UVMC NURSING CARE INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- UVMC NURSING CARE INC (EIN 31-1224064)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-13
- IRS object ID
- 201233189349303418
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-13T14:47:25-06:00 | 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 | 311224064 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UVMC Nursing Care Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % TIMOTHY D SNIDER | InCareOfName |
| Name Control | UVMC | 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 | 20800427 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.uvmc.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1987 | YearFormation |
| State Legal Domicile | OH | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE SKILLED NURSING AND REHABILITATIVE SERVICES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 7 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 20162984 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 20483383 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 150933 | InvestmentIncomePriorYear |
| Investment Income Current Year | 227760 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 101148 | OtherRevenuePriorYear |
| Other Revenue Current Year | 89284 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 20415065 | TotalRevenuePriorYear |
| Total Revenue Current Year | 20800427 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 69851 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 0 | 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 | 19203091 | OtherExpensePriorYear |
| Other Expenses Current Year | 19288410 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 19272942 | TotalExpensesPriorYear |
| Total Expenses Current Year | 19288410 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1142123 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1512017 | RevenuesLessExpensesCY |
| Total Assets BOY | 17770423 | TotalAssetsBOY |
| Total Assets EOY | 19081169 | TotalAssetsEOY |
| Total Liabilities BOY | 7961165 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 7730904 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 9809258 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 11350265 | 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 | 15261670 | Expense |
| Revenue | 19398023 | Revenue |
| Description | Nursing Homes - See schedule O | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 677407 | Expense |
| Revenue | 1085360 | Revenue |
| Description | Retirement Community - See schedule O | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 15939077 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | true | CreditCounseling |
| Term Or Permanent Endowments | false | 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 | false | 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 | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | 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 | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 109 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| 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 | 7 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 6 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | true | 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 D SNIDER | NamePerson |
| Telephone Number | 9374407853 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3130 N COUNTY ROAD 25A | AddressLine1 |
| City | Troy | City |
| State | OH | State |
| ZIP Code | 45373 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (9 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| Douglas Murray | ||||||
| Chairman | 0.5 | X | X | 0 | 0 | 0 |
| Rowan R Nickol MD | ||||||
| First Vice Chairman | 40.0 | X | X | 0 | 332731 | 23974 |
| Peter E Nims | ||||||
| Director | 0.5 | X | 0 | 0 | 0 | |
| Craig Bundschuh | ||||||
| Secretary | 0.5 | X | X | 0 | 0 | 0 |
| Arthur R Disbrow | ||||||
| Director | 0.5 | X | 0 | 0 | 0 | |
| R Douglas Haines | ||||||
| Director | 0.5 | X | 0 | 0 | 0 | |
| William Lukens | ||||||
| Director | 0.5 | X | 0 | 0 | 0 | |
| Thomas Parker | ||||||
| President/CEO | 40.0 | X | 0 | 362894 | 52290 | |
| TIMOTHY SNIDER | ||||||
| Vice President/CFO | 40.0 | X | 0 | 251661 | 27768 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 947286 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 104032 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Concept Rehab Inc | NamePerson |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7150 Granite Circle | AddressLine1 |
| City | TOLEDO | City |
| State | OH | State |
| ZIP Code | 43617 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | Therapy Services | DescriptionOfServices |
| Compensation | 1161049 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| Total Contributions | 0 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT REVENUE (NURSING HOMES) | 623000 | 19398023 | 19398023 |
| RETIREMENT COMMUNITY FEES | 531390 | 1085360 | 1085360 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 20483383 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 227760 | TotalRevenueColumn |
| Exclusion | $227,760 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
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 | ExclusionExclusionAmount |
|---|---|---|---|
| BEAUTY SHOP | 812900 | 48726 | $48,726 |
| TRANSPORTATION | 448000 | 27075 | $27,075 |
| TELEVISION/TELEPHONE | 517000 | 1247 | $1,247 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 12236 | TotalRevenueColumn |
| Related Or Exempt Function Income | 12236 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 89284 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 20800427 | TotalRevenueColumn |
| Related Or Exempt Function Income | 20495619 | RelatedOrExemptFunctionIncome |
| Exclusion | $304,808 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
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 | 0 | Total |
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 | 0 | Total |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 780155 | Total |
| Management And General | 780155 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4454 | Total |
| Management And General | 4454 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9554 | Total |
| Management And General | 9554 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
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 | 10879 | Total |
| Management And General | 10879 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1364806 | Total |
| Program Services | 1364806 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14484 | Total |
| Management And General | 14484 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1074519 | Total |
| Program Services | 801125 | ProgramServices |
| Management And General | 273394 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 697223 | Total |
| Program Services | 580006 | ProgramServices |
| Management And General | 117217 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24133 | Total |
| Management And General | 24133 | 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 | 3536 | Total |
| Management And General | 3536 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 845024 | Total |
| Program Services | 688526 | ProgramServices |
| Management And General | 156498 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19802 | Total |
| Management And General | 19802 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| PURCHASED PERSONNEL | 11504577 | 9832224 | 1672353 |
| BED OCCUPANCY TAX | 1009553 | 1009553 | |
| PURCHASED SERVICES | 808915 | 581766 | 227149 |
| OPERATING SUPPLIES | 1008575 | 1008575 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 108221 | Total |
| Program Services | 72496 | ProgramServices |
| Management And General | 35725 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19288410 | Total |
| Program Services | 15939077 | ProgramServices |
| Management And General | 3349333 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1500 | BOY |
| EOY | 5000 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 439191 | BOY |
| EOY | 485199 | 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 | 1684360 | BOY |
| EOY | 1966416 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | 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 | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 44017 | BOY |
| EOY | 50346 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 21841083 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 13616355 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8645497 | BOY |
| EOY | 8224728 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6926742 | BOY |
| EOY | 8343715 | 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 | 29116 | BOY |
| EOY | 5765 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17770423 | BOY |
| EOY | 19081169 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1860007 | BOY |
| EOY | 1837669 | 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 | 1534109 | BOY |
| EOY | 1461112 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38048 | BOY |
| EOY | 40243 | 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 | 4529001 | BOY |
| EOY | 4391880 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7961165 | BOY |
| EOY | 7730904 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9809258 | BOY |
| EOY | 11350265 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9809258 | BOY |
| EOY | 11350265 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17770423 | BOY |
| EOY | 19081169 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 1512017 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 28990 | 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) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3464 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 0 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 0 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 0 | CurrentTaxYearMinus1Year |
| Current Tax Year | 0 | CurrentTaxYear |
| Total | 3464 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 19741583 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 20455599 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 20874981 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 20162984 | CurrentTaxYearMinus1Year |
| Current Tax Year | 20483383 | CurrentTaxYear |
| Total | 101718530 | Total |
Gross Receipts From Non UBI GrossReceiptsFromNonUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 111099 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 112837 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 116558 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 101148 | CurrentTaxYearMinus1Year |
| Current Tax Year | 89284 | CurrentTaxYear |
| Total | 530926 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 19856146 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 20568436 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 20991539 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 20264132 | CurrentTaxYearMinus1Year |
| Current Tax Year | 20572667 | CurrentTaxYear |
| Total | 102252920 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 102252920 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 737163 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 223151 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 144183 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 181374 | CurrentTaxYearMinus1Year |
| Current Tax Year | 227760 | CurrentTaxYear |
| Total | 1513631 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 737163 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 223151 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 144183 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 181374 | CurrentTaxYearMinus1Year |
| Current Tax Year | 227760 | CurrentTaxYear |
| Total | 1513631 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 20593309 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 20791587 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 21135722 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 20445506 | CurrentTaxYearMinus1Year |
| Current Tax Year | 20800427 | CurrentTaxYear |
| Total | 103766551 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.98541 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.98148 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.01459 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.01852 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Agent Trustee Etc | true | AgentTrusteeEtc |
| Beginning Balance | 38048 | BeginningBalance |
| Additions During Year | 106082 | AdditionsDuringYear |
| Distributions During Year | 103887 | DistributionsDuringYear |
| Ending Balance | 40243 | EndingBalance |
| Included On FS | true | IncludedOnFS |
| Current Year Minus3 Years | CurrentYearMinus3Years |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 641407 | OtherCostOrOtherBasis |
| Book Value | 641407 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 13730064 | OtherCostOrOtherBasis |
| Depreciation | 8296837 | Depreciation |
| Book Value | 5433227 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 5464475 | OtherCostOrOtherBasis |
| Depreciation | 3877771 | Depreciation |
| Book Value | 1586704 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 2005137 | OtherCostOrOtherBasis |
| Depreciation | 1441747 | Depreciation |
| Book Value | 563390 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 8224728 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| REFUNDABLE FEES | $4,356,500 |
| PAYABLE TO THIRD PARTY PAYORS | $35,380 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 4391880 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Trust, Escrow and Custodial Arrangements | Part IV | The long-term care facilities are managed by an outside company. The escrow liability on Form 990, Part X, line 21 represents funds held by each nursing home for use by the residents. Medicaid residents are able to keep a portion of their benefits and are responsible for personal care items such as hair care, toiletries, dining out, etc. The nursing home holds the funds for the residents, and the residents are able to access their funds when they are needed. |
| Income Taxes | Schedule D, Part X, Line 2 | UVMC (parent corporation) 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 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 | false | 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 (3 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Rowan R Nickol MD | |||||||||||||
| 0 | 258350 | 0 | 54829 | 0 | 19552 | 0 | 2450 | 0 | 21524 | 0 | 356705 | 0 | 0 |
| Thomas Parker | |||||||||||||
| 0 | 258307 | 0 | 66488 | 0 | 38099 | 0 | 43710 | 0 | 8580 | 0 | 415184 | 0 | 0 |
| TIMOTHY SNIDER | |||||||||||||
| 0 | 196471 | 0 | 37691 | 0 | 17499 | 0 | 14700 | 0 | 13068 | 0 | 279429 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Schedule J, Part I, Lines 6a and 6b: | Identifier |
| Explanation | Premier Health Partners (PHP), of which UVMC Nursing Care, Inc. 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. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (14 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Mission Statement | Part III, Line 1 | UVMC Nursing Care, Inc., as a subsidiary of UVMC, serves 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 and 4b | The primary exempt purpose of UVMC Nursing Care, Inc. is to provide skilled nursing and rehabilitative services in a long-term healthcare setting to individuals in the community served by Upper Valley Medical Center, a related tax-exempt hospital. As a part of the UVMC health system, UVMC Nursing Care, Inc. is committed to preserving long-term access to quality health care services for Miami County and the surrounding area. This organization was formed in 1987 to assure access to appropriate care at an acceptable cost for patients in a managed care environment. In June of 1989, it was granted tax exempt status. UVMC 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. UVMC Vision: UVMC is committed to preserving long-term access to quality health care services for Miami County and the surrounding area. UVMC Values: Quality customer service is an absolute priority at UVMC. Our environment is one where people treat each other with kindness and respect. Our culture is defined by "Caring Plus" - UVMC's commitment to quality, kindness and compassion for our patients, visitors and each other. UVMC Nursing Care, Inc. operates two nursing homes in Miami County. The mission of these facilities is: To serve the people entrusted to our care, with kindness and professionalism, while striving to attain the highest possible quality of life and care for each. Consistent with its mission, each of the facilities provides comprehensive care to all persons without regard to race, color, national origin, handicap or age. Koester Pavilion is a 150-bed nursing home providing long-term care for skilled and intermediate care patients as well as Freedom Court, a specialized Alzheimer's unit. SpringMeade Health Center is a 99-bed nursing home offering a recuperative, rehabilitative health center and convalescent and extended care services including Freedom Court, a dedicated Alzheimer's unit. Both nursing homes care for Medicaid, Medicare, insurance and private pay patients. Patient days for 2011 were: 50,117 Koester Pavilion 35,575 SpringMeade ______ 85,971 Total The majority of the expenditures for UVMC Nursing Care, Inc. relate to the costs of the professional and nursing services needed to serve those entrusted to our care. Expenses associated with long-term care are reported on Form 990, Part III, Line 4A. SpringMeade Residence, located on the same campus as the Health Center, offers two- and three-bedroom retirement living coach homes. SpringMeade coach homes are situated to offer a view of the natural beauty and visual amenities which surround the area. Services are designed to enhance the lives of the residents by providing: -All property taxes and insurance on the structures -Year round interior and exterior maintenance and grounds keeping -SpringMeade sponsored special events and social functions -Electronic contact system that provides notification for rapid response to health emergencies. Expenses associated with the Retirement Community are reported on Form 990, Part III, Line 4B. |
| Number of Employees | Form 990, Part V, Question 2a | UVMC Nursing Care, Inc. does not have direct employees. AdCare Health Systems, Inc. provides all nursing, administrative and financial services to perform the day-to-day operation of the nursing homes. Allocated personnel expenses are reported on Part IX, Line 24A of Form 990. |
| Management Services | Form 990, Part VI, Section A, Question 3 | AdCare Health Systems, Inc., under the direction of the executive management team of UVMC, provides all administrative, nursing, and financial services to perform the day-to-day operations of the nursing homes. |
| Organization Members | PART VI, SECTION A, LINE 6 | UVMC is the sole corporate member of UVMC Nursing Care, Inc., and as such, has sole authority to elect the board of trustees of the organization. |
| ELECTION OF GOVERNING BODY | PART VI, SECTION A, LINE 7A | UVMC has the sole authority to elect the board of trustees for UVMC Nursing Care, Inc. 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, SECTION A, LINE 7B | Premier Health Partners (PHP) develops and oversees the implementation of the strategic plan for UVMC (Parent Corporation), addresses such matters as location of clinical and administrative services and the consolidation of such services. UVMC shall comply with and implement this plan and shall not take any action that materially departs from this plan without PHP approval. UVMC entities develop and submit an annual capital and operating budget to PHP for approval. UVMC shall adopt and implement the capital and operating budget so approved and/or revised for it by PHP. UVMC periodically develops and submits a business plan to PHP for approval. UVMC shall implement the business plan approved by PHP. UVMC 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. UVMC 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 which includes UVMC Nursing Care, Inc. 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, LLP (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 Nursing Care, Inc. 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. |
| CONFLICTS OF INTEREST POLICY | PART VI, SECTION B, LINE 12C | Premier Health Partners (PHP), of which UVMC Nursing Care, Inc. 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, 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 Nursing Care, Inc. 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 GOVERNING DOCS, CONFLICT OF INT. POLICY, FINANCIAL STMTS | PART VI, SECTION C, LINE 19 | The governing documents, conflicts of interest policy, and financial statements are made available to the public when required by law or for accreditation purposes. |
| Changes in Net Assets | Part XI, Line 5 | 38,321 Unrealized Gain on Market Value (9,331) Amortization of Premiums/Discounts __________ 28,990 |
| Average Hours per Week | Part VII, Section A, Column B | Hours reported are spread among the entities listed on Schedule R, Parts II and IV. |
| 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, UVMC NURSING CARE, INC., 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 (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| Upper Valley Medical Center | ||||||||||
| 3130 North County Road 25A | Troy | OH | 45373 | 310537095 | Hospital | OH | 501(c)(3) | 3 | UVMC | true |
| Upper Valley Professional Corporation | ||||||||||
| 3130 North County Road 25A | Troy | OH | 45373 | 311400963 | Health Care | OH | 501(c)(3) | 9 | UVMC | true |
| UVPC Specialists | ||||||||||
| 3130 North County Road 25A | Troy | OH | 45373 | 203687536 | Health Care | OH | 501(c)(3) | 9 | UVPC | true |
| 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 |
| UVMC | ||||||||||
| 3130 North County Road 25A | Troy | OH | 45373 | 341850683 | Parent | OH | 501(c)(3) | 11, I | NA | false |
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 | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets |
|---|---|---|---|---|---|---|---|---|---|---|
| UVMC Management Corporation | ||||||||||
| 3130 North County Road 25A | Troy | OH | 45373 | 311360489 | MGT Company | OH | UVMC | C Corp. | 0 | 0 |
| After Hours Family Care Inc | ||||||||||
| 31 Stanfield | Troy | OH | 45373 | 311269483 | Healthcare | OH | UVPC | C Corp. | 0 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | 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 | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Upper Valley Medical Center | ||
| o | 57771 | Cash |
| Upper Valley Professional Corp | ||
| q | 250000 | Cash |