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THE UNION HOSPITAL ASSOCIATION: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
THE UNION HOSPITAL ASSOCIATION (EIN 34-0714771)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-14
IRS object ID
201323199349305442
Schema version
2012v2.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-11-14T16:01:08-07:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN340714771EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1THE UNION HOSPITAL ASSOCIATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlUNIONameControl
Phone3303433311Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1659 BoulevardAddressLine1
CityDoverCity
StateOHState
ZIP Code44622ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameEugene A Thorn IIIName
TitleVice President - FinanceTitle
Phone3303640805Phone
Date Signed2013-11-15DateSigned
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1Union HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonEugene A Thorn IIINameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1659 BoulevardAddressLine1
CityDoverCity
StateOHState
ZIP Code44622ZIPCode
FieldValueIRS element (for citing)
Gross Receipts112511593GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.unionhospital.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1906YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionTo provide excellent quality health care to the community at a competitive price through highly competent people and an integrated provider network.ActivityOrMissionDescription
Nbr Voting Members Governing Body17NbrVotingMembersGoverningBody
Nbr Independent Voting Members16NbrIndependentVotingMembers
Total Nbr Employees1196TotalNbrEmployees
Total Nbr Volunteers142TotalNbrVolunteers
Total Gross UBI146683TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year322846ContributionsGrantsPriorYear
Contributions Grants Current Year370098ContributionsGrantsCurrentYear
Program Service Revenue Prior Year86599963ProgramServiceRevenuePriorYear
Program Service Revenue CY85720902ProgramServiceRevenueCY
Investment Income Prior Year3792510InvestmentIncomePriorYear
Investment Income Current Year2948408InvestmentIncomeCurrentYear
Other Revenue Prior Year10778143OtherRevenuePriorYear
Other Revenue Current Year12510863OtherRevenueCurrentYear
Total Revenue Prior Year101493462TotalRevenuePriorYear
Total Revenue Current Year101550271TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year51596199SalariesEtcPriorYear
Salaries Etc Current Year53903045SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year91271TotalFundrsngExpCurrentYear
Other Expense Prior Year48600647OtherExpensePriorYear
Other Expenses Current Year44532220OtherExpensesCurrentYear
Total Expenses Prior Year100196846TotalExpensesPriorYear
Total Expenses Current Year98435265TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1296616RevenuesLessExpensesPriorYear
Revenues Less Expenses CY3115006RevenuesLessExpensesCY
Total Assets BOY150415888TotalAssetsBOY
Total Assets EOY155573487TotalAssetsEOY
Total Liabilities BOY44064687TotalLiabilitiesBOY
Total Liabilities EOY44508157TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY106351201NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY111065330NetAssetsOrFundBalancesEOY
Mission DescriptionPatient Care: Union Hospital Association provides quality medical health care regardless of race, creed, sex, national origin, handicap, age or ability to pay.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense67501768Expense
Revenue85720902Revenue
DescriptionThe Union Hospital Association provided quality medical health care regardless of race, creed, age, sex, national origin, handicap, or the ability to pay. Hospital medical services provided 5,680 inpatients a total of 21,400 patient days and 253,000 outpatient visits a total of 338,000 procedures.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense482085Expense
Revenue39438Revenue
DescriptionPatient and family support programs, general and other: During 2012 Union Hospital provided 38,920 meals for residents who were unable to prepare meals for themselves due to medical limitations. These meals are provided at cost and are delivered by a volunteer group, Mobile Meals. The Hospital had 142 volunteers donate 21,365 hours toward the common purpose of serving the health care needs of the community. The value of these hours is $202,967 which is returned to the community through lower cost of patient services. The Hospital co sponsors annual events that provides laboratory tests and blood pressure checks for the residents of the community; these services are provided at or below cost. Medicare and Medicaid made up 45% of patient care provided. The Hospital also participates in a local program called Rainbow Connection, a non profit charity that is dedicated to emeting the needs of disadvantaged and disabled resident of Tuscarawas County; we write off 50% of all charges for those patients while the program pays the remaining 50%. We also provided to the local Hospice agency a write off specified charges for individuals under this program (188 patients, $246,200). We sponsor a Helpline program that enabled 750 elderly and disabled consumers the opportunity to remian in their homes and feel safe in that setting. Since the Hospital does not provide mental health services as part of its normal operations, we lease building space to Community Professional Services, a mental health non profit organization at $2.04 per square foot, well below the average rate of $11.75 per square foot. Thus the rental rate and related in kind support provided by the Hospital are justified as a continuance of our mission. We operate a 35ft mobile medical vehicle that provides screenings to the areas that would have been underserved. An outreach sports medicine program provides training to various school to promote helathy athletes and physicals at a fraction of the cost. The Hospital supports and hosts various groups such as Down Syndrome, RSD, pain management, cancer supports,etc. We also provide babysitting and AARP driving courses to the community and sent out 55,000 biannual healthy newsletters to the community.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp0TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense67983853TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity1DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096108NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1196NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members17NbrVotingGoverningBodyMembers
Number Independent Voting Members16NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledOHStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonEugene A Thorn IIINamePerson
Telephone Number3303640805TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1659 BoulevardAddressLine1
CityDoverCity
StateOHState
ZIP Code44622ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (27 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
R Bruce James
President and CEO400XX338669043617
John R Herzig
Board Member20X000
James J Pringle
Board Member3.000X000
Anne E Geib Hanner
Board Member20X000
Michael B Hovan
Chairman20X000
Agnes K Swigart
Treasurer3.000X000
Mark N Kubina
Medical Staff Vice President20X000
Robert A Horn
Board Member3.000X000
Craig B Laughlin
Board Member22X000
Lois E Andreas
Board Member3.000X000
Robert E Moore Jr
Board member20X000
C Jason Deeds
Chairman of the Board3.000X000
John E Dooling
Board Member3.000X000
Perry L Hershberger
Board Member20X000
Andrew J Wherley
Medical Staff Past President20X000
James E Knisely
Vice Chairman3.000X000
William V Swoger
Medical Staff Vice President20X000
Darwin K Smith
Vice President400X135672021209
Thomas J Kelly Jr
Vice President400X252163042138
Eugene A Thorn III
Vice President400X192459027881
Diana L Boyd
Vice President400X150443029903
Robert J Craig
Vice President400X154288029903
Darrin Kuczynski
Physician400608235060205X
James McQuillan
Physician400647209060205X
Scott Holder
Physician400627744059274X
Thomas Teater
Physician400569875060205X
Nicholas Groch
Physician400373107051552X
FieldValueIRS element (for citing)
Total Reportable Comp From Org4049864TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation486092TotalOtherCompensation
Number Individuals GT100 K41NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Emergimed Inc
659 BoulevardDoverOH44622Emergency services5722371
Seneca Medical
PO BOX 712361CincinnatiOH45271Seller of medical equipment2495317
Cardinal Health
5490 Collections Center DriveChicagoIL60693Seller of medical drugs5012294
Anesthesia Care of Union Hospital
659 BoulevardDoverOH44622Anesthesia and pain care associates1451441
Laboratory Corp of AM Holdings
PO Box 12140BurlingtonNC27216Laboratory services provider853001
FieldValueIRS element (for citing)
Number Of Contractors GT100 K84NumberOfContractorsGT100K
Federated Campaigns0FederatedCampaigns
Membership Dues920MembershipDues
Fundraising Events0FundraisingEvents
Related Organizations0RelatedOrganizations
Government Grants0GovernmentGrants
All Other Contributions369178AllOtherContributions
Noncash Contributions0NoncashContributions
Total Contributions370098TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Net Patient Revenue62200085632913856329130$0
Laboratory Services621500000$0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column87989TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue87989UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue85720902TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2931893TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue58694UnrelatedBusinessRevenue
Exclusion$2,873,199ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real872165Real
Personal0Personal

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real445144Real
Personal0Personal

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real427021Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column427021TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$427,021ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities0Securities
Other16515Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities0Securities
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities0Securities
Other16515Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column16515TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$16,515ExclusionAmount
FieldValueIRS element (for citing)
Cntrbtns Rprtd Fundraising Events0CntrbtnsRprtdFundraisingEvents
Gross Sales Of Inventory21683721GrossSalesOfInventory
Cost Of Goods Sold10516178CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column11167543TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$11,167,543ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Health Promotion90009958100581000$0
Helpline Program9000991378871378870$0
Athletic training90009979123791230$0

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column641189TotalRevenueColumn
Related Or Exempt Function Income641189RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue916299TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column101550271TotalRevenueColumn
Related Or Exempt Function Income86549212RelatedOrExemptFunctionIncome
Unrelated Business Revenue146683UnrelatedBusinessRevenue
Exclusion$14,484,278ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1238330Total
Program Services0ProgramServices
Management And General1238330ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total40046490Total
Program Services34392089ProgramServices
Management And General5608746ManagementAndGeneral
Fundraising45655Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2009434Total
Management And General1989340ManagementAndGeneral
Fundraising20094Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total7476213Total
Program Services95524ProgramServices
Management And General7380689ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3132578Total
Program Services2533796ProgramServices
Management And General595354ManagementAndGeneral
Fundraising3428Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total111132Total
Program Services0ProgramServices
Management And General111132ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total89347Total
Program Services0ProgramServices
Management And General89347ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total19598113Total
Program Services16004874ProgramServices
Management And General3588589ManagementAndGeneral
Fundraising4650Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total432636Total
Program Services47548ProgramServices
Management And General378706ManagementAndGeneral
Fundraising6382Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total10316409Total
Program Services8597061ProgramServices
Management And General1719348ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1265964Total
Program Services0ProgramServices
Management And General1265964ManagementAndGeneral
Fundraising0Fundraising

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2029756Total
Program Services1551016ProgramServices
Management And General473844ManagementAndGeneral
Fundraising4896Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total197283Total
Program Services88213ProgramServices
Management And General106844ManagementAndGeneral
Fundraising2226Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total43123Total
Program Services12887ProgramServices
Management And General30236ManagementAndGeneral
Fundraising0Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total1364202Total
Program Services817157ProgramServices
Management And General547045ManagementAndGeneral
Fundraising0Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total5603630Total
Program Services3501560ProgramServices
Management And General2100444ManagementAndGeneral
Fundraising1626Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total881202Total
Program Services3834ProgramServices
Management And General877368ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Dues13928796211273572309
Education49071939481320
Meals546652205524555

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total2356400Total
Program Services325529ProgramServices
Management And General2030871ManagementAndGeneral
Fundraising0Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total98435265Total
Program Services67983853ProgramServices
Management And General30360141ManagementAndGeneral
Fundraising91271Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY8075335BOY
EOY6997491EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY13025147BOY
EOY13092966EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2158387BOY
EOY2361169EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1270233BOY
EOY1303593EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis128940406LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec78653757LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY51930858BOY
EOY50286649EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY47310158BOY
EOY47442469EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY2102912BOY
EOY1913501EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY2009690BOY
EOY2009690EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY22533168BOY
EOY30165959EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY150415888BOY
EOY155573487EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY6488598BOY
EOY7630857EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY26650000BOY
EOY26180000EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY3411487BOY
EOY3034092EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY7514602BOY
EOY7663208EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY44064687BOY
EOY44508157EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY96216016BOY
EOY100193986EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY177963BOY
EOY121127EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY9957222BOY
EOY10750217EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY106351201BOY
EOY111065330EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY150415888BOY
EOY155573487EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses3115006ReconcilationRevenueExpenses
Reconciliation Unrealized Invest929156ReconciliationUnrealizedInvest
Reconcilation Donated Services0ReconcilationDonatedServices
Reconcilation Invest Expenses0ReconcilationInvestExpenses
Reconcilation Prior Adjustment0ReconcilationPriorAdjustment
Reconcilation Other Changes669967ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis1105252OtherCostOrOtherBasis
Book Value1105252BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis55859694OtherCostOrOtherBasis
Depreciation23609531Depreciation
Book Value32250163BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis2616768OtherCostOrOtherBasis
Depreciation2168717Depreciation
Book Value448051BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis68822079OtherCostOrOtherBasis
Depreciation52875509Depreciation
Book Value15946570BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis536613OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value536613BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings50286649TotalOfBookValueLandBuildings

Other Assets OtherAssets (6 entries)

DescriptionDescriptionBook ValueBookValue
Assets whose use is limited by donor specification121127
Assets whose use is limited indenture agreement589
Trust agreements10750217
Other receivables17193760
Deferred financing costs431728
Interest in TVRCC1668538
FieldValueIRS element (for citing)
Total Book Value Other Assets30165959TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescriptionAmountAmount
Interest payable$120,995
Workers compensation payable$232,658
Interest rate swap agreement$4,547,652
Accrued payroll withholdings$2,220,926
Other payables$165,977
Hospital franchise fee$375,000
FieldValueIRS element (for citing)
Total Of Amounts7663208TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierSchD_P10_S00_L02Identifier
Return ReferenceSchedule D, Part X, Line 2ReturnReference
ExplanationThe hospital is a not for profit corporation exempt from federal income taxes under Section 501c3 of the Internal Revenue Code; therefore no provision has been made for federal income taxes in the accompanying financial statements. In addition the IRS has determined that the Hosptial is not a "private foundation" within the meaning of section 509(a) of the code.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense4113958TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense4113958NetCommunityBenefitExpense
Percent Of Total Expense0.0418PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense13408580TotalCommunityBenefitExpense
Direct Offsetting Revenue10115473DirectOffsettingRevenue
Net Community Benefit Expense3293108NetCommunityBenefitExpense
Percent Of Total Expense0.0334PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense17522538TotalCommunityBenefitExpense
Direct Offsetting Revenue10115473DirectOffsettingRevenue
Net Community Benefit Expense7407066NetCommunityBenefitExpense
Percent Of Total Expense0.0752PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs45NumberOfActivitiesOrPrograms
Persons Served50810PersonsServed
Total Community Benefit Expense468364TotalCommunityBenefitExpense
Direct Offsetting Revenue39438DirectOffsettingRevenue
Net Community Benefit Expense428926NetCommunityBenefitExpense
Percent Of Total Expense0.0044PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense

Research Research

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs9NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense10164TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense10164NetCommunityBenefitExpense
Percent Of Total Expense0.0001PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs54NumberOfActivitiesOrPrograms
Persons Served50810PersonsServed
Total Community Benefit Expense478528TotalCommunityBenefitExpense
Direct Offsetting Revenue39438DirectOffsettingRevenue
Net Community Benefit Expense439090NetCommunityBenefitExpense
Percent Of Total Expense0.0045PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs54NumberOfActivitiesOrPrograms
Persons Served50810PersonsServed
Total Community Benefit Expense18001066TotalCommunityBenefitExpense
Direct Offsetting Revenue10154911DirectOffsettingRevenue
Net Community Benefit Expense7846156NetCommunityBenefitExpense
Percent Of Total Expense0.0797PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense3557TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense3557NetCommunityBuildingExpense
Percent Of Total Expense0.000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Building Expense3557TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense3557NetCommunityBuildingExpense
Percent Of Total Expense0.000PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$6,690,171BadDebtExpenseAmount
Amount Attributable To4800AmountAttributableTo
Amount Reimbursed By Medicare28027749AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare21376435CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall6651314MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (3 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipOfficers Etc Profit Or OwnershipOfficersEtcProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
Tuscarawas Ambulatory Surgery Center
ambulatory surgery center0.700.3
Tuscarawas Valley Regional Cancer Center
Oncology center0.500
DASCO Home Medical Equipment
Home medical equipment sales0.500
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1The Union Hospital AssociationBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1659 BoulevardAddressLine1
CityDoverCity
StateOHState
ZIP Code44622ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1The Union Hospital AssociationBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent100FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent300FPGDiscountPercent
Explains Basis1ExplainsBasis
Other FactorsXOtherFactors
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Attached To InvoicesXAttachedToInvoices
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities1CollectionActivities
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Average Negotiated RatesXAverageNegotiatedRates
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities4NumberOfOtherFacilities

Other Facilities OtherFacilities (5 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityTypeAddress Line2Address/AddressLine2
Tuscarawas Ambulatory Surgery Center
320 Oxford StreetDoverOH44622Ambulatory surgery center
Tuscarawas Valley Regional Cancer Center
659 BoulevardDoverOH44622Physician oncology center
Union Physician Services LLC
300 Medical Park DriveDoverOH44622Physician officesSuite 101 C
DASCO UH Home Medical Equipment LLC
375 North West StreetWestervilleOH43082Home medical equipment sales
UHMS LLC
659 BoulevardDoverOH44622Physician offices

Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SchH_P01_S00_L07Schedule H, Part I, Line 7Used the ratio of patient cost to charges from Worksheet 2 to calculate the reported charity care.
SchH_P02_S00_L00Schedule H, Part IIThe Hospital has numerous community building activities. Project Search welcomes mentally handicapped or learning disabled youth into the workforce to give the young adults the ability to learn workforce traits and skills and to be more socially interactive. The Hospital provides space for a classroom setting and internship positions for this program. Many of these youth have secured positions from this program. We provide clinical rotations for numerous nursing and technical programs related to healthcare, which help secure the youth to the area. We also host and offer numerous support groups for various illnesses and social concerns.
SchH_P03_S0A_L04Schedule H, Part III, Section A, Line 4Patient accounts are due in full when billed. Accounts are considered delinquent and subsequently written off as bad debt based on individual credit evaluation and circumstances of the account. Line 2 represents 3% of gross patient revenue as seen as being uncollectible by self pay patients which is based upon historical trending valuations. A bad debt expense footnote is not presented in the notes to the financial statements.
SchH_P03_S0B_L08Schedule H, Part III, Section B, Line 8Amounts are generated by the Medicare cost report which utilizes a department cost to charge methodology.
SchH_P03_S0C_L09bSchedule H, Part III, Section C, Line 9bThe Hospital will refund any monies paid on an account deemed charity or that qualifies for finanancial assistance once that assessment has been determinded. The account is then written off to such classification and any or all collections will cease after determination has been made.
SchH_P05_S0B_L11Schedule H, Part V, Section B, Line 11Charges are consistent with all payers.
SchH_P05_S0B_L12Schedule H, Part V, Section B, Line 12Charges are consistent with all payers.
SchH_P06_S00_L02Schedule H, Part VI, Line 2Our Community Wellness department is committed to addressing the health assessments and concerns of our community. The department compiled data gathered by utilizing secondary sources such as the CDC and Ohio Obesity prevention. We have identified six areas that are of high concern in our community; they are cancer, diabetes, heart disease and strokes, physical activity and fitness, tobacco use, and the overall education of the community on health issues. In response to the areas of concern, th Hospital offers blood pressure and choloestrol screenings, fasting blood sugar tests, and vascular screenings at reduced costs or free to members of the community. We also have cancer prevention day which includes pap smears, mammograms and skin cancer exams at a free or reduced cost. In response to the obesity and physical activity risks, the Hospital sponsors the annual Run for Home marathon training sessions, supports the fit youth initiative, and maintains a walking trail. For the general health of the community we also teach classes on bicycle helmet safety, AARP driver safety, babysitting basics, CPR, and smoking cessation.
SchH_P06_S00_L03Schedule H, Part VI, Line 3Inpatients are given an informational booklet upon admission to the hospital, this booklet contains information regarding contact with patient accounts, accepted insurances and other payment options for the insured or uninsured. The Hospital also employees a patient financial specialist who meets with the patient and or family to discuss family size, income and other qualifiying information for the various charity care programs. Financial assistance information is not provided at discharge but provided with the initial statement. The Hospital also discusses with the patients and family the availability of state and federal programs for medical care.
SchH_P06_S00_L04Schedule H, Part VI, Line 4Tuscarawas County is one of the 88 counties of the State of Ohio. The county has a population of approximately 91,000 residents with 25% under the age of 25 and 25% between the ages of 45 and 62. It is predominately a caucasion county in a rural setting with 7.2% of families being below the federal proverty level. 30% of adults smoke and 31% are obese or overweight; heart disease and strokes are prevalent health issues of the county. To help counteract these issues, the Hospital provides numerous blood pressure, cholesterol and blood sugar screenings throughout the year. The Hospital also provides smoking cessation programs and sponsors youth and adult fitness initiatives and marathon trainings and sponsors to combat the obesity epidemic.
SchH_P06_S00_L05Schedule H, Part VI, Line 5The Hospital provides many low cost clinics for blood pressure, cholesterol screenings, cancer screenings, and diabetes clinics to the area to help the community stay healthy and prevent diseases. We offer health fairs and promote health speakers on various health and safety issues to the community at no charge. The board is made up of individuals representing the community, there is an open medical staff and all surplus funds are used to make the Hospital a better organization for its community.
SchH_P06_S00_L07Schedule H, Part VI, Line 7Community benefit report is not filed with any state.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
R Bruce James
President and CEO293669045000000150000286170382286000
Darwin K Smith
Vice President12378501188700075370136710156880000
Diana L Boyd
Vice President13583201461100080130146320173088000
Robert J Craig
Vice President14033601395300075770223260184192000
Eugene A Thorn III
Vice President174514017945000106610172190220339000
Thomas J Kelly Jr
Vice President227322024841000139540281850294302000
Darrin Kuczynski
Physician550531057704000150000452050668440000
James McQuillan
Physician549657097552000150000452050707414000
Scott Holder
Physician549246078498000138530454210687018000
Thomas Teater
Physician553027016848000150000452050630080000
Nicholas Groch
Physician37310700000150000365520424659000

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1Tuscarawas County OhioBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN346002853IssuerEIN
CUSIP Number90069baa2CUSIPNumber
Date Issued2009-10-15DateIssued
Issue Price27515000IssuePrice
Description Of PurposeRe issue of 1993 and 2001 bondsDescriptionOfPurpose
Defeased1Defeased
On Behalf Of Issuer1OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Amount Retired0AmountRetired
Amount Bond Defeased0AmountBondDefeased
Total Proceeds0TotalProceeds
Amount In Reserve Fund0AmountInReserveFund
Capitalized Interest0CapitalizedInterest
Refunding Escrow0RefundingEscrow
Issuance Costs From Proceeds484184IssuanceCostsFromProceeds
Credit Enhancement0CreditEnhancement
Working Capital Expenditures0WorkingCapitalExpenditures
Capital Expenditures2969070CapitalExpenditures
Other Spent Proceeds0OtherSpentProceeds
Amount Unspent0AmountUnspent
Year Of Subst Completion2009YearOfSubstCompletion
Current Refunding1CurrentRefunding
Advance Refunding1AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Prcntge Prvt Business Use By Others0PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0PercentageOfPrvtBusinessReUBI
Total Private Business Use0TotalPrivateBusinessUse
Bond Iss Meet Prvt Security Pay Test1BondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed Prop0ChangeInUseBondFinancedProp
Non Qualified Bond Remed Procdrs1NonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiled
Rebate Not Due Yet0RebateNotDueYet
Exception To Rebate0ExceptionToRebate
No Rebate Due0NoRebateDue
Variable Rate Issue1VariableRateIssue
Hedge Identified In Books And Recds1HedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

FieldValueIRS element (for citing)
Business Name Line1RBS Citizens NABusinessNameLine1
FieldValueIRS element (for citing)
Term Of Hedge20.5TermOfHedge
Superintegrated Hedge0SuperintegratedHedge
Hedge Terminated0HedgeTerminated
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Written Proc To Monitor Reqs1WrittenProcToMonitorReqs

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
F990_P06_S0A_L06Form 990, Part VI, Section A, Line 6The Hospital has a 17 member board of trustees who oversee the manangement of the Hospital. All monthly financial reporting is presented to the board of trustees. The trustees also oversee the hiring of any upper management and the approval of all capital and operating budgets.
F990_P06_S0B_L11bForm 990, Part VI, Section B, Line 11bThe 990 is prepared internally by the Manager of Accounting. The general ledger is reconciled to teh appropriate schedules on teh form and to the audited financial statements. After this reveiw it is then forwarded to the Vice President of Finance who reviews it for completeness and accuracy. After his review it is then submitted to the Finance Committee made up of Board of Trustee members; after the committee reviews it is then forwarded to the Board of Trustees for review adn approval. The return is also reviewed by an independent accounting firm.
F990_P06_S0B_L12cForm 990, Part VI, Section B, Line 12cOfficers and members of the board are required annually to review the conflict of interest policy and make known any conflicts that may have or have arose or any other discloseable event. If any notable event is disclosed it is reported to the Hospital CEO and Chairman of the Board of Trustees. Additionally, all financial transactions are reveiwed through the Hospital's accounting systems.
F990_P06_S0B_L15Form 990, Part VI, Section B, Line 15Compensation amounts are established based on the appropriate healthcare industry standards and related surveys. Compensation amounts for key management is reviewed by the Executive Committee of the Board of Trustees.
F990_P06_S0C_L19Form 990, Part VI, Section C, Line 19The public can at anytime during normal business office hours may inquire at the administrative office in the main hospital building and ask for a copy of the Form 990.0 The public may also view online at the Hospital's website the annual report and community benefit report.
F990_P11_S00_L09Form 990, Part XI, Line 9unrealized gain/loss in investments and swaps

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeEOY AssetsEOYAssetsDirect Controlling Entity NADirectControllingEntityNA
Union Hospital Medical Services
659 BoulevardDoverOH44622270273520Physician officesOH00N/A
Union Physician Services
659 BoulevardDoverOH44622264215547Physician officeOH-55716462331594N/A

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
Tuscarawas Valley Regional Cancer Center
659 BoulevardDoverOH44622340000100Physician and Hospital OrganizationOH501c33N/A0
Union Hospital Auxillary
659 BoulevardDoverOH44622341204928Fundraising for the HospitalOH501c311-III-FIN/A0

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAPredominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsCode VCodeVAmountGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
Tuscarawas Ambulatory Surgery Center
320 Oxford StDoverOH44622311525875Ambulatory surgery centerOHN/ARelated71565314236620$000.7
Dasco Union Hospital Home Medical Equipment LLC
375 N West StWestervilleOH43082270495743Durable medical equipment salesOHN/AUnrelated58693116300000.5

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityPercentage OwnershipPercentageOwnershipShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsControlled OrgControlledOrg
Valley Healthcare Inc
659 BoulevardDoverOH44622341654921InactiveOHN/AC1
Union Care Corporation
659 BoulevardDoverOH44622341556177InactiveOHN/AC1
Union Pharmaceutical Care
659 BoulevardDoverOH44622043588229Retail pharmacy salesOHN/AC103880
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization1DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Tuscarawas Valley Regional Cancer Center
f325000Union Hospital received $325,000 in distributions from TVRCC
Union Hospital Auxillary
c160000Hospital receives annual donation from the Auxillary
Tuscarawas Ambulatory Surgery Center
j400505Lease payments received for space
Tuscarawas Ambulatory Surgery Center
a-iv400505Rents received
Dasco Union Hospital Home Medical Equipment LLC
a-iv13600fair market of space rented
Dasco Union Hospital Home Medical Equipment LLC
f58842Distributions received

Reasonable Cause Explanation ReasonableCauseExplanation

FieldValueIRS element (for citing)
Explanationproper extensions were filedExplanation