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MUSKINGUM VALLEY HEALTH CENTERS: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
MUSKINGUM VALLEY HEALTH CENTERS (EIN 20-8814374)
Tax period
2009-09-01 to 2010-08-31
Filed
2011-07-14
IRS object ID
201121959349301012
Schema version
2009v1.7
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)
Timestamp2011-07-14T14:49:15-05:00Timestamp
Tax Period End Date2010-08-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PLANTE & MORAN PLLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line165 EAST STATE ST STE 600AddressLine1
CityCOLUMBUSCity
StateOHState
ZIP Code43215ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-09-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN208814374EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MUSKINGUM VALLEY HEALTH CENTERSBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMUSKNameControl
Phone7044545239Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1716 ADAIR AVEAddressLine1
CityZANESVILLECity
StateOHState
ZIP Code43701ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDANIEL J ATKINSONName
TitleCEOTitle
Phone7044545239Phone
Date Signed2011-07-12DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NamePLANTE MORAN PLLCName
Phone6148493000Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDANIEL J ATKINSONNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1716 ADAIR AVEAddressLine1
CityZANESVILLECity
StateOHState
ZIP Code43701ZIPCode
FieldValueIRS element (for citing)
Gross Receipts9811372GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.MVHEALTHCENTERS.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2007YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionMuskingum Valley Health Center's mission is to provide affordable, accessible and quality healthcare. MVHC provides numerous services, including, Adult Primary Care, Pediatrics, Dental, Mental Health, OB/GYN, and Podiatry Services During the organization's fiscal year, approximately 16,753 patients received services resulting in 69,000 visits. Additionally, MVHC provided sliding fee scale adjustments in the amount of $744,600 to its patients.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees149TotalNbrEmployees
Total Nbr Volunteers12TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1586383ContributionsGrantsPriorYear
Contributions Grants Current Year2338465ContributionsGrantsCurrentYear
Program Service Revenue Prior Year6106697ProgramServiceRevenuePriorYear
Program Service Revenue CY7368173ProgramServiceRevenueCY
Investment Income Prior Year1141InvestmentIncomePriorYear
Investment Income Current Year3038InvestmentIncomeCurrentYear
Other Revenue Prior Year175092OtherRevenuePriorYear
Other Revenue Current Year101696OtherRevenueCurrentYear
Total Revenue Prior Year7869313TotalRevenuePriorYear
Total Revenue Current Year9811372TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year4988094SalariesEtcPriorYear
Salaries Etc Current Year5930888SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year2202210OtherExpensePriorYear
Other Expenses Current Year2065844OtherExpensesCurrentYear
Total Expenses Prior Year7190304TotalExpensesPriorYear
Total Expenses Current Year7996732TotalExpensesCurrentYear
Revenues Less Expenses Prior Year679009RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1814640RevenuesLessExpensesCY
Total Assets BOY2692596TotalAssetsBOY
Total Assets EOY3633705TotalAssetsEOY
Total Liabilities BOY1985877TotalLiabilitiesBOY
Total Liabilities EOY1112346TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY706719NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY2521359NetAssetsOrFundBalancesEOY
Mission DescriptionMUSKINGUM VALLEY HEALTH CENTERS' MISSION IS TO PROVIDE AFFORDABLE, ACCESSIBLE, AND QUALITY HEALTHCARE.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense6203502Expense
Revenue7469621Revenue
DescriptionHealthcare Services: Muskingum Valley Health Center provides numerous services, including Adult Primary Care, Pediatrics, Dental, Mental Health, OB/GYN, and Podiatry Services. During the organization's fiscal year, approximately 16,753 patients received services resulting in 69,000 visits. Additionally, MVHC provided sliding fee scale adjustments in the amount of $744,600 to its patients.Description
Total Program Service Expense6203502TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
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 Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10963NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees149NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
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
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address1OfficerMailingAddress
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 Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledOHStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1DANIEL J ATKINSONBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7408919090TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1716 ADAIR AVEAddressLine1
CityZANESVILLECity
StateOHState
ZIP Code43701ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (23 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
BRAD BOND
PRESIDENT1.00XX000
COREY HAMILTON
VICE PRESIDENT1.00XX000
RANDY COCHRANE
SECRETARY1.00XX000
JOHN WILSON
TREASURER1.00XX000
CAROL HOWDYSHELL
DIRECTOR1.00X000
RICHARD HUCK
DIRECTOR1.00X000
MARY KELLER
DIRECTOR1.00X000
Carolyn Jenkins
DIRECTOR1.00X000
JAN SNOUFFER
DIRECTOR1.00X000
RONALD WEINER
DIRECTOR1.00X000
ALICE BALDWIN
DIRECTOR1.00X000
HEATHER COEN
DIRECTOR1.00X000
LINDA MAYLE
DIRECTOR1.00X000
SHARON PEYTON
DIRECTOR1.00X000
TERRI RAY
DIRECTOR1.00X000
LISA KING
CEO40.00X114055010769
DAN ATKINSON
CFO40.00X9107104218
SUE HOOVER
COO40.00X7546300
GERALD TIBERIO MD
CMO40.00X18673805492
GEORGE MOSES MD
PHYSICIAN40.0023037007544X
RICHARD ESSIG MD
PHYSICIAN40.0024203500X
roger ward MD
PHYSICIAN40.0011716204156X
BIJAN GOODARZI MD
PHYSICIAN40.0010530100X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1162195TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation32179TotalOtherCompensation
Number Individuals GT100 K6NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
ANTHEM BLUE CROSS AND BLUE SHIELD
PO BOX 105673ATLANTAGA303485673HEALTH INSURANCE453060
MEDICAL CLAIMS PROCESSING
2531 MAPLE AVENUEZANESVILLEOH43701BILLING AGENCY218850
PATTERSON DENTAL SUPPLY
2128 CITYGATE DRIVECOLUMBUSOH43219DENTAL SUPPLIES101891
MCKESSON MEDICAL-SURGICAL INC
PO BOX 933027ATLANTAGA311933027MEDICAL SUPPLIES101218
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K
Government Grants1231043GovernmentGrants
All Other Contributions1107422AllOtherContributions
Noncash Contributions924000NoncashContributions
Total Contributions2338465TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT SERVICESDescription
Business Code623000BusinessCode
Total Revenue Column7368173TotalRevenueColumn
Related Or Exempt Function Income7368173RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue7368173TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column3038TotalRevenueColumn
Exclusion$3,038ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionCONTRACT SERVICESDescription
Business Code623000BusinessCode
Total Revenue Column101448TotalRevenueColumn
Related Or Exempt Function Income101448RelatedOrExemptFunctionIncome

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column248TotalRevenueColumn
Exclusion$248ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue101696TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column9811372TotalRevenueColumn
Related Or Exempt Function Income7469621RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$3,286ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total485976Total
Program Services92715ProgramServices
Management And General393261ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total4617080Total
Program Services4013840ProgramServices
Management And General603240ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total91714Total
Program Services73371ProgramServices
Management And General18343ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total736118Total
Program Services588894ProgramServices
Management And General147224ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total38931Total
Management And General38931ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total30200Total
Management And General30200ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total687904Total
Program Services467158ProgramServices
Management And General220746ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total11160Total
Management And General11160ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total899059Total
Program Services639718ProgramServices
Management And General259341ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total93160Total
Program Services83844ProgramServices
Management And General9316ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total31985Total
Program Services108ProgramServices
Management And General31877ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total19952Total
Management And General19952ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total39312Total
Program Services35381ProgramServices
Management And General3931ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total57081Total
Program Services51373ProgramServices
Management And General5708ManagementAndGeneral

Other Expenses OtherExpenses

FieldValueIRS element (for citing)
DescriptionBAD DEBT EXPENSEDescription
Total157100Total
Program Services157100ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total7996732Total
Program Services6203502ProgramServices
Management And General1793230ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1371BOY
EOY1611EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY344353BOY
EOY533789EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY100000BOY
EOY369278EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY893635BOY
EOY989575EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY40173BOY
EOY50406EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis1726924LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec112426LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1262851BOY
EOY1614498EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY50213BOY
EOY74548EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY2692596BOY
EOY3633705EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY417704BOY
EOY460688EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY3300BOY
EOY481EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY640873BOY
EOY600177EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY924000BOY
EOY51000EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1985877BOY
EOY1112346EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY706719BOY
EOY2521359EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY706719BOY
EOY2521359EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2692596BOY
EOY3633705EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years1194333CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1965051CurrentTaxYearMinus1Year
Current Tax Year2338465CurrentTaxYear
Total5497849Total

Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years1966376CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6107272CurrentTaxYearMinus1Year
Current Tax Year7368173CurrentTaxYear
Total15441821Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years3160709CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8072323CurrentTaxYearMinus1Year
Current Tax Year9706638CurrentTaxYear
Total20939670Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50920939670PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years541CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1141CurrentTaxYearMinus1Year
Current Tax Year3038CurrentTaxYear
Total4720Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years541CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1141CurrentTaxYearMinus1Year
Current Tax Year3038CurrentTaxYear
Total4720Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years46920CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year175092CurrentTaxYearMinus1Year
Current Tax Year101696CurrentTaxYear
Total323708Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years3208170CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8248556CurrentTaxYearMinus1Year
Current Tax Year9811372CurrentTaxYear
Total21268098Total
FieldValueIRS element (for citing)
Public Support Percentage5090.98460PublicSupportPercentage509
Prior Year Support Percentage0.98050PriorYearSupportPercentage
Investment Income Percentage0.00020InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00010PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509
General ExplanationSchedule A, Part II, Line 12, Explanation of Other Income: CONTRACT SERVICES OTHER REVENUEGeneralExplanation

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)
Other Cost Or Other Basis51000OtherCostOrOtherBasis
Book Value51000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis873000OtherCostOrOtherBasis
Book Value873000BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis251752OtherCostOrOtherBasis
Depreciation112426Depreciation
Book Value139326BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis551172OtherCostOrOtherBasis
Book Value551172BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1614498TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionCONDITIONAL ADVANCE CONTRIBUTIONDescription
Amount$51,000Amount
FieldValueIRS element (for citing)
Total Of Amounts51000TotalOfAmounts
Total Revenue9811372TotalRevenue
Total Expenses7996732TotalExpenses
Excess Or Deficit For Year1814640ExcessOrDeficitForYear
Total Adjustments0TotalAdjustments
Excess Or Deficit Per FS1814640ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt9811372TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal9811372RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9909811372TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt7996732TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal7996732ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form9907996732TotalExpensesPerForm990

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
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 (3 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
GERALD TIBERIO MD
1765380102000000054920192230000
GEORGE MOSES MD
2192160100001015400075440237914000
RICHARD ESSIG MD
242035000000000242035000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePart I, Line 4a:ReturnReference
ExplanationDr. George Moses received 5 weeks of severance pay totaling $10,154 based on his current, regular base annual salary, payable on MVHC's regular pay dates, and MVHC agreed not to oppose Dr. Moses' unemployment application after the end of the severance payment.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonZANESVILLE MUSKINGUM COUNTY HEALTHNamePerson
FieldValueIRS element (for citing)
RelationshipBOARD VP COREY HAMILTON IS COMMISSIONER OF THE HEALTH DEPARTMENT.Relationship
Amount Of Transaction231376AmountOfTransaction
Description Of TransactionZANESVILLE MUSKINGUM COUNTY HEALTH DEPARTMENT PROVIDED CASH AND NON-CASH SUPPORT CONSISTING OF MEDICAL AND DENTAL EQUIPMENT AND PERSONNEL THROUGHOUT THE FISCAL YEAR.DescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule M IRS990ScheduleM

Real Estate Commercial RealEstateCommercial

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions2NumberOfContributions
Noncash Contribs Rptd F990924000NoncashContribsRptdF990
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGifts
Third Parties Used0ThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierExplanationExplanation
Form 990, Part VI, Section B, line 11THE CFO REVIEWS FORM 990, AND AN ELECTRONIC COPY IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING.
Form 990, Part VI, Section B, line 12cBoard members will sign Conflict of Interest and Confidentiality Statement annually. Forms will be filed with the organizations permanent record for members. THE CEO/HR DIRECTOR REVIEWS AND MAINTAINS THESE FORMS. MVHC Board Members are required to disclose Conflicts of Interests that might influence judgement in a Board Member's decision making process. Following disclosure, MVHC's Board Executive Committee shall determine appropriate action, ranging from abstaining from specific Board decisions to stepping down from membership.
Form 990, Part VI, Section B, line 15Compensation for the Officers is monitored and determined by the Board of Directors. The compensation packages are benchmarked based on the National Association of Community Health Center's survey information. Compensation ranges are reviewed and approved on a annual basis and documented in the minutes of the board meetings. All other compensation is determined and monitored by the Director of Human Resources, CFO, and CEO. These compensation ranges are primarily based on the National Association of Community Health Center's compensation survey. Approved compensation is documented in the individuals personnel file and monitored through the budgetary process. The last year this process was completed was in 2009.
Form 990, Part VI, Section C, line 18FORM 1023 AND FORM 990 ARE AVAILABLE UPON REQUEST.
Form 990, Part VI, Section C, line 19THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 2C EXPLANATIONTHE FINANCE COMMITTEE OVERSEES AUDIT OF THE FINANCIAL STATEMENT, AND REVIEWS ALL FINANCIAL MATTERS INCLUDING INTERNAL STATEMENTS ON A MONTHLY BASIS. THE FINANCE COMMITTEE IS ALSO RESPONSIBLE FOR THE SELECTION OF THE INDEPENDENT ACCOUNTANT.
FORM 990, PART VI, LINE 9 EXPLANATIONLISA KING CAN BE REACHED AT THE FOLLOWING ADDRESS: GENESIS HEALTHCARE SYSTEMS-BETHESDA 2951 MAPLES AVENUE ZANESVILLE, OH 43701