STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

THE UNION HOSPITAL ASSOCIATION: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
THE UNION HOSPITAL ASSOCIATION (EIN 34-0714771)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-08-13
IRS object ID
201242269349302109
Schema version
2011v1.2
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-08-13T11:07:05-07:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN340714771EIN

Name Name

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

US Address USAddress

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

Officer Officer

FieldValueIRS element (for citing)
NameEugene A Thorn IIIName
TitleVice President - FinanceTitle
Phone3303640805Phone
Date Signed2012-05-15DateSigned
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1Union HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonEugene ThornNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1659 BoulevardAddressLine1
CityDoverCity
StateOHState
ZIP Code44622ZIPCode
FieldValueIRS element (for citing)
Gross Receipts112466199GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.unionhospital.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1906YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionTo provide excellent quality health care to the community at a competitive price through highly competent people and an integrated provider network.ActivityOrMissionDescription
Nbr Voting Members Governing Body17NbrVotingMembersGoverningBody
Nbr Independent Voting Members16NbrIndependentVotingMembers
Total Nbr Employees1114TotalNbrEmployees
Total Nbr Volunteers119TotalNbrVolunteers
Total Gross UBI89276TotalGrossUBI
Net Unrelated Business Txbl Income21129NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year374856ContributionsGrantsPriorYear
Contributions Grants Current Year322846ContributionsGrantsCurrentYear
Program Service Revenue Prior Year86019026ProgramServiceRevenuePriorYear
Program Service Revenue CY86599963ProgramServiceRevenueCY
Investment Income Prior Year2478243InvestmentIncomePriorYear
Investment Income Current Year3792510InvestmentIncomeCurrentYear
Other Revenue Prior Year10863949OtherRevenuePriorYear
Other Revenue Current Year10778143OtherRevenueCurrentYear
Total Revenue Prior Year99736074TotalRevenuePriorYear
Total Revenue Current Year101493462TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year49673234SalariesEtcPriorYear
Salaries Etc Current Year51596199SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year51036TotalFundrsngExpCurrentYear
Other Expense Prior Year48221706OtherExpensePriorYear
Other Expenses Current Year48600647OtherExpensesCurrentYear
Total Expenses Prior Year97894940TotalExpensesPriorYear
Total Expenses Current Year100196846TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1841134RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1296616RevenuesLessExpensesCY
Total Assets BOY149951538TotalAssetsBOY
Total Assets EOY150415888TotalAssetsEOY
Total Liabilities BOY40072679TotalLiabilitiesBOY
Total Liabilities EOY44064687TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY109878859NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY106351201NetAssetsOrFundBalancesEOY
Mission DescriptionPatient Care: Union Hospital Association provides quality medical health care regardless of race, creed, sex, national origin, handicap, age or ability to pay.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense71903565Expense
Grants0Grants
Revenue87087979Revenue
DescriptionThe Union Hospital Association provided quality medical health care regardless of race, creed, age, sex, national origin, handicap, or the ability to pay. Hospital medical services provided 5900 inpatients a total of 24000 patient days and 242000 outpatient visits a total of 346000 procedures. (251000)Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense432838Expense
Revenue0Revenue
DescriptionPatient and Family support programs, general and other: During 2011, Union Hospital prepared 36,851 meals for residents who were unable to prepare meals for themselves due to a medical condition. These meals are provided at cost and are delivered by a volunteer group, Mobile Meals. The Hospital had 128 volunteers donate 20,633 hourse toward the common purpose of servicing the health care needs of the community. The value of these hours is $165,064 which is returned to the community through lower cost of patient services. The Hospital co sponsors an annual program that provides laboratory tests and blood pressure checks for the residents of the community; these services are provided at or below cost. Medicare and Medicaid made up 45% of the patient care provided. The Hospital aslo participates in a local program called Rainbow Connection, a non profit chairty that is dedicated to meeting the needs of disadvantaged and disabled residents of Tuscarawas County; we write off 50% of all charges for those patients while the program pays the remaining 50%. We also provided to the local Hospice agency a write off specified charges for individuals under this program (138 patients, $165,399). We sponsor a Helpline program that enabled 740 elderly and disabled consumers the opportunity to remain in their homes and feel safe in that setting. Since the Hospital does not probide mental health services as part of its normal operations, we lease building space to Community Professional Services, a mental non profit organization, at $2.04 per square foot, well below the average rate of $11.75 per square foot. Thus the rental rate and related in kind support provided by the Hospital are justified as a continuance of our mission. We operate a 35ft mobile medical vehicle that provides screenings to the areas that would have been underserved. An outreach sports medicine program provides training to various school to promote healthy athletes and physicals at a fraction of the cost. The hospital supports and hosts various groups such as Down Sydrome, RSD, Pain management, cancer supports, etc. We also provide baby sitting and AARP driving courses to the community and sent out 55,000 bi annual healthy living newsletters to the community.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp0TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense72336403TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity1DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096109NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1114NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members17NbrVotingGoverningBodyMembers
Number Independent Voting Members16NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
Own WebsiteXOwnWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

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

Address US AddressUS

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

Form990 Part VII Section A Form990PartVIISectionA (27 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
John R Herzig
Board Member2.00X000
James E Knisely
Board Member2.00X000
James J Pringle
Board Member2.00X000
Anne E Geib Hanner
Board Member2.00X000
Michael B Hovan
Chairman2.00X000
Agnes K Swigart
Treasurer2.00X000
Mark N Kubina
Medical Staff Vice President2.00X000
Michael McCombs
Medical Staff Board Member2.00X000
Robert A Horn
Board Member2.00X000
Craig B Laughlin
Board Member2.00X000
Lois E Andreas
Board Member2.00X000
Robert E Moore Jr
Board member2.00X000
C Jason Deeds
Vice Chairman of the Board8.00X000
John E Dooling
Board Member2.00X000
Perry L Hershberger
Board Member2.00X000
Andrew J Wherley
Medical Staff President2.00X000
R Bruce James
President and CEO40X298166047069X
Darwin K Smith
Vice President40123775020658X
Thomas J Kelly Jr
Vice President40242756042750X
Eugene A Thorn III
Vice President40179816028008X
Diana L Boyd
Vice President40141805022505X
Robert J Craig
Vice President40152656029959X
Darrin Kuczynski
Physician4050318916931250877X
James McQuillan
Physician4043461617014350877X
Scott Holder
Physician4038358616872351021X
Thomas Teeter
Physician4034427117014350877X
Nicholas Groch
Physician40250386037988X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3055022TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs678321TotalReportableCompFrmRltdOrgs
Total Other Compensation432589TotalOtherCompensation
Number Individuals GT100 K36NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Emergimed Inc
659 BoulevardDoverOH44622Emergency services4956890
Seneca Medical
PO BOX 712361CincinnatiOH45271Seller of medical equipment2530031
Cardinal Health
5490 Collections Center DriveChicagoIL60693Seller of medical drugs5202423
Anesthesia Care of Union Hospital
659 BoulevardDoverOH44622anesthesia and pain care associates1632819
Laboratory Corp of AM Holdings
PO Box 12140BurlingtonNC27216Laboratory services provider922456
FieldValueIRS element (for citing)
Number Of Contractors GT100 K94NumberOfContractorsGT100K
Federated Campaigns0FederatedCampaigns
Membership Dues1065MembershipDues
Fundraising Events0FundraisingEvents
Related Organizations0RelatedOrganizations
Government Grants0GovernmentGrants
All Other Contributions321781AllOtherContributions
Noncash Contributions0NoncashContributions
Total Contributions322846TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Net patient revenue62200086510687865106870$0
Laboratory services62150089276089276$0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue86599963TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column3790223TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$3,790,223ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

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

Royalties Revenue RoyaltiesRevenue

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

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real876542Real
Personal0Personal

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real517449Real
Personal0Personal

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real359093Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column359093TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$359,093ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities0Securities
Other2287Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities0Securities
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities0Securities
Other2287Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column2287TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$2,287ExclusionAmount
FieldValueIRS element (for citing)
Cntrbtns Rprtd Fundraising Events0CntrbtnsRprtdFundraisingEvents
Gross Sales Of Inventory20297046GrossSalesOfInventory
Cost Of Goods Sold10455288CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column9841758TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$9,841,758ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Health promotion90009952346523460$0
Helpline income9000991309621309620$0
Athletic training90009975395753950$0

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column318589TotalRevenueColumn
Related Or Exempt Function Income318589RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue577292TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column101493462TotalRevenueColumn
Related Or Exempt Function Income87087979RelatedOrExemptFunctionIncome
Unrelated Business Revenue89276UnrelatedBusinessRevenue
Exclusion$13,993,361ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1182630Total
Program Services0ProgramServices
Management And General1182630ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

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

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total38805173Total
Program Services33369845ProgramServices
Management And General5423394ManagementAndGeneral
Fundraising11934Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1890584Total
Program Services0ProgramServices
Management And General1890584ManagementAndGeneral
Fundraising0Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total6479954Total
Program Services9800ProgramServices
Management And General6470154ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3237858Total
Program Services2625739ProgramServices
Management And General611201ManagementAndGeneral
Fundraising918Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total174019Total
Program Services174019ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total167505Total
Program Services0ProgramServices
Management And General167505ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total122535Total
Program Services400ProgramServices
Management And General122135ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Lobbying FeesForServicesLobbying

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

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

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

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total17419772Total
Program Services13920516ProgramServices
Management And General3499106ManagementAndGeneral
Fundraising150Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total380631Total
Program Services51961ProgramServices
Management And General298029ManagementAndGeneral
Fundraising30641Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total11038665Total
Program Services9767778ProgramServices
Management And General1269566ManagementAndGeneral
Fundraising1321Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1224417Total
Program Services0ProgramServices
Management And General1224417ManagementAndGeneral
Fundraising0Fundraising

Royalties Royalties

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

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1708306Total
Program Services1483072ProgramServices
Management And General225231ManagementAndGeneral
Fundraising3Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total150313Total
Program Services84957ProgramServices
Management And General65352ManagementAndGeneral
Fundraising4Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

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

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total28036Total
Program Services6917ProgramServices
Management And General21119ManagementAndGeneral
Fundraising0Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total1468194Total
Program Services879448ProgramServices
Management And General588746ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

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

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total5740960Total
Program Services3591231ProgramServices
Management And General2149482ManagementAndGeneral
Fundraising247Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total853646Total
Program Services7059ProgramServices
Management And General846587ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Bad debt expense6214662621466200
Dues144095733113667391
Meals530702435506341
Education expense6546223765416970

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1646359Total
Program Services115468ProgramServices
Management And General1525165ManagementAndGeneral
Fundraising5726Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total100196846Total
Program Services72336403ProgramServices
Management And General27809407ManagementAndGeneral
Fundraising51036Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY4617638BOY
EOY8075335EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY12913506BOY
EOY13025147EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2233630BOY
EOY2158387EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1119068BOY
EOY1270233EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis125133013LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec73202155LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY54225261BOY
EOY51930858EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY50263544BOY
EOY47310158EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY2394880BOY
EOY2102912EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY2009690BOY
EOY2009690EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY20174321BOY
EOY22533168EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY149951538BOY
EOY150415888EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY6551536BOY
EOY6488598EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY27100000BOY
EOY26650000EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY3679814BOY
EOY3411487EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2741329BOY
EOY7514602EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY40072679BOY
EOY44064687EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY99298397BOY
EOY96216016EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY304769BOY
EOY177963EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY10275693BOY
EOY9957222EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY109878859BOY
EOY106351201EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY149951538BOY
EOY150415888EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses1296616ReconcilationRevenueExpenses
Reconcilation Other Changes-4824274ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule D IRS990ScheduleD

Land Land

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

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis55199694OtherCostOrOtherBasis
Depreciation22176276Depreciation
Book Value33023418BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis2593464OtherCostOrOtherBasis
Depreciation2090628Depreciation
Book Value502836BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis65567989OtherCostOrOtherBasis
Depreciation48935251Depreciation
Book Value16632738BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis666614OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value666614BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings51930858TotalOfBookValueLandBuildings

Other Assets OtherAssets (6 entries)

DescriptionDescriptionBook ValueBookValue
Assets whose use is limited donor specification133160
Assets whose use is limited indenture agreement588
Trust agreements9957222
Other receivables10430200
Deferred financing costs447867
Interest in TVRCC1564131
FieldValueIRS element (for citing)
Total Book Value Other Assets22533168TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
Interest payable$128,057
Workers compensation payable$354,301
Interest rate swap agreement$4,856,666
Accrued payroll withholdings$1,916,186
Other payables$259,392
FieldValueIRS element (for citing)
Total Of Amounts7514602TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

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

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent150XPcent150
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent250XPcent250
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense3887258TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense3887258NetCommunityBenefitExpense
Percent Of Total Expense0.00043PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense12776225TotalCommunityBenefitExpense
Direct Offsetting Revenue5110693DirectOffsettingRevenue
Net Community Benefit Expense7665533NetCommunityBenefitExpense
Percent Of Total Expense0.00084PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense16663483TotalCommunityBenefitExpense
Direct Offsetting Revenue5110693DirectOffsettingRevenue
Net Community Benefit Expense11552791NetCommunityBenefitExpense
Percent Of Total Expense0.00127PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense409154TotalCommunityBenefitExpense
Direct Offsetting Revenue40070DirectOffsettingRevenue
Net Community Benefit Expense369084NetCommunityBenefitExpense
Percent Of Total Expense0.0004PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs9NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense10063TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense10063NetCommunityBenefitExpense
Percent Of Total Expense0.00001PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs9NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense419217TotalCommunityBenefitExpense
Direct Offsetting Revenue40070DirectOffsettingRevenue
Net Community Benefit Expense379147NetCommunityBenefitExpense
Percent Of Total Expense0.00041PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs9NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense17082700TotalCommunityBenefitExpense
Direct Offsetting Revenue5150763DirectOffsettingRevenue
Net Community Benefit Expense11931938NetCommunityBenefitExpense
Percent Of Total Expense0.00168PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense13621TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense13621NetCommunityBuildingExpense
Percent Of Total Expense0.0001PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Building Expense13621TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense13621NetCommunityBuildingExpense
Percent Of Total Expense0.0001PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$6,214,662BadDebtExpenseAmount
Amount Attributable To48611AmountAttributableTo
Amount Reimbursed By Medicare29837102AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare22568185CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall7268917MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

Form990 Schedule H Part IV Form990ScheduleHPartIV (3 entries)

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

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

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

Address Address

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

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1The Union Hospital AssociationBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent100FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent300FPGDiscountPercent
Explains Basis1ExplainsBasis
Other FactorsXOtherFactors
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Permit LawsuitXPermitLawsuit
Permit Lien On ResidenceXPermitLienOnResidence
Permit Body AttachmentXPermitBodyAttachment
Collection Activities1CollectionActivities
Report To Credit AgencyXReportToCreditAgency
LawsuitXLawsuit
Lien On ResidenceXLienOnResidence
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Average Negotiated RatesXAverageNegotiatedRates
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities4NumberOfOtherFacilities

Other Facilities OtherFacilities (4 entries)

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

Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SchH_P01_S00_L07Schedule H, Part I, Line 7Used the ratio of patient cost to charges from Worksheet 2 to calculate charity care reported.
SchH_P01_S00_L072fSchedule H, Part I, Line 7, Column fBad debt $6,214,662
SchH_P02_S00_L00Schedule H, Part IIThe Hospital has numerous community building activities. Project Search welcomes mentally handicapped or learning disabled youth into the workforce to give the young adults the ability to learn workforce traits and skills and to be more socially interactive. The Hospital provides space for a classroom setting and internship positions for this program. Many of these youth have secured positions from this program. We provide clinical rotations for numerous nursing and technical programs retlated to healthcare. These programs secure the youth to the area, we also host and offer numerous support groups for various illnesses and social concerns.
SchH_P03_S0A_L04Schedule H, Part III, Section A, Line 4Patient accounts receivable are due in full when billed. Accounts are considered delinquent and subsequently written off as bad debt based on individual credit evaluation and circumstances of the account. Line 2 represents 3% of gross patient revenue as seen as being uncollectible by self pay patients which is based upon historical trending valuations. A bad debt expense footnote is not presented in the notes to the financial statements.
SchH_P03_S0B_L08Schedule H, Part III, Section B, Line 8Amounts are generated by the Medicare cost report which utilizes a department cost to charge methodology.
SchH_P03_S0C_L09bSchedule H, Part III, Section C, Line 9bThe Hospital will refund any monies paid on an account deemed charity care or that qualifies for financial assistance once that assessment has been determined. The account is then written off to such classification and any or all collections will cease after the determination has been made.
SchH_P05_S0B_L11Schedule H, Part V, Section B, Line 11Charges are consistent with all payers.
SchH_P06_S00_L02Schedule H, Part VI, Line 2Our Community Wellness department is committed to addressing the health assessments of our community. The department compiled data gathered by utilizing secondary sources such as the CDC and Ohio Obesity prevention. We have identified six areas that are of high concern in our community; they are cancer, diabetes, heart disease and strokes, physical activity and fitness, tobacco use, and the overall education of the community on health issues. In response to the areas of concern, the Hospital offers blood pressure screening, cholesterol screenings, fasting blood sugar tests, and vascular screening at reduced costs or free to members of the community basis. We also have cancer prevention day which includes pap smears, mammograms and skin cancer exams at a free or reduced cost. In response to the obesity and physical activity risks, the Hospital sponsors the annual Run for Home marathon training sessions, supports the fit youth initiative, and maintains a walking trail. For the general health of the community we also teach classes on bicycle helmet safety, AARP driver safety, babysitting basics, CPR, and smoking cessation.
SchH_P06_S00_L03Schedule H, Part VI, Line 3Inpatients are given an informational booklet upon admission to the hospital, this booklet contains information regarding contact with patient accounts, accepted insurances and other payment options for the insured or uninsured. The Hospital also employees a patient financial specialist who meets with the patient and or family to discuss family size, income and other qualifying information for the various charity care programs. Financial assistance information is not provided at discharge but provided with the initial statement. The Hospital also discusses with the patients and family the availablity of state and federal programs for medical care.
SchH_P06_S00_L04Schedule H, Part VI, Line 4Tuscarawas County is one of the 88 counties of the State of Ohio. The county has a population of approximately 91,000 residents with 25% under the age of 25 and 25% between the ages of 45 and 62. It is predominately a caucasion county in a rural setting with 7.2% of families being below the federal poverty level. 30% of adults smoke and 31% are obese or overweight; heart disease and strokes are the prevalent health issues of the county. To help counteract these issues, the Hospital provides numerous blood pressure, cholesterol and blood sugar screenings throughout the year. The Hospital also provides smoking cessation programs and sponsors youth and adult fitness initiatives and marathon trainings and sponsors to combat the obesity epidemic.
SchH_P06_S00_L05Schedule H, Part VI, Line 5The Hospital provides many low cost clinics for blood pressure, cholesterol screenings, cancer screenings, and diabetes clinics to the area to help the community stay healthy and prevent diseases. We offer health fairs and promote health speakers on various health and safety issues to the community at no charge. The board is made up of individuals representing the community, there is an open medical staff and all surplus funds are used to make the Hospital a better organization for its community.
SchH_P06_S00_L07Schedule H, Part VI, Line 7Community benefit report is not filed with any state.

Schedule J IRS990ScheduleJ

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

Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
R Bruce James
29816600000147000323690345235000
Darwin K Smith
1237750000069870136710144433000
Diana L Boyd
1418050000078720146330164310000
Robert J Craig
1526560000076330223260182615000
Eugene A Thorn III
17981600000107890172190207824000
Thomas J Kelly Jr
24275600000145650281850285506000
Darrin Kuczynski
3029801693122002090009569041308055406616931200
James McQuillan
3029801701431316360009569041308048549317014300
Scott Holder
302980168723806060009568041453043460716872300
Thomas Teeter
302980170143412910009569041308039514817014300
Nicholas Groch
2503860000054040325840288374000

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

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

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Amount Retired0AmountRetired
Amount Bond Defeased0AmountBondDefeased
Total Proceeds0TotalProceeds
Amount In Reserve Fund0AmountInReserveFund
Capitalized Interest0CapitalizedInterest
Refunding Escrow0RefundingEscrow
Issuance Costs From Proceeds484184IssuanceCostsFromProceeds
Credit Enhancement0CreditEnhancement
Working Capital Expenditures0WorkingCapitalExpenditures
Capital Expenditures2969070CapitalExpenditures
Other Spent Proceeds0OtherSpentProceeds
Amount Unspent0AmountUnspent
Year Of Subst Completion2009YearOfSubstCompletion
Current Refunding1CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Prcntge Prvt Business Use By Others0PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0PercentageOfPrvtBusinessReUBI
Total Private Business Use0TotalPrivateBusinessUse
Post Issuance Compliance Procdrs1PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T Filed0Form8038TFiled
Variable Rate Issue1VariableRateIssue
Hedge Identified In Books And Recds1HedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

FieldValueIRS element (for citing)
Business Name Line1RBS Citizens NABusinessNameLine1
FieldValueIRS element (for citing)
Term Of Hedge20.5TermOfHedge
Superintegrated Hedge0SuperintegratedHedge
Hedge Terminated0HedgeTerminated
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Exception To Rebate0ExceptionToRebate

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
F990_P06_S0A_L06Form 990, Part VI, Section A, Line 6The Hospital has a 17 member board of trustees who oversee the management of the Hospital. All monthly financial reporting is presented to the board of trustees. The trustees also oversee the hiring of any upper manangement and the approval of all capital and operating budgets.
F990_P06_S0B_L11bForm 990, Part VI, Section B, Line 11bThe 990 is prepared internally by the Hospital's staff accountant. The general ledger is reconciled to the appropriate schedules on the form and to the auditied financial statements. After this review it is then forwarded to the Vice President of Finance who reviews it for completeness and accuracy. After his review it is then submitted to the Finance Committee made up of Board of Truestee members; after the committee review it is then forwarded to the Board of Trustees for review and approval. The return is also reviewed by an independent accounting firm.
F990_P06_S0B_L12cForm 990, Part VI, Section B, Line 12cOfficers and board members are required to annually review the conflict of interest policy and make known any conflicts that may or have arose or any other discloseable event. If any notable event is disclosed it is reported to the Hospital CEO and Chairman of the Board of Trustees. Additionally, all financial transactions are reviewed through the Hospital's accounting systems.
F990_P06_S0B_L15Form 990, Part VI, Section B, Line 15Compensation amounts are established based upon the appropriate healthcare industry standards and related surveys. Compensation amounts for key management is reviewed by the Executive Committee of the Board of Trustees.
F990_P06_S0C_L19Form 990, Part VI, Section C, Line 19The public at anytime may inquire at the administrative office in the main hospital building and ask for a copy of the Form 990. The general public may also go to the Hospitals website to view the annual report and our Community Benefit Report.
F990_P11_S00_L05Form 990, Part XI, Line 5$(4,448,769) unrealized loss on investments and swaps; $(387,096) noncontrolling interest purchase $11,591 change in minority interest.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeEOY AssetsEOYAssetsDirect Controlling Entity NADirectControllingEntityNA
Union Hospital Medical Services
659 BoulevardDoverOH44622270273520Physcian officesOH57380350N/A
Union Physcian Services
659 BoulevardDoverOH44622264215547Physcian officeOH12276402492821N/A

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
Tuscarawas Valley Regional Cancer Center
659 BoulevardDoverOH44622340000100Physician and Hospital OrganizationOH501c33N/A0
Union Hospital Auxillary
659 BoulevardDoverOH44622341204928fundraising for the HospitalOH501c311-III-FIN/A0

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAPredominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
Tuscarawas Ambulatory Surgery Center
320 Oxford StDoverOH44622311525875ambulatory surgery centerOHN/ARelated7030001607449000.7
Dasco Union Hospital Home Medical Equipment LLC
375 N West StWestervilleOH43082270495743durable medical equipment salesOHN/AUnrelated6190952476000.5

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
Valley Healthcare Inc
659 BoulevardDoverOH44622341654921InactiveOHN/AC001
Union Care Corporation
659 BoulevardDoverOH44622341556177InactiveOHN/AC001
Union Pharmaceutical Care
659 BoulevardDoverOH44622043588229retail pharmacy salesOHN/AC-135720291
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Tuscarawas Ambulatory Surgery Center
a-iv400505Fair market of space as determined by lease agreement.
Dasco Union Hospital Home Medical Equipment LLC
a-iv13600Fair market of of space as determined by lease agreement.
Tuscarawas Ambulatory Surgery Center
i400505Lease of building as determined by lease agreement.