UPPER VALLEY MEDICAL CENTER: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization: UPPER VALLEY MEDICAL CENTER (EIN 31-0537095)
Tax period: 2013-01-01 to 2013-12-31
Filed: 2014-11-13
IRS object ID: 201433179349302308
Schema version: 2013v3.1
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	2014-11-13T10:23:58-06:00	ReturnTs
Tax Period End	2013-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	ERNST & YOUNG US LLP	BusinessNameLine1

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	111 MONUMENT CIRCLE 4000	AddressLine1
City	INDIANAPOLIS	City
State	IN	State
ZIP Code	46204	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2013-01-01	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	BusinessNameLine1

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	AddressLine1
Address Line2	Suite 500	AddressLine2
City	Dayton	City
State	OH	State
ZIP Code	45402	ZIPCode

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	TIMOTHY D SNIDER	PersonNm
Person Title	V/P - CFO	PersonTitleTxt
Phone	9374404845	PhoneNum
Signature	2014-11-12	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	CHRISTOPHER B BOGGS	PreparerPersonNm
PTIN	P00032493	PTIN
Phone	9374404845	PhoneNum

Field	Value	IRS element (for citing)
Tax	2013	TaxYr
Build TS	2015-11-30 17:44:51Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	Thomas Parker	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3130 N County Line Rd 25 A	AddressLine1
City	Troy	City
State	OH	State
ZIP Code	45373	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	$232,092,919	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	18	VotingMembersGoverningBodyCnt
Voting Members Independent	13	VotingMembersIndependentCnt
Total Employee	1655	TotalEmployeeCnt
Total Volunteers	154	TotalVolunteersCnt
Total Gross UBI	$220,523	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	-$4,595	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$204,249	PYContributionsGrantsAmt
CY Contributions Grants	$178,614	CYContributionsGrantsAmt
PY Program Service Revenue	$136,222,579	PYProgramServiceRevenueAmt
CY Program Service Revenue	$130,298,278	CYProgramServiceRevenueAmt
PY Investment Income	$5,591,678	PYInvestmentIncomeAmt
CY Investment Income	$2,513,361	CYInvestmentIncomeAmt
PY Other Revenue	$5,273,533	PYOtherRevenueAmt
CY Other Revenue	$2,270,429	CYOtherRevenueAmt
PY Total Revenue	$147,292,039	PYTotalRevenueAmt
CY Total Revenue	$135,260,682	CYTotalRevenueAmt
PY Grants And Similar Paid	$466,210	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$574,010	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$82,671,356	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$77,177,058	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$57,075,139	PYOtherExpensesAmt
CY Other Expenses	$50,138,772	CYOtherExpensesAmt
PY Total Expenses	$140,212,705	PYTotalExpensesAmt
CY Total Expenses	$127,889,840	CYTotalExpensesAmt
PY Revenues Less Expenses	$7,079,334	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$7,370,842	CYRevenuesLessExpensesAmt
Total Assets BOY	$146,435,432	TotalAssetsBOYAmt
Total Assets EOY	$157,678,217	TotalAssetsEOYAmt
Total Liabilities BOY	$112,239,789	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$93,218,464	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$34,195,643	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$64,459,753	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	$112,822,434	ExpenseAmt
Grant	$574,010	GrantAmt
Revenue	$130,298,278	RevenueAmt
Desc	See Schedules H and O.	Desc
Total Program Service Expenses	$112,822,434	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	112	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	1655	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	18	GoverningBodyVotingMembersCnt
Independent Voting Member	13	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	AddressLine1
City	Dayton	City
State	OH	State
ZIP Code	45402	ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (36 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Douglas R Murray
Trustee	0.5	2.5	Yes (X)	$0	$0
Rowan R Nickol MD
BOARD Chair	0.5	39.5	Yes (X)		$21,096	Yes (X)	$223,946
Craig C Bundschuh
Secretary	0.5	2.5	Yes (X)	$0	$0	Yes (X)
Cliff R Alexander
Trustee	0.5	1.0	Yes (X)	$0	$0
Ronald R Fox
Trustee	0.5	1.0	Yes (X)	$0	$0
Daniel P French
Trustee	0.5	1.0	Yes (X)	$0	$0
Gail Haddad RN
Trustee	0.5	1.0	Yes (X)	$0	$0
William E Lukens
Trustee	0.5	2.5	Yes (X)	$0	$0
Peter E Nims MD
Trustee	0.5	2.5	Yes (X)	$0	$0
James R Pancoast
Premier President & CEO	8.0	7.0	Yes (X)	$0	$0
Michael R Tinkler DDS
Trustee	0.5	1.0	Yes (X)	$0	$0
Joel H Walker
Trustee	0.5	1.0	Yes (X)	$0	$0
Mary Patricia Wampler RN
Trustee	0.5	1.0	Yes (X)	$0	$0
Thomas Parker
President & CEO	32.0	8.0	Yes (X)	$412,988	$24,072	Yes (X)
Steven Staley
Trustee	0.5	1.0	Yes (X)	$0	$0
Arthur R Disbrow
Vice Chair	0.5	2.5	Yes (X)	$0	$0	Yes (X)
Paul Weber MD
Trustee	0.5	39.5	Yes (X)		$24,332		$255,549
Ronal Manis MD
Trustee/ Medical Staff 1st VP	0.5	0.0	Yes (X)	$57,167
Timothy D Snider
Vice President/CFO	12.0	8.0		$115,310	$17,211	Yes (X)
Jenna M Downey Esq
Recording Secretary	0.25	1.25		$0	$0	Yes (X)
James Hurak
Vice President - Operations	40.0	0.0		$190,282	$42,995			Yes (X)
Rebecca Rice
Vice President - Operations	40.0	0.0		$198,707	$31,781			Yes (X)
WILLIAM E LINESCH
VP - HUMAN RESOURCES (PREMIER)	8.0	32.0			$37,280		$450,825	Yes (X)
Dale E Creech
CLO (Premier)	8.0	32.0			$53,790		$576,123	Yes (X)
MARK W SHAW
VP - MANAGED CARE (Premier)	8.0	32.0			$54,122		$428,171	Yes (X)
Mark S Shaker
SR VP SRVCE INTEGRATE(PREMIER)	8.0	32.0			$29,963		$725,914	Yes (X)
RENEE P GEORGE
VP - REVENUE CYCLE (Premier)	8.0	32.0			$33,291		$276,642	Yes (X)
Danny Bailey DPM
Chief Medical Officer	40.0	0.0		$329,372	$30,605			Yes (X)
Thomas A Nash
VP - CPO (Premier)	8.0	32.0			$21,245		$263,269	Yes (X)
Shakil Rahman MD
Physician	40.0	0.0		$327,449	$24,786				Yes (X)
Rafay Atiq MD
Physician	40.0	0.0		$258,663	$24,495				Yes (X)
William Watercutter
Team Leader of IT Applications	40.0	0.0		$145,414	$16,115				Yes (X)
Thomas Bigley
Director of Pharmacy	40.0	0.0		$170,523	$20,950				Yes (X)
Kathleen J Scarbrough
President, UVMC Foundation	40.0			$135,176	$33,793				Yes (X)
Michael Maiberger
SR VP-CHIEF STRATEGY (PREMIER)	0.0	0.0			$75,119		$546,586			Yes (X)
David Meckstroth
Former President & CEO	0.0	0.0					$157,916			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,341,051	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$3,904,941	TotReportableCompRltdOrgAmt
Total Other Compensation	$617,041	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	34	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/AddressLine1	CityContractorAddress/USAddress/City	StateContractorAddress/USAddress/State	ZIP CodeContractorAddress/USAddress/ZIPCode	ServicesServicesDesc	CompensationCompensationAmt
Cerner Corporation
2800 Rockcreek Pkwy	KANSAS CITY	MO	64117	Medical Services	$928,710
Community Blood Center
349 S Main St	DAYTON	OH	45402	Medical services	$702,886
Valley Anesthesia
PO Box 63437	CINCINNATI	OH	45263	Medical Services	$1,784,605
Software Information Systems
PO Box 890500	CHARLOTTE	NC	28289	Information Systems	$815,407
Siemens Healthcare Diagnostics
13776 Collections Center Drive	CHICAGO	IL	60693	Laboratory Services	$656,489

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	30	CntrctRcvdGreaterThan100KCnt
Related Organizations	$178,614	RelatedOrganizationsAmt
Total Contributions	$178,614	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
NET MEDICARE / MEDICAID	621110	$62,335,133	$62,335,133
NET PATIENT CARE SERVICES	621110	$75,270,017	$75,049,494	$220,523
JOINT OPERATING AGREEMENT	900099	-$9,393,000	-$9,393,000
FRANCHISE TAX RECOVERIES	900099	$1,985,638	$1,985,638
OTHER	900099	$100,490	$100,490

Field	Value	IRS element (for citing)
Total Program Service Revenue	$130,298,278	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$650,310	TotalRevenueColumnAmt
Exclusion	$650,310	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$268,795	TotalRevenueColumnAmt
Exclusion	$268,795	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	$204,987	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$61,129	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$143,858	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$143,858	TotalRevenueColumnAmt
Exclusion	$143,858	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$98,117,413	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$96,506,973	SecuritiesAmt
Other	$16,184	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$1,610,440	SecuritiesAmt
Other	-$16,184	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,594,256	TotalRevenueColumnAmt
Exclusion	$1,594,256	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	$284,995	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$247,951	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$37,044	TotalRevenueColumnAmt
Exclusion	$37,044	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
CAFETERIA SALES	721210	$695,417	$695,417
INTEREST RATE SWAP	523920	$381,816	$381,816
ALL OTHER REVENUE	900099	$1,012,294	$1,012,294

Field	Value	IRS element (for citing)
Other Revenue Total	$2,089,527	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$135,260,682	TotalRevenueColumnAmt
Related Or Exempt Func Income	$130,077,755	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$220,523	UnrelatedBusinessRevenueAmt
Exclusion	$4,783,790	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$574,010	TotalAmt
Program Services	$574,010	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	$1,393,322	TotalAmt
Program Services	$1,198,591	ProgramServicesAmt
Management And General	$194,731	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$45,590	TotalAmt
Management And General	$45,590	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$56,838,637	TotalAmt
Program Services	$48,874,928	ProgramServicesAmt
Management And General	$7,963,709	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$4,917,664	TotalAmt
Program Services	$4,225,257	ProgramServicesAmt
Management And General	$692,407	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$10,127,399	TotalAmt
Program Services	$8,701,461	ProgramServicesAmt
Management And General	$1,425,938	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$3,854,446	TotalAmt
Program Services	$3,311,740	ProgramServicesAmt
Management And General	$542,706	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$7,600	TotalAmt
Program Services	$6,530	ProgramServicesAmt
Management And General	$1,070	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$545,886	TotalAmt
Program Services	$469,025	ProgramServicesAmt
Management And General	$76,861	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$57,860	TotalAmt
Management And General	$57,860	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$15,001	TotalAmt
Program Services	$15,001	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	$97,595	TotalAmt
Management And General	$97,595	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$384,810	TotalAmt
Program Services	$384,810	ProgramServicesAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$297,915	TotalAmt
Program Services	$297,915	ProgramServicesAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,016,249	TotalAmt
Program Services	$873,161	ProgramServicesAmt
Management And General	$143,088	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$4,878,009	TotalAmt
Program Services	$4,191,185	ProgramServicesAmt
Management And General	$686,824	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,745,940	TotalAmt
Program Services	$1,500,112	ProgramServicesAmt
Management And General	$245,828	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$155,728	TotalAmt
Program Services	$133,801	ProgramServicesAmt
Management And General	$21,927	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	$776	TotalAmt
Program Services	$667	ProgramServicesAmt
Management And General	$109	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$2,526,917	TotalAmt
Program Services	$2,526,917	ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$7,976,197	TotalAmt
Program Services	$6,853,148	ProgramServicesAmt
Management And General	$1,123,049	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
OPERATING SUPPLIES/EQUIP	$15,983,961	$15,983,961
REPAIRS & MAINTENANCE	$2,866,093	$2,462,547	$403,546
PURCHASED SERVICES	$9,094,950	$7,814,381	$1,280,569
HOSPITAL FRANCHISE TAX	$2,032,745	$2,032,745

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$454,540	TotalAmt
Program Services	$390,541	ProgramServicesAmt
Management And General	$63,999	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$127,889,840	TotalAmt
Program Services	$112,822,434	ProgramServicesAmt
Management And General	$15,067,406	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$67,341	BOYAmt
EOY	$1,750	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$837,638	BOYAmt
EOY	$6,703,608	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	$19,856,384	BOYAmt
EOY	$20,355,287	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	$417,486	BOYAmt
EOY	$426,436	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$508,925	BOYAmt
EOY	$685,168	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$1,692,646	BOYAmt
EOY	$2,101,888	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$148,087,963	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$89,118,883	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$57,221,125	BOYAmt
EOY	$58,969,080	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$50,184,926	BOYAmt
EOY	$49,510,522	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$11,044,371	BOYAmt
EOY	$13,502,968	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	$4,604,590	BOYAmt
EOY	$5,421,510	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$146,435,432	BOYAmt
EOY	$157,678,217	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$11,868,973	BOYAmt
EOY	$14,175,351	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$145,545	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$1,790	BOYAmt
EOY	$0	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$46,662,667	BOYAmt
EOY	$44,224,934	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	$696,461	BOYAmt
EOY	$2,667,875	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	$53,009,898	BOYAmt
EOY	$32,004,759	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$112,239,789	BOYAmt
EOY	$93,218,464	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$34,195,643	BOYAmt
EOY	$64,459,753	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	$34,195,643	BOYAmt
EOY	$64,459,753	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$146,435,432	BOYAmt
EOY	$157,678,217	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$7,370,842	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$3,818,522	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$19,074,746	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	$12,301	GrantsOtherOrganizationsAmt
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$2,700	OtherActivitiesAmt
Total Lobbying Expenditures	$15,001	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	$409,459	OtherCostOrOtherBasisAmt
Book Value	$409,459	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$74,185,170	OtherCostOrOtherBasisAmt
Depreciation	$33,534,564	DepreciationAmt
Book Value	$40,651,147	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$78,425	OtherCostOrOtherBasisAmt
Depreciation	$78,425	DepreciationAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$64,739,555	OtherCostOrOtherBasisAmt
Depreciation	$54,153,202	DepreciationAmt
Book Value	$10,586,353	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$8,674,813	OtherCostOrOtherBasisAmt
Depreciation	$1,352,692	DepreciationAmt
Book Value	$7,322,121	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$58,969,080	TotalBookValueLandBuildingsAmt
Financial Derivatives		FinancialDerivativesGrp
Closely Held Equity Interests		CloselyHeldEquityInterestsGrp

Other Securities OtherSecuritiesGrp

Field	Value	IRS element (for citing)
Desc	ALTERNATIVE INVESTMENTS	Desc
Book Value	$13,502,968	BookValueAmt
Method Valuation	F	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Securities	$13,502,968	TotalBookValueSecuritiesAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (8 entries)

DescDesc	AmtAmt
PENSION OBLIGATION	$12,621,862
JOA PAYABLE	$9,868,000
MALPRACTICE INSURANCE	$3,793,993
DUE TO MEDICARE / MEDICAID	$2,301,322
PHYSICIAN RELATED	$2,065,401
WORKER'S COMPENSATION	$932,479
OTHER/FRANCHISE TAX	$408,330
DUE TO AFFILIATES	$13,372

Field	Value	IRS element (for citing)
Total Liability	$32,004,759	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, Inc. is the parent organization of Upper Valley Medical Center: Premier Health (Premier), MedAmerica Health Systems (MAHS), Atrium Health System (AHS), and UVMC, Inc. (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, 2013 and 2012 for such unrelated business activities are not significant. MAHS, SHP, AHS, and UVMC also own or control certain subsidiaries, which are for profit corporations subject to federal income taxes. These are: * 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) * Med-Terra, Inc. - Tax-Exempt coproration under section 501(c)(2) of the internal revenue code. 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	$6,433,333
Central America and the Caribbean	Program Services	$24,155	Insurance

Field	Value	IRS element (for citing)
Subtotal Spent	$6,457,488	SubtotalSpentAmt
Total Spent	$6,457,488	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
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
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	$9,539,000	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,751,000	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$7,788,000	NetCommunityBenefitExpnsAmt
Total Expense	0.06090	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$19,322,000	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$12,685,000	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,637,000	NetCommunityBenefitExpnsAmt
Total Expense	0.05190	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$508,000	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$371,000	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$137,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00110	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$29,369,000	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$14,807,000	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$14,562,000	NetCommunityBenefitExpnsAmt
Total Expense	0.11390	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$66,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$66,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00050	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$955,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$955,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00750	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,661,000	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$677,000	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,984,000	NetCommunityBenefitExpnsAmt
Total Expense	0.02330	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$298,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$298,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00230	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,980,000	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$677,000	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,303,000	NetCommunityBenefitExpnsAmt
Total Expense	0.03360	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$34,349,000	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$15,484,000	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$18,865,000	NetCommunityBenefitExpnsAmt
Total Expense	0.14750	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$234,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$234,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00180	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$234,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$234,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00180	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$1,347,000	BadDebtExpenseAmt
Reimbursed By Medicare	$30,308,000	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$34,247,000	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$3,939,000	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	BusinessNameLine1

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	110 N MAIN ST 500	AddressLine1
City	DAYTON	City
State	OH	State
ZIP Code	45402	ZIPCode

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	BusinessNameLine1

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
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 Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	see Part V, Section c	OwnWebsiteURLTxt
Rpt Available Upon Request	Yes (X)	RptAvailableUponRequestInd
Adopt Implementation Strategy	Yes (X)	AdoptImplementationStrategyInd
Exec Implementation Strategy	Yes (X)	ExecImplementationStrategyInd
Develop Community Wide Plan	Yes (X)	DevelopCommunityWidePlanInd
Exec Community Wide Plan	Yes (X)	ExecCommunityWidePlanInd
Prioritize Health Needs	Yes (X)	PrioritizeHealthNeedsInd
Prioritize Services	Yes (X)	PrioritizeServicesInd
All Needs Addressed	Yes (true)	AllNeedsAddressedInd
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Used Deter Elig Free Care	Yes (true)	FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care	200.	FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt Care	Yes (true)	FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care	400.	FPGFamilyIncmLmtDscntCarePct
Explained Basis	Yes (true)	ExplainedBasisInd
Income Level	Yes (X)	IncomeLevelInd
Medical Indigency	Yes (X)	MedicalIndigencyInd
Insurance Status	Yes (X)	InsuranceStatusInd
Other Factors	Yes (X)	OtherFactorsInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
Posted On Website	Yes (X)	PostedOnWebsiteInd
Attached To Invoice	Yes (X)	AttachedToInvoiceInd
Posted In Emergency Room	Yes (X)	PostedInEmergencyRoomInd
Posted In Admission Office	Yes (X)	PostedInAdmissionOfficeInd
Available On Request	Yes (X)	AvailableOnRequestInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Collection Activities	false	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Other Actions Taken	Yes (X)	OtherActionsTakenInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Average Negotiated Rates	Yes (X)	AverageNegotiatedRatesInd
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 A, 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 3 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 Valley Medical Center, and the greater Dayton Area Hospital Association with its member hospitals. Part V, Section B, Question 4 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, QUESTION 5A: THE DIRECT WEBSITE ADDRESS WHERE THE CHNA CAN BE ACCESSED IS: http://www.uvmc.com/WorkArea/DownloadAsset.aspx?id=76905 PART V, SECTION B, LINE 12I: IF THE PATIENT'S FAMILY'S INCOME FALLS WITHIN 400% OF THE FEDERAL POVERTY GUIDELINES, THE PATIENT QUALIFIES FOR ASSISTANCE UNDER THE HOSPITAL FINANCIAL ASSISTANCE POLICY. ALL OR PART OF THE ACCOUNT WILL BE WRITTEN OFF TO CHARITY CARE, BASED UPON A SLIDING FEE SCHEDULE. THE AMOUNTS CHARGED TO PATIENTS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOT MORE THAN THE AMOUNTS GENERALLY BILLED TO INDIVIDUALS WHO HAVE INSURANCE COVERING SUCH CARE. PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE ARE NOT BILLED GROSS CHARGES FOR EMERGENCY OR MEDICALLY NECESSARY CARE. WE OFFER REASONABLE PAYMENT PLANS TO THOSE WHO HAVE QUALIFIED FOR CHARITY CARE. PATIENTS MAY ALSO QUALIFY FOR CHARITY CARE DISCOUNTS DUE TO A MEDICALLY-BASED CATASTROPHIC EVENT WHICH HAS OCCURRED IN THEIR LIFE. IF A PATIENT QUALIFIES FOR THIS DISCOUNT, HE/SHE WOULD ONLY BE HELD RESPONSIBLE FOR PAYMENT OF HIS/HER FAMILY'S MEDICAL EXPENSES UP TO 15% OF THEIR ANNUAL INCOME. PART V, SECTION B, LINE 14G: THE HOSPITAL WIDELY DISTRIBUTES INFORMATION ABOUT ITS FINANCIAL ASSISTANCE POLICY WITHIN THE AREA THAT IT SERVES. THIS INFORMATION INCLUDES THE METHOD OF APPLYING FOR AND ACCESSING FINANCIAL ASSISTANCE. NOTICES ARE PUBLICIZED IN PATIENTS' BILLS AND ARE POSTED IN THE EMERGENCY ROOM, ADMITTING AND REGISTRATION AREAS, AS WELL AS OTHER PUBLIC AREAS. A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS PUBLISHED ON THE HOSPITAL'S WEBSITE. FINANCIAL COUNSELORS, PATIENT ADVOCATES, AND CUSTOMER SERVICE REPRESENTATIVES DISCUSS THE FINANCIAL ASSISTANCE POLICY WITH ALL UNINSURED PATIENTS, AND ANY PATIENT WHO EXPRESSES FINANCIAL HARDSHIP WITH PAYING THEIR BILL. APPLICATIONS FOR FINANCIAL ASSISTANCE POLICY ARE AVAILABLE IN BOTH ENGLISH AND SPANISH. PART V, SECTION B, LINE 18E: BEFORE INITIATING COLLECTIONS ACTIONS, THE HOSPITAL NOTIFIES SELF-PAY PATIENTS OF ITS FINANCIAL ASSISTANCE POLICY. NOTICES OF THE POLICY ARE PUBLICIZED IN THE PATIENTS' BILLS AND ARE ALSO POSTED IN THE EMERGENCY ROOM, ADMITTING, maternity AND REGISTRATION AREAS, AS WELL AS OTHER PUBLIC AREAS. A SUMMARY OF THE FINANCIAL ASSISTANCE IS PUBLISHED ON THE HOSPITAL'S WEBSITE. FINANCIAL COUNSELORS, PATIENT ADVOCATES, PATIENT REGISTRATION, AND CUSTOMER SERVICE REPRESENTATIVES DISCUSS THE FINANCIAL ASSISTANCE POLICY WITH ALL UNINSURED PATIENTS WHO ARE ADMITTED TO THE HOSPITAL. FINANCIAL COUNSELORS ALSO CONTACT UNINSURED OUTPATIENTS WHO ARE SCHEDULED TO HAVE MAJOR PROCEDURES. IN ANY INSTANCE WHERE A PATIENT CALLS THE HOSPITAL AND EXPRESSES A CONCERN ABOUT THEIR ABILITY TO PAY, THE FINANCIAL ASSISTANCE POLICY IS EXPLAINED.	ExplanationTxt

Field	Value	IRS element (for citing)
Facility	7	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (7 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	FacilityFacilityTxt
DIALYSIS SERVICES
3130 N COUNTY RD 25A	TROY	OH	45373	DIALYSIS
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	SLEEP DISORDER, 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 2013 was $1,033,000, with direct offsetting revenues of $677,000. The net community benefit expense was $356,000. 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 2013, the amounts paid for call time and subsidies were $2,628,000. PART II, LINE 9: Other community building activities include cash donations made to other organizations throughout the Miami County area. Upper Valley Medical Center makes several direct charitable donations to other not-for-profit organizations throughout Miami County. These organizations include area schools, chambers of commerce, churches, etc. These donations are given in the spirit of aiding in the overall well-being of the community. 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 $6,861,000 AND INCURRED COST OF $10,770,000, FOR AN ADDITIONAL NET SHORTFALL OF $3,909,000 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) 30,308,000 MEDICARE REVENUE NOT REPORTED IN PART III, SECTION B 6,861,000 TOTAL MEDICARE ASSOCIATED REVENUE 37,169,000 ALLOWABLE MEDICARE COST PER MEDICARE COST REPORT (PART III, SECTION B) 34,247,000 MEDICARE COST NOT REPORTED IN PART III, SECTION B 10,770,000 TOTAL MEDICARE ASSOCIATED COST 45,017,000 MEDICARE SHORTFALL PER PART III, SECTION B 3,939,000 ADDITIONAL SHORTFALL NOT INCLUDED IN PART III, SECTION B 3,909,000 TOTAL MEDICARE SHORTFALL 7,848,000 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 39% 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 primary purpose of the Organization's community benefit plan is to work toward improved health in the communities that we serve by responding to community needs with programs that increase access to health care. This is accomplished through identifying community needs, making prudent choices for the use of resources, building and strengthening relationships in the community, and demonstrating accountability and transparency. The Organization works with the community on programs that address the underlying causes of persistent health problems, 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 UVMC Board of Directors, executive management, mangers, 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 OB	ExplanationTxt

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (11 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Valuation Method UsedValuationMethodUsedDesc	Non Cash AssistanceNonCashAssistanceDesc	Purpose Of GrantPurposeOfGrantTxt	Address Line2USAddress/AddressLine2
EDISON FOUNDATION
1973 EDISON DR	PIQUA	OH	45356	311379781	501(C)(3)	$10,200	N/A	N/A	CAPITAL, EVENT SPONSORSHIP & GENERAL FUND
Health Partners Free Clinic
1300 N County Rd 25A	Troy	OH	45373	311596731	501(C)(3)	$91,350	N/A	N/A	Operations
Hospice of Miami County
PO Box 502	Troy	OH	45373	311031277	501(c)(3)	$145,947	N/A	N/A	Operations
Troy Development Council
405 SW Public Sq	Troy	OH	45373	310918399	501(c)(3)	$15,000	N/A	N/A	Sponsorship	Suite 330
Miami County Dental Clinic
1364 W Main St	Troy	OH	45373	204901192	501(c)(3)	$47,800	N/A	N/A	Operations
Troy Foundation
216 W Franklin St	Troy	OH	45373	316018703	501(c)(3)	$5,800	N/A	N/A	Community Support
UVMC Foundation
3130 N COUNTY ROAD 25A	Troy	OH	45373	311581859	501(c)(3)	$11,100	N/A	N/A	Community Support
Miami County Recovery Council
1059 North Market Street	Troy	OH	45373	310917327	501(c)(3)	$61,610	N/A	N/A	Sponsorship
Victoria Theatre Association
138 North Main Street	Dayton	OH	45402	310897638	501(c)(3)	$45,000	N/A	N/A	Performing Arts
Dayton Art Institue
456 Belmonte Park North	Dayton	OH	45406	310537480	501(c)(3)	$15,140	N/A	N/A	Sponsorship
Goodwill Easter Seals
1511 Kuntz Road	Dayton	OH	45404	310537112	501(c)(3)	$5,750	N/A	N/A	Sponsorship

Field	Value	IRS element (for citing)
Total501c3 Org	11	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	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	Yes (true)	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	Yes (true)	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (19 entries)

TitleTitleTxt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt
Rowan R Nickol MD
BOARD Chair	$139,695	$72,817	$11,434	$2,237	$18,859	$245,042
Michael Maiberger
SR VP-CHIEF STRATEGY (PREMIER)	$311,209	$108,151	$127,226	$48,688	$26,431	$621,705	$36,422
Thomas Parker
President & CEO								$305,233	$84,701	$23,054	$20,176	$3,896	$437,060
James Hurak
Vice President - Operations								$144,539	$26,056	$19,687	$20,827	$22,168	$233,277
Shakil Rahman MD
Physician								$276,297	$50,000	$1,152	$2,826	$21,960	$352,235
Rafay Atiq MD
Physician								$232,571	$25,000	$1,092	$2,630	$21,865	$283,158
William Watercutter
Team Leader of IT Applications								$127,976	$16,423	$1,015	$7,813	$8,302	$161,529
Thomas Bigley
Director of Pharmacy								$147,453	$20,709	$2,361	$9,623	$11,327	$191,473
Rebecca Rice
Vice President - Operations								$146,343	$30,463	$21,901	$20,535	$11,246	$230,488
WILLIAM E LINESCH
VP - HUMAN RESOURCES (PREMIER)	$302,375	$85,347	$63,103	$29,823	$7,457	$488,105
Dale E Creech
CLO (Premier)	$367,721	$97,597	$110,805	$30,227	$23,563	$629,913
MARK W SHAW
VP - MANAGED CARE (Premier)	$259,238	$77,695	$91,238	$31,273	$22,849	$482,293
Mark S Shaker
SR VP SRVCE INTEGRATE(PREMIER)	$416,041	$119,115	$190,758	$25,000	$4,963	$755,877
RENEE P GEORGE
VP - REVENUE CYCLE (Premier)	$218,785	$57,230	$627	$7,790	$25,501	$309,933
Paul Weber MD
Trustee	$212,469	$37,440	$5,640	$2,283	$22,049	$279,881
Danny Bailey DPM
Chief Medical Officer								$280,582	$44,111	$4,679	$10,281	$20,324	$359,977
Thomas A Nash
VP - CPO (Premier)	$185,778	$20,000	$57,491		$21,245	$284,514
David Meckstroth
Former President & CEO			$157,916			$157,916
Kathleen J Scarbrough
President, UVMC Foundation								$109,651	$17,881	$7,644	$13,977	$19,816	$168,969

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

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 2013. The individuals listed below have met the multi-year vesting requirement under the pension restoration plan and received the associated payment in 2013: William Linesch $36,185; Dale Creech $106,150; Mark Shaw $83,410; Mark Shaker $168,642. Michael Maiberger met the multi-year vesting requirement under the SERP and received an associated payment in 2013 of $35,422. 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. In addition to the supplemental nonqualified retirement plans noted above, the organization offers a 451 or 457(b) nonqualified deferred compensation arrangement to certain executives. All contributions to these plans are through employee elected deferrals. The following individuals participated in either a 451 or 457(b) plan: James Hurak; William Linesch; Rowan Nickol M.D.; Thomas Parker; Rebecca Rice; Kathleen Scarbrough; Mark Shaker; and Paul Weber, M.D. The employee elected deferrals into these plans are properly reported as part of the compensation amounts report on Schedule J, Part II, Column B(iii).

Schedule J, Part I, Lines 6a & 6b:

PREMIER HEALTH (Premier), OF WHICH UPPER VALLEY MEDICAL CENTER IS AN AFFILIATE, HAS AN INCENTIVE COMPONENT FOR ALL EXECUTIVE AND DIRECTOR LEVEL EMPLOYEES THAT TIES A PORTION OF THEIR TOTAL COMPENSATION TO ORGANIZATIONAL AND INDIVIDUAL OBJECTIVES AND OUTCOMES. THE ORGANIZATIONAL CRITERION IS WEIGHTED ACCORDING TO BALANCED SCORECARD CATEGORIES: POSITIVE WORK ENVIRONMENT (15%), QUALITY (30%), PATIENT SATISFACTION (15%), PHYSICIAN PARTNERSHIP, (15%), AND FINANCIAL (25%). THE FINANCIAL CATEGORY OF THE SCORECARD IS BASED ON NET EARNINGS OF THE INDIVIDUAL HOSPITAL AND THE NET EARNINGS OF THE SYSTEM as A WHOLE. THIS FINANCIAL TARGET IS SET BASED ON THE OPERATING AND CASH FLOW MARGINS REQUIRED TO MAINTAIN THE SYSTEM'S AA CREDIT RATINGS. INCENTIVE OBJECTIVES FOR DIRECTORS AND ABOVE ARE WEIGHTED 45% ON ORGANIZATIONAL CRITERIA, 45% ON INDIVIDUAL CRITERIA, AND 10% ON ORGANIZATIONAL EFFECTIVENESS. THE 2013 INCENTIVE PLAN AMOUNTS WERE PAID TO THE PARTICIPANTS IN 2014. THESE ARE NOT REPORTED AS DEFERRED COMPENSATION ON THE 2013 FORM 990 BASED ON THE DEFINITION OF DEFERRED COMPENSATION CONTAINED IN THE FORM 990 INSTRUCTIONS. PER THE INSTRUCTIONS, "DEFERRED COMPENSATION IS GENERALLY TREATED AS EARNED OR ACCRUED IN THE YEAR THAT SERVICES ARE RENDERED, EXCEPT WHEN ENTITLEMENT TO PAYMENT IS CONTINGENT ON SATISFACTION OF ORGANIZATIONAL GOALS OR SPECIFIED PERFORMANCE CRITERIA (OTHER THAN MERE LONGEVITY OF SERVICE) UNDER THE DEFERRED COMPENSATION PLAN." BASED ON THE INCENTIVE PROGRAM CRITERIA OUTLINED ABOVE, WE BELIEVE THE INCENTIVE PAYMENTS MEET THE EXCEPTION NOTED IN THE INSTRUCTIONS. SUCH AMOUNTS ARE PROPERLY REPORTED AS COMPENSATION FOR FORM 990 PURPOSES WHEN INCLUDED IN THE PARTICIPANTS' FORM W-2 WAGES.

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	BusinessNameLine1

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	$10,195,000	RetiredAmt
Bond Defeased	$0	BondDefeasedAmt
Total Proceeds	$61,646,799	TotalProceedsAmt
In Reserve Fund	$5,374,563	InReserveFundAmt
Capitalized Interest	$0	CapitalizedInterestAmt
Refunding Escrow	$0	RefundingEscrowAmt
Issuance Costs From Proceeds	$663,253	IssuanceCostsFromProceedsAmt
Credit Enhancement	$0	CreditEnhancementAmt
Working Capital Expenditures	$0	WorkingCapitalExpendituresAmt
Capital Expenditures	$19,589,170	CapitalExpendituresAmt
Other Spent Proceeds	$36,019,812	OtherSpentProceedsAmt
Unspent	$0	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	0.00170	PrivateBusConcerningUBIPct
Total Private Business Use	0.00220	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
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	BusinessNameLine1

Field	Value	IRS element (for citing)
Term Of Hedge	11.67	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	BusinessNameLine1

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	Schedule K	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 $2,011,410 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 $1,641,639 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 (2 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
Digestive Specialty CareInc
>35% Owner- Fayez Abboud	$552,290	GASTROENTEROLOGY SERVICES	false
Angela Nickol
Dghtr-Law of R Nickol, MD	$45,590	Nurse's Salary	false

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 CORPORATE COMPLIANCE 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 19:	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 XI, Line 9:	Pension adjustment 16,908,289 Gain on sale of Dialysis Centers 6,519,500 Discontinued operations - Dialysis Centers 171,068 Equity transfers (2,465,893) PHG adjustment (732,572) JOA - sale of Dialysis Centers (475,000) Pension transfer (412,065) PHO Equity Infusion (250,000) Change in Auxilliary Cash position (9,967) Foundation adjustment (178,614) Total 19,074,746

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrganizationControlledOrganizationInd
UVMC
110 N Main St Suite 500	DAYTON	OH	45402	341850683	PARENT	OH	501(c)(3)	11, I	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/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Controlled OrganizationControlledOrganizationInd
UVMC MANAGEMENT CORPORATION
110 N Main St Suite 500	DAYTON	OH	45402	311360489	MGT COMPANY	OH	UVMC	C CORP	$0	$0	Yes (true)
After Hours Family Care Inc
31 Stanfield Rd	Troy	OH	45373	311269483	Health Care	OH	UVPC	C Corp	$0	$0	Yes (true)

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	Yes (true)	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (true)	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (true)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	Yes (true)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (16 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
Upper Valley Professional Corporation
R	$2,800,000	Cash
Med-Terra Inc
R	$1,195,566	Cash
UVMC
S	$334,107	Cash
UVPC SPECIALISTS INC
M	$93,825	Cash
UVPC SPECIALISTS INC
Q	$113,402	Cash
Upper Valley Professional Corporation
A(IV)	$65,525	CASH
Upper Valley Professional Corporation
D	$3,000,000	CASH
Upper Valley Professional Corporation
Q	$1,769,387	FMV
UVMC MANAGEMENT CORPORATION
O	$586,501	FMV
UVMC MANAGEMENT CORPORATION
R	$412,065	FMV
UVMC MANAGEMENT CORPORATION
S	$121,252	FMV
Med-Terra Inc
D	$3,000,000	FMV
Med-Terra Inc
K	$896,141	FMV
Med-Terra Inc
p	$233,969	FMV
Med-Terra Inc
Q	$303,501	FMV
UVMC Foundation
C	$178,614	FMV