2011-07-14T14:49:15-05:00 2010-08-31 PLANTE & MORAN PLLC 65 EAST STATE ST STE 600 COLUMBUS OH 43215 990 2009-09-01 208814374 MUSKINGUM VALLEY HEALTH CENTERS MUSK 7044545239 716 ADAIR AVE ZANESVILLE OH 43701 DANIEL J ATKINSON 7044545239 2011-07-12 1 PLANTE MORAN PLLC 6148493000 2009 2016-02-24 21:20:13Z DANIEL J ATKINSON 716 ADAIR AVE ZANESVILLE OH 43701 9811372 0 X WWW.MVHEALTHCENTERS.ORG X 2007 OH Muskingum 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. 15 14 149 12 0 0 1586383 2338465 6106697 7368173 1141 3038 175092 101696 7869313 9811372 0 0 4988094 5930888 0 0 2202210 2065844 7190304 7996732 679009 1814640 2692596 3633705 1985877 1112346 706719 2521359 MUSKINGUM VALLEY HEALTH CENTERS' MISSION IS TO PROVIDE AFFORDABLE, ACCESSIBLE, AND QUALITY HEALTHCARE. 0 0 6203502 7469621 Healthcare 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. 6203502 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 1 3 0 1 149 1 0 0 0 0 0 0 0 0 0 15 14 0 0 0 0 0 0 0 1 1 1 0 1 1 1 1 1 1 1 1 0 OH X DANIEL J ATKINSON 7408919090 716 ADAIR AVE ZANESVILLE OH 43701 BRAD BOND 1.00 X X 0 0 0 COREY HAMILTON 1.00 X X 0 0 0 RANDY COCHRANE 1.00 X X 0 0 0 JOHN WILSON 1.00 X X 0 0 0 CAROL HOWDYSHELL 1.00 X 0 0 0 RICHARD HUCK 1.00 X 0 0 0 MARY KELLER 1.00 X 0 0 0 Carolyn Jenkins 1.00 X 0 0 0 JAN SNOUFFER 1.00 X 0 0 0 RONALD WEINER 1.00 X 0 0 0 ALICE BALDWIN 1.00 X 0 0 0 HEATHER COEN 1.00 X 0 0 0 LINDA MAYLE 1.00 X 0 0 0 SHARON PEYTON 1.00 X 0 0 0 TERRI RAY 1.00 X 0 0 0 LISA KING 40.00 X 114055 0 10769 DAN ATKINSON 40.00 X 91071 0 4218 SUE HOOVER 40.00 X 75463 0 0 GERALD TIBERIO MD 40.00 X 186738 0 5492 GEORGE MOSES MD 40.00 X 230370 0 7544 RICHARD ESSIG MD 40.00 X 242035 0 0 roger ward MD 40.00 X 117162 0 4156 BIJAN GOODARZI MD 40.00 X 105301 0 0 1162195 0 32179 6 0 1 0 ANTHEM BLUE CROSS AND BLUE SHIELD PO BOX 105673 ATLANTA GA 303485673 HEALTH INSURANCE 453060 MEDICAL CLAIMS PROCESSING 2531 MAPLE AVENUE ZANESVILLE OH 43701 BILLING AGENCY 218850 PATTERSON DENTAL SUPPLY 2128 CITYGATE DRIVE COLUMBUS OH 43219 DENTAL SUPPLIES 101891 MCKESSON MEDICAL-SURGICAL INC PO BOX 933027 ATLANTA GA 311933027 MEDICAL SUPPLIES 101218 4 1231043 1107422 924000 2338465 NET PATIENT SERVICES 623000 7368173 7368173 7368173 3038 3038 CONTRACT SERVICES 623000 101448 101448 248 248 101696 9811372 7469621 0 3286 485976 92715 393261 4617080 4013840 603240 91714 73371 18343 736118 588894 147224 38931 38931 30200 30200 687904 467158 220746 11160 11160 899059 639718 259341 93160 83844 9316 31985 108 31877 19952 19952 39312 35381 3931 57081 51373 5708 BAD DEBT EXPENSE 157100 157100 7996732 6203502 1793230 0 1371 1611 344353 533789 100000 369278 893635 989575 40173 50406 1726924 112426 1262851 1614498 50213 74548 2692596 3633705 417704 460688 3300 481 640873 600177 924000 51000 1985877 1112346 X 706719 2521359 706719 2521359 2692596 3633705 X 0 1 1 X 1 1 X 1194333 1965051 2338465 5497849 1966376 6107272 7368173 15441821 3160709 8072323 9706638 20939670 0 0 0 20939670 541 1141 3038 4720 541 1141 3038 4720 46920 175092 101696 323708 3208170 8248556 9811372 21268098 0.98460 0.98050 0.00020 0.00010 X Schedule A, Part II, Line 12, Explanation of Other Income: CONTRACT SERVICES OTHER REVENUE RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 51000 51000 873000 873000 251752 112426 139326 551172 551172 1614498 CONDITIONAL ADVANCE CONTRIBUTION 51000 51000 9811372 7996732 1814640 0 1814640 9811372 0 9811372 0 9811372 7996732 0 7996732 0 7996732 X X 1 0 0 0 0 0 0 0 0 GERALD TIBERIO MD 176538 0 10200 0 0 0 0 0 5492 0 192230 0 0 0 GEORGE MOSES MD 219216 0 1000 0 10154 0 0 0 7544 0 237914 0 0 0 RICHARD ESSIG MD 242035 0 0 0 0 0 0 0 0 0 242035 0 0 0 Part I, Line 4a: Dr. 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. ZANESVILLE MUSKINGUM COUNTY HEALTH BOARD VP COREY HAMILTON IS COMMISSIONER OF THE HEALTH DEPARTMENT. 231376 ZANESVILLE MUSKINGUM COUNTY HEALTH DEPARTMENT PROVIDED CASH AND NON-CASH SUPPORT CONSISTING OF MEDICAL AND DENTAL EQUIPMENT AND PERSONNEL THROUGHOUT THE FISCAL YEAR. 0 X 2 924000 0 0 0 Form 990, Part VI, Section B, line 11 THE 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 12c Board 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 15 Compensation 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 18 FORM 1023 AND FORM 990 ARE AVAILABLE UPON REQUEST. Form 990, Part VI, Section C, line 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 2C EXPLANATION THE 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 EXPLANATION LISA KING CAN BE REACHED AT THE FOLLOWING ADDRESS: GENESIS HEALTHCARE SYSTEMS-BETHESDA 2951 MAPLES AVENUE ZANESVILLE, OH 43701