2014-05-14T17:22:43-05:00 2013-06-30 861065772 Deloitte Tax LLP 250 East Fifth Street Suite 1900 Cincinnati OH 45202 990 2012-07-01 311435820 UC Health UCHE 5135856000 3200 Burnet Avenue Cincinnati OH 45229 Charity N Fannin 5135856000 2014-05-14 1 James W Sowar P00529407 5137847100 2014-05-15 2012 2015-11-30 17:44:51Z Hugh R Hinds Jr 3200 Burnet Avenue Cincinnati OH 45229 1219585152 0 X www.uchealth.com X 1996 OH UC Health, the only university-based academic medical center in the region, serves its patients through its mission to provide life changing, patient centered medical care, drive innovation through groundbreaking research, and educate and inspire the next generation of healthcare professionals. We strive to be the region's quality health care partner and a national leader in solving complex medical problems. 9 9 9288 728 1282544 0 68331 23581947 101498393 1127109811 14724247 24903131 3488641 42972531 119779612 1218567420 387395 24027918 0 0 49757024 686082247 0 0 0 53408266 489284188 103552685 1199394353 16226927 19173067 1207074517 1211709459 712343857 625899638 494730660 585809821 X UC Health, the only academic medical center in the region, serves its patients through its mission to provide life changing, patient centered medical care, drive innovation through groundbreaking research, and educate and inspire the next generation of healthcare professionals. We strive to be the region's quality health care partner and a national leader in solving complex medical problems. 1 1 530675245 24027918 856335306 Patient Services and Physician Services 122279617 83441461 Subsidized Health Services 168320803 152955133 Unpaid Cost of Medicaid 177864163 67095084 Health Professions Education: Program Service Revenue - $21,055,804, Program Service Expenses - $70,901,724;Traditional Charity Care: Program Service Revenue - $46,039,280, Program Service Expenses - $97,027,205;Community Health Improvement Services: Program Service Expenses - $7,310,451;Financial and In-Kind Contributions: Program Service Expenses - $2,599,366;Research: Program Service Expenses - $25,417. 177864163 67095084 999139828 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 1067 0 1 9288 1 1 1 1 CJ 0 0 0 0 0 0 0 0 X 9 9 0 0 1 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X Charity N Fannin 5135859835 3200 Burnet Avenue Cincinnati OH 45229 Margaret E Buchanan 5.00 1.00 X X 0 0 0 George L Strike 5.00 2.00 X X 0 0 0 Joseph Broderick MD 5.00 0.00 X X 0 0 0 C Francis Barrett Esq 5.00 1.00 X 0 0 0 Sandra Heimann 5.00 1.00 X 0 0 0 William E Hurford MD 5.00 0.00 X 0 0 0 Rev Damon Lynch Jr 5.00 1.00 X 0 0 0 William C Portman III 5.00 0.00 X 0 0 0 Creighton B Wright MD 5.00 0.00 X 0 0 0 Jeffrey L Wyler 5.00 0.00 X 0 0 0 James Kingsbury 57.00 3.00 X 1324960 0 -16282 Hugh R Hinds 56.00 4.00 X 597311 0 240874 Faheemah Muhammad 49.00 1.00 X 74362 0 8504 Kevin Joseph MD 60.00 0.00 X 415668 0 44347 W Brian Gibler MD end 613 60.00 0.00 X 606575 0 79888 Myles Pensak MD 59.00 1.00 X 288893 0 30958 Diya Mutasim MD 50.00 0.00 X 1322445 0 75234 Angelo Colosimo MD 50.00 0.00 X 965439 0 82154 Hugh Gloster MD 50.00 0.00 X 943388 0 53184 Adam Ingraffea MD 50.00 0.00 X 767368 0 28924 Michael Edwards MD 49.00 1.00 X 695550 0 79456 8001959 0 707241 820 0 1 0 Aramark Management Services LP 2300 Warrenville Road Downers Grove IL 60515 Enviornmental and Food Services 14866527 Hoxworth Blood Center - Univ of Cincinn PO Box 691060 Cincinnati OH 45269 Blood Services 10532004 Epic System Corporation 1979 Milky Way Verona WI 53593 IT Services 10216325 Medassets Inc PO Box 405652 Atlanta GA 303845652 Purchasing Services 4368444 Metro Aviation Inc 1214 Hawn Avenue Shreveport LA 71107 Helicopter Flights 4039216 153 20900000 2681947 23581947 Net Patient Services 621990 1073619512 1073619512 Clinical Contract Rev. 621110 25384597 25050375 334222 Residents 621990 12160081 12160081 Research Revenue 621110 6648022 6648022 Medical Directorship 621110 1604582 1602582 2000 7693017 7550046 142971 1127109811 18012818 18012818 5123387 0 5123387 5123387 37827 5085560 6817116 296890 0 223693 6817116 73197 6890313 6890313 1258215 794039 464176 464176 Meaningful Use 900099 14966767 14966767 Joint Venture Income 900003 3956346 3956346 Cafeteria 722210 3423078 3423078 15038777 14273253 765524 37384968 1218567420 1159826984 1282544 33875945 X 24027918 24027918 2604115 2083292 520823 553122001 442497601 110624400 103468126 82774501 20693625 26888005 21510404 5377601 3467566 3467566 769228 769228 153082250 122465800 30616450 852323 681858 170465 17614490 14091592 3522898 28199966 22559973 5639993 393514 314811 78703 4527835 3622268 905567 13827552 11062042 2765510 53116671 42493337 10623334 3078503 2462802 615701 Medical Supplies 176093705 176093705 Hosptial Franchise Tax 13867701 13867701 Maintenance & Repairs 5954449 4763559 1190890 Membership Dues/License 4084391 3267513 816878 10354044 8499151 1854893 1199394353 999139828 200254525 0 34929374 43170958 0 176837129 178710953 0 35448 12992716 14294874 10668136 9142734 1100773581 639210767 422650779 461562814 462277939 433679616 50187949 18994842 344492 451120 36186003 51666100 1207074517 1211709459 108130854 99197750 222623 454405 291615721 286675340 25033752 41321467 2354161 284986746 198250676 712343857 625899638 X 486157447 576784199 4826495 5118269 3746718 3907353 494730660 585809821 1207074517 1211709459 X 19173067 11192978 60713116 X 0 1 X 1 0 X 23581947 23581947 1146032924 1146032924 1169614871 1169614871 0 0 0 1169614871 23136205 23136205 23136205 23136205 18461855 18461855 1211212931 1211212931 0.96570 0.01910 X Schedule A, Part II, Line 12, Explanation of Other Income: All Other Revenue Cafeteria Schedule A, Part IV, Supplemental Information: Schedule A, Part III: UC Health is not within its first five years of operation; however, it was a IRC Section 509(a)(3), Type III - Functionally Integrated Supporting Organization prior to the current fiscal year ended June 30, 2013. UC Health received a redetermination from the Internal Revenue Service as a IRC Section 509(a)(2) organization for the fiscal year ended June 30, 2013. Therefore, we have completed only the 2012 column as the organization was not a IRC Section 509(a)(2) organization prior to this fiscal year. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 45564 45564 0 Part IV, Supplemental Information: Part II-A, Line 1(c) and Part II-B, Line 1, Lobbying Activities: Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. UC Health does not participate in or intervene in (including the publishing or distributing or statements) any political campaign on behalf of (or in opposition to) any candidate for public office. 3647390 105327 55307 3808024 2784684 864218 -1512 3647390 2591176 182279 11229 2784684 2497817 90310 3049 2591176 3296887 -710828 -88242 2497817 1.00000 0 0 27393867 27393867 581918591 313804821 268113770 7247580 3712243 3535337 459953974 313385070 146568904 24259569 8308633 15950936 461562814 Employee Benefit Related Liabilities 134296775 Interest Payable 4149736 Due to Affiliates 3865033 Due to Third Party Payors 14310056 Asset Retirement Obligations Payable 9315495 Other Liabilities 9378889 Professional Liabilities 22934692 198250676 Description of Intended Use of Endowment Funds: Part V, Line 4: The intended use for the organization's endowment funds is to enhance the high-quality services and compassionate care provided by UC Health. 1 1 X 1 X 1 X 1 1 1 0 1 1 97027205 46039280 50987925 0.04250 168320803 152955133 15365670 0.01280 265348008 198994413 66353595 0.05530 7310451 7310451 0.00610 70901724 21055804 49845920 0.04160 122279617 83441461 38838156 0.03240 25417 25417 0.00000 2599366 2599366 0.00220 203116575 104497265 98619310 0.08230 468464583 303491678 164972905 0.13760 0 32388578 0 175029111 153501835 21527276 X 1 1 3 1 University of Cincinnati Medical Cnt

234 Goodman Street Cincinnati OH 45219

uchealth.com/university-of-cincinnati- X X X X X A 2 West Chester Hospital LLC

7700 University Drive Cincinnati OH 45069

uchealth.com/westchesterhospital X X X B 3 Daniel Drake Cntr for Post-Acute Care

151 West Galbraith Road Cincinnati OH 45216

uchealth.com/danieldrakecenter X LTAC/SNF A Facility Reporting Group A 1 X X X X X X X X X 12 1 0 1 X X 1 0 1 1 150.000000000000 1 200.000000000000 1 X X X X X X X 1 1 X 1 0 1 X 0 0 Facility Reporting Group B 1 X X X X X X X X X 12 1 1 1 X X 1 0 1 1 150.000000000000 1 200.000000000000 1 X X X X X X X 1 1 X 1 0 1 X 0 0 38 Drake Rehab at West Chester

7626 University Court Suite 101 West Chester OH 45069

Rehabilitation Services Drake Rehab at Stetson Square

260 Stetson Street Suite 266 Cincinnati OH 45219

Rehabilitation Services Drake Development LLC (Bridgeway Pointe

165 West Galbraith Road Cincinnati OH 45219

Assisted Living Facility UC Health Physicians Offices

222 Piedmont Avenue Cincinnati OH 45219

Physician Practices UC Health Physicians Offices South

7675 Wellness Way West Chester OH 45069

Physician Practices UC Health Physicians Offices North

7690 Discovery Drive West Chester OH 45069

Physician Practices UC Health Pain Medicine

7759 University Drive Suite C West Chester OH 45069

Physician Practices UC Health Psychiatry

260 Stetson Street Cincinnati OH 45219

Physician Practices Hoxworth Center

3130 Highland Ave Cincinnati OH 45219

Physician Practices Precision Radiotherapy LLC

7710 Discovery Drive West Chester OH 45069

Radiation Oncology Practice UC Health Primary Care

1251 Nilles Rd Suite 4 Fairfield OH 45014

Primary Care Practice UC Health Primary Care

11340 Montgomery Road Cincinnati OH 45249

Primary Care Practice UC Health Primary Care

9313 Mason Montgomery Rd Suite 200 Mason OH 45040

Primary Care Practice UC Health Physician Offices

9275 Montgomery Road Cincinnati OH 45242

Physician Practices UC Health Physician Offices

4460 Red Bank Expressway Cincinnati OH 45227

Physician Practices UC Health Primary Care

841 West State Street Trenton OH 45067

Primary Care Practice UC Health Primary Care

11590 Century Blvd Cincinnati OH 45246

Primary Care Practice UC Health Primary Care

5900 West Chester Road West Chester OH 45069

Primary Care Practice UC Health Primary Care

305 Crescent Avenue Cincinnati OH 45215

Primary Care Practice UC Health Physician Offices

2123 Auburn Avenue Cincinnati OH 45219

Physician Practices UC Health Dermatology Office

525 Alexandria Pike Suite 310 Southgate KY 41071

Physician Practices UC Health Dermatology Office

3012 Glenmore Avenue Cincinnati OH 45238

Physician Practices UC Health Gynecologic Oncology

3535 Southern Boulevard Kettering OH 45429

Physician Practices UC Health Fetal Maternal Medicine

3000 Mack Road Fairfield OH 45014

Physician Practices UC Health Fetal Maternal Medicine

7500 State Road Cincinnati OH 45255

Physician Practices UC Health Nephrology

107 Bridgeway Suite 101 Auroa IN 47001

Dialysis Clinic UC Health Nephrology

232 State Road 129S Batesville IN 47006

Dialysis Clinic UC Health Nephrology

1531 North Commerce East Drive Greensburg IN 47240

Dialysis Clinic UC Health Nephrology

4760 East Galbraith Rd Suite 203 Cincinnati OH 45236

Dialysis Clinic UC Health Nephrology

1401 Harrodsburg Rd Suite C335 Lexington KY 40504

Dialysis Clinic UC Health Nephrology

220 Clifty Drive Suite K Madison IN 47250

Dialysis Clinic UC Health Nephrology

1210 Pope Drive Maysville KY 41056

Dialysis Clinic UC Health Nephrology

2340 North State Highway 7 North Vernon IN 47265

Dialysis Clinic UC Health Nephrology

110 East 13th Street Rushville IN 46173

Dialysis Clinic UC Health Orthopaedics and Sports Medici

7570 Highway 42 Florence KY 41042

Physician Practices UC Health Orthopaedics and Sports Medici

2449 Ross-Millville Rd Suite 265 Hamilton OH 45013

Physician Practices UC Health Orthopaedics and Sports Medici

5575 Cheviot Road Cincinnati OH 45239

Physician Practices UC Health Orthopaedics and Sports Medici

630 West Main Street Suite 109 Wilmington OH 45177

Physician Practices Part I, Line 7: The net community benefit expenses are estimated using a cost-to-charge ratio. The cost-to-charge ratio is based on allowable cost per the Medicare Cost Report as a percent of total patient charges. Part III, Line 4: UC Health offers uninsured patients who are not eligible for any discount under the terms of the Charity Care Policy an uninsured discount of a percentage off billed charges to help ease the burden of medical expenses. The uninsured discount is not included in bad debt expense. Bad debt expense, at cost, is calculated using a cost-to-charge ratio. The cost-to-charge ratio is based on allowable cost per the Medicare Cost Report as a percent of total patient charges.The organization's share of bad debt expense was $105,798,336 at charges ($32,388,578 at cost). Part III, Line 8: UC Health follows the Catholic Health Association of the United States policy document, Community Benefit Program, A Revised Resource for Social Accountability ("CHA Guidelines") for determining community benefit. Part III, Line 9b: UC Health representatives will assist patients in filling out the Financial Assistance Application. Part VI, Line 2: UC Health utilizes various methods to assess the health care needs of the communities it serves. The primary method includes membership in various industry organizations including Greater Cincinnati Health Council, Ohio Hospital Association, and American Hospital Association; and affiliations with various regulatory agencies, including Joint Commission on Accreditation of Healthcare Organizations, Commission on Accreditation of Rehabilitation Facilities, and Ohio Department of Health. Additionally, UC Health utilizes an independent research group to monitor patient satisfaction, solicit feedback from physicians, and be actively involved in community health fairs and education events. Additionally, UC Health conducted a Community Health Needs Assessment to identify and begin to address the health needs of the communities which each hospital serves. Using both qualitative and quantitative feedback as well as publically available and proprietary health indicators, UC Health was able to identify and prioritize community health needs for each hospital. Part VI, Line 3: UC Health utilizes a multifaceted approach regarding the communication of assistance programs available to patients. There are signs throughout the hospitals alerting patients of charity care programs available. While registering patients, registrars can offer patients financial assistance applications, which provide information regarding programs available. Financial counselors will also meet with patients and outline programs available, determine eligibility, and offer assistance to complete the application process. When a patient receives their balance due statement, the back of the statement provides information regarding programs and eligibility. During the collections process, representatives will also offer financial assistance information if a patient notifies them that they do not have the ability to pay. Finally, UC Health provides detailed information online to educate patients of programs that are available. Part VI, Line 4: UC Health is a physician-led, integrated health system serving primarily Cincinnati and the Ohio, Kentucky, and Indiana Tristate region. Some key demographics in Hamilton and Butler counties, the main counties served by University of Cincinnati Medical Center, LLC, Daniel Drake Center for Post-Acute Care, LLC, West Chester Hospital, LLC and University of Cincinnati Physicians Company, LLC include:- Over the past 10 years, Hamilton County's population decreased by 5 percent - it is the only UC Health county to lose population.- Hamilton County has the largest number of disabled residents at more than 95,000.- The largest African American population in both size (205,952 people) and percentage (26%) is in Hamilton County.- The Hispanic/Latino population in the region more than doubled between 2000 and 2010 - the largest percentage growth was in Butler County, which saw an increase from 1.4 % to 4%.- Nearly 1 in 5 residents of Hamilton County live in poverty.UC Health has committed itself to providing health care services no one else can to the underserved in our region. These achievements are made possible by the dedicated physicians, nurses, clinicians and administrators who believe in the commitment to our region as a growing, thriving community for today and for the future. Part VI, Line 5: A substantial part of what UC Health provides to the community is in fulfilling the role of caring for the region's most vulnerable patients - providing life-changing, patient-centered care regardless of the ability to pay. As the primary adult teaching affiliate of the University of Cincinnati College of Medicine, University of Cincinnati Medical Center partners with physicians and faculty for various research programs, bringing medical advances and ground breaking clinical initiatives directly to the patients and community. University of Cincinnati Medical Center is involved in a program with the United States Air Force to offer training for military medical personnel in the areas of trauma and critical care. West Chester Hospital provides access to over 750 credentialed physicians to the community and holds community health seminars. West Chester Hospital also hosted the UC Health Safety and Wellness Festival featuring on-site health screenings as well as representation from emergency medical service agencies, community organizations and businesses. Daniel Drake Center for Post-Acute Care (Daniel Drake Center) provides long-term acute care, skilled nursing care, assisted living, various outpatient services, wellness programs, and an aquatic center to the Greater Cincinnati area. In addition, Daniel Drake Center hosts support groups for individuals and families who are faced with the challenges of a chronic illness or injury, such as brain injury or stroke survivors. Daniel Drake Center offers a patient and family library to provide information on the treatment and recovery process and ways to improve overall wellness and quality of life. University of Cincinnati Physicians Company is one of Greater Cincinnati's largest primary care and specialties physician groups, practicing in several locations throughout the region. University of Cincinnati Physicians Company offers a wide range of services to meet the needs of the community, including the aged and indigent. Part VI, Line 6: UC Health is a physician-led, integrated health system serving primarily Cincinnati and the Ohio, Kentucky, and Indiana Tristate region with national and international referrals for tertiary services. Affiliated with the University of Cincinnati and sponsored by UC Healthcare System, UC Health includes the 726-licensed bed University of Cincinnati Medical Center, LLC, the largest hospital in Cincinnati and the region's only university-based academic medical center; the 170-licensed bed West Chester Hospital, LLC, one of the Region's newest hospitals serving the northern suburbs of Cincinnati; University of Cincinnati Physicians, the University of Cincinnati College of Medicine's multi-specialty physician group; the Daniel Drake Center for Post-Acute Care, LLC, a specialized medical and rehabilitative hospital; and other related facilities and services. Reports Filed With States Part VI, Line 7 OH Part V, Line 8 Facility Reporting Group A See below Facility 1 -- University of Cincinnati Medical Center Part V, Section B, line 3: UC Health reviewed and assessed the Greater Cincinnati Health Council's "AIM for Better Health Assessment", a community-wide health needs assessment, an intiative in which UC Health supported and participated. UC Health conducted stakeholder interviews and focus groups including public health officials from Hamilton and Butler Counties as well as the City of Cincinnati, local elected officials and local government administrators, leaders of community-based organizations including the NAACP, Hispanic Chamber of Commerce, African American Chamber of Commerce, the Healthcare Connection (a federally qualified health care clinic), Su Casa, Carmel Presbyterian Church, United Way, Lakota School District, the Center for Closing the Health Gap, fire and EMS offices, and Legal Aid. Internal stakeholders included senior clinical and administrative leaders from each of the hospitals. Facility 1 -- University of Cincinnati Medical Center Part V, Section B, line 5c: The Community Health Needs Assessment ("CHNA") of the University of Cincinnati Medical Center can be located at the following web address: http://uchealth.com/wp-content/uploads/2013/06/UCMC-Assessment-FINAL.pdf Facility 1 -- University of Cincinnati Medical Center Part V, Section B, line 7: UC Health leaders prioritized the identified needs with the goal of quickly impacting the health of the community and to be in alignment with existing hospitals' strengths. Facility 1 -- University of Cincinnati Medical Center Part V, Section B, line 14g: In addition to posting the Charity Care and Financial Assistance Policies to the website and making the policy available upon request, the policy is also referenced in the following ways: - Signs are posted throughout the Emergency Room and other areas within the hospital facility providing details of financial assistance available.- Pamphlets are available in facility admitting and registration areas outlining those financial programs available to the insured.- All Patient Financial Services correspondence, including patient statements and reminder letters, reference financial assistance programs available. Facility 1 -- University of Cincinnati Medical Center Part V, Section B, line 20d: In compliance with state law, UC Health posts a price list containing the charges for room and board, emergency room, operating room, delivery, physical therapy, observation and other procedures. The Hospital's charges are the same for all patients; but a patient's responsibility may vary, depending on payment plans negotiated with individual health insurers. Uninsured or underinsured patients are able to consult with a hospital financial counselor to determine if they qualify for discounts. Such discounts are determined in accordance with UC Health's Charity Care and Financial Assistance Policies. Facility 3 -- Daniel Drake Center for Post-Acute Care Part V, Section B, line 3: UC Health reviewed and assessed the Greater Cincinnati Health Council's "AIM for Better Health Assessment", a community-wide health needs assessment, an intiative in which UC Health supported and participated. UC Health conducted stakeholder interviews and focus groups including public health officials from Hamilton and Butler Counties as well as the City of Cincinnati, local elected officials and local government administrators, leaders of community-based organizations including the NAACP, Hispanic Chamber of Commerce, African American Chamber of Commerce, the Healthcare Connection (a federally qualified health care clinic), Su Casa, Carmel Presbyterian Church, United Way, Lakota School District, the Center for Closing the Health Gap, fire and EMS offices, and Legal Aid. Internal stakeholders included senior clinical and administrative leaders from each of the hospitals. Facility 3 -- Daniel Drake Center for Post-Acute Care Part V, Section B, line 5c: The Community Health Needs Assessment ("CHNA") of the Drake Center can be located at the following web address: http://uchealth.com/wp-content/uploads/2013/06/Drake-Center_CHNA-Report_130523_v3.pdf Facility 3 -- Daniel Drake Center for Post-Acute Care Part V, Section B, line 7: UC Health leaders prioritized the identified needs with the goal of quickly impacting the health of the community and to be in alignment with existing hospitals' strengths. Facility 3 -- Daniel Drake Center for Post-Acute Care Part V, Section B, line 14g: In addition to posting the Charity Care and Financial Assistance Policies to the website and making the policy available upon request, the policy is also referenced in the following ways: - Signs are posted throughout the Emergency Room and other areas within the hospital facility providing details of financial assistance available.- Pamphlets are available in facility admitting and registration areas outlining those financial programs available to the insured.- All Patient Financial Services correspondence, including patient statements and reminder letters, reference financial assistance programs available. Facility 3 -- Daniel Drake Center for Post-Acute Care Part V, Section B, line 20d: In compliance with state law, UC Health posts a price list containing the charges for room and board, emergency room, operating room, delivery, physical therapy, observation and other procedures. The Hospital's charges are the same for all patients; but a patient's responsibility may vary, depending on payment plans negotiated with individual health insurers. Uninsured or underinsured patients are able to consult with a hospital financial counselor to determine if they qualify for discounts. Such discounts are determined in accordance with UC Health's Charity Care and Financial Assistance Policies. Part V, Line 8 Facility Reporting Group B See below Facility 2 -- West Chester Hospital, LLC Part V, Section B, line 3: UC Health reviewed and assessed the Greater Cincinnati Health Council's "AIM for Better Health Assessment", a community-wide health needs assessment, an intiative in which UC Health supported and participated. UC Health conducted stakeholder interviews and focus groups including public health officials from Hamilton and Butler Counties as well as the City of Cincinnati, local elected officials and local government administrators, leaders of community-based organizations including the NAACP, Hispanic Chamber of Commerce, African American Chamber of Commerce, the Healthcare Connection (a federally qualified health care clinic), Su Casa, Carmel Presbyterian Church, United Way, Lakota School District, the Center for Closing the Health Gap, fire and EMS offices, and Legal Aid. Internal stakeholders included senior clinical and administrative leaders from each of the hospitals. Facility 2 -- West Chester Hospital, LLC Part V, Section B, line 4: West Chester Hospital conducted its CHNA in conjunction with UCPHA, Inc., a surgical hospital of which UC Health is the sole member. West Chester Hospital serves the same community as the surgical hospital due to its location. Facility 2 -- West Chester Hospital, LLC Part V, Section B, line 5c: The Community Health Needs Assessment ("CHNA") of the West Chester Hospital can be located at the following web address: http://uchealth.com/wp-content/uploads/2013/06/WC_Surgical_CHNA-Report_130523_v3.pdf Facility 2 -- West Chester Hospital, LLC Part V, Section B, line 7: UC Health leaders prioritized the identified needs with the goal of quickly impacting the health of the community and to be in alignment with existing hospitals' strengths. Facility 2 -- West Chester Hospital, LLC Part V, Section B, line 14g: In addition to posting the Charity Care and Financial Assistance Policies to the website and making the policy available upon request, the policy is also referenced in the following ways: - Signs are posted throughout the Emergency Room and other areas within the hospital facility providing details of financial assistance available.- Pamphlets are available in facility admitting and registration areas outlining those financial programs available to the insured.- All Patient Financial Services correspondence, including patient statements and reminder letters, reference financial assistance programs available. Facility 2 -- West Chester Hospital, LLC Part V, Section B, line 20d: In compliance with state law, UC Health posts a price list containing the charges for room and board, emergency room, operating room, delivery, physical therapy, observation and other procedures. The Hospital's charges are the same for all patients; but a patient's responsibility may vary, depending on payment plans negotiated with individual health insurers. Uninsured or underinsured patients are able to consult with a hospital financial counselor to determine if they qualify for discounts. Such discounts are determined in accordance with UC Health's Charity Care and Financial Assistance Policies. 0 UC Healthcare System 3200 Burnet Avenue Cincinnati OH 45229 273850988 501(c)(3) 125000 General Support UC Physicians Inc 2222 Piedmont Ave Cincinnati OH 45219 311246809 501(c)(3) 18420090 General Support Medical Center Fund of Cincinnati 2830 Victory Parkway Cincinnati OH 45206 310904251 501(c)(3) 4463504 General Support University of Cincinnati Foundation PO Box 19970 Cincinnati OH 45219 310896555 501(c)(3) 225500 General Support University of Cincinnati 2600 Clifton Ave Cincinnati OH 45221 316000989 Gov't Entity 51495 General Support Cincinnati Children's Medical Center 3333 Burnet Ave Cincinnati OH 45229 310833936 501(c)(3) 8769 General Support Cincinnati Marathon Inc 644 Linn Street Suite 626 Cincinnati OH 45203 311571531 501(c)(3) 15000 Sponsorship Cincinnati Zoo & Botanical Garden 3400 Vine Street Cincinnati OH 45220 310537171 501(c)(3) 10000 Sponsorship The Community Foundation of West Chester Liberty 5641 Union Centre Drive West Chester OH 45069 311661966 501(c)(3) 6600 Sponsorship of various events Greater Cincinnati & Northern Kentucky African American Chamber of Commerce 2945 Gilbert Avenue Cincinnati OH 45206 311504758 501(c)(6) 10000 Sponsorship Lifecenter Organ Donor Network 615 Elisnore Place Suite 400 Cincinnati OH 45202 311040508 501(c)(3) 10200 Sponsorship March of Dimes Foundation 10806 Kenwood Road Cincinnati OH 45242 131846366 501(c)(3) 11500 General Support Michelle Moran dba Cincinnati Rollergirls PO Box 30248 Cincinnati OH 45230 204525401 N/A 6000 Sponsorship Nami of Hamilton County Inc 4790 Red Bank Expressway Suite 218 Cincinnati OH 45227 310998076 501(c)(3) 20000 Sponsorship Phillipine Nurses Association of Ohio Foundation 8199 Knightsbridge Ln Concord OH 44060 453073398 501(c)(3) 10000 Sponsorship The Visiting Nurse Association 2400 Reading Road 2nd Floor Cincinnati OH 45202 310536716 501(c)(3) 10000 Sponsorship United Way of Greater Cincinnati 2400 Reading Road Cincinnati OH 45202 310537502 501(c)(3) 45000 General Support West Chester Chamber Alliance 8922 Beckett Road West Chester OH 45069 310901492 501(c)(6) 25000 General Support World Choir Games 2012 525 Vine Street Suite 1500 Cincinnati OH 45202 272305710 501(c)(3) 200000 Sponsorship Abercrumbie Group 10301 Giverny Boulevard Cincinnati OH 45241 300520187 N/A 55000 Sponsorship American Cancer Society Inc Route 422 and SIPE Avenue Hershey PA 17033 251798733 501(c)(3) 25000 Sponsorship American Heart Association Inc PO Box 1590 Hagerstown MD 217411590 135613797 501(c)(3) 129000 Sponsorship/Donations Center for Respite Care Inc 830 Ezzard Charles Drive Cincinnati OH 45214 202544994 501(c)(3) 50000 General Support 19 4 X X 1 1 X X X X X 0 0 0 0 0 0 0 0 0 James Kingsbury 833935 0 404978 0 86047 0 -28500 0 12218 0 1308678 0 0 0 Hugh R Hinds 484425 0 89686 0 23200 0 222222 0 18652 0 838185 0 0 0 Kevin Joseph MD 332253 0 83415 0 0 0 0 0 44347 0 460015 0 0 0 W Brian Gibler MD end 613 506000 0 100575 0 0 0 0 0 79888 0 686463 0 0 0 Myles Pensak MD 253311 0 25000 0 10582 0 28453 0 2505 0 319851 0 0 0 Diya Mutasim MD 32168 0 1267777 0 22500 0 72500 0 2734 0 1397679 0 0 0 Angelo Colosimo MD 942939 0 0 0 22500 0 72500 0 9654 0 1047593 0 0 0 Hugh Gloster MD 107415 0 813473 0 22500 0 43750 0 9434 0 996572 0 0 0 Adam Ingraffea MD 277340 0 490028 0 0 0 21250 0 7674 0 796292 0 0 0 Michael Edwards MD 673050 0 0 0 22500 0 72500 0 6956 0 775006 0 0 0 Part I, Line 1a An executive receives a housing allowance and club membership dues. The personal use portion of these benefits are treated as taxable compensation to the executive. A County of Butler OH 316000061 123550GB5 2010-11-04 204957604 Hospital Facilities 0 0 0 B Port of Greater Cincinnati Development Auth 311752368 NoneAvail 2012-06-29 24200000 Refinance revenue bonds and purchase assets 0 0 0 A 204957604 18688850 3219925 183048829 2011 0 0 1 1 B 24200000 299957 23900043 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 1 0 0 B 0 0 0 0 1 0 0 A 1 0 0 0 0 0 B 1 0 0 0 0 0 Schedule K, Part I: The CUSIP number reported denotes one CUSIP number for the County of Butler , Ohio bond. The bond issue consists of 14 CUSIPs. The CUSIP numbers are as follows: - 123550FN0 - 123550FP5 - 123550FQ3 - 123550FR1 - 123550FS9 - 123550FT7 - 123550FU4 - 123550FV2 - 123550FW0 - 123550FX8 - 123550FY6 - 123550FZ3 - 123550GA7 - 123550GB5 New Program Services Form 990, Part III, line 2 University of Cincinnati Medical Center, LLC, West Chester Hospital, LLC, Daniel Drake Center for Post-Acute Care, LLC, and University of Physicians Company, LLC have been converted to nonprofit single member limited liability coompanies of UC Health. Therefore, the activities of these entities are reported on UC Health Form 990. Changes in Program Services Form 990, Part III, line 3 University of Cincinnati Medical Center, LLC, West Chester Hospital, LLC, Daniel Drake Center for Post-Acute Care, LLC, and University of Physicians Company, LLC have been converted to single member limited liability companies of UC Health. Therefore, the activities of these entities are reported on UC Health Form 990. Form 990, Part VI, Section A, line 4 UC Health's organizational documents were updated to include University of Cincinnati Medical Center, LLC, West Chester Hospital, LLC, Daniel Drake Center for Post-Acute Care, LLC, and University of Cincinnati Physicians Company, LLC, which were converted to nonprofit single member limited liability companies of UC Health as of July 1, 2012. Form 990, Part VI, Section A, line 6 UC Health has a single corporate member, UC Healthcare System. Form 990, Part VI, Section A, line 7a UC Health has a single corporate member, UC Healthcare System, who has the ability to elect members to the governing body of UC Health. Form 990, Part VI, Section B, line 11 A copy of the Form 990 has been provided to each of UC Health's Audit Committee Members. UC Health's Audit Committee demonstrated review of the Form 990 by a vote to approve the Form 990 for review by the full Board of Directors. The Form 990 is then provided to the Board Members for review, prior to filing. Form 990, Part VI, Section B, line 12c On an annual basis and as new individuals are appointed or hired, the corporate internal audit department of UC Health conducts a survey which is distributed to all Board of Directors, physicians and management. The corporate internal audit department collects and reviews all responses, utilizing the assistance of legal counsel, as needed. The corporate internal audit department reports compliance with the policy and non-responses to the Senior Management and Audit Committee of UC Health. Form 990, Part VI, Section B, line 15 UC Health utilizes information from independent compensation consultants and compensation surveys to determine the compensation of Senior Vice Presidents, the Chief Financial Officer, and the Chief Executive Officer. The compensation is approved by the Compensation Committee of the UC Health's Board. The compensation of the Chief Executive Officer is evidenced by a written employment contract. The compensation of all other individuals is also determined at fair market value. Form 990, Part VI, Section C, line 19 The organization will provide any documents open for public inspection upon request. Other Fees Form 990, Part IX, line 11g Purchased Services: Program service expenses 91,362,860. Management and general expenses 22,840,715. Fundraising expenses 0. Total expenses 114,203,575. Service Contracts: Program service expenses 20,019,026. Management and general expenses 5,004,757. Fundraising expenses 0. Total expenses 25,023,783. Consulting, Bank, Billing Fees: Program service expenses 11,083,914. Management and general expenses 2,770,978. Fundraising expenses 0. Total expenses 13,854,892. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 9: Change in Pension Liability 59,968,881. Change in Fair Value of Derivative 350,675. Purchase of UCPHA, Inc. Interest 25,585. Transfer of Net Assets to UC Health Foundation -7,239. Transfer from Equity Investments 375,214. University of Cincinnati Medical Center LLC 234 Goodman Street Cincinnati OH 45219 311479038 Health Care Services OH 731901618 530802126 UC Health Daniel Drake Center for Post-Acute Care LLC 151 West Galbraith Road Cincinnati OH 45216 311273012 Health Care Services OH 51385155 24992847 UC Health University of Cincinnati Physicians Company LLC 3200 Burnet Avenue Cincinnati OH 45229 311405915 Health Care Services OH 327924279 203951803 UC Health West Chester Hospital LLC 7700 University Drive Cincinnati OH 45069 311588499 Health Care Services OH 163583359 182582227 UC Health Drake Development LLC (dba Bridgeway Pointe) 165 West Galbraith Road Cincinnati OH 45216 311658885 Health Care Services OH 3125219 640308 Daniel Drake Center for Post-Acute Care LLC UC Health Partners LLC 234 Goodman Street Cincinnati OH 45219 271031772 Health Care Services OH 5047905 1262304 UC Health Universal Surgical-Dental Associates LLC 2830 Victory Parkway Cincinnati OH 45206 311315108 Dental Care Services OH 2557500 495401 UC Health UC Healthcare System 3200 Burnet Avenue Cincinnati OH 45229 273850988 Support Services OH 501(c)(3) Schedule A, Line 11c N/A 0 Alliance Liability Self Insurance Trust 3200 Burnet Avenue Cincinnati OH 45229 311534045 Support Services OH 501(c)(3) Schedule A, Line 11a UC Health 1 UC Health Foundation(fka University Hospital FoundationInc) 3200 Burnet Avenue Cincinnati OH 45229 261594868 Fundraising OH 501(c)(3) Schedule A, Line 11a UC Healthcare System 1 UCPHA Inc 7750 Discovery Drive West Chester OH 45069 300047074 Health Care Services OH 501(c)(3) Schedule A, Line 3 UC Health 1 JHHA Real Estate LLC 3200 Burnet Avenue Cincinnati OH 45229 272460325 Real Estate OH UC Health Unrelated 3804 0 0 0.54890 UCP Ash LLC 2830 Victory Parkway Cincinnati OH 45206 300047090 Healthcare Services OH Related -40 0 0 Piedmont-Eden Limited Partnership 2830 Victory Parkway Cincinnati OH 45206 311209336 Real Estate OH Related 0 0 UC Health Assurance Company PO Box 1051 GT Grand Cayman, CJ Insurance CJ UC Health C 8778251 44762359 1.00000 1 Midwest Laundry Inc 3200 Burnet Avenue Cincinnati OH 45229 311309029 Commercial Laundry OH UC Health C 6667776 4129553 1.00000 1 Jewish Hospital Services Inc 3200 Burnet Avenue Cincinnati OH 45229 311049967 Miscellaneous Services OH UC Health C 1.00000 1 Piedmont-Eden Corporation 2830 Victory Parkway Cincinnati OH 45206 311187960 Real Estate OH University of Cincinnati Physicians CompanyLLC C 16575 496209 0.79300 1 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 UC Healthcare System B 125000 FMV UCPHA Inc S 17511807 FMV UC Healthcare System M 4571046 FMV UC Healthcare System L 120000 FMV Piedmont-Eden Limited Partnership B 511150 FMV UCPHA Inc L 156000 FMV