UPPER VALLEY MEDICAL CENTER: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: UPPER VALLEY MEDICAL CENTER (EIN 31-0537095)
Tax period: 2011-01-01 to 2011-12-31
Filed: 2012-11-13
IRS object ID: 201233189349303013
Schema version: 2011v1.3
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)
Timestamp	2012-11-13T12:51:09-06:00	Timestamp
Tax Period End Date	2011-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

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

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	111 MONUMENT CIRCLE SUITE 2600	AddressLine1
City	INDIANAPOLIS	City
State	IN	State
ZIP Code	46204	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	310537095	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Upper Valley Medical Center	BusinessNameLine1

Field	Value	IRS element (for citing)
In Care Of Name	% TIMOTHY SNIDER	InCareOfName
Name Control	UPPE	NameControl
Phone	9374407853	Phone

US Address USAddress

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

Officer Officer

Field	Value	IRS element (for citing)
Name	TIMOTHY D SNIDER	Name
Title	VICE PRESIDENT/CFO	Title
Date Signed	2012-11-13	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Phone	3176817000	Phone

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	Thomas Parker	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

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

Field	Value	IRS element (for citing)
Gross Receipts	223119622	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	www.uvmc.com	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1926	YearFormation
State Legal Domicile	OH	StateLegalDomicile
Activity Or Mission Description	The primary exempt purpose is to provide comprehensive inpatient, outpatient and emergency health care services to area residents. The Hospital furthers its exempt purpose by promoting community health.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	17	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	13	NbrIndependentVotingMembers
Total Nbr Employees	1628	TotalNbrEmployees
Total Nbr Volunteers	180	TotalNbrVolunteers
Total Gross UBI	192858	TotalGrossUBI
Net Unrelated Business Txbl Income	-42161	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	26332	ContributionsGrantsPriorYear
Contributions Grants Current Year	63258	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	140499574	ProgramServiceRevenuePriorYear
Program Service Revenue CY	147412296	ProgramServiceRevenueCY
Investment Income Prior Year	2760318	InvestmentIncomePriorYear
Investment Income Current Year	2719969	InvestmentIncomeCurrentYear
Other Revenue Prior Year	1414283	OtherRevenuePriorYear
Other Revenue Current Year	1433718	OtherRevenueCurrentYear
Total Revenue Prior Year	144700507	TotalRevenuePriorYear
Total Revenue Current Year	151629241	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	140741	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	242433	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	73405112	SalariesEtcPriorYear
Salaries Etc Current Year	79119649	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	62537181	OtherExpensePriorYear
Other Expenses Current Year	65994730	OtherExpensesCurrentYear
Total Expenses Prior Year	136083034	TotalExpensesPriorYear
Total Expenses Current Year	145356812	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	8617473	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	6272429	RevenuesLessExpensesCY
Total Assets BOY	160660248	TotalAssetsBOY
Total Assets EOY	154457885	TotalAssetsEOY
Total Liabilities BOY	106955964	TotalLiabilitiesBOY
Total Liabilities EOY	117307199	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	53704284	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	37150686	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	SEE SCHEDULE O	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	113469223	Expense
Grants	242433	Grants
Revenue	147860671	Revenue
Description	See Schedules H and O.	Description
Total Program Service Expense	113469223	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	true	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	true	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	true	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	true	ReportFin48Footnote
Independent Audit Financial Stmt	false	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	true	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	true	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	true	Hospital
Financial Stmt Attached	true	FinancialStmtAttached
Grants To Organizations	true	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	true	ScheduleJRequired
Tax Exempt Bonds	true	TaxExemptBonds
Invest Tax Exempt Bonds	false	InvestTaxExemptBonds
Escrow Account	false	EscrowAccount
On Behalf Of Issuer	false	OnBehalfOfIssuer
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	true	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	true	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	true	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	true	RelatedOrgControlledEntity
Transaction Related Entity	true	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	true	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	93	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	1628	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	true	UnrelatedBusinessIncome
Form990-T Filed	true	Form990-TFiled
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	false	QuidProQuoContributions
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	17	NbrVotingGoverningBodyMembers
Number Independent Voting Members	13	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	true	MembersOrStockholders
Election Of Board Members	true	ElectionOfBoardMembers
Decisions Subject To Approval	true	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	true	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
States Where Copy Of Return Is Filed	OH	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	TIMOTHY SNIDER	NamePerson
Telephone Number	9374407853	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	3130 NORTH COUNTY RD 25A	AddressLine1
City	Troy	City
State	OH	State
ZIP Code	45373	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (35 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Reportable Comp From OrganizationReportableCompFromOrganization	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee	FormerFormer
Douglas R Murray
Chair	0.5	X	X
Rowan R Nickol MD
First Vice Chair	40.0	X	X	332731	88007
Craig C Bundschuh
Second Vice Chair/Secretary	0.5	X	X
Cliff R Alexander
Director	0.5	X
Arthur R Disbrow
Director	0.5	X
Ronald R Fox
Director	0.5	X
Daniel P French
Director	0.5	X
Gail Haddad RN
Director	0.5	X
R Douglas Haines
Director	0.5	X
L Stewart Lowry MD
Director	40.0	X		329401	23845
William E Lukens
Director	0.5	X
Peter E Nims MD
Director	0.5	X
P Naga Maddireddy MD
Director	0.5	X				13317
James Pancoast
Director	0.5	X
Michael R Tinkler DDS
Director	0.5	X
Joel H Walker
Director	0.5	X
Mary Patricia Wampler RN
Director	0.5	X
Thomas Parker
President/CEO	40.0		X		52290	362894
Timothy Snider
Vice President/CFO	40.0		X		27768	251661
Judith Snyder
Vice President	40.0				66446	226578	X
Rebecca Rice
Vice President	40.0				64923	205063	X
James Hurak
Vice President	40.0				53058	193119	X
Barbara Evert MD
Former Vice President	40.0				9885	171342	X
Mary M Clancy
VP-CIO (PHP)	40.0			467688	55146		X
WILLIAM E LINESCH
VP - HR & OE (PHP)	40.0			424338	41137		X
THOMAS J ARQUILLA
VP-BUSINESS DEV (PHP)	40.0			203967	28003		X
MARK W SHAW
VP-MANAGED CARE (PHP)	40.0			349386	84013		X
J NICHOLAS LAIR
VP-CHF PURCH OFFICER (PHP)	40.0			295289	34887		X
RENEE P GEORGE
VP-REVENUE CYCLE (PHP)	40.0			269407	33415		X
Shakil Rahman MD
Physician	40.0				26255	392449		X
Rafay Atiq MD
Physician	40.0				24216	248056		X
William Watercutter
Director of IT	40.0				24601	149158		X
Thomas Bigley
Director of Pharmacy	40.0				24896	169174		X
Tracy Moser
Director of Human Resources	40.0				26783	138417		X
Michael J Maiberger
Former President/CEO				495480	26597				X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	2521228	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	3167687	TotalReportableCompFrmRltdOrgs
Total Other Compensation	816171	TotalOtherCompensation
Number Individuals GT100 K	22	NumberIndividualsGT100K
Formers Listed	true	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
Brackett Builders
185 Marybill Dr	TROY	OH	45373	Construction	4323228
Valley Anesthesia Inc
3130 North County Rd 25A	TROY	OH	45373	Anesthesiology	1639358
North Dayton Pathologist Inc
2222 Philadelphia Dr	DAYTON	OH	45406	Pathology	998585
Premier Health Care Services Inc
332 Congress Park Dr	DAYTON	OH	45459	Occupational Health	444662
Quest Diagnostics
3 Giralda Farms	MADISON	NJ	07940	Lab/Healthcare	439509

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	20	NumberOfContractorsGT100K
All Other Contributions	63258	AllOtherContributions
Total Contributions	63258	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue
NET MEDICARE / MEDICAID	621300	65161268	65161268
NET PATIENT CARE SERVICES	212000	81376260	81376260
JOINT HOSPITAL SERVICES - LAUNDRY	812300	611250	601602	9648
TRAINING & EDUCATION	561499	115878	115878
RENTAL FROM AFFILIATES	532000	23940	23940

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	123700	TotalRevenueColumn
Related Or Exempt Function Income	123700	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Program Service Revenue	147412296	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	2092929	TotalRevenueColumn
Exclusion	$2,092,929	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	303678	TotalRevenueColumn
Exclusion	$303,678	ExclusionAmount

Royalties Revenue RoyaltiesRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	195527	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	131989	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	63538	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	63538	TotalRevenueColumn
Exclusion	$63,538	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	71445370	Securities
Other	236384	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	71297256	Securities
Other	61136	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	148114	Securities
Other	175248	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	323362	TotalRevenueColumn
Exclusion	$323,362	ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	ExclusionExclusionAmount	Unrelated Business RevenueUnrelatedBusinessRevenue
NUTRITION SERVICES	722210	811667	73072	$738,595
PHYSICIAN LABORATORY SERVICES	621500	137654			137654
MEDICAL RECORDS FEES	541800	47856	47856

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	373003	TotalRevenueColumn
Related Or Exempt Function Income	327447	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	45556	UnrelatedBusinessRevenue

Field	Value	IRS element (for citing)
Total Other Revenue	1370180	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	151629241	TotalRevenueColumn
Related Or Exempt Function Income	147851023	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	192858	UnrelatedBusinessRevenue
Exclusion	$3,522,102	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	242433	Total
Program Services	242433	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	0	Total

Foreign Grants ForeignGrants

Field	Value	IRS element (for citing)
Total	0	Total

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	0	Total

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	2073851	Total
Program Services	57061	ProgramServices
Management And General	2016790	ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	59138291	Total
Program Services	46973327	ProgramServices
Management And General	12164964	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	4676107	Total
Program Services	4002047	ProgramServices
Management And General	674060	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	9070495	Total
Program Services	6784531	ProgramServices
Management And General	2285964	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	4160905	Total
Program Services	3469280	ProgramServices
Management And General	691625	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	72966	Total
Management And General	72966	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	176938	Total
Management And General	176938	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	15403	Total
Management And General	15403	ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	111981	Total
Management And General	111981	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	7147210	Total
Program Services	6588491	ProgramServices
Management And General	558719	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	478597	Total
Program Services	52046	ProgramServices
Management And General	426551	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	3456024	Total
Program Services	2368732	ProgramServices
Management And General	1087292	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	4714902	Total
Program Services	57817	ProgramServices
Management And General	4657085	ManagementAndGeneral

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	3118666	Total
Program Services	2740462	ProgramServices
Management And General	378204	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	160901	Total
Program Services	124340	ProgramServices
Management And General	36561	ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	1492678	Total
Program Services	1463887	ProgramServices
Management And General	28791	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	2678813	Total
Program Services	2196627	ProgramServices
Management And General	482186	ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	7265994	Total
Program Services	5607050	ProgramServices
Management And General	1658944	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	1246389	Total
Management And General	1246389	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
OPERATING SUPPLIES/EQUIP	14706075	14697922	8153
JOINT OPERATING AGREEMENT	7223000	7223000
PURCHASED SERVICES	6854500	3964218	2890282
BAD DEBTS	3648419	3648419

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	1425274	Total
Program Services	1207533	ProgramServices
Management And General	217741	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	145356812	Total
Program Services	113469223	ProgramServices
Management And General	31887589	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	3395	BOY
EOY	3518	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	2562716	BOY
EOY	1340748	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	11001086	BOY
EOY	16363312	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
BOY	45177	BOY
EOY	28995	EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	478548	BOY
EOY	487223	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	534319	BOY
EOY	633671	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	1337541	BOY
EOY	1891735	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	142590916	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	79179660	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	56242584	BOY
EOY	63411256	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	86868834	BOY
EOY	68986819	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	1586047	BOY
EOY	1310608	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	160660248	BOY
EOY	154457885	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	51319938	BOY
EOY	62253136	EOY

Grants Payable GrantsPayable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	53190064	BOY
EOY	51180950	EOY

Escrow Account Liability EscrowAccountLiability

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Loans From Officers Directors LoansFromOfficersDirectors

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	2445962	BOY
EOY	3873113	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	106955964	BOY
EOY	117307199	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	51123204	BOY
EOY	34468919	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	1507638	BOY
EOY	1592465	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	1073441	BOY
EOY	1089302	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	53704283	BOY
EOY	37150686	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	160660248	BOY
EOY	154457885	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	6272429	ReconcilationRevenueExpenses
Reconcilation Other Changes	-22826026	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	false	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

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)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbying
Total Direct Lobbying		TotalDirectLobbying
Total Lobbying Expenditures		TotalLobbyingExpenditures
Other Exempt Purpose Expenditures		OtherExemptPurposeExpenditures
Total Exempt Purpose Expenditures		TotalExemptPurposeExpenditures
Lobbying Nontaxable		LobbyingNontaxableAmount
Grassroots Nontaxable		GrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non Tx		TotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying Nontx		TotLobbyExpendMnsLobbyingNontx
Volunteers	false	Volunteers
Paid Staff Or Management	false	PaidStaffOrManagement
Media Advertisements	false	MediaAdvertisements
Mailings Members	false	MailingsMembers
Publications Or Broadcast	false	PublicationsOrBroadcast
Grants Other Organizations	true	GrantsOtherOrganizations
Grants Other Organizations	$8,653	GrantsOtherOrganizationsAmount
Direct Contact Legislators	true	DirectContactLegislators
Direct Contact Legislators	$6,750	DirectContactLegislatorsAmount
Rallies Demonstrations	false	RalliesDemonstrations
Other Activities	false	OtherActivities
Total Lobbying Expenditures IIB	15403	TotalLobbyingExpendituresIIB
Not Described In501c3	false	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	Schedule C, Part II-B, Lines 1f & 1g	Identifier
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.	Explanation

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amts		ArtPublicExhibitionAmts
Held Works Of Art Amts		HeldWorksOfArtAmts

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	1253294	BeginningOfYearBalance
Contributions	85008	Contributions
Investment Earnings Or Losses	121433	InvestmentEarningsOrLosses
Grants Or Scholarships	45284	GrantsOrScholarships
Other Expenditures	7898	OtherExpenditures
End Of Year Balance	1406553	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	1013866	BeginningOfYearBalance
Contributions	213180	Contributions
Investment Earnings Or Losses	62404	InvestmentEarningsOrLosses
Grants Or Scholarships	24999	GrantsOrScholarships
Other Expenditures	11157	OtherExpenditures
End Of Year Balance	1253294	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	974642	BeginningOfYearBalance
Contributions	161508	Contributions
Investment Earnings Or Losses	-80688	InvestmentEarningsOrLosses
Grants Or Scholarships	30895	GrantsOrScholarships
Other Expenditures	10701	OtherExpenditures
End Of Year Balance	1013866	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	946469	BeginningOfYearBalance
Contributions	74844	Contributions
Investment Earnings Or Losses	-2389	InvestmentEarningsOrLosses
Grants Or Scholarships	16333	GrantsOrScholarships
Other Expenditures	27949	OtherExpenditures
End Of Year Balance	974642	EndOfYearBalance

Field	Value	IRS element (for citing)
Permanent Endowment EOY Balance	0.77440	PermanentEndowmentEOYBalance
Term Endowment EOY Balance	0.22560	TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs	false	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	true	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	true	AreRelatedOrgsListedScheduleR

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	409459	OtherCostOrOtherBasis
Book Value	409459	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	65088429	OtherCostOrOtherBasis
Depreciation	33023264	Depreciation
Book Value	32065165	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	78425	OtherCostOrOtherBasis
Depreciation	78425	Depreciation

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	70102287	OtherCostOrOtherBasis
Depreciation	44871109	Depreciation
Book Value	25231178	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	6912316	OtherCostOrOtherBasis
Depreciation	1206862	Depreciation
Book Value	5705454	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	63411256	TotalOfBookValueLandBuildings
Federal Income Tax Liability	0	FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
Description	DUE TO MEDICARE / MEDICAID	Description
Amount	$3,873,113	Amount

Field	Value	IRS element (for citing)
Total Of Amounts	3873113	TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Intended uses of the organization's endowment funds	Schedule D, Part V, Line 4	The permanent and term endowment funds are to be used to provide building/equipment and program related needs for the UVMC Health System, to provide support to the Upper Valley Medical Center Cancer Care Center, and to provide healthcare scholarships. In addition, the term endowment funds are to be used to provide financial support for indigent patient bills, to provide health education programs, and to provide benefits to enhance a child's well being while spending time in the hospital.
Income Taxes	Schedule D, Part X, Line 2	UVMC is tax-exempt under Section 501(c)(3) of the Internal Revenue Code. As such, there is no income tax liability recorded at December 31, 2011 and 2010. In addition, Management annually reviews its tax positions and has determined that there are no material uncertain tax positions that require recognition in the combined financial statements. UVMC and its respective subsidiaries are a group of corporations that are tax-exempt corporations under Section 501(c)(3) of the Internal Revenue Code except for the following subsidiaries: - UVMC Management Corporation - For-profit corporation subject to federal income taxes - After Hours Family Care, Inc. - For-profit corporation subject to federal income taxes - Med-Terra, Inc. - Tax-exempt corporation under Section 501(c)(2) of the Internal Revenue Code

Schedule F IRS990ScheduleF

Accts Actvs Out US Table AcctsActvsOutUSTable (4 entries)

RegionRegion	Type Of Activities ConductedTypeOfActivitiesConducted	Total ExpendituresTotalExpenditures
North America	Investments	464435
Europe (Including Iceland and Greenland)	Investments	3576097
East Asia and the Pacific	Investments	788366
Central America and the Caribbean	Investments	7500000

Field	Value	IRS element (for citing)
Subtotal Amount Spent	12328898	SubtotalAmountSpent
Total Amount Spent	12328898	TotalAmountSpent
Transfer To Foreign Corp	false	TransferToForeignCorp
Interest In Foreign Trust	false	InterestInForeignTrust
Own Foreign Corp	false	OwnForeignCorp
Passive Foreign Invest Co	false	PassiveForeignInvestCo
Foreign Partnership	false	ForeignPartnership
Boycott Countries	false	BoycottCountries

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	true	CharityCarePolicy
Written Policy	true	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	true	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	true	FPGReferenceDiscountedCare
Pcent400	X	Pcent400
Free Disc Care Medically Indigent	true	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	true	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	false	ExpensesExceededBudget
Annual Community Benefit Report	true	AnnualCommunityBenefitReport
Report Publically Available	true	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	8776234	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1877661	DirectOffsettingRevenue
Net Community Benefit Expense	6898573	NetCommunityBenefitExpense
Percent Of Total Expense	0.04870	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	15661841	TotalCommunityBenefitExpense
Direct Offsetting Revenue	11067403	DirectOffsettingRevenue
Net Community Benefit Expense	4594438	NetCommunityBenefitExpense
Percent Of Total Expense	0.03240	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Total Community Benefit Expense	425742	TotalCommunityBenefitExpense
Direct Offsetting Revenue	333510	DirectOffsettingRevenue
Net Community Benefit Expense	92232	NetCommunityBenefitExpense
Percent Of Total Expense	0.00070	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	24863817	TotalCommunityBenefitExpense
Direct Offsetting Revenue	13278574	DirectOffsettingRevenue
Net Community Benefit Expense	11585243	NetCommunityBenefitExpense
Percent Of Total Expense	0.08180	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1069932	TotalCommunityBenefitExpense
Direct Offsetting Revenue	99907	DirectOffsettingRevenue
Net Community Benefit Expense	970025	NetCommunityBenefitExpense
Percent Of Total Expense	0.00680	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	54280	TotalCommunityBenefitExpense
Net Community Benefit Expense	54280	NetCommunityBenefitExpense
Percent Of Total Expense	0.00040	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	3516441	TotalCommunityBenefitExpense
Direct Offsetting Revenue	783279	DirectOffsettingRevenue
Net Community Benefit Expense	2733162	NetCommunityBenefitExpense
Percent Of Total Expense	0.01930	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	214430	TotalCommunityBenefitExpense
Net Community Benefit Expense	214430	NetCommunityBenefitExpense
Percent Of Total Expense	0.00150	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	4855083	TotalCommunityBenefitExpense
Direct Offsetting Revenue	883186	DirectOffsettingRevenue
Net Community Benefit Expense	3971897	NetCommunityBenefitExpense
Percent Of Total Expense	0.02800	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	29718900	TotalCommunityBenefitExpense
Direct Offsetting Revenue	14161760	DirectOffsettingRevenue
Net Community Benefit Expense	15557140	NetCommunityBenefitExpense
Percent Of Total Expense	0.10980	PercentOfTotalExpense

Economic Development EconomicDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	632	TotalCommunityBuildingExpense
Net Community Building Expense	632	NetCommunityBuildingExpense

Leadership Development LeadershipDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	1200	TotalCommunityBuildingExpense
Net Community Building Expense	1200	NetCommunityBuildingExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	12970	TotalCommunityBuildingExpense
Net Community Building Expense	12970	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Other Other

Field	Value	IRS element (for citing)
Total Community Building Expense	18361	TotalCommunityBuildingExpense
Net Community Building Expense	18361	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Total Community Building Expense	33163	TotalCommunityBuildingExpense
Net Community Building Expense	33163	NetCommunityBuildingExpense
Percent Of Total Expense	0.00020	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	true	BadDebtExpenseReported
Bad Debt Expense	$802,643	BadDebtExpenseAmount
Amount Reimbursed By Medicare	34935883	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	40058840	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-5122957	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost To Charge Ratio	X	CostToChargeRatio

Field	Value	IRS element (for citing)
Written Debt Collection Policy	true	WrittenDebtCollectionPolicy
Provision For Charity Care	true	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	UPPER VALLEY MEDICAL CENTER	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	3130 NORTH COUNTY ROAD 25A	AddressLine1
City	TROY	City
State	OH	State
ZIP Code	45373	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Er24 Hours	X	Er24Hours
Other	BEHAVIORAL HEALTH	Other

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	UPPER VALLEY MEDICAL CENTER	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
Eligibility Criteria Explained	true	EligibilityCriteriaExplained
Uses FPG Free	true	UsesFPGFree
FPG Free Percent	200.	FPGFreePercent
Uses FPG Discounted	true	UsesFPGDiscounted
FPG Discount Percent	400.	FPGDiscountPercent
Income Level	X	IncomeLevel
Medical Indigency	X	MedicalIndigency
Insurance Status	X	InsuranceStatus
Other Factors	X	OtherFactors
Explains Application Method	true	ExplainsApplicationMethod
Attached To Invoices	X	AttachedToInvoices
Posted In Emergency Room	X	PostedInEmergencyRoom
Posted In Admission Office	X	PostedInAdmissionOffice
Available On Request	X	AvailableOnRequest
Other Publicity	X	OtherPublicity
Actions On Nonpayment	true	ActionsOnNonpayment
Notify Upon Admission	X	NotifyUponAdmission
Notified All Patients	X	NotifiedAllPatients
Documented Determination	X	DocumentedDetermination
Other Actions Taken	X	OtherActionsTaken
Nondiscrim Emergency Care Policy	true	NondiscrimEmergencyCarePolicy
Average Negotiated Rates	X	AverageNegotiatedRates
Amounts Generally Billed	false	AmountsGenerallyBilled
Gross Charges	false	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	7	NumberOfOtherFacilities

Other Facilities OtherFacilities (7 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
DIALYSIS SERVICES
3130 N COUNTY RD 25A	TROY	OH	45373	DIALYSIS
HYATT CENTER
450 HYATT STREET	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 SOUTH DORSET ROAD	TROY	OH	45373	LABORATORY, IMAGING OCCUPATIONAL HEALTH REHABILITATIVE THERAPY
STANFIELD PLACE
31 STANFIELD ROAD	TROY	OH	45373	LABORATORY, IMAGING
JACOB DETTMER BUILDING
3130 N COUNTY RD 25A	TROY	OH	45373	SLEEP DISORDER
VERSAILLES CENTER
471 MARKER ROAD	VERSAILLES	OH	45380	LABORATORY

Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
SUPPLEMENTAL INFORMATION	Part I, line 3c	Not applicable. Upper Valley Medical Center uses the Federal Poverty Guidelines for determining eligibility for free or discounted care under the organization's charity care policy.
SUPPLEMENTAL INFORMATION	Part I, line 6a	An annual written community benefit report is prepared by the organization directly. In addition, Upper Valley Medical Center's community benefit information is included in an annual written community benefit report with Premier Health Partners, a related organization. Both of these reports are made available to the public via publications in local newspapers, as well as on the organizations' websites.
SUPPLEMENTAL INFORMATION	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 2011 was $1,105,770, with direct offsetting revenues of $783,279. The net community benefit expense was $322,491.
SUPPLEMENTAL INFORMATION	Part I, line 7, column (f)	Bad debt expenses of $3,648,419, which are included on Form 990, Part IX, line 25, column (A), have been removed from the denominator prior to the calculation of the percent of total expense.
SUPPLEMENTAL INFORMATION	Part I, line 7	A cost-to-charge ratio methodology was used to calculate the community benefit expenses which appear in the table in Schedule H, Part I, Sections 7a-c. This cost-to-charge ratio was derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges. The community benefits expenses which appear in the table under Sections 7e-j are calculated based on actual costs.
SUPPLEMENTAL INFORMATION - Community Building Activities	Part II	To aid in the leadership development and training for community members, Upper Valley Medical Center participates in the Leadership Piqua and Leadership Troy programs. These programs consist of annual sessions, whereby participants learn leadership and interpersonal skills to be informed civic-oriented leaders who are interested in helping to direct the future of the Miami County communities. Upper Valley Medical Center is a member of the local area chambers of commerce. Through this membership and the various chamber activities, the organization participates in the economic development of the Miami County area. In 2011, Upper Valley Medical Center participated in the Project Search Program. Project Search is a high school transition program which provides training and education leading to employment for individuals with disabilities. It is a collaborative program between Upper Valley Medical Center, Upper Valley Joint Vocational School, Rehabilitation Services Commission, the Miami and Shelby County Boards of Developmental Disabilities, and Capabilities. Eight individuals were selected to gain employable skills working in various departments within the hospital performing various tasks. The goal of this program is to have the individuals gain more independence and an ability to work in gainful employment. A Project Search Coordinator and a Job Coach supervise the students on a daily basis. 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.
SUPPLEMENTAL INFORMATION - BAD DEBTS	Part III, line 4	Upper Valley Medical Center uses Worksheet A and the cost-to-charge ratio methodology from Worksheet 2, Ratio of Patient Care Cost-to-Charges to determine the amounts reported as the organization's bad debt expense (at cost) on Part III, Section A., lines 2-3. The Medical Center does not have a footnote in the audited financial statements that describes bad debt expense. Bad debt expense is incurred when an account is taken out of accounts receivable and turned over to a collection agency. This is done immediately if a patient refuses payment arrangements, refuses to apply for charitable assistance and there is no 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 the organization's collection policy and the patient has not returned phone calls, set up a payment plan, applied for charitable assistance and there is no insurance balance being contended. The collection agency attempts to collect the account in accordance with established guidelines. Collection attempts are immediately ceased and the account returned back to the organization if the patient applies for charitable assistance. Any amounts collected from these accounts are credited back against bad debt. Upper Valley Medical Center recognizes that there are accounts written off to bad debt that may have qualified for charity care if the patient 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. The policy is as follows: The collection agency pursues all bad-debt accounts until they exhaust their efforts of until 9 months after the placement date, whichever occurs earlier. If the collection agency has not been able to resolve the account, the account is returned to the organization for final close-back. These accounts are then sent to the third party vendor who gathers external credit data that presents the account as less than 200% Federal Poverty Level or not enough information (typically indicative of indigent). These accounts are reclassified from bad debt expense to charity expense on our income statement. Any credit score that presents the accounts as greater than 200% Federal Poverty Level remains in bad debt expense. Due to this process, Upper Valley Medical Center does not feel it has reported bad debt expense for patients eligible under the organization's charity care policy.
SUPPLEMENTAL INFORMATION - MEDICARE SHORTFALL	Part III, line 8	The Medicare shortfall of $5,122,957 should be treated as community benefit because the organization is providing high-quality care in excess of the cost to those in its community who need care. The Medicare population at the organization is approximately 30% of net patient revenue. The Medicare advantage plans and Medicare managed care plans are excluded from this percentage. Upper Valley Medical Center uses the Medicare Allowable Costing Methodology (Medicare Cost Report 2552-96) to determine Medicare allowable costs reported.
SUPPLEMENTAL INFORMATION	Part III, line 9b	Upper Valley Medical Center makes reasonable efforts to determine whether or not an individual is eligible for assistance under the state's or hospital's financial assistance policy before engaging in extraordinary collective actions against that individual. Patients who are known to qualify for financial assistance are not subjected to extraordinary collections actions. 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's financial assistance programs. Reasonable efforts include: 1) Validating that the patient owes the unpaid bills and that all sources of third party payment have been identified and billed by the hospital. 2) Documenting that the organization has or has attempted to offer the patient the opportunity to apply for charity care under its financial assistance policy. 3) Documenting that the patient does not qualify for financial assistance. 4) Documenting that the patient has been offered a payment plan, but has not honored the terms of that plan. The Financial Counselors meet with both inpatient and 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.
SUPPLEMENTAL INFORMATION - FACILITY INFORMATION	Part V, Section B	Part V, Section B, line 9 Not applicable. Upper Valley Medical Center uses the Federal Poverty Guidelines for determining eligibility for free care under the organization's charity care policy. Part V, Section B, line 10 Not applicable. Upper Valley Medical Center uses the Federal Poverty Guidelines for determining eligibility for discounted care under the organization's charity care policy. Part V, Section B, line 11 If the patient's family income falls within 400% of the federal poverty guidelines, the patient qualifies for assistance under the hospital's financial assistance policy and all or part of the account will be written off to charity care, based upon a sliding fee schedule. The amount 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 charged gross charges for emergency or medically necessary care. Patients may also qualify for charity care discounts due to a medically-based catastrophic event which have occurred in their life. If a patient qualifies for this discount, he/she would only be held responsible for payment of his/her medical expenses up to 25% of their annual income. Part V, Section B, line 13 Upper Valley Medical Center widely distributes information about its financial assistance policy within the Miami County area and surrounding communities that it serves. This information includes the method of applying for and accessing financial assistance. Notices are publicized in patient's bills and are posted in the emergency room, admitting and registration areas, hospital business offices and patient financial services offices, as well as other public areas. A summary of the financial assistance policy is published on the UVMC website, in brochures available in patient areas and in other places within the community. Financial counselors, patient advocates and customer service representatives discuss the financial assistance policy with all uninsured patients and any patient who express financial hardship with paying their bill. Information regarding the financial assistance policy is available in both English and Spanish. Part V, Section B, line 15 Upper Valley Medical Center does not impose extraordinary collection actions such as wage garnishments, liens on primary residences or other legal actions for any patient without first making reasonable efforts to determine whether the patient is eligible for charity care under its financial assistance policy. Reasonable efforts include: a. Validating that the patient owes the unpaid bills and that all sources of third party payment have been indentified and billed by the hospital, b. Documenting that Upper Valley Medical Center has or has attempted to offer the patient the opportunity to apply for charity care under its financial assistance policy, c. Document 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. Part V, Section B, line 16 Upper Valley Medical Center engages the services of third party collection agencies to assist in its collection efforts. These collection agencies may engage in similar collection actions allowed by the hospital under its billing and collections policy after first making reasonable efforts to determine whether the patient is eligible for charity care under its financial assistance policy. Part V, Section B, line 17 Before initiating collections actions, Upper Valley Medical Center notifies patients of its financial assistance policy. Notices of the policy are publicized in patient's bills and are also posted in the emergency room, admitting and registration areas, hospital business offices and patient financial services offices, as well as other public areas. A summary of the financial assistance policy is published on the UVMC website, in brochures available in patient areas and in other places within the community. Patient advocates discuss the financial assistance policy directly with all uninsured patients in the emergency department and those who are admitted to the hospital. The patient advocates also contact uninsured outpatients who are scheduled to have major procedures and all inpatients who are covered by Medicare only. In any instance where a patient calls the hospital and expresses a concern about their ability to pay, the financial assistance policy is explained. For all accounts with balances over $500, the patient advocate attempts to contact the patient three times prior to turning the account over for collections. Part V, Section B, line 18 Upper Valley Medical Center's financial assistance policy ensures that the financial capacity of people who require health care services does not prevent them from seeking or receiving care. Upper Valley Medical Center provides, without discrimination, care for emergency medical conditions, consistent with Section 1867 of the Social Security Act (EMTALA), to individuals regardless of their eligibility for financial assistance or for government assistance. Part V, Section B, lines 19 & 20 Upper Valley Medical Center does not have a discount program for all uninsured patients. However, for those uninsured or underinsured patients who apply for and meet the eligibility criteria for financial assistance under the financial assistance policy, the hospital uses the lowest negotiated commercial insurance rate for the services received by the patient. Part V, Section B, line 21 Upper Valley Medical Center does not have a discount program for all uninsured patients. Uninsured or underinsured patients who do not apply for financial assistance or those who do not qualify for financial assistance are charged the gross charges for any services provided to the patient.
SUPPLEMENTAL INFORMATION - Needs assessment:	Part VI, Question 2:	The primary purpose of the UVMC 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. UVMC 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. UVMC strives to work with Premier Health Partners, the UVMC Board of Directors, executive management, managers, staff members, community groups, and individuals to provide a collaborative approach to the governance and management of community benefit activities.
SUPPLEMENTAL INFORMATION - Patient education of eligibility for assistance	Part VI, Question 3:	There are several ways in which Upper Valley Medical Center informs and educates patients who may be billed for services about their eligibility for assistance under federal, state, or local government programs or under the Medical Center's financial assistance policy. First, notification of such available assistance is clearly posted in registration areas, as well as the maternity and emergency departments. Next, patient advocates, patient access staff members and financial advocates in the inpatient and emergency departments meet with uninsured and under-insured patients, as well as those with just Medicare coverage, to discuss eligibility for assistance. Financial counselors also discuss options to resolve unpaid account balances with uninsured and under-insured patients. A summary of the financial assistance policy is posted on the hospital's website, along with information on how to obtain an application. When a patient receives a bill from Upper Valley Medical Center, the reverse side of the bill contains information about the State of Ohio Free Care Program (Care Assurance). The patient statement offers a summary of the financial assistance options available and the contact information for assistance.
SUPPLEMENTAL INFORMATION - Community information	Part VI, Question 4:	Upper Valley Medical Center serves the northern Miami Valley area with acute care services, community health and wellness programs and more. Upper Valley Medical Center is located in Miami County, Ohio and is the sole hospital system operating within the county. The population of Upper Valley Medical Center's primary service area is approximately 130,000 people. Including the adjacent counties, which are also served (Shelby, Darke, and Champaign Counties), Upper Valley Medical Center's total primary and secondary service area population approaches 300,000 residents. The overall service area is categorized as having relatively slow growth with an aging population, consistent with current trends throughout Ohio. The median household income of Miami County and the surrounding area is slightly above $50,000 per year, with approximately 10% of its citizens living below the federal poverty level. Approximately 48% of the hospital's gross revenues are generated from Medicare patients, while another 19% of the revenues are generated from either uninsured patients or Medicaid recipients. The current unemployment rate of Miami County is approximately 9%. Recent job growth has been negative.
SUPPLEMENTAL INFORMATION - Promotion of Community Health	Part VI, Question 5	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 surrounding counties. The hospital furthers it tax-exempt purpose by promoting the health of the community in many ways. A principal financial contribution to the community is the provision of acute health services to patients regardless of their ability to pay. In addition to charity care services provided, Upper Valley Medical Center experienced bad debt expenses and also incurred costs from providing care for patients covered by government programs such as Medicare and Medicaid, where reimbursement is limited. Upper Valley Medical Center also subsidizes an obstetrics clinic and a behavioral health clinic and provides a comprehensive continuum of psychiatric and chemical dependency programs. These services are provided at a reduced cost or no cost for those who are uninsured or unable to pay. Thousands of individuals throughout Miami and surrounding counties benefited from Upper Valley Medical Center's health-focused programs during 2011, including health fairs, screenings, immunizations, support groups and other services. Many of these programs are free to the public or offered at a reduced price. Free presentations are available to area civic, service and social groups, professional organizations, schools, churches, and industries through the UVMC speaker's bureau. Speakers are available on a wide variety of medical/health care topics and are able to provide accurate up-to-date information to the community. Upper Valley Medical Center's use of surplus funds includes the purchase of property, plant and equipment of approximately $16 million. Highlights include: -Epic (Electronic Medical Record) Implementation -Cancer Care Center Expansion -CT Scanner for Cancer Care -Hemodialysis Machines -Emergency Room Renovation for Behavioral Health Assessments -Information Systems Upgrades. The UVMC board of directors consists of 18 members of the community. The majority of the board members are neither employees nor contractors of the organization. None of these board members receive compensation from the organization for services provided in the role of board member. The Medical Center extends medical staff privileges to all qualified physicians in its community for the majority of its departments. See Schedule O, Part III for more comprehensive details about how the Medical Center promotes the health of the community.
SUPPLEMENTAL INFORMATION - Affiliated Health Care System	Part VI, Question 6	Upper Valley Medical Center is affiliated with Miami Valley Hospital, Good Samaritan Hospital, and Atrium Medical Center. The agreement between the systems provides for the creation of Premier Health Partners (PHP), an Ohio non-profit corporation. Each hospital system has the authority to determine the amounts it contributes to community building and other indigent programs.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	true	RecordsMaintained

Recipient Table RecipientTable (6 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant
UVMC FOUNDATION
3130 N COUNTY ROAD 25A	TROY	OH	45373	311581859	501(C)(3)	36000	SCHOLARSHIP
AMERICAN CANCER SOCIETY
5555 FRANTZ ROAD	DUBLIN	OH	43017	340726080	501(C)(3)	7500	SPONSORSHIP MIAMI CO RELAY FOR LIFE
EDISON FOUNDATION
1973 EDISON DRIVE	PIQUA	OH	45356	311379781	501(C)(3)	124200	CAPITAL, EVENT SPONSORSHIP & GENERAL FUND
Health Partners Free Clinic
1300 North County Rd 25A	Troy	OH	45373	311596731	501(C)(3)	61000	Operations
Troy City Schools
151 Staunton Rd	Troy	OH	45373	316000985		75000	Equipment & Sponsorship
AMERICAN HEART ASSOCIATION
1313 W Dorothy Lane	Kettering	OH	45409	135613797	501(c)(3)	6000	GO RED NORTH SPONSORSHIP

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	6	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	0	TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	Form 990, Schedule I, Part I, Line 2	Identifier
Return Reference	Description of Organization's Procedures for Monitoring the Use of Grants	ReturnReference
Explanation	UPPER VALLEY MEDICAL CENTER MONITORS THE USE OF GRANT FUNDS IN THE UNITED STATES BY VERIFYING THAT THE ORGANIZATIONS REQUESTING ASSISTANCE ARE 501(C)(3) TAX EXEMPT ORGANIZATIONS. THE GRANTS THAT ARE GIVEN ARE USUALLY SMALL IN NATURE AND 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.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	false	SeverancePayment
Supplemental Nonqual Retire Plan	true	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	false	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	false	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	false	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	true	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	true	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	false	AnyNonFixedPayments
Initial Contract Exception	false	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (20 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs	Base Compensation Filing OrgBaseCompensationFilingOrg	Bonus Filing OrgBonusFilingOrg	Other Compensation Filing OrgOtherCompensationFilingOrg	Deferred Comp Filing OrgDeferredCompFilingOrg	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Total Compensation Filing OrgTotalCompensationFilingOrg
Rowan R Nickol MD
258350	54829	19552	66483	21524	420738
L Stewart Lowry MD
302724	8839	17838	2450	21395	353246
Michael J Maiberger
294532	103295	97653	14700	11897	522077	20993
Thomas Parker
							258307	66488	38099	43710	8580	415184
Timothy Snider
							196471	37691	17499	14700	13068	279429
Judith Snyder
							152010	42542	32026	60205	6241	293024
Rebecca Rice
							146617	32400	26046	58249	6674	269986
James Hurak
							133704	33843	25572	39899	13159	246177
Shakil Rahman MD
							287924	103488	1037	2450	23805	418704
Rafay Atiq MD
							222093	25000	963	2450	21766	272272
William Watercutter
							126384	13080	9694	9135	15466	173759
Thomas Bigley
							141342	20632	7200	10321	14575	194070
Tracy Moser
							117714	15560	5143	8696	18087	165200
Barbara Evert MD
							70304	58239	42799	4652	5233	181227
Mary M Clancy
313530	126634	27524	41787	13359	522834	151055
WILLIAM E LINESCH
300256	103880	20202	33815	7322	465475	118246
THOMAS J ARQUILLA
126756	67633	9578	6832	21171	231970	75243
MARK W SHAW
255244	86405	7737	62595	21418	433399	86405
J NICHOLAS LAIR
199671	94873	745	14638	20249	330176	94873
RENEE P GEORGE
202151	66675	581	9394	24021	302822	66675

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifier

ExplanationExplanation

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, UVMC Management Corporation (related organization) compensates for this limitation and supplements the affected executives' qualified pension through certain nonqualified plans. UVMC Management Corporation supplements through a Supplemental Executive Retirement Plan or "SERP". The benefits under the SERP are subject to multi-year vesting and a participant can forfeit benefits earned if vesting requirements are not satisfied. The SERP is a non-qualified deferred compensation plan subject to the requirements of the Internal Revenue Code Section 409A. The 2011 Participant in the SERP with a vested amount is: Michael Maiberger, and his vested amount of SERP for 2011 is $20,993. Additionally, the 451 Deferred Compensation Plan is offered to a select group of key management or highly compensated employees. This plan is intended to be a nonqualified deferred compensation arrangement which complies with the requirements of the Internal Revenue Code Section 409A. This plan is funded solely by the plan participants and maintained by a related organization. The 2011 participant is Michael Maiberger. The amount of his deferral under the Plan for 2011 is $56,488. All or parts of these payments were also properly reported on prior years' filed IRS Form 990 returns disclosing compensation earned by these individuals under the plans for each such year. However, 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, which in this situation is 2012.

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

PREMIER HEALTH PARTNERS (PHP), OF WHICH UPPER VALLEY MEDICAL CENTER IS A PART, 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%), FINANCIAL (20%) AND MAJOR PROJECTS (5%). THE FINANCIAL CATEGORY OF THE SCORECARD IS BASED ON NET EARNINGS OF THE INDIVIDUAL HOSPITAL AND THE NET EARNINGS OF THE SYSTEM OF A WHOLE. THIS FINANCIAL TARGET IS SET BASED ON THE OPERATING AND CASH FLOW MARGINS REQUIRED TO MAINTAIN THE SYSTEM AA CREDIT RATINGS. DIRECTORS, VICE PRESIDENTS AND ABOVE INCENTIVE OBJECTIVES ARE WEIGHTED 45% ON ORGANIZATIONAL CRITERIA AND 45% ON INDIVIDUAL CRITERIA, AND 10% ON ORGANIZATIONAL EFFECTIVENESS. THE 2011 INCENTIVE PLAN AMOUNTS WERE PAID TO THE PARTICIPANTS IN 2012. THESE ARE NOT REPORTED AS DEFERRED COMPENSATION ON THE 2011 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'S 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, WHICH IN THIS SITUATION IS 2012.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	County of Miami Ohio	BusinessNameLine1

Field	Value	IRS element (for citing)
Issuer EIN	316000055	IssuerEIN
CUSIP Number	593328EV5	CUSIPNumber
Date Issued	2006-06-29	DateIssued
Issue Price	57502248	IssuePrice
Description Of Purpose	See Part VI	DescriptionOfPurpose
Defeased	false	Defeased
On Behalf Of Issuer	false	OnBehalfOfIssuer
Pool Financing	false	PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

Field	Value	IRS element (for citing)
Amount Retired	5855000	AmountRetired
Amount Bond Defeased	0	AmountBondDefeased
Total Proceeds	61109249	TotalProceeds
Amount In Reserve Fund	5240175	AmountInReserveFund
Capitalized Interest	0	CapitalizedInterest
Refunding Escrow	0	RefundingEscrow
Issuance Costs From Proceeds	663253	IssuanceCostsFromProceeds
Credit Enhancement	0	CreditEnhancement
Working Capital Expenditures	0	WorkingCapitalExpenditures
Capital Expenditures	19589170	CapitalExpenditures
Other Spent Proceeds	35616651	OtherSpentProceeds
Amount Unspent	0	AmountUnspent
Year Of Subst Completion	2009	YearOfSubstCompletion
Current Refunding	true	CurrentRefunding
Advance Refunding	false	AdvanceRefunding
Final Allocation Made	true	FinalAllocationMade
Adequate Books And Recds Maintaind	true	AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

Field	Value	IRS element (for citing)
Owning Bond Financed Property	false	OwningBondFinancedProperty
Any Lease Arrangements	true	AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty	true	MngmentCntrctBondFinancdPrprty
Engage Bond Counsel Contracts	true	EngageBondCounselContracts
Any Research Agreements	false	AnyResearchAgreements
Prcntge Prvt Business Use By Others	0.00100	PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI	0.00200	PercentageOfPrvtBusinessReUBI
Total Private Business Use	0.00300	TotalPrivateBusinessUse
Post Issuance Compliance Procdrs	true	PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

Field	Value	IRS element (for citing)
Form8038 T Filed	false	Form8038TFiled
Variable Rate Issue	false	VariableRateIssue
Hedge Identified In Books And Recds	false	HedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

Field	Value	IRS element (for citing)
Business Name Line1	0	BusinessNameLine1

Field	Value	IRS element (for citing)
Gross Proceeds Invested In GIC	false	GrossProceedsInvestedInGIC

Name Of GIC Provider NameOfGICProvider

Field	Value	IRS element (for citing)
Business Name Line1	0	BusinessNameLine1

Field	Value	IRS element (for citing)
Gross Proceeds Invested	true	GrossProceedsInvested
Exception To Rebate	false	ExceptionToRebate

Form990 Schedule K Part VI Form990ScheduleKPartVI

Field	Value	IRS element (for citing)
Identifier	See Schedule O	Identifier
Return Reference	0	ReturnReference

Schedule L IRS990ScheduleL

Loan Table LoanTable

Field	Value	IRS element (for citing)
Name Person	DIGESTIVE SPECIALTY	NamePerson
Purpose Of Loan	LINE OF CREDIT	PurposeOfLoan
Loan From Organization	X	LoanFromOrganization
Original Principal	$52,847	OriginalPrincipalAmount
Balance Due	28995	BalanceDue
Default	false	Default
Approved By Board	true	ApprovedByBoard
Written Agreement	true	WrittenAgreement

Field	Value	IRS element (for citing)
Total Balance Due	28995	TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Field	Value	IRS element (for citing)
Name Person	Digestive Specialty Care	NamePerson

Field	Value	IRS element (for citing)
Relationship	>35% OWNED-ABBOUD (FORM.)	Relationship
Amount Of Transaction	300000	AmountOfTransaction
Description Of Transaction	GASTROENTEROLOGY SERVICES	DescriptionOfTransaction
Sharing Of Revenues	false	SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (18 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
MISSION STATEMENT	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.
PROGRAM SERVICES	PART III, LINE 4A	Upper Valley Medical Center (UVMC) was founded in 1986 as the umbrella corporation for the merger of Miami County's three independent & competing hospitals. In 1998, acute care services were consolidated into a centrally located facility. Currently, the hospital is licensed for 139 acute care beds and 39 behavioral health beds. UVMC's vision is committed to preserving long-term access to quality health care services for Miami County and the surrounding area. Quality customer service is a priority at UVMC. Our culture is defined by "Caring Plus" which is UVMC's commitment to quality, kindness, and compassion for our patients, their families, visitors, physicians, and co-workers. It is an important part of the basic foundation of UVMC's patient-centered approach to care. UVMC also uses AIDET -- a powerful, proven communication tool designed to reinforce our Caring Plus customer service. AIDET is an acronym that represents how we can gain trust and communicate with patients who are nervous, anxious, and feeling vulnerable about their illness by remembering these key words: Acknowledge, Introduce, Duration, Explanation, and Thank-you. In January 2009, a joint operating agreement was implemented in which Upper Valley Medical Center became a part of the Premier Health Partners (PHP), a comprehensive health system serving southwestern Ohio through member and affiliate organizations in seven counties. The association with PHP, a not-for-profit corporation, allows for more flexibility in accessing specialty services not provided locally. It also gives local residents more access to community health services such as expanded wellness programs provided in conjunction with Premier Community Health and the CareFinders physician referral network. Upper Valley Medical Center is a member of PHP along with three other hospitals. Each hospital has the authority to determine the amounts it contributes to community building and other indigent programs. The policies for bad debts and charity collections are established by PHP. The hospital was granted tax exempt status as a hospital in February of 1935.
PROGRAM SERVICES - CONTINUED	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. 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. As a part of the PHP system of providers, UVMC also shares the PHP mission of building healthier communities with others who share our commitment to provide high quality cost-competitive health care services. A principal financial contribution that Upper Valley Medical Center makes to the community is its provision of acute health care services to patients regardless of their ability to pay. The hospital operates a 24-hour emergency room 365 days per year that is open to all individuals. It also participates in government-sponsored health care programs such as Medicare, Medicaid, TRICARE, and has an active charity care program. The Board of Directors for Upper Valley Medical Center consists of 18 members of the community. The majority of them are neither employees nor contractors of the organization. No board member receives compensation from the organization for services provided in the role of board member. The Medical Center extends medical staff privileges to all qualified physicians in its community for the majority of its departments. The medical staff consists of 215 physicians and the health system continues to actively recruit new doctors to Miami County in important primary and specialty areas of medicine.
PROGRAM SERVICES - CONTINUED	PART III, LINE 4A	COMMUNITY BENEFIT APPROACH Upper Valley Medical Center is located between Troy and Piqua, Ohio and serves the northern Miami Valley area with acute care services, community health and wellness programs, and more. It is the sole hospital system operating within Miami County. The hospital also offers easy access to quality care by providing outpatient services throughout the Miami County area. Satellite locations provide Laboratory, Radiology, Surgical, Sports Medicine, Occupational Health, Dialysis, and Rehabilitative services. Upper Valley Medical Center also provided Home Health/Home Care visits to community residents in their homes for part of the year. 2011 operating statistics for Upper Valley Medical Center follow: Patient Days: -Acute Care (Excluding Newborns) 30,096 -Behavioral Health 8,282 Other Volume Indicators: -Laboratory Tests 571,308 -Radiology/Imaging Exams 110,554 -Cardiopulmonary Procedures 122,760 -Rehabilitation Services Visits 50,410 -Emergency Room Visits 42,693 -Occupational Health Procedures 35,387 -Cancer Care Visits 11,281 -Home Care Services Visits 12,097 -Dialysis Treatments 10,085 -Outpatient Surgeries 7,353 -Inpatient Surgeries 1,798 -Behavioral Health Outpatient Visits 9,876 -Births 689 Approximately 48% of the hospital's gross revenues are generated from Medicare patients, while another 19% of the revenues are generated from either uninsured patients or Medicaid recipients. The primary purpose of the UVMC 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. UVMC 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 members of the community who may be economically disadvantaged, disenfranchised, and/or have disproportionate unmet health needs. UVMC strives to work with Premier Health Partners, the UVMC Board of Directors, executive management, managers, staff members, community groups, and individuals to provide a collaborative approach to the governance and management of community benefit activities.
PROGRAM SERVICES - CONTINUED	PART III, LINE 4A	COMMUNITY OUTREACH FOR THE BROADER COMMUNITY During 2011, thousands of individuals throughout Miami and surrounding counties benefited from Upper Valley Medical Center's health-focused programs, such as health fairs, screenings, immunizations, support groups, and other services. Many of these programs are free to the public or offered at a reduced price. Free presentations are available to area civic, service and social groups, professional organizations, schools, churches, and industries through the UVMC Speaker's Bureau. Speakers are available on a wide variety of medical/healthcare topics and are able to provide accurate, up-to-date information to the community. UVMC, along with other PHP hospitals, began Target Zero, an important safety initiative that ensures all staff members are committed to safety first in every aspect of their work. The outcome of this initiative is to create the safest environment for all patients, visitors, and employees with the goal of zero preventable accidents. This is achieved by a daily check-in, which is a 15-minute standup meeting, led by a senior executive and attended by directors/managers to identify any safety issues from the last shift or 24 hours. Upper Valley Medical Center participated in STate Action on Avoidable Readmissions (STAAR), a statewide initiative. The goal of the pilot project is to reduce costly, avoidable hospital readmissions by improving patient care and the transition from hospital care to home or extended care facility. In the spring of 2011, UVMC introduced Quiet Time in the patient care setting daily from 2:00 p.m. to 4:00 p.m. Among the goals of Quiet Time is to enhance the patient experience by reducing environmental stimuli and promoting patient rest and/or sleep during those hours. Evidence-based research suggests that this timeframe is when the body is most ready for rest due to natural lows in the body's circadian rhythm. Upper Valley Medical Center subsidizes the outpatient services for Behavioral Health. It provides traditional private outpatient therapy and medication management for adults, adolescents, and children. Clients include those who either have no insurance or qualify for Medicaid services. Also 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. The obstetrics clinic serves the prenatal, delivery, and postnatal medical needs of women in the hospital's Miami County service area who either have no medical insurance or qualify for Medicaid services. The net community benefit expense for 2011 was $322,000 for these services. UVMC increased support of the local Health Partners Free Clinic in the form of contributions totaling $61,000 as part of both organizations' common mission to assure access to needed health care services in our communities.
PROGRAM SERVICES - CONTINUED	PART III, LINE 4A	A Heart Month Health Fair was held in February. With heart disease being the leading cause of death for American adults, people should be aware of their risks. The event was open to the community and included free screenings for total cholesterol, HDL, blood sugar, as well as blood pressure testing. UVMC programs and Cardiology professionals also provided health testing and helpful information. The second Go Red for Women/North Expo was held at Edison Community College in September. The event was presented by UVMC in conjunction with the American Heart Association's "Go Red" initiatives focusing on promoting women's heart health. UVMC provided more than 300 free health tests/screenings and counseling. The keynote speaker used humor to emphasize the need for women to lighten up and get a handle on stress that surrounds them. Other activities at the event included mini-makeovers, hand/chair massages, heart healthy cooking demonstrations, and more. The annual McGraw Cancer Awareness Symposium was also held in September. The keynote speaker presented the topic "Genetics and Cancer: How Your Genes Influence Your Cancer Risk." The symposium also included a panel discussion. This event was sponsored by the UVMC Cancer Care Center and the UMVC Foundation along with a gift from the McGraw Family Fund of the Troy Foundation and support from Myriad Labs. The symposium was free and open to the public. The Nutrition Services Department encompasses all components of food production for patient meals, cafeteria services, vending foods, and internal catering. The clinical team of dietitians and diet technicians accommodate inpatient and outpatient as well as community nutrition therapy and education. Nutrition Services also prepares meals for the Altrusa Mobile Meals and Piqua Meals on Wheels programs. The number of meals prepared was 12,736 and 12,825 respectively. The hospital subsidizes these programs. People of different ages have the opportunity to contribute their time and skills to various departments within the hospital such as the gift shop, emergency services, escort services, surgical services, chaplaincy, reception, etc. During 2011, 180 UVMC volunteers provided over 28,000 hours of service throughout the hospital system. These volunteers generously give of their time to perform services that benefit our patients, visitors, and staff. The UVMC Auxiliary also sponsors an important community program called Lifeline, a low-cost medical alert service designed to reduce the risk of living alone. Lifeline began in 1985 with 25 clients and now serves over 500 clients in a seven county area. The hospital offers this program office and storage space. The Department of Pastoral Care has staff chaplains and community clergy volunteers who provide spiritual care at all UVMC facilities 24 hours a day. In addition, nondenominational worship services are provided for patients, their family members, visitors, and staff. There is no fee to patients for the services that the UVMC Pastoral Care staff provides. Teams from UVMC participated in the Miami County Relay for Life held in May. The event celebrates cancer survivorship, helps increase awareness of cancer prevention and treatment, and raises funds for important cancer research and programs. UVMC Center for Sports Medicine offers many services and programs throughout the year to the community. In February, it held its annual Symposium. The Sportsmetrics Knee Injury Reduction Program is designed to reduce the risk of injury and enhance performance for female athletes. Also, offered for the ninth year, was Explosive Speed & Power for local athletes who want to improve speed, agility, vertical jump, strength, and flexibility. These are just a few of the specialized programs that are offered.
PROGRAM SERVICES - CONTINUED	Part III, Line 4a	The caring professionals of Upper Valley Medical Center have shown their commitment to the needs of the community through the annual United Way Fund campaign for many years. Employees demonstrate their commitment to the community by contributing to the local chapters of the United Way Fund in order to benefit the many important services provided by local agencies. The 2011 fund drive brought in over $15,000 in contributions. Food pantries around the area reported an increase in requests. The Caring Plus Holiday Food Drive collected a record 657 food items for its annual event. Items were donated to the Bethany Center in Piqua and St. Patrick Soup Kitchen in Troy, both of which provide food and other assistance for those in need in our communities. The hospital offers interpreters, at no cost to the patient, to serve hearing-impaired or non-English speaking patients. EDUCATION Both the Ohio Board of Nursing and the Ohio Counselor/Social Worker Board approved Upper Valley Medical Center as a provider of continuing education credits. This distinction enables the Education and Development Department to meet its responsibility to assist in the maintenance and improvement of healthcare education. This is significant for those in search of opportunities to maintain and improve their professional skills and fulfill educational needs and requirements. The department coordinates education programs, provides resources, satellite teleconferences, and provides continuing education credits for a variety of disciplines. The scope of the department's services includes coordination of: Advanced Cardiac Life Support Education Fair Continuing Education In-Services CPR Nursing Orientation Education on managing diabetes is available for inpatients and outpatients who have the disease. This department also teaches community diabetes classes and coordinates a support group. The subsidy for offering all of the above programs was $426,000 in 2011. The Health Sciences Library, located on the Lower Level, is open to the public during normal business hours, or by making special arrangements with the librarian. A Health Education Center, adjacent to the Library, offers educational materials to help promote wellness and understanding about diseases. Information is available via computer, videos, and pamphlets. The subsidy for offering this service was $67,000 in 2011. EMS Education provides initial training and continuing education that local EMS providers require. First Responder is a 40-hour program designed to fit the needs of those who are often "first-on-the-scene", such as police officers and industrial health personnel. A 130-hour class provides the foundation for pre-hospital care for a basic Emergency Medical Technician. Refresher classes are also offered for EMS levels. This program was subsidized by the hospital in the amount of $96,000 in 2011. During 2011, Upper Valley Medical Center participated in the Project SEARCH program. This is a high school transition program, designed to provide training and education leading to employment for individuals with disabilities. Local Project SEARCH partners include UVMC, Upper Valley Career Center, Capabilities Inc., the Board of Developmental Disabilities in Miami and Shelby counties, and the state Bureau of Vocational Rehabilitation. RESEARCH PROGRAMS UVMC Cancer Care Center partners with the Dayton Clinical Oncology Program (DCOP). Clinical trials investigate cancer prevention and evaluate agents and drugs for the prevention of cancer. One type of study is a "chemo-prevention trial." This type of study is conducted by recruiting healthy, cancer-free individuals who are at risk for developing cancer. Chemo-prevention trials use medications, vitamins, and other substances which have been tested for preventing the development of a specific type of cancer. DCOP develops and investigates new drugs and new combinations of surgery, chemotherapy, and radiation treatments for cancer. UVMC is an active partner in these new treatment protocols. UVMC surgeons, oncologists, and radiation oncologists are active participants in DCOP trials both in patient recruitment and treatment. Our affiliation with DCOP provides cancer patients access to clinical trial protocols. As a result of this affiliation, our patients can receive the latest in cancer treatments and participate in clinical trials from several research bases such as NSABP Foundation, Southwest Oncology Group (SWOG), Radiation Therapy Oncology Group (RTOG), and M.D. Anderson Cancer Center. Through participation in clinical trials, cancer patients benefit from, as well as contribute to, how this disease is treated. AWARDS AND RECOGNITION UVMC has received many awards and recognitions that demonstrate our commitment to excellence, to our patients, and to our employees. The Department of Health and Human Services, Centers for Medicare & Medicaid Services issued a preview performance score report for the UVMC Dialysis Unit. The purpose of the End Stage Renal Disease Quality Incentive report is to improve patient care by setting quality of care performance standards. Facilities failing to meet the quality of care performance standards may be subject to a payment reduction of up to two percent. The UVMC Dialysis Unit total performance score was 30 out of 30 possible points, meaning the unit will not incur any payment reduction in the next year. GROWTH AND ENHANCEMENTS Upper Valley Medical Center invested over $16 million in important technological advancements to enhance the range of services offered. Highlights include: Implementation of EPIC (Electronic Medical Record) Expansion of Cancer Care Center Purchase of equipment such as CT Scanner and Hemodialysis Machines Renovation of Emergency Department for Behavioral Health Assessments Upgrades to Information Systems. See Schedule H for more information.
DID THE ORGANIZATION HAVE MEMBERS OR STOCKHOLDERS?	PART VI, QUESTION 6	Upper Valley Medical Center has two members. One member is UVMC, the parent company of the hospital. The second member is Premier Health Partners, 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 Health Partners has the general authority to operate and manage the operations of the Premier Health Partners activities of the corporation.
MEMBERS/STOCKHOLDERS WHO MAY ELECT GOVERNING BODY MEMBERS	PART VI, QUESTION 7A	UVMC has the sole authority to elect the board of trustees for Upper Valley Medical Center (hospital.) UVMC has the authority to remove trustees at any regular or special board meeting or by written consent. In addition to removal by UVMC, a trustee may be removed from office with approval by UVMC, by the affirmative vote of not less than two-thirds of the entire board of trustees. Premier Health Partners (PHP) has the right to request that UVMC remove a trustee of the corporation if PHP has determined that such trustee is frustrating the goals and purposes of the Premier Health Partners network. Such request shall not be unreasonably refused by UVMC.
APPROVAL OF GOVERNING BODY DECISIONS	PART VI, QUESTION 7B	Premier Health Partners (PHP) develops and oversees the implementation of the strategic plan for Upper Valley Medical Center (hospital), which addresses such matters as location of clinical and administrative services and the consolidation of such services. Hospital shall comply with and implement this plan and shall not take any action that materially departs from this plan without PHP approval. Hospital develops and submits an annual capital and operating budget to PHP for approval. Hospital shall adopt and implement the capital and operating budget so approved and/or revised for it by PHP. Hospital periodically develops and submits a business plan to PHP for approval. Hospital shall implement the business plan approved by PHP. PHP is the sole agent to negotiate all relationships with payors on behalf of hospital with all third party payors and alternative delivery systems including, but not limited to insurers. Hospital must have approval from PHP 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 $500,000. Hospital must seek PHP approval for any acquisitions, sale or transfer of any material asset used in PHP activities.
REVIEW OF FORM 990	PART VI, SECTION B, LINE 11B	The 990 tax return and attached schedules are prepared by staff members of the UVMC Finance department. Draft returns are reviewed by the Budget and Reimbursement Manager, Controller and Chief Financial Officer. After revisions are made, the draft returns are sent to Ernst & Young (E&Y) for review and evaluation. Review notes are made available by E&Y, changes are made, and then the returns are reviewed again by the finance management team. An electronic version of the return is provided to the UVMC Board of Directors at least one week prior to the board meeting. At that meeting, the Chief Financial Officer of UVMC presents detailed information on compensation and community benefits, as well as addresses questions from the board. The board then approves the return and associated schedules for filing. In addition, an electronic version is sent out at least one week prior to the Premier Health Partners (PHP) audit committee meeting. At the meeting, the Vice President/Controller of PHP shares detailed information on compensation and community benefits, as well as addresses any questions from the committee. The Audit Committee then approves the return and schedules for filing.
CONFLICTS OF INTEREST PROCESS	PART VI, LINE 12C	Premier Health Partners (PHP), of which Upper Valley Medical Center is included, requires all board members, officers, executives and management personnel to annually review the PHP 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 Conflicts of Interest Policy. This is accomplished with a memo sent out annually from the Chairman of the Board and Chief Executive Officer of PHP to all board members, executive directors, management directors and above personnel, purchasing department staff and authorized purchasers. 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. Last, this memo 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 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 such conflict. Additionally, any Board or Board Committee meeting where the subject of conflicts of interest is discussed, the normally taken 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 does exist, the board 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 PHP Conflicts 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 conflicts of interest questionnaires are summarized by person in a word document and sent electronically to the Finance department for any necessary disclosures required on the 990 tax return.
OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN	PART VI, SECTION B, LINE 15A & 15B	Premier Health Partners, of which UVMC is a part, 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. PHP annually reviews executive compensation survey data for a regional peer group of systems and hospitals that are similar in size and complexity to PHP and its subsidiaries. The data for the survey is provided by a third party consultant group that is independent of PHP. 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 which are independent. This committee reviews in detail the compensation for the PHP 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 PHP board annually.
AVAILABILITY OF DOCUMENTS	PART VI, LINE 19	The governing documents, conflict of interest policy, and financial statements are made available to the public when required by law or for accreditation purposes.
Other Changes in Net Assets	Part XI, Line 5	Pension Adjustment (12,690,391) Net Transfers with Affiliates (8,787,781) Unrealized Gain/(Loss) on Investments (907,395) Amortization of Investment Premiums/Discounts (383,222) Change in Foundation General Funds (184,915) Change in Foundation Restricted Funds 86,550 Change in Foundation Endowment Funds 15,861 Change in Temporarily Restricted Funds (1,723) Other Changes 26,990 Total (22,826,026)
Supplemental Information on Tax-Exempt Bonds	Schedule K	Schedule K, Part I, Line A, Column F - Purpose of Bond The bond issue of 06/29/2006 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 $1,473,860 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 $1,507,260 of earnings on the Debt Service Reserve Fund used to pay debt service on the 2006 series bonds. Schedule K, Part IV, Line 1 - Arbitrage An arbitrage rebate calculation and a yield restriction calculation were performed 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 three-year temporary period described in Treas. Reg. 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. Schedule K, Part V - Procedures To Undertake Corrective Action While the organization does not have written procedures, the organization does have procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations.
AVERAGE HOURS PER WEEK	PART VII, SECTION A, COLUMN B	HOURS REPORTED FOR OFFICERS ARE SPREAD AMONG THE ENTITIES LISTED IN SCHEDULE R, PARTS II AND IV. HOURS REPORTED FOR VICE PRESIDENTS OF PREMIER HEALTH PARTNERS (PHP) ARE SPREAD AMONG THE FOUR HOSPITALS IN PHP OF WHICH UPPER VALLEY MEDICAL CENTER IS A PART.
Statement Pertaining to Form 5471:		UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(a) AND (b), THE TAXPAYER IS REQUIRED TO FILE FORMS 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS, AS A CATEGORY 5 FILER WITH RESPECT TO CERTAIN CONTROLLED FOREIGN CORPORATIONS (CFCs). THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 5471 FOR THESE CFCs BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT. Samaritan Health Partners 110 North Main St, Suite 500 Dayton, OH 45402 EIN: 31-1107411 THE FILING ORGANIZATION, UPPER VALLEY MEDICAL CENTER, IS NOT FILING A SEPARATE FORM 5471 - SCHEDULE I BECAUSE IT HAS NO INCOME FROM THE FOREIGN CORPORATION.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg
UVMC
3130 NORTH COUNTY ROAD 25A	TROY	OH	45373	341850683	PARENT	OH	501(c)(3)	11, I	NA	false
UVMC Foundation
3130 North County Road 25A	Troy	OH	45373	311581859	Foundation	OH	501(c)(3)	11, III-O	NA	false
Miami County Mental Health Center
3130 North County Road 25A	Troy	OH	45373	260841036	MENTAL HEALTH	OH	501(c)(3)	9	UVMC	true
Med-Terra Inc
3130 North County Road 25A	Troy	OH	45373	311232074	HOLDING CO	OH	501(c)(2)	N/A	UVMC	true
Premier Health Partners
40 West Fourth Street	Dayton	OH	45402	311446699	JOA Parent	OH	501(c)(3)	11, I	NA	false
Upper Valley Professional Corporation
3130 North County Road 25A	Troy	OH	45373	311400963	Health Care	OH	501(c)(3)	9	UVMC	true
UVPC Specialists Inc
3130 North County Road 25A	Troy	OH	45373	203687536	Health Care	OH	501(c)(3)	9	UVPC	true
UVMC NURSING CARE INC
3130 NORTH COUNTY ROAD 25A	TROY	OH	45373	311224064	NURSING HOME	OH	501(c)(3)	9	UVMC	true

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Type Of EntityTypeOfEntity
UVMC MANAGEMENT CORPORATION
3130 NORTH COUNTY ROAD 25A	TROY	OH	45373	311360489	MGT COMPANY	OH	UVMC	C CORP
After Hours Family Care Inc
31 Stanfield Rd	Troy	OH	45373	311269483	Health Care	OH	UVPC	C Corp

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	true	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	true	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	true	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	true	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	false	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	false	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	false	ExchangeOfAssets
Rental Of Facilities To Other Orgs	false	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	true	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	false	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	true	PerformOfServicesByOtherOrgs
Sharing Of Facilities	false	SharingOfFacilities
Sharing Of Paid Employees	false	SharingOfPaidEmployees
Reimbursement Paid To Other Org	true	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	true	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	true	OtherTransferToOtherOrg
Other Transfer From Other Org	true	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (21 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
Med-Terra Inc
a (iv	2085	FMV
Med-Terra Inc
b	1800000	Cash
Med-Terra Inc
f	1653400	FMV
Med-Terra Inc
j	767515	FMV
Med-Terra Inc
o	235878	CASH
Med-Terra Inc
p	212880	FMV
UVMC Nursing Care Inc
P	57771	fmv
Upper Valley Professional Corporation
a(iv)	16000	FMV
Upper Valley Professional Corporation
b	7100000	Cash
Upper Valley Professional Corporation
e	3650000	Cash
Upper Valley Professional Corporation
p	1688144	FMV
Upper Valley Professional Corporation
q	303452	Cash
Upper Valley Professional Corporation
r	1750000	Cash
UVPC Specialists Inc
l	104000	FMV
UVPC Specialists Inc
p	67210	FMV
UVMC
c	61000	CASH
Miami County Mental Health Center
a(iv)	5770	FMV
Miami County Mental Health Center
l	161023	FMV
Miami County Mental Health Center
p	57061	pmv
UVMC Management Corporation
l	683785	fmv
UVMC Management Corporation
r	54923	cash