book Value | $53,111,540 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $60,229 | OtherCostOrOtherBasisAmt |
| Depreciation | $60,229 | DepreciationAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $62,624,613 | OtherCostOrOtherBasisAmt |
| Depreciation | $39,325,873 | DepreciationAmt |
| Book Value | $23,298,740 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,060,983 | OtherCostOrOtherBasisAmt |
| Book Value | $6,060,983 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $85,400,226 | TotalBookValueLandBuildingsAmt |
| Financial Derivatives | FinancialDerivativesGrp | |
| Closely Held Equity Interests | CloselyHeldEquityInterestsGrp |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ALTERNATIVE INVESTMENTS | Desc |
| Book Value | $11,785,627 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $11,785,627 | TotalBookValueSecuritiesAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (8 entries)
| DescDesc | AmtAmt |
|---|---|
| PENSION OBLIGATION | $23,452,534 |
| JOA PAYABLE | $5,276,000 |
| DUE TO AFFILIATES | $4,778,650 |
| MALPRACTICE INSURANCE | $3,419,419 |
| DEFERRED COMPENSATION | $2,223,111 |
| DUE TO MEDICARE / MEDICAID | $1,794,576 |
| WORKER'S COMPENSATION | $974,042 |
| OTHER/FRANCHISE TAX | $618,426 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $42,536,758 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule D, Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | The following footnote is from the audited combined financial statements for Premier Health and affiliates. UVMC is the parent organization of Upper Valley Medical Center: Premier Health (Premier), MedAmerica Health Systems (MAHS), Atrium Health System (AHS), and UVMC have been determined by the Internal Revenue Service to be tax-exempt nonprofit corporations and public charities under Sections 501(c)(3) and 509(a), respectively, of the Internal Revenue Code. Samaritan Health Partners (SHP) is tax-exempt under Section 501(c)(3) and is a public charity by reason of being included in the group ruling issued to the U.S. Catholic Church. As tax-exempt organizations, their income is exempt from federal income tax except to the extent of any unrelated business activities. Taxes payable at December 31, 2014 and 2013 for such unrelated business activities are not significant. Premier, MAHS, SHP, AHS, and UVMC also own or control certain subsidiaries, which are for profit corporations subject to federal income taxes. These are: * PHIC (a wholly owned subsidiary of Premier Health) * PHPlan (a wholly owned subsidiary of PHIC) * MVHE, Inc and Premier Health Specialists, Inc. (formerly Health Specialists of Dayton, Inc.) (subsidiaries of MAHS) * Samaritan Family Care (subsidiary of SHP) and Samaritan North Surgery Center Limited (a joint-venture partnership of which GSH is an 80% owner) * Middletown Surgery Center, LLC (a joint venture partnership of which AMC is an 80.5% owner) (subsidiary of AHS) * UVMC Management Corporation and After Hours Family Care, Inc. (subsidiaries of UVMC) Management annually reviews its tax positions and has determined that there are no material uncertain tax positions. | ExplanationTxt |
Schedule F IRS990ScheduleF
Account Activities Outside US AccountActivitiesOutsideUSGrp (2 entries)
| RegionRegionTxt | Type Of Activities ConductedTypeOfActivitiesConductedTxt | Region Total ExpendituresRegionTotalExpendituresAmt | Specific Services ProvidedSpecificServicesProvidedTxt |
|---|---|---|---|
| Central America and the Caribbean | Investments | $9,618,370 | |
| Central America and the Caribbean | Program Services | $25,175 | Insurance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Spent | $9,643,545 | SubtotalSpentAmt |
| Total Spent | $9,643,545 | TotalSpentAmt |
| Transfer To Foreign Corp | false | TransferToForeignCorpInd |
| Interest In Foreign Trust | false | InterestInForeignTrustInd |
| Foreign Corp Ownership | false | ForeignCorpOwnershipInd |
| Passive Foreign Investmest Co | false | PassiveForeignInvestmestCoInd |
| Foreign Partnership | false | ForeignPartnershipInd |
| Boycott Countries | false | BoycottCountriesInd |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,643,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,583,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,060,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03140 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $24,359,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $15,844,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,515,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06580 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $676,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $508,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $168,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $30,678,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,935,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $12,743,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09850 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $541,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $541,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00420 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $503,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $503,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00390 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,243,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $242,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,001,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02320 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,287,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $242,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,045,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03130 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $34,965,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $18,177,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $16,788,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12980 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $238,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $238,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $238,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $238,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,530,000 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $29,281,000 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $31,093,000 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,812,000 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | Yes (X) | CostAccountingSystemInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UPPER VALLEY MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 N MAIN ST 500 | AddressLine1Txt |
| City | DAYTON | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.PREMIERHEALTH.COM | WebsiteAddressTxt |
| State License | Ohio Reg# 1036 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UPPER VALLEY MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Part V, Section C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 14 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Part V, Section C | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400. | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | X | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | X | FAPSummaryOnWebsiteURLTxt |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part V, Section B, Line 1 | FormAndLineReferenceDesc |
| Explanation | THE STATE OF OHIO DOES NOT LICENSE HOSPITALS, BUT THE OHIO DEPARTMENT OF HEALTH DOES REGISTER HOSPITALS. AS PART OF THIS REGISTRATION PROCESS, HOSPITALS IN THE STATE OF OHIO ARE REQUIRED TO COMPLETE AND SUBMIT THE ANNUAL HOSPITAL REGISTRATION AND PLANNING REPORT (AHR) EACH CALENDAR YEAR. Upper Valley's REGISTRATION NUMBER IS 1036. Part V, Section B, Question 5: Partnering in the data review process and in the process for identifying and prioritizing community health needs and services were the Board of trustees and executive leadership of Upper Valley Medical Center, community health collaboratives featuring community, health, and business stakeholders/advocates organized by both Upper Medical Center, and the greater Dayton Area Hospital Association with its member hospitals. Part V, Section B, Question 6A & 6B: Upper Valley Medical Center partnered with member hospitals of the Greater Dayton Area Hospital Association and Wright State University to prepare their Community Health Needs Assessment. PART V, Section B, QUESTION 7A: THE DIRECT WEBSITE ADDRESS WHERE THE CHNA CAN BE ACCESSED IS: http://www.UVMC.org/WorkArea/DownloadAsset.aspx?id=76905 PART V, Section B, QUESTION 10A: The direct website address where the implementation strategy can be accessed is: http://www.premierhealth.com/our-community/mking-a-difference/community-he alth-improvement-plan/uvmc/ PART V, Section B, QUESTION 11: Premier Health was part of a collaboration in 2013 with the Greater Dayton Area Hospital Association and hospitals throughout Southwestern Ohio to conduct a regional Community Health Needs Assessment. Identified Priorities: --------------------- In the Community Health Assessment, researchers identified priority areas for community health improvement using a variety of criteria. The priorities that are included and excluded in the plan are outlined here. Priorities that are included in the plan are not listed in order of importance. Priorities Included in the Plan: ------------------------------- Through the Community Health Risk Assessment, the identified priorities with an improvement plan Upper Valley Medical Center are: Primary and Chronic Diseases: 1. Hypertension - from 2004 to 2012, the rate of hospital inpatient hypertension discharge diagnoses increased from 96 to 130 per 1,000 adults. 2. Melanoma of the skin - The cancer rate has increased from 35.4 to 88.0 per 100,000 from 2000 to 2011. Priorities Addressed Through Collaboration: ------------------------------------------- All identified priorities are important elements of improving the health of our community. In some instances priorities are already being targeted by collaborative groups of which Upper Valley Medical Center is a part. Additional strategies will not be developed independent of these efforts. Because of the importance of these community-wide efforts, the following identified priorities are not included in the Community Health Improvement Plan. Maternal and Infant Priorities: 1. First trimester prenatal care 2. Teen pregnancy 3. Low birth weight 4. Tobacco use in pregnant women Upper Valley Medical Center is involved in several state-wide initiatives addressing these issues. As part of these collaborations, it will share the goals and objectives developed by those groups for program implementation and measurement. Ohio Perinatal Quality Collaborative. Upper Valley Medical Center is a non-charter member of this organization as a maternity hospital. The mission of the Collaborative is, "Through collaborative use of improvement science methods, reduce preterm births and improve outcomes of pre-term newborns in Ohio as quickly as possible." Projects of the collaborative include: * 39 Weeks Delivery Charter Project - To reduce elective unnecessary scheduled births before 39 weeks gestational age. (Reduce infant mortality and low birth weights.) * 39 Weeks Dissemination and Birth Registry Accuracy Project - This project was to address inaccuracies in birth certificate data within the Quality Improvement framework. * Obstetrics Antenatal Corticosteroids Project- This project focuses on increasing the use of antenatal corticosteroids to reduce mortality and morbidity among preterm infants. (Reduce infant mortality.) * Progesterone Project - This project intends to help raise awareness about the need for screening and intervention for progesterone, provide support to teams to implement screening, identification and treatment, develop the capacity and capability of skilled ultrasound technicians and remove administrative barriers to the administration of progesterone. (Reduce infant mortality and low birth weights.) Ohio Hospital Association (OHA). OHA has developed a plan to reduce infant mortality (which also addresses low infant birth weight and first trimester care) in Ohio which includes: * Safe sleep (infant mortality) * Eliminating elective deliveries before 39 weeks (infant mortality) * Progesterone for high risk mothers (infant mortality) * Eliminating health disparities * Safe spacing (infant mortality and low birth weight) * Access to prenatal care (First trimester care, infant mortality and low birth weight) * Promote breast milk * These program areas also then address increasing first trimester care, improving low birth weight and decreasing infant mortality. Upper Valley Medical Center is concerned about the data showing the use of tobacco among pregnant women. It is further researching this issue to identify potential resources to address this issue. Primary and Chronic Diseases 5. Department alcohol and drug discharge diagnoses The Tri-County Board of Recovery and Mental Health Services Serving Darke, Miami and Shelby Counties coordinates alcohol and substance abuse services in Miami County. According to its 2014-2016 strategic plan, it intends to expand funding for programs that treat addictions, development and implement a community behavioral health prevention plan and establish a new behavioral health "one stop shop" model program in Miami County. Key Health Priorities by Objective: Priority Area 1: Reduce the incidence and complications from adult hypertension. Blood pressure is how hard blood pushes against the walls of our arteries when our heart pumps blood. When someone has high blood pressure, which is also called hypertension, the increased pressure against the arteries causes damage. Hypertension is called the silent killer because usually those who have it do not feel anything. High blood pressure increases risk for heart disease, stroke, heart failure, kidney disease and blindness. In many cases hypertension can be prevented by maintaining a healthy weight, being active, eating healthy, not using tobacco and limiting alcohol. Most people who are diagnosed with high blood pressure can be controlled. Those with high blood pressure should take the same steps that may prevent high blood pressure. If medication is needed, it is imperative to take it every day. From 2004 to 2012, the rate of hospital inpatient hypertension discharge diagnoses increased from 96 to 130 per 1000 adults. Because of the significant health threat posed by hypertension, a community-focused, population health improvement strategy would benefit all parts of the community. Priority Area 1: Reduce the proportion of adults with hypertension. Objective 1.1: Increase the proportion of adults with hypertension whose blood pressure is under control. Evidence-based Strategies: * Coordinate a hypertension education health communications campaign that will include communications tactics; free, community-based screenings and free online education. * Promote lectures about high blood pressure prevention and control in worksites, congregations, senior centers and other community based venues. * Identify an educational brochure targeted to those who already have high blood pressure about the importance of medication adherence and healthy lifestyle. Make collateral available through system websites, Facebook pages, at employer and community events and other outlets to be identified. These will include how to get more information by telephone and/or online. Outcome Indicators Short and Intermediate Term: To have communications at least once a year in existing hospital communications vehicles that highlights hypertension and how it can be prevented/treated successfully. Long Term: Increase the proportion of adults with hypertension whose blood pressure is under control. Objective 1.2: Increase the proportion of adults who have had their blood pressure measured within the preceding two years and can state whether their blood pressure was normal or high. Evidence-based Strategies: * Upper Valley Medical Center will conduct blood pressure screenings on at least 250 individuals per year at worksites, congregations, senior centers and other community-based venues. * Attempt telephone follow-up with 100% of those who have a stage 2 hypertension result, do not opt out of follow-up and have a working te | ExplanationTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 6 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| HYATT CENTER | ||||
| 450 HYATT ST | TIPP CITY | OH | 45371 | LABORATORY, IMAGING, SPORTS MEDICINE, SURGERY |
| OUTPATIENT CARE CENTER NORTH | ||||
| 280 LOONEY RD | PIQUA | OH | 45356 | LABORATORY, IMAGING, REHABILITATIVE THERAPY |
| OUTPATIENT CARE CENTER SOUTH | ||||
| 998 S DORSET RD | TROY | OH | 45373 | LABORATORY, IMAGING OCCUPATIONAL HEALTH REHABILITATIVE THERAPY |
| STANFIELD PLACE | ||||
| 31 STANFIELD RD | TROY | OH | 45373 | LABORATORY, IMAGING |
| JACOB DETTMER BUILDING | ||||
| 3130 N COUNTY RD 25A | TROY | OH | 45373 | Behavorial Health |
| VERSAILLES CENTER | ||||
| 471 MARKER RD | VERSAILLES | OH | 45380 | LABORATORY |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, line 6a: | FormAndLineReferenceDesc |
| Explanation | THE COMMUNITY BENEFIT REPORT FOR Upper VALLEY Medical IS PART OF THE PREMIER HEALTH REPORT. PART I, LINE 7: A COST TO CHARGE RATIO WAS USED TO CALCULATE THIS FINANCIAL ASSISTANCE AT COST. THIS CALCULATION TAKES TOTAL OPERATING EXPENSES LESS OTHER OPERATING REVENUES DIVIDED BY TOTAL GROSS REVENUES. UNREIMBURSED MEDICAID AND OTHER MEANS-TESTED GOVERNMENTAL PROGRAMS WERE CALCULATED USING A COST ACCOUNTING SYSTEM. THIS SYSTEM ADDRESSES ALL PATIENT SEGMENTS AND INCLUDES FULLY LOADED COSTS. FOR THE REMAINING ITEMS THE ORGANIZATION USED SPECIFIC NUMBERS FOR EXPENSE PAID DIRECTLY FOR THESE SERVICES. PART I, LINE 7G: Included in subsidized health services are revenues and expenses related to an obstetrics clinic which is subsidized by both the Miami County Health Department and Upper Valley Medical Center. This clinic serves the prenatal, delivery, and postnatal medical needs of women in the hospital's Miami County service area. Also included in subsidized health services are revenues and expenses related to an outpatient behavioral health clinic which serves the mental and behavioral health needs of area residents. The clients in both of these clinics include those who either have no medical insurance or qualify for Medicaid services. The total community benefit expense for these clinics in 2014 was $467,000, with direct offsetting revenues of $242,000. The net community benefit expense was $225,000. Also included in subsidized health services are the expenses the hospital incurs related to the call time and physician subsidies due to the large number of indigent patients coming through the emergency room. The hospital operates a 24-hour emergency room 365 days per year. This emergency room is open to all individuals regardless of their ability to pay. For 2014, the amounts paid for call time and subsidies were $2,777,000. PART II, LINE 9: Upper Valley MEDICAL CENTER (UVMC) PARTICIPATES IN THE FOLLOWING COMMUNITY BENEFIT ACTIVITIES: BOARD CHARITABLE CREDIT FUND: AS PART OF UVMC'S COMMUNITY PARTNERSHIP ACTIVITY, BOARD MEMBERS OF THE HOSPITAL ARE GRANTED CHARITABLE CREDITS TO BE DONATED IN THE NAME OF THE BOARD MEMBER WITH PRIORITIES TO NOT-FOR-PROFIT, TAX-EXEMPT 501(C)(3) HEALTH AND HUMAN SERVICES ORGANIZATIONS, ARTS AND CULTURE ORGANIZATIONS, AS WELL AS OTHER COMMUNITY ACTIVITIES IN THE miami and Montgomery AREAs. ALSO SUGGESTED ARE ORGANIZATIONS THAT FOCUS ON SUPPORTING YOUTH, EDUCATION, UNDERSERVED GROUPS, AND SAFE NEIGHBORHOODS. THE AMOUNT OF SUPPORT PROVIDED IN 2014 WAS $114,000. PART III, LINE 2 & 3: BAD DEBT EXPENSE IS INCURRED WHEN AN ACCOUNT IS TAKEN OUT OF ACCOUNTS RECEIVABLE AND TURNED OVER TO A COLLECTION AGENCY. THIS ACTION MAY OCCUR IF A PATIENT REFUSES PAYMENT ARRANGEMENTS, REFUSES TO APPLY FOR FINANCIAL ASSISTANCE, AND THERE IS NOT AN INSURANCE BALANCE BEING CONTENDED. AN ACCOUNT IS WRITTEN OFF TO BAD DEBT AFTER 120 DAYS IF AN ATTEMPT TO COLLECT FROM THE PATIENT IS MADE WITHIN OUR COLLECTION POLICY. THE COLLECTION AGENCY ATTEMPTS TO COLLECT THE ACCOUNT IN ACCORDANCE WITH ESTABLISHED GUIDELINES. COLLECTION ATTEMPTS ARE CEASED AND THE ACCOUNT RETURNED BACK TO THE ORGANIZATION IF THE PATIENT APPLIES FOR FINANCIAL ASSISTANCE. ANY AMOUNTS COLLECTED FROM THESE ACCOUNTS ARE CREDITED BACK AGAINST BAD DEBT EXPENSE. THE ORGANIZATION RECOGNIZES THAT THERE ARE ACCOUNTS WRITTEN OFF TO BAD DEBT THAT MAY HAVE QUALIFIED FOR CHARITY CARE IF THE PATIENT HAD PROVIDED THE NECESSARY FINANCIAL INFORMATION. IN ORDER TO RESOLVE THIS, THE ORGANIZATION HAS ENGAGED A THIRD PARTY VENDOR TO ANALYZE DATA BASED ON CREDIT SCORES TO REALLOCATE SOME OF THIS EXPENSE TO CHARITY CARE. A REPRESENTATIVE SAMPLE OF THESE ACCOUNTS IS THEN SENT TO OUR THIRD PARTY VENDOR WHO GATHERS EXTERNAL CREDIT DATA THAT PRESENTS THE ACCOUNT AS LESS THAN 100% FEDERAL POVERTY LEVEL OR NOT ENOUGH INFORMATION (TYPICALLY INDICATIVE OF INDIGENT). THESE ACCOUNTS ARE RECLASSED FROM BAD DEBT EXPENSE TO CHARITY EXPENSE ON OUR INCOME STATEMENT. ANY CREDIT SCORE THAT PRESENTS THE ACCOUNTS AS GREATER THAN 100% FEDERAL POVERTY LEVEL REMAINS IN BAD DEBT EXPENSE. DUE TO THIS PROCESS, THE ORGANIZATION HAS USED BEST EFFORTS TO NOT REPORT BAD DEBT EXPENSE FOR PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY. PART III, LINE 4: THE ORGANIZATION DOES NOT HAVE A FOOTNOTE IN THE AUDITED FINANCIAL STATEMENTS WHICH DISCUSSES THIS CALCULATION. PART III, SECTION B, LINES 5, 6, AND 7: THE AMOUNTS REPORTED ON LINES 5, 6, AND 7 DO NOT INCLUDE CERTAIN MEDICARE PROGRAM REVENUES AND COSTS, AND THUS DO NOT REFLECT ALL OF THE ORGANIZATION'S REVENUES AND COSTS ASSOCIATED WITH ITS PARTICIPATION IN MEDICARE PROGRAMS. IN ADDITION TO THE AMOUNTS REPORTED ON LINE 5, 6, AND 7, THE ORGANIZATION RECEIVED REVENUE OF $15,549,000 AND INCURRED COST OF $21,536,000, FOR AN ADDITIONAL NET SHORTFALL OF $5,987,000 ASSOCIATED WITH THESE PROGRAMS. BELOW IS A RECONCILIATION OF THE AMOUNTS ASSOCIATED WITH MEDICARE PROGRAMS. ALLOWABLE MEDICARE REVENUE PER MEDICARE COST REPORT (PART III, SECTION B) $29,281,000 MEDICARE REVENUE NOT REPORTED IN PART III, SECTION B $15,549,000 TOTAL MEDICARE ASSOCIATED REVENUE $44,830,000 ALLOWABLE MEDICARE COST PER MEDICARE COST Report (PART III, SECTION B) $31,093,000 MEDICARE COST NOT REPORTED IN PART III, SECTION B $21,536,000 TOTAL MEDICARE ASSOCIATED COST $52,629,000 MEDICARE SHORTFALL PER PART III, SECTION B $1,812,000 ADDITIONAL SHORTFALL NOT INCLUDED IN PART III, SECTION B$5,987,000 TOTAL MEDICARE SHORTFALL $7,799,000 PART III, LINE 8: THE ORGANIZATION'S SHORTFALL SHOULD BE CONSIDERED CHARITY CARE BECAUSE IT IS PROVIDING HIGH-QUALITY CARE IN EXCESS OF THE COST TO OUR COMMUNITY RESIDENTS THAT NEED CARE. THE MEDICARE POPULATION AT THE ORGANIZATION IS IN EXCESS OF 32% OF NET PATIENT REVENUE. THE ORGANIZATION USED A COST ACCOUNTING SYSTEM TO CALCULATE THE MEDICARE ALLOWABLE COSTS. PART III, LINE 9B: THE ORGANIZATION MAKES REASONABLE EFFORTS TO DETERMINE WHETHER OR NOT AN INDIVIDUAL IS ELIGIBLE FOR ASSISTANCE UNDER THE STATE OR HOSPITAL FINANCIAL ASSISTANCE POLICY BEFORE ENGAGING IN EXTRAORDINARY COLLECTIVE ACTIONS AGAINST THAT INDIVIDUAL. PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE ARE OFFERED REASONABLE PAYMENT PLAN ARRANGEMENTS FOR ANY REMAINING BALANCES. ANY THIRD PARTY COLLECTING SELF-PAY RECEIVABLES ON OUR BEHALF IS REQUIRED TO MAKE REASONABLE EFFORTS TO DETERMINE IF THE INDIVIDUAL MEETS THE QUALIFICATIONS OF THE STATE OR OF OUR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS. REASONABLE EFFORTS INCLUDE: A. VALIDATING THAT THE PATIENT OWES THE UNPAID BILLS AND THAT ALL SOURCES OF THIRD PARTY PAYMENT HAVE BEEN IDENTIFIED AND BILLED BY THE HOSPITAL. B. DOCUMENTING THAT THE ORGANIZATION HAS OR HAS ATTEMPTED TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR CHARITY CARE UNDER ITS FINANCIAL ASSISTANCE POLICY. C. DOCUMENTED THAT THE PATIENT DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE. D. DOCUMENT THAT THE PATIENT HAS BEEN OFFERED A PAYMENT PLAN, BUT HAS NOT HONORED THE TERMS OF THAT PLAN. THE FINANCIAL COUNSELORS MEET WITH INPATIENT, OUTPATIENT SELF-PAY, AND OTHER PATIENTS UPON REQUEST WHO MAY NEED FINANCIAL ASSISTANCE. IN ADDITION TO ASSISTING PATIENTS WHO WANT TO APPLY FOR ASSISTANCE THROUGH THE MEDICAID PROGRAM, THE FINANCIAL COUNSELOR WILL PROVIDE THE PATIENT WITH A FINANCIAL ASSISTANCE APPLICATION. PART VI, LINE 2: The organization works with the community on programs that address the underlying causes of persistent health programs as part of a comprehensive strategy to improve the health status and quality of life for identified members of the community who are economically disadvantaged, disenfranchised and/or who have disproportionate unmet health needs. The organization strives to work with Premier Health, the Good Samaritan Hospital Board of Directors, executive management, managers, staff members, community groups, and individuals to provide a collaborative approach to the governance and management of community benefit activities. PART VI, LINE 3: THERE ARE SEVERAL WAYS IN WHICH OUR ORGANIZATION INFORMS AND EDUCATES PATIENTS WHO MAY BE BILLED FOR SERVICES ABOUT ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS, OR UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. FIRST, NOTIFICATION OF SUCH AVAILABLE ASSISTANCE IS CLEARLY POSTED IN REGISTRATION AREAS, AS WELL AS MATERNITY AND EMERGENCY DEPARTMENTS. NEXT, PATIENT ADVOCATES, PATIENT ACCESS STAFF MEMBERS, AND FINANCIAL COUNSELORS IN THE INPATIENT AND EMERGENCY DEPARTMENTS MEET WITH UNINSURED AND UNDERINSURED PATIENTS, AND THOSE WITH ONLY MEDICARE COVERAGE TO DISCUSS ELIGIBILITY FOR ASSISTANCE. FINANCIAL COUNSELORS ALSO DISCUSS OPTIONS TO RESOLVE UNPAID ACCOUNT BALANCES WITH UNINSURED AND UNDERINSURED PATIENTS. A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS POSTED ON THE HOSPITAL'S WEBSITE, ALONG WITH INFORMATION ON HOW TO OBTAIN AN APPLICATION. WHEN A PATIENT RECEIVES A BILL, THE REVERSE SIDE OF THE BILL CONTAINS INFORMATION ABOUT THE STATE OF OHIO FREE CARE PROGRAM (CARE ASSURANCE) AND A FINANCIA | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (13 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|---|
| EDISON FOUNDATION | |||||||||
| 1973 EDISON DR | PIQUA | OH | 45356 | 311379781 | 501(C)(3) | $10,188 | N/A | N/A | CAPITAL, EVENT SPONSORSHIP & GENERAL FUND |
| Hospice of Miami County | |||||||||
| PO Box 502 | Troy | OH | 45373 | 311031277 | 501(c)(3) | $120,250 | N/A | N/A | Operations |
| Miami County Dental Clinic | |||||||||
| 1364 W Main St | Troy | OH | 45373 | 204901192 | 501(c)(3) | $60,163 | N/A | N/A | Operations |
| Miami County Recovery Council | |||||||||
| 1059 North Market Street | Troy | OH | 45373 | 310917327 | 501(c)(3) | $62,640 | N/A | N/A | Sponsorship |
| Dayton Art Institue | |||||||||
| 456 Belmonte Park North | Dayton | OH | 45406 | 310537480 | 501(c)(3) | $5,245 | N/A | N/A | Sponsorship |
| Goodwill Easter Seals | |||||||||
| 1511 Kuntz Road | Dayton | OH | 45404 | 310537112 | 501(c)(3) | $21,500 | N/A | N/A | Sponsorship |
| Dayton Performing Alliance | |||||||||
| 126 N Main St Suite 210 | Dayton | OH | 45402 | 316000101 | 501(c)(3) | $25,918 | N/A | N/A | Community Support |
| Reach Out Montgomery County | |||||||||
| 25 East Foraker St | Dayton | OH | 45409 | 311434282 | 501(c)(3) | $10,592 | N/A | N/A | Community Support |
| Dayton Foundation | |||||||||
| 500 Kettering Tower | Dayton | OH | 45423 | 316027287 | 501(c)(3) | $16,475 | N/A | N/A | Community Support |
| Troy Community Development | |||||||||
| 405 SW Public SQ | Troy | OH | 45373 | 311301818 | 501(c)(3) | $15,000 | N/A | N/A | Community Support |
| AIDS Resource Center Ohio | |||||||||
| 15 W 4th StSuite 200 | Dayton | OH | 45402 | 311226780 | 501(c)(3) | $8,750 | N/A | N/A | Community Support |
| Samaritan Behav Health | |||||||||
| 020633634 | 501(c)(3) | $130,767 | N/A | N/A | Behavorial Health Grant for Miami Co | ||||
| Health Partners Free Clinic | |||||||||
| 1300 North County Rd 25A | Troy | OH | 45373 | 311596731 | 501(c)(3) | $87,230 | N/A | N/A | Community Support |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 13 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Form 990, Schedule I, Part I, Line 2 | FormAndLineReferenceDesc |
| Explanation | UPPER VALLEY MEDICAL CENTER MONITORS THE USE OF GRANT FUNDS BY VERIFYING THAT the ORGANIZATIONS REQUESTING ASSISTANCE ARE 501(C)(3) TAX EXEMPT ORGANIZATIONS. THE GRANTS THAT ARE GIVEN ARE USUALLY SMALL IN NATURE. LARGER ONES ARE APPROVED BY THE UVMC BOARD OF DIRECTORS. THEY ARE USUALLY GIVEN FOR A SPECIFIC PURPOSE, SUCH AS ONGOING OPERATIONS OR A CAPITAL PROJECT, AND ARE RELATED TO HEALTHCARE IN THE COMMUNITY. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (true) | 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 (23 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Michael Maiberger | ||||||||||||||
| SYSTEM SR VP - CSO | $0 | $320,114 | $0 | $103,541 | $0 | $140,569 | $0 | $15,964 | $0 | $30,930 | $0 | $611,118 | $0 | $36,545 |
| Thomas Parker | ||||||||||||||
| Sys VP - Service Lines | $353,725 | $0 | $77,093 | $0 | $23,932 | $0 | $24,748 | $0 | $3,744 | $0 | $483,242 | $0 | $0 | $0 |
| Tim D Snider | ||||||||||||||
| Vice President/CFO (See Sch O) | $197,727 | $0 | $31,660 | $0 | $1,147 | $0 | $12,268 | $0 | $24,587 | $0 | $267,389 | $0 | $0 | $0 |
| James Hurak | ||||||||||||||
| Vice President - Operations | $147,949 | $0 | $20,053 | $0 | $22,138 | $0 | $21,019 | $0 | $26,290 | $0 | $237,449 | $0 | $0 | $0 |
| Thomas Bigley | ||||||||||||||
| Director of Pharmacy | $148,792 | $0 | $18,949 | $0 | $3,699 | $0 | $8,442 | $0 | $13,749 | $0 | $193,631 | $0 | $0 | $0 |
| Rebecca Rice | ||||||||||||||
| President & CEO | $263,033 | $0 | $21,943 | $0 | $24,587 | $0 | $31,742 | $0 | $14,570 | $0 | $355,875 | $0 | $0 | $0 |
| Dale E Creech | ||||||||||||||
| Sys VP - CLO | $0 | $370,828 | $0 | $95,619 | $0 | $110,244 | $0 | $128,946 | $0 | $26,734 | $0 | $732,371 | $0 | $0 |
| MARK W SHAW | ||||||||||||||
| Sys VP - MANAGED CARE | $0 | $265,641 | $0 | $72,161 | $0 | $51,115 | $0 | $73,213 | $0 | $26,161 | $0 | $488,291 | $0 | $0 |
| RENEE P GEORGE | ||||||||||||||
| Sys VP-Rev Cycle (to Sep) | $0 | $230,033 | $0 | $32,277 | $0 | $597 | $0 | $8,355 | $0 | $13,488 | $0 | $284,750 | $0 | $0 |
| Danny Bailey DPM | ||||||||||||||
| Chief Medical Officer | $289,128 | $0 | $25,876 | $0 | $10,491 | $0 | $9,108 | $0 | $24,059 | $0 | $358,662 | $0 | $0 | $0 |
| Thomas A Nash | ||||||||||||||
| Sys VP - CPO | $0 | $131,219 | $0 | $64,106 | $0 | $88,881 | $0 | $86,773 | $0 | $24,433 | $0 | $395,412 | $0 | $0 |
| David Meckstroth | ||||||||||||||
| Former President & CEO | $0 | $0 | $0 | $0 | $0 | $165,509 | $0 | $0 | $0 | $0 | $0 | $165,509 | $0 | $0 |
| Kathleen J Scarbrough | ||||||||||||||
| President, UVMC Foundation | $59,889 | $43,824 | $10,490 | $7,676 | $7,790 | $5,700 | $10,185 | $6,267 | $14,694 | $9,333 | $103,048 | $72,800 | $0 | $0 |
| Christopher Grove MD | ||||||||||||||
| TRUSTEE | $0 | $283,690 | $0 | $29,056 | $0 | $17,918 | $0 | $2,806 | $0 | $25,827 | $0 | $359,297 | $0 | $0 |
| Thomas R Curtin | ||||||||||||||
| Sys VP-Rev Cycle (from Sep) | $0 | $184,090 | $0 | $45,762 | $0 | $2,543 | $0 | $24,688 | $0 | $29,142 | $0 | $286,225 | $0 | $0 |
| Terry R Fry | ||||||||||||||
| VP - CNO (UVMC) | $145,215 | $0 | $13,856 | $0 | $19,049 | $0 | $20,395 | $0 | $722 | $0 | $199,237 | $0 | $0 | $0 |
| Gary G Ginter | ||||||||||||||
| Sys VP - CIO | $0 | $309,065 | $0 | $27,885 | $0 | $1,758 | $0 | $28,460 | $0 | $12,816 | $0 | $379,984 | $0 | $0 |
| Barbara A Johnson | ||||||||||||||
| Sys VP - Human Resources | $0 | $358,650 | $0 | $97,078 | $0 | $6,911 | $0 | $10,423 | $0 | $11,102 | $0 | $484,164 | $0 | $0 |
| Tammy S Lundstrom MD | ||||||||||||||
| Sys VP - CMO | $0 | $478,960 | $0 | $129,296 | $0 | $5,942 | $0 | $8,159 | $0 | $1,537 | $0 | $623,894 | $0 | $0 |
| Sylvain TREPANIER | ||||||||||||||
| Sys VP - CNO | $0 | $310,122 | $0 | $42,753 | $0 | $1,126 | $0 | $2,664 | $0 | $11,011 | $0 | $367,676 | $0 | $0 |
| Delores A Mullen | ||||||||||||||
| DIR-EMERGENCY SVS-UVMC | $114,509 | $0 | $12,337 | $0 | $1,558 | $0 | $15,598 | $0 | $25,168 | $0 | $169,170 | $0 | $0 | $0 |
| Scott Shelton | ||||||||||||||
| Sys VP - CPO (from Sep) | $0 | $233,356 | $0 | $33,563 | $0 | $168,447 | $0 | $35,429 | $0 | $3,018 | $0 | $473,813 | $0 | $0 |
| Nick Lair | ||||||||||||||
| Former Key Employee | $0 | $195,567 | $0 | $69,780 | $0 | $26,307 | $0 | $34,808 | $0 | $26,011 | $0 | $352,473 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PART I, LINE 4A: | FormAndLineReferenceDesc |
| Explanation | Thomas Nash received $85,768 of severance payments. Schedule J, Part I, Line 4B: Due 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, Upper Valley Medical Center compensates for this limitation and supplements the affected executives' qualified pension through certain nonqualified plans. Upper Valley Medical Center supplements through a Pension Restoration Plan and Supplemental Executive Retirement Plan or "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 2014. The individuals listed below have met the multi-year vesting requirement under the pension restoration plan and received the associated payment in 2014: Dale Creech $103,141, Nick Lair $7,833, Mark Shaw $43,312, and Scott Shelton $167,741. Michael Maiberger and Danny S Bailey met the multi-year vesting requirements under the SERP and received associated payments in 2014 of $36,544 and $5,739,respectively. 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. ANY PAYMENTS MADE AFTER THE 2-1/2 MONTHS WERE PROPERLY REPORTED ON PRIOR YEARS' FILED IRS FORM 990 RETURNS, DISCLOSING COMPENSATION EARNED BY THESE INDIVIDUALS UNDER THE PLANS FOR EACH SUCH YEAR. Schedule J, Part II, line 3: Timothy Snider serves as an officer for both Upper Valley Medical Center and another unrelated hospital. However, 100% of his compensation is paid by Upper Valley Medical Center. Mr. Snider spends approximately one-half of his working hours at each Hospital. The compensation reported on Part VII & Schedule J, Part II includes all of his reportable compensation, even though Upper Valley Medical Center is reimbursed by the unrelated hospital for his time spent at that institution. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | County of Miami Ohio | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 316000055 | BondIssuerEIN |
| CUSIP | 593328EV5 | CUSIPNum |
| Bond Issued | 2006-06-29 | BondIssuedDt |
| Issue Price | $57,502,248 | IssuePriceAmt |
| Purpose | See Part VI | PurposeDesc |
| Defeased | false | DefeasedInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Pool Financing | false | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $12,545,000 | RetiredAmt |
| Bond Defeased | $0 | BondDefeasedAmt |
| Total Proceeds | $61,915,569 | TotalProceedsAmt |
| In Reserve Fund | $5,374,563 | InReserveFundAmt |
| Capitalized Interest | $0 | CapitalizedInterestAmt |
| Refunding Escrow | $663,253 | RefundingEscrowAmt |
| Issuance Costs From Proceeds | $0 | IssuanceCostsFromProceedsAmt |
| Credit Enhancement | $0 | CreditEnhancementAmt |
| Working Capital Expenditures | $0 | WorkingCapitalExpendituresAmt |
| Capital Expenditures | $0 | CapitalExpendituresAmt |
| Other Spent Proceeds | $19,589,170 | OtherSpentProceedsAmt |
| Unspent | $36,288,583 | UnspentAmt |
| Substantial Completion | 2009 | SubstantialCompletionYr |
| Current Refunding | Yes (true) | CurrentRefundingInd |
| Advance Refunding | false | AdvanceRefundingInd |
| Final Allocation Made | Yes (true) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (true) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | Yes (true) | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | Yes (true) | MgmtContractBondFincdPropInd |
| Engage Bond Counsel Contracts | Yes (true) | EngageBondCounselContractsInd |
| Any Research Agreements | false | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00050 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00230 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00280 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | false | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | false | ChangeInUseBondFinancedPropInd |
| Remedial Action Taken | false | RemedialActionTakenInd |
| Procs Nonqualified Bond Remdtd | Yes (true) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiledInd |
| Rebate Not Due Yet | false | RebateNotDueYetInd |
| Exception To Rebate | false | ExceptionToRebateInd |
| No Rebate Due | Yes (true) | NoRebateDueInd |
| Variable Rate Issue | false | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | Yes (true) | HedgeIdentifiedInBksAndRecInd |
Hedge Provider Name HedgeProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BOAML | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 10.67 | TermOfHedgePct |
| Superintegrated Hedge | false | SuperintegratedHedgeInd |
| Hedge Terminated | false | HedgeTerminatedInd |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGICInd |
GIC Provider Name GICProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 0 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Proceeds Invested | Yes (true) | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (true) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (true) | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Footnotes | FormAndLineReferenceDesc |
| Explanation | Schedule K, part I, Line A, Column F Purpose of Bond: The Bond issue of 6/29/2006 was used to currently refund the 1996A, 1996B and 1996C series bonds and to provide capital for hospital improvements and equipment purchases. Schedule K, Part II, Line 3: Total proceeds of Issue-Includes sale proceeds of $57,502,248 plus $2,280,180 earnings on Debt Service Reserve Fund and $2,133,141 earnings on Project Fund. Schedule K, Part II, Line 11: Other Spent Proceeds includes $34,109,391 sale proceeds used to currently refund the 1996A, 1996B and 1996C bonds and $2,179,192 of earnings on the Debt Service Fund used to pay debt service on the 2006 series bonds. Schedule K, Part IV, Line 1: An arbitrage rebate calculation and yield restriction calculation were performed in 2011 by a rebate analyst and it was determined that no arbitrage rebate or yield restriction liability were owed. Therefore, Form 8038-T was not required to be filed. Schedule K, Part IV, Line 5: Gross Proceeds Invested Beyond an Available Temporary Period. A portion of the proceeds received from the sale of the 2006 series bonds, and the earnings thereon, which were held in the Project Fund were not expended prior to June 29, 2009, the end of the 3 year temporary period described in Treas. Req. 1.148-2(e)(2). Those amounts were fully spent as of December 24, 2009. A yield restriction calculation waS performed by a rebate analyst on the five-year anniversary date of the issuance of the 2006 series bonds and it was determined that no yield reduction payments were owed. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Digestive Specialty CareInc | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | >35% Owner- Fayez Abboud | RelationshipDescriptionTxt |
| Transaction | $561,874 | TransactionAmt |
| Transaction | GASTROENTEROLOGY SERVICES | TransactionDesc |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part V, schedule L | FormAndLineReferenceDesc |
| Explanation | Dr Fayez Abboud was a former CEO of Upper Valley Medical Center. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part I, Line 1 and Part III, Line 1 | Upper Valley Medical Center, as a subsidiary of UVMC, serves as an integral part in achieving UVMC's mission: UVMC will strive to provide quality care that upholds the dignity of all individuals. Care will be given in a holistic manner without regard to race, religion, creed, national origin, or social status. Our health care delivery system is structured to optimize the delivery of safe, efficient, and cost-effective health care. |
| FORM 990 , Part I, Question 10: | UPPER VALLEY MEDICAL CENTER HAS DESIGNATED ITS INVESTMENTS AS TRADING. IN ACCORDANCE WITH THE AICPA GUIDE FOR HEALTHCARE, ALL UNREALIZED GAINS AND LOSSES ARE RECOGNIZED THROUGH THE PROFIT AND LOSS STATEMENT. FOR 990 REPORTING, THIS ACTIVITY IS EXCLUDED PER THE INSTRUCTIONS BY THE INTERNAL REVENUE SERVICE. Form 990, PART III, LINE 4A: The primary exempt purpose of Upper Valley Medical Center is to provide comprehensive inpatient, outpatient, and emergency health care services to the residents of Miami and the surrounding counties. The hospital furthers its tax-exempt purpose by promoting the health of the community in many ways. See Schedule H for more information. |
| Form 990, Part VI, Section A, Question 3: | Premier Health (Premier) as the operator of Upper Valley Medical Center (Upper Valley) develops and oversees the implementation of the strategic plan for Upper Valley, which includes (but is not limited to) such matters as location of clinical and administrative services and the consolidation of such services. UPPER VALLEY shall comply with and implement this plan and shall not take any action that materially departs from this plan without Premier's approval. UPPER VALLEY develops and submits an annual capital and operating budget to Premier for approval. UPPER VALLEY shall adopt and implement the capital and operating budget so approved and/or revised for it by Premier. UPPER VALLEY may periodically develop and submit a business plan to Premier for approval. UPPER VALLEY shall implement any business plan approved by Premier. Premier is the sole agent to negotiate all relationships with payors on behalf of UPPER VALLEY with all third party payors and alternative delivery systems including, but not limited to insurers. UPPER VALLEY 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. UPPER VALLEY must seek Premier's approval for any acquisitions, sale or transfer of any material asset used in Premier's activities. Form 990, Part VI, Section A, Question 6: Upper Valley Medical Center has two corporate members. One member is UVMC, the parent company of the hospital. The second member is Premier Health (Premier), an Ohio nonprofit corporation, formed pursuant to the Joint Operating Agreement. UVMC has the sole authority to elect the Board of Trustees of the corporation. Premier has the general authority to operate and manage the operations of the Premier's activities of the corporation. |
| Form 990, Part VI, Section A, Question 7A: | UVMC has the sole authority to elect the board of trustees of Upper Valley Medical Center. UVMC has the authority to remove trustees at any regular or special board meeting or by written consent. Premier Health (Premier) has the right to request that UVMC remove a trustee of UVMC or Upper Valley Medical Center if Premier has determined that such trustee is frustrating the goals and purposes of Premier's network. Such request shall not be unreasonably refused by UVMC. |
| Form 990, Part VI, Section A, Question 7B: | SEE THE RESPONSE ABOVE FOR FORM 990, PART VI, SECTION A, QUESTION 3. |
| Form 990, Part VI, Section B, Line 11B: | This 990 tax return and attached schedules (the return) are prepared by staff member in the Premier Health (Premier) tax department, of which Upper Valley Medical Center is an affiliate. The return is reviewed by the Tax Manager and Director of Tax Compliance of Premier. The Return is concurrently sent to Ernst & Young U.S. LLP for their review. After all changes from the above groups are made, the return is reviewed by the Vice-President/Controller of Premier and the Chief Financial Officer of this entity. A final version of the return is sent to Ernst & Young U.S. LLP for a final review AND THEN 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 questions from the board of trustees, PENDING THEIR REVIEW. The 990 tax return is also shared with the Audit Committee of Premier. |
| Form 990, Part VI, Section B, Line 12C: | PREMIER HEALTH (PREMIER), OF WHICH Upper Valley Medical Center IS AN AFFILIATE, REQUIRES ALL BOARD MEMBERS, OFFICERS, EXECUTIVE DIRECTORS, VICE PRESIDENTS, DIRECTORS, PURCHASING DEPARTMENT STAFF, AUTHORIZED PURCHASERS, MEDICAL DIRECTORS, DEPARTMENT AND SECTIONS CHAIRS, 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 OFFICER. 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 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 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 TAX RETURN. |
| Form 990, Part VI, Section B, Line 15A & 15B: | Premier Health (Premier), of which Upper Valley Medical Center is an affiliate, follows a market based compensation philosophy designed to attract and retain the executive talent required to meet the high performance standards of our board and our community. Premier annually reviews executive compensation survey data for a regional peer group of systems and hospitals that are similar in size and complexity to Premier and its affiliates. The data for the survey is provided by a third party consultant group that is independent of Premier. The report includes comparability for key executives, vice presidents, and director level positions. The independent comparability data is reviewed by the executive compensation committee on an annual basis. This committee is comprised of three members, all of whom are independent. This committee reviews in detail the compensation for the Premier CEO, COO, CFO, Chief Strategy Officer, and the hospital CEOs. Other positions are reviewed at a high level for reasonableness. All the meeting minutes are documented and kept on file along with any comparability data and the consultant report. After the compensation committee reviews and approves the compensation actions, the process is audited by the internal audit department. The executive compensation committee presents the compensation actions to the Premier board annually. |
| Form 990, Part VI, Section C, Line 19A: | The 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 on the company website. Form 990,Part VII, Line 1a Item 17: Timothy Snider serves as an officer for both Upper Valley Medical Center and another unrelated hospital. However, 100% of his compensation is paid by Upper Valley Medical Center. Mr. Snider spends approximately one-half of his working hours at each Hospital. The compensation reported on Part VII & Schedule J, Part II includes all of his reportable compensation, even though Upper Valley Medical Center is reimbursed by the unrelated hospital for his time spent at that institution. |
| Form 990, Part XI, Line 9: | Pension adjustment (12,864,455) Capital donations 796,782 Equity transfers (7,381,632) PHG reclasses (143,725) PHO equity infusion 250,000 Transfer from Mid-Terra 29,195,608 Change in Auxilliary Cash position 48,221 Foundation adjustment (85,580) Total 9,815,219 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| UVMC | ||||||||||
| 110 N Main St Suite 500 | DAYTON | OH | 45402 | 341850683 | PARENT | OH | 501(c)(3) | 11-C FI | NA | false |
| UVMC Foundation | ||||||||||
| 3130 N COUNTY ROAD 25A | Troy | OH | 45373 | 311581859 | Foundation | OH | 501(c)(3) | 11, III-D | NA | false |
| Med-Terra Inc | ||||||||||
| 110 N MAIN ST Suite 500 | DAYTON | OH | 45402 | 311232074 | HOLDING CO | OH | 501(c)(2) | N/A | UVMC | Yes (true) |
| Premier Health | ||||||||||
| 110 N Main St Suite 500 | Dayton | OH | 45402 | 311446699 | JOA Parent | OH | 501(c)(3) | 11, I | NA | false |
| Upper Valley Professional Corp (UVPC) | ||||||||||
| 110 N Main St Suite 500 | DAYTON | OH | 45402 | 311400963 | Health Care | OH | 501(c)(3) | 9 | UVMC | Yes (true) |
| UVPC Specialists Inc | ||||||||||
| 110 N Main St Suite 500 | DAYTON | OH | 45402 | 203687536 | Health Care | OH | 501(c)(3) | 9 | UVPC | Yes (true) |
| UVMC NURSING CARE INC | ||||||||||
| 110 N Main St Suite 500 | DAYTON | OH | 45402 | 311224064 | NURSING HOME | OH | 501(c)(3) | 9 | UVMC | Yes (true) |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| UVMC MANAGEMENT CORPORATION | ||||||||||||
| 110 N Main St Suite 500 | DAYTON | OH | 45402 | 311360489 | MGT COMPANY | OH | UVMC | C CORP | $0 | $0 | 0.00000 | Yes (true) |
| After Hours Family Care Inc | ||||||||||||
| 110 North Main St | Dayton | OH | 45402 | 311269483 | Health Care | OH | UVPC | C Corp | $0 | $0 | 0.00000 | Yes (true) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | 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 | Yes (true) | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (13 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| UVMC | ||
| c | $677,130 | FMV |
| UVMC | ||
| q | $416,500 | FMV |
| UVPC SPECIALISTS INC | ||
| b | $2,487,761 | FMV |
| UVMC Foundation | ||
| c | $205,232 | Cash |
| UVMC Foundation | ||
| q | $112,000 | FMV |
| Upper Valley Professional Corporation | ||
| b | $4,892,871 | Cash |
| Upper Valley Professional Corporation | ||
| o | $2,278,931 | FMVC |
| Upper Valley Professional Corporation | ||
| Q | $239,847 | FMV |
| Med-Terra Inc | ||
| I | $272,126 | FMV |
| Med-Terra Inc | ||
| K | $916,847 | FMV |
| Med-Terra Inc | ||
| Q | $236,717 | FMV |
| Med-Terra Inc | ||
| s | $29,195,608 | FMV |
| Premier Health | ||
| b | $143,725 | cash |