UPPER VALLEY MEDICAL CENTER: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- UPPER VALLEY MEDICAL CENTER (EIN 31-0537095)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-11-10
- IRS object ID
- 201123149349302257
- Schema version
- 2010v3.4
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-11-10T11:25:58-06:00 | Timestamp |
| Tax Period End Date | 2010-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1900 Scripps Center 312 Walnut St | AddressLine1 |
| City | Cincinnati | City |
| State | OH | State |
| ZIP Code | 45202 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 310537095 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Upper Valley Medical Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | UPPE | NameControl |
| Phone | 9374407853 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3130 North County Road 25A | AddressLine1 |
| City | Troy | City |
| State | OH | State |
| ZIP Code | 45373 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TIMOTHY D SNIDER | Name |
| Title | VP OF FINANCE/CFO | Title |
| Date Signed | 2011-11-05 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5136121400 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Thomas Parker | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3130 North County Road 25A | AddressLine1 |
| City | Troy | City |
| State | OH | State |
| ZIP Code | 45373 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 155276916 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.uvmc.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1926 | YearFormation |
| State Legal Domicile | OH | StateLegalDomicile |
| Activity Or Mission Description | The primary exempt purpose is to provide comprehensive inpatient, outpatient and emergency health care services to area residents. The Hospital furthers its exempt purpose by promoting community health. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 19 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 15 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1575 | TotalNbrEmployees |
| Total Nbr Volunteers | 180 | TotalNbrVolunteers |
| Total Gross UBI | 367884 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 71819 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 26332 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 141663219 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 140499574 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 2339094 | InvestmentIncomePriorYear |
| Investment Income Current Year | 2760318 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1604714 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1414283 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 145678846 | TotalRevenuePriorYear |
| Total Revenue Current Year | 144700507 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 87845 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 140741 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 78320379 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 73405112 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 64005025 | OtherExpensePriorYear |
| Other Expenses Current Year | 62537181 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 142413249 | TotalExpensesPriorYear |
| Total Expenses Current Year | 136083034 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 3265597 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 8617473 | RevenuesLessExpensesCY |
| Total Assets BOY | 155810058 | TotalAssetsBOY |
| Total Assets EOY | 160660248 | TotalAssetsEOY |
| Total Liabilities BOY | 108646835 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 106955964 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 47163223 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 53704284 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | SEE SCHEDULE O | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 108592087 | Expense |
| Grants | 26332 | Grants |
| Revenue | 140499574 | Revenue |
| Description | See Schedule O | Description |
| Total Program Service Expense | 108592087 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | false | FinancialStmtAttached |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | true | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | true | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | true | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | true | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | true | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 97 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 1575 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 19 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 15 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | OH | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | TIMOTHY SNIDER | NamePerson |
| Telephone Number | 9374407853 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3130 NORTH COUNTY RD 25A | AddressLine1 |
| City | Troy | City |
| State | OH | State |
| ZIP Code | 45373 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (31 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| Douglas R Murray | |||||||||
| Chair | 0.5 | X | 0 | 0 | 0 | ||||
| Rowan R Nickol MD | |||||||||
| First Vice Chair | 0.5 | X | 0 | 329755 | 17868 | ||||
| Craig C Bundschuh | |||||||||
| Second Vice Chair/Secretary | 0.5 | X | 0 | 0 | 0 | ||||
| Cliff R Alexander | |||||||||
| Director | 0.5 | X | 0 | 0 | 0 | ||||
| Arthur R Disbrow | |||||||||
| Director | 0.5 | X | 0 | 0 | 0 | ||||
| Ronald R Fox | |||||||||
| Director | 0.5 | X | 0 | 0 | 0 | ||||
| Daniel P French | |||||||||
| Director | 0.5 | X | 0 | 0 | 0 | ||||
| Gail Haddad RN | |||||||||
| Director | 0.5 | X | 0 | 0 | 0 | ||||
| R Douglas Haines | |||||||||
| Director | 0.5 | X | 0 | 0 | 0 | ||||
| L Stewart Lowry MD | |||||||||
| Director | 0.5 | X | 39993 | 303614 | 21047 | ||||
| William E Lukens | |||||||||
| Director | 0.5 | X | 0 | 0 | 0 | ||||
| Peter E Nims MD | |||||||||
| Director | 0.5 | X | 0 | 0 | 0 | ||||
| Victoria O'Campo MD | |||||||||
| Director | 1.0 | X | 30528 | 0 | 0 | ||||
| James Pancoast | |||||||||
| Director | 0.5 | X | 0 | 0 | 0 | ||||
| Michael R Tinkler DDS | |||||||||
| Director | 0.5 | X | 0 | 0 | 0 | ||||
| W Ray Wagoner | |||||||||
| Director | 0.5 | X | 0 | 0 | 0 | ||||
| Joel H Walker | |||||||||
| Director | 0.5 | X | 0 | 0 | 0 | ||||
| Mary Patricia Wampler RN | |||||||||
| Director | 0.5 | X | 0 | 0 | 0 | ||||
| Michael J Maiberger | |||||||||
| President/CEO | 37.5 | X | 393432 | 63338 | 65599 | X | |||
| Thomas Parker | |||||||||
| Executive Vice President/COO | 37.5 | 261041 | 0 | 55414 | X | ||||
| Timothy Snider | |||||||||
| Vice President/CFO | 37.5 | 250862 | 0 | 37597 | X | ||||
| Barbara Evert MD | |||||||||
| Vice President | 40.0 | 323140 | 0 | 29859 | X | ||||
| Judith Snyder | |||||||||
| Vice President | 40.0 | 197466 | 0 | 61879 | X | ||||
| Rececca Rice | |||||||||
| Vice President | 40.0 | 194824 | 0 | 57438 | X | ||||
| James Hurak | |||||||||
| Vice President | 40.0 | 178737 | 0 | 59873 | X | ||||
| Shakil Rahman MD | |||||||||
| Physician | 40.0 | 325767 | 0 | 20748 | X | ||||
| Rafay Atiq MD | |||||||||
| Physician | 40.0 | 239220 | 0 | 25305 | X | ||||
| William Watercutter | |||||||||
| Director of IT | 40.0 | 143013 | 0 | 24939 | X | ||||
| Thomas Bigley | |||||||||
| Director of Pharmacy | 40.0 | 142919 | 0 | 18626 | X | ||||
| William Smith PhD | |||||||||
| Psychologist | 40.0 | 122006 | 0 | 38358 | X | ||||
| Randal P Lennartz | |||||||||
| Senior Vice President | 0 | 183934 | 0 | X | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2842948 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 880641 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 534550 | TotalOtherCompensation |
| Number Individuals GT100 K | 33 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Brackett Builders | |||||
| 185 Marybill Dr | TROY | OH | 45373 | Construction | 3521325 |
| Valley Anesthesia Inc | |||||
| 3130 North County Rd 25A | TROY | OH | 45373 | Anesthesiology | 1618574 |
| North Dayton Pathologist Inc | |||||
| 2222 Philadelphia Dr | DAYTON | OH | 45406 | Pathology | 976668 |
| Premier Health Care Services Inc | |||||
| 332 Congress Park Dr | DAYTON | OH | 45459 | Occupational Health | 427673 |
| Quest Diagnostics | |||||
| 3 Giralda Farms | MADISON | NJ | 07940 | Lab/Healthcare | 435993 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 17 | NumberOfContractorsGT100K |
| Government Grants | 15533 | GovernmentGrants |
| All Other Contributions | 10799 | AllOtherContributions |
| Total Contributions | 26332 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| NET MEDICARE / MEDICAID | 621300 | 72847819 | 72847819 | |
| NET PATIENT CARE SERVICES | 212000 | 66268590 | 66268590 | |
| JOINT HOSPITAL SERVICES - LAUNDRY | 812300 | 611552 | 598353 | 13199 |
| TRAINING & EDUCATION | 561499 | 145271 | 145271 | |
| RENTAL FROM AFFILIATES | 532000 | 184728 | 184728 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 441614 | TotalRevenueColumn |
| Related Or Exempt Function Income | 441614 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 140499574 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2524121 | TotalRevenueColumn |
| Related Or Exempt Function Income | 2872 | RelatedOrExemptFunctionIncome |
| Exclusion | $2,521,249 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 268750 | TotalRevenueColumn |
| Exclusion | $268,750 | ExclusionAmount |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 32214 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 42190 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -9976 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -9976 | TotalRevenueColumn |
| Exclusion | -$9,976 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 10428073 | Securities |
| Other | 73593 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 10351049 | Securities |
| Other | 183170 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 77024 | Securities |
| Other | -109577 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -32553 | TotalRevenueColumn |
| Exclusion | -$32,553 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|---|
| NUTRITION SERVICES | 722210 | 755580 | 82946 | $672,634 | |
| PHYSICIAN LABORATORY SERVICES | 621500 | 304261 | 304261 | ||
| MEDICAL RECORDS FEES | 541800 | 47464 | 47464 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 316954 | TotalRevenueColumn |
| Related Or Exempt Function Income | 266530 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 50424 | UnrelatedBusinessRevenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1424259 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 144700507 | TotalRevenueColumn |
| Related Or Exempt Function Income | 140886187 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 367884 | UnrelatedBusinessRevenue |
| Exclusion | $3,420,104 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 140741 | Total |
| Program Services | 140741 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2297410 | Total |
| Program Services | 66660 | ProgramServices |
| Management And General | 2230750 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54094833 | Total |
| Program Services | 43515946 | ProgramServices |
| Management And General | 10578887 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4839736 | Total |
| Program Services | 3900343 | ProgramServices |
| Management And General | 939393 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8325715 | Total |
| Program Services | 6743246 | ProgramServices |
| Management And General | 1582469 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3847418 | Total |
| Program Services | 3100634 | ProgramServices |
| Management And General | 746784 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 110495 | Total |
| Management And General | 110495 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 127988 | Total |
| Management And General | 127988 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15362 | Total |
| Program Services | 587 | ProgramServices |
| Management And General | 14775 | ManagementAndGeneral |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 107767 | Total |
| Management And General | 107767 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7092266 | Total |
| Program Services | 6736190 | ProgramServices |
| Management And General | 356076 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 599769 | Total |
| Program Services | 60070 | ProgramServices |
| Management And General | 539699 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3826557 | Total |
| Program Services | 2840690 | ProgramServices |
| Management And General | 985867 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2937516 | Total |
| Program Services | 1765170 | ProgramServices |
| Management And General | 1172346 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3114594 | Total |
| Program Services | 2614419 | ProgramServices |
| Management And General | 500175 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 214917 | Total |
| Program Services | 149131 | ProgramServices |
| Management And General | 65786 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 141917 | Total |
| Program Services | 79338 | ProgramServices |
| Management And General | 62579 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2766711 | Total |
| Program Services | 2229692 | ProgramServices |
| Management And General | 537019 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6969997 | Total |
| Program Services | 6049741 | ProgramServices |
| Management And General | 920256 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2673764 | Total |
| Management And General | 2673764 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| OPERATING SUPPLIES/EQUIP | 14343286 | 14334037 | 9249 |
| JOINT OPERATING AGREEMENT | 7422000 | 7422000 | |
| PURCHASED SERVICES | 6145125 | 3152805 | 2992320 |
| BAD DEBTS | 2555883 | 2555883 | |
| HOSPITAL FRANCHISE TAX | 1035724 | 1035724 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 335543 | Total |
| Program Services | 99040 | ProgramServices |
| Management And General | 236503 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 136083034 | Total |
| Program Services | 108592087 | ProgramServices |
| Management And General | 27490947 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3295 | BOY |
| EOY | 3395 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6455773 | BOY |
| EOY | 2562716 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11360422 | BOY |
| EOY | 11001086 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4198 | BOY |
| EOY | 45177 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1037092 | BOY |
| EOY | 478548 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 464810 | BOY |
| EOY | 534319 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1278585 | BOY |
| EOY | 1337541 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 131271384 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 75028800 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 55592589 | BOY |
| EOY | 56242584 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 78089816 | BOY |
| EOY | 86868834 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1523478 | BOY |
| EOY | 1586047 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 155810058 | BOY |
| EOY | 160660248 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 49919364 | BOY |
| EOY | 51319938 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 55163529 | BOY |
| EOY | 53190064 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3563942 | BOY |
| EOY | 2445962 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 108646835 | BOY |
| EOY | 106955964 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 44994454 | BOY |
| EOY | 51123204 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1244029 | BOY |
| EOY | 1507638 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 924740 | BOY |
| EOY | 1073441 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 47163223 | BOY |
| EOY | 53704283 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 155810058 | BOY |
| EOY | 160660248 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 8617473 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -2076413 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | true | GrantsOtherOrganizations |
| Grants Other Organizations | $8,612 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | true | DirectContactLegislators |
| Direct Contact Legislators | $6,750 | DirectContactLegislatorsAmount |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | false | OtherActivities |
| Total Lobbying Expenditures IIB | 15362 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Schedule C, Part II-B, Lines 1f & 1g | Identifier |
| Explanation | Amounts include a portion of membership dues paid to Ohio Hospital Association, Greater Dayton Area Hospital Association and Ohio Council Home Care that were used for lobbying purposes. Also includes payments to a contracted lobbyist for health care related issues. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2168769 | BeginningOfYearBalance |
| Contributions | 511361 | Contributions |
| Investment Earnings Or Losses | 62404 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 49999 | GrantsOrScholarships |
| Other Expenditures | 111456 | OtherExpenditures |
| End Of Year Balance | 2581079 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2135470 | BeginningOfYearBalance |
| Contributions | 304326 | Contributions |
| Grants Or Scholarships | 107414 | GrantsOrScholarships |
| Other Expenditures | 163613 | OtherExpenditures |
| End Of Year Balance | 2168769 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2061537 | BeginningOfYearBalance |
| Contributions | 450032 | Contributions |
| Grants Or Scholarships | 49092 | GrantsOrScholarships |
| Other Expenditures | 327007 | OtherExpenditures |
| End Of Year Balance | 2135470 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 0.41590 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.58410 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | true | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | true | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 409459 | OtherCostOrOtherBasis |
| Book Value | 409459 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 62615360 | OtherCostOrOtherBasis |
| Depreciation | 30939045 | Depreciation |
| Book Value | 31676315 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 78425 | OtherCostOrOtherBasis |
| Depreciation | 78425 | Depreciation |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 58314885 | OtherCostOrOtherBasis |
| Depreciation | 42873474 | Depreciation |
| Book Value | 15441411 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 9853255 | OtherCostOrOtherBasis |
| Depreciation | 1137856 | Depreciation |
| Book Value | 8715399 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 56242584 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE TO MEDICARE / MEDICAID | Description |
| Amount | $2,445,962 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 2445962 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Intended uses of the organization's endowment funds | Schedule D, Part V, Line 4 | The permanent and term endowment funds are to be used to provide building/equipment and program related needs for the UVMC Health System, to provide support to the Upper Valley Medical Center Cancer Care Center, and to provide healthcare scholarships. In addition, the term endowment funds are to be used to provide financial support for indigent patient bills, to provide health education programs, and to provide toys to enhance a child's well being while spending time in the hospital. |
| Income Taxes | Schedule D, Part X, Line 1 | UVMC is a part of Premier Health Partners which is tax-exempt under Section 501(c)(3) of the Internal Revenue Code. As such, there is no income tax liability recorded at December 31, 2010 and 2009. In addition, Management annually reviews its tax positions and has determined that there are no material uncertain tax positions that require recognition in the combined financial statements. UVMC and its respective subsidiaries are a group of corporations that are tax-exempt corporations under Section 501(c)(3) of the Internal Revenue Code except for the following subsidiaries: - UVMC Management Corporation - For-profit corporation subject to federal income taxes - After Hours Family Care, Inc. - For-profit corporation subject to federal income taxes - Med-Terra, Inc. - Tax-exempt corporation under Section 501(c)(2) of the Internal Revenue Code |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8387102 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1703239 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6683863 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05010 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 14378817 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11363392 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3015425 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02260 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 407870 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 297003 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 110867 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 23173789 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13363634 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9810155 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07350 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1020127 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 103854 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 916273 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00690 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 67233 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 67233 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3344896 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 765520 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2579376 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01930 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 176085 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 176085 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00130 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4608341 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 869374 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3738967 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02800 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 27782130 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 14233008 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 13549122 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10150 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 632 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 632 | NetCommunityBuildingExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 1242 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1242 | NetCommunityBuildingExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 8000 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 8000 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Other Other
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 39983 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 39983 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 49857 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 49857 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $598,722 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 34980848 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 37966705 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -2985857 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UPPER VALLEY MEDICAL CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3130 NORTH COUNTY ROAD 25A | AddressLine1 |
| City | TROY | City |
| State | OH | State |
| ZIP Code | 45373 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
| Other | BEHAVIORAL HEALTH W/ 24-HR CRISIS INTERVENTION | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UPPER VALLEY MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 6 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (6 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| DIALYSIS SERVICES | ||||
| 3130 N COUNTY RD 25A | TROY | OH | 45373 | DIALYSIS |
| HYATT CENTER | ||||
| 450 HYATT STREET | TIPP CITY | OH | 45371 | LABORATORY, IMAGING, SPORTS MEDICINE, SURGERY |
| OUTPATIENT CARE CENTER NORTH | ||||
| 280 LOONEY RD | PIQUA | OH | 45356 | LABORATORY, IMAGING, REHABILITATIVE THERAPY |
| OUTPATIENT CARE CENTER SOUTH | ||||
| 998 SOUTH DORSET ROAD | TROY | OH | 45373 | LABORATORY, IMAGING OCCUPATIONAL HEALTH REHABILITATIVE THERAPY |
| STANFIELD PLACE | ||||
| 31 STANFIELD ROAD | TROY | OH | 45373 | LABORATORY, IMAGING |
| JACOB DETTMER BUILDING | ||||
| 3130 N COUNTY RD 25A | TROY | OH | 45373 | SLEEP DISORDER |
Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SUPPLEMENTAL INFORMATION | Part I, line 3c | Not applicable. Upper Valley Medical Center uses the Federal Poverty Guidelines for determining eligibility for free or discounted care under the organization's charity care policy. |
| SUPPLEMENTAL INFORMATION | Part I, line 6a | An annual written community benefit report is prepared by the organization directly. In addition, Upper Valley Medical Center's community benefit information is included in an annual written community benefit report with Premier Health Partners, a related organization. Both of these reports are made available to the public via publications in local newspapers, as well as on the organizations' websites. |
| SUPPLEMENTAL INFORMATION | Part I, line 7g | Included in subsidized health services are revenues and expenses related to an obstetrics clinic which is subsidized by both the Miami County Health Department and Upper Valley Medical Center. This clinic serves the prenatal, delivery and postnatal medical needs of women in the hospital's Miami County service area. Also included in subsidized health services are revenues and expenses related to an outpatient behavioral health clinic which serves the mental and behavioral health needs of area residents. The clients in both of these clinics include those who either have no medical insurance or qualify for Medicaid services. The total community benefit expense for these clinics in 2010 was $1,060,225, with direct offsetting revenues of $765,520. The net community benefit expense was $294,705. |
| SUPPLEMENTAL INFORMATION | Part I, line 7, column (f) | Bad debt expenses of $2,555,883, which are included on Form 990, Part IX, line 25, column (A), have been removed from the denominator prior to the calculation of the percent of total expense. |
| SUPPLEMENTAL INFORMATION | Part I, line 7 | A cost-to-charge ratio methodology was used to calculate the community benefit expenses which appear in the table in Schedule H, Part I, Sections 7a-c. This cost-to-charge ratio was derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges. The community benefits expenses which appear in the table under Sections 7e-j are calculated based on actual costs. |
| SUPPLEMENTAL INFORMATION - Community Building Activities | Part II | To aid in the leadership development and training for community members, Upper Valley Medical Center participates in the Leadership Piqua and Leadership Troy programs. These programs consist of annual sessions, whereby participants learn leadership and interpersonal skills to be informed civic-oriented leaders who are interested in helping to direct the future of the Miami County communities. Upper Valley Medical Center is a member of the local area chambers of commerce. Through this membership and the various chamber activities, the organization participates in the economic development of the Miami County area. In 2010, Upper Valley Medical Center participated in the Project Search Program. Project Search is a high school transition program which provides training and education leading to employment for individuals with disabilities. It is a collaborative program between Upper Valley Medical Center, Upper Valley Joint Vocational School, Rehabilitation Services Commission, the Miami and Shelby County Boards of Developmental Disabilities, and Capabilities. Four individuals were selected to gain employable skills working in various departments within the hospital performing various tasks. The goal of this program is to have the individuals gain more independence and an ability to work in gainful employment. A Project Search Coordinator and a Job Coach supervise the students on a daily basis. Other community building activities include cash donations made to other organizations throughout the Miami County area. Certain board members of the hospital are granted charitable credits to be donated in the name of the board member to not-for-profit, tax-exempt, 501 (c)(3) health and human services organizations in the Miami County area. The recipient organization must use the funds in the spirit of the Hospital's mission to improve the general health status of the community. Upper Valley Medical Center also makes several direct charitable donations to other not-for-profit organizations throughout Miami County. These organizations include area schools, chambers of commerce, churches, etc. These donations are given in the spirit of aiding in the overall well-being of the community. |
| SUPPLEMENTAL INFORMATION | Part III, line 4 | Upper Valley Medical Center uses Worksheet A and the cost-to-charge ratio methodology from Worksheet 2, Ratio of Patient Care Cost-to-Charges to determine the amounts reported as the organization's bad debt expense (at cost) on Part III, Section A., lines 2-3. In determining bad debt expense, the Medical Center deducts all applicable discounts and payments made on patient accounts from the balances that go to bad debts. Footnote per Audited Financial Statement: Upper Valley Medical Center's management recognizes bad debt expense and the allowance for doubtful accounts based upon historical experience. After satisfaction of amounts due from insurance, established guidelines related to past due balances are followed. Recoveries on previously written off receivables are netted against the bad debt expense in the year of recovery. Upper Valley Medical Center recognizes that there are accounts written off to bad debt that may have qualified for charity care if the patient provided the necessary financial information. In order to resolve this, the organization has engaged a third party vendor to analyze data based on credit scores to reallocate some of this expense to charity care. The policy is as follows: After 18 months, if the collection agency has not been able to resolve the account, the account is returned to the organization for final closeback. These accounts are then sent to the third party vendor who gathers external credit data that presents the account as less than 100% Federal Poverty Level or not enough information (typically indicative of indigent). These accounts are reclassified from bad debt expense to charity expense on our income statement. Any credit score that presents the accounts as greater than 100% Federal Poverty Level remains in bad debt expense. Due to this process, Upper Valley Medical Center does not feel it has reported bad debt expense for patients eligible under the organization's charity care policy. |
| SUPPLEMENTAL INFORMATION | Part III, line 8 | The Medicare shortfall of $2,985,857 should be treated as community benefit because the organization is providing high-quality care in excess of the cost to those in its community who need care. The Medicare population at the organization is approximately 30% of net patient revenue. The Medicare advantage plans and Medicare managed care plans are excluded from this percentage. Upper Valley Medical Center uses the Medicare Allowable Costing Methodology (Medicare Cost Report 2552-96) to determine Medicare allowable costs reported. |
| SUPPLEMENTAL INFORMATION | Part III, line 9b | Upper Valley Medical Center uses the eligibility guidelines under Federal House Bill 5101.3-2-0717 to determine patient accounts which qualify for basic, medically necessary hospital services under the State of Ohio Free Care Program (Care Assurance). The patient must complete the HCAP application and sign an affidavit that states that they meet the State's requirements. Proof of income is not required and there are no dollar limits to the amounts which may be written off. Upper Valley Medical Center's Patient Financial Advocates meet with self-pay and other patients who may need financial assistance. In addition to assisting patients who want to apply for assistance through the Medicaid program, the Patient Financial Advocate will provide the patient with a form for completing a financial statement, which must be returned to the Patient Financial Advocate within 10 days. If the financial statement falls within 400% of the federal poverty guidelines, the patient qualifies for assistance and all or part of the account will be written off to charity care, based on a Sliding Fee Schedule which has been established. There are no dollar limits to the amounts which may be written off. Patients may also qualify for charity care discounts due to a medically-based catastrophic event which has occurred in their life. If a patient qualifies for this discount, he/she would only be held responsible for payment of his/her account up to 25% of their annual income. For patient accounts which have been sent to collections, charity care is determined by Upper Valley Medical Center's professional collection agencies and is reported to the Medical Center on a monthly basis. Upon determination by the agencies of charity care, the account is closed with the agency and returned to the Medical Center, where it is written off to charity care. The professional collection agencies follow the Medical Center's guidelines for determining charity care. |
| SUPPLEMENTAL INFORMATION | Part V, Section B | As permitted, section B has not been completed for 2010. |
| SUPPLEMENTAL INFORMATION - Needs assessment: | Part VI, Question 2: | The primary purpose of the UVMC Community Benefit Plan is to work toward improved health in the communities that we serve by responding to community needs with programs that increase access to health care. This is accomplished through identifying community needs, making prudent choices for the use of resources, building and strengthening relationships in the community, and demonstrating accountability and transparency. UVMC works with the community on programs that address the underlying causes of persistent health problems, as part of a comprehensive strategy to improve the health status and quality of life for identified members of the community who are economically disadvantaged, disenfranchised and/or who have disproportionate unmet health needs. UVMC strives to work with Premier Health Partners, the UVMC Board of Directors, executive management, managers, staff members, community groups, and individuals to provide a collaborative approach to the governance and management of community benefit activities. |
| SUPPLEMENTAL INFORMATION - Patient education of eligibility for assistance | Part VI, Question 3: | There are several ways in which Upper Valley Medical Center informs and educates patients who may be billed for services about their eligibility for assistance under federal, state, or local government programs or under the Medical Center's charity care policy. First, notification of such available assistance is clearly posted in registration areas, as well as the maternity and emergency departments. Next, patient financial advocates in the inpatient and emergency departments meet with uninsured and under-insured patients, as well as those with Medicare only coverage, to discuss eligibility for assistance. Patient Financial Advocates also meet with uninsured and under-insured patients and those who have unpaid account balances, who are scheduled for large dollar procedures to discuss eligibility options. Finally, when a patient receives a bill from Upper Valley Medical Center, the reverse side of the bill contains information about the State of Ohio Free Care Program (Care Assurance). Also included with that bill is another form which details all the financial assistance options available. |
| SUPPLEMENTAL INFORMATION - Community information | Part VI, Question 4: | Upper Valley Medical Center serves the northern Miami Valley area with acute care services, community health and wellness programs and more. Upper Valley Medical Center is located in Miami County, Ohio and is the sole hospital system operating within the county. The population of Upper Valley Medical Center's primary service area is approximately 130,000 people, with a recent growth rate of just slightly over 1%. Including the adjacent counties which are also served (Shelby, Darke, and Champaign Counties), Upper Valley Medical Center's total primary and secondary service area population approaches 300,000 residents. The overall service area is categorized as having relatively slow growth with an aging population, consistent with current trends throughout Ohio. The median household income of Miami County and the surrounding area is slightly less than $50,000 per year, with approximately 12% of its citizens living below the federal poverty level. Approximately 49% of the hospital's gross revenues are generated from Medicare patients, while another 18% of the revenues are generated from either uninsured patients or Medicaid recipients. The current unemployment rate of Miami County is approximately 11%. Recent job growth has been negative. |
| SUPPLEMENTAL INFORMATION - Promotion of Community Health | Part VI, Question 5 | The primary exempt purpose of Upper Valley Medical Center is to provide comprehensive inpatient, outpatient and emergency health care services to the residents of Miami and surrounding counties. The hospital furthers it tax-exempt purpose by promoting the health of the community in many ways. A principal financial contribution to the community is the provision of acute health services to patients regardless of their ability to pay. In addition to charity care services provided, Upper Valley Medical Center experienced bad debt expenses and also incurred costs from providing care for patients covered by government programs such as Medicare and Medicaid, where reimbursement is limited. Upper Valley Medical Center also subsidizes an obstetrics clinic and a behavioral health clinic and provides a comprehensive continuum of psychiatric and chemical dependency programs. These services are provided at a reduced cost or no cost for those who are uninsured or unable to pay. Thousands of individuals throughout Miami and surrounding counties benefited from Upper Valley Medical Center's health-focused programs during 2010, including health fairs, screenings, immunizations, support groups and other services. Many of these programs are free to the public or offered at a reduced price. Free presentations are available to area civic, service and social groups, professional organizations, schools, churches, and industries through the UVMC speaker's bureau. Speakers are available on a wide variety of medical/health care topics and are able to provide accurate up-to-date information to the community. Upper Valley Medical Center's use of surplus funds includes the purchase of property, plant and equipment of over $10 million. Highlights include: -Cancer Care Linear Accelerator -Power Plant and Infrastructure Upgrade -C-Arm Imaging Equipment -Patient Room Upgrades -Orthopedic Office -Information Systems Upgrades The UVMC board of directors consists of 19 members of the community. The majority of the board members are neither employees nor contractors of the organization. None of these board members receive compensation from the organization for services provided in the role of board member. The Medical Center extends medical staff privileges to all qualified physicians in its community for the majority of its departments. See Schedule O, Part III for more comprehensive details about how the Medical Center promotes the health of the community. |
| SUPPLEMENTAL INFORMATION - Affiliated Health Care System | Part VI, Question 6 | Upper Valley Medical Center is affiliated with Miami Valley Hospital, Good Samaritan Hospital, and Atrium Medical Center. The agreement between the systems provides for the creation of Premier Health Partners (PHP), an Ohio non-profit corporation. Each hospital system has the authority to determine the amounts it contributes to community building and other indigent programs. |
| STATE FILING OF COMMUNITY BENEFIT REPORT | 990 SCHEDULE H, PART VI | OH, |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable (6 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant | Address Line2AddressUS/AddressLine2 |
|---|---|---|---|---|---|---|---|---|
| UVMC FOUNDATION | ||||||||
| 3130 N COUNTY ROAD 25A | TROY | OH | 45373 | 311581859 | 501(C)(3) | 48100 | SCHOLARSHIP & GENERAL FUND | |
| AMERICAN CANCER SOCIETY | ||||||||
| 5555 FRANTZ ROAD | DUBLIN | OH | 43017 | 340726080 | 501(C)(3) | 7500 | SPONSORSHIP MIAMI CO RELAY FOR LIFE | |
| EDISON FOUNDATION | ||||||||
| 1973 EDISON DRIVE | PIQUA | OH | 45356 | 311379781 | 501(C)(3) | 5500 | EVENT SPONSORSHIP & GENERAL FUND | |
| Health Partners Free Clinic | ||||||||
| 1300 North County Rd 25A | Troy | OH | 45373 | 311596731 | 501(C)(3) | 15000 | Operations | |
| Miami County Health District | ||||||||
| 510 W Water St | Troy | OH | 45373 | 316000055 | 5286 | Sponsorship | Suite 130 | |
| Troy City Schools | ||||||||
| 151 Staunton Rd | Troy | OH | 45373 | 316000985 | 10000 | Equipment | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 6 | TotalNbrOf501C3AndGovtGrants |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Form 990, Schedule I, Part I, Line 2 | Identifier |
| Return Reference | Description of Organization's Procedures for Monitoring the Use of Grants | ReturnReference |
| Explanation | UPPER VALLEY MEDICAL CENTER MONITORS THE USE OF GRANT FUNDS IN THE UNITED STATES BY VERIFYING THAT THE ORGANIZATIONS REQUESTING ASSISTANCE ARE 501(C)(3) TAX EXEMPT ORGANIZATIONS. THE GRANTS THAT ARE GIVEN ARE USUALLY SMALL IN NATURE AND LARGER ONES ARE APPROVED BY THE UVMC BOARD OF DIRECTORS. THEY ARE USUALLY GIVEN FOR A SPECIFIC PURPOSE, SUCH AS ONGOING OPERATIONS OR A CAPITAL PROJECT, AND ARE RELATED TO HEALTHCARE IN THE COMMUNITY. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | true | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | true | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | true | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (15 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Rowan R Nickol MD | |||||||||||||
| 0 | 277503 | 0 | 50527 | 0 | 1725 | 0 | 2450 | 0 | 15418 | 0 | 347623 | 0 | 0 |
| L Stewart Lowry MD | |||||||||||||
| 39993 | 259026 | 0 | 26998 | 0 | 17590 | 0 | 2450 | 0 | 18597 | 39993 | 324661 | 0 | 0 |
| Michael J Maiberger | |||||||||||||
| 245262 | 39485 | 62093 | 9996 | 86077 | 13857 | 35736 | 5752 | 21026 | 3385 | 450194 | 72475 | 19130 | 0 |
| Thomas Parker | |||||||||||||
| 198131 | 0 | 44215 | 0 | 18695 | 0 | 37576 | 0 | 17838 | 0 | 316455 | 0 | 0 | 0 |
| Timothy Snider | |||||||||||||
| 187265 | 0 | 45000 | 0 | 18597 | 0 | 14700 | 0 | 22897 | 0 | 288459 | 0 | 0 | 0 |
| Randal P Lennartz | |||||||||||||
| 0 | 0 | 0 | 0 | 0 | 183934 | 0 | 0 | 0 | 0 | 0 | 183934 | 0 | 0 |
| Barbara Evert MD | |||||||||||||
| 224054 | 0 | 52800 | 0 | 46286 | 0 | 14700 | 0 | 15159 | 0 | 352999 | 0 | 0 | 0 |
| Judith Snyder | |||||||||||||
| 135520 | 0 | 32339 | 0 | 29607 | 0 | 51714 | 0 | 10165 | 0 | 259345 | 0 | 0 | 0 |
| Rececca Rice | |||||||||||||
| 139192 | 0 | 32120 | 0 | 23512 | 0 | 50042 | 0 | 7396 | 0 | 252262 | 0 | 0 | 0 |
| James Hurak | |||||||||||||
| 120032 | 0 | 31020 | 0 | 27685 | 0 | 38908 | 0 | 20965 | 0 | 238610 | 0 | 0 | 0 |
| Shakil Rahman MD | |||||||||||||
| 277634 | 0 | 47401 | 0 | 732 | 0 | 2450 | 0 | 18298 | 0 | 346515 | 0 | 0 | 0 |
| Rafay Atiq MD | |||||||||||||
| 213842 | 0 | 25000 | 0 | 378 | 0 | 2432 | 0 | 22873 | 0 | 264525 | 0 | 0 | 0 |
| William Watercutter | |||||||||||||
| 123433 | 0 | 8892 | 0 | 10688 | 0 | 8707 | 0 | 16232 | 0 | 167952 | 0 | 0 | 0 |
| Thomas Bigley | |||||||||||||
| 131786 | 0 | 9257 | 0 | 1876 | 0 | 8714 | 0 | 9912 | 0 | 161545 | 0 | 0 | 0 |
| William Smith PhD | |||||||||||||
| 108849 | 0 | 0 | 0 | 13157 | 0 | 20862 | 0 | 17496 | 0 | 160364 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SEVERANCE OR CHANGE-OF-CONTROL PAYMENT | SCHEDULE J, PART I, LINE 4A | The individual that received severance payments for 2010 is: Randal Lennartz - $183,934.48. Severance payments were determined according to his employment contract. |
| PARTICIPANTS IN NONQUALIFIED RETIREMENT PLANS | SCHEDULE J, PART I, LINE 4B | Due to restrictions imposed by the Internal Revenue Code, certain persons are limited in the amount of benefit that can be earned under a qualified retirement plan. Like many employers, UVMC Management Corporation (related organization) compensates for this limitation and supplements the affected executives' qualified pension through certain nonqualified plans. UVMC Management Corporation supplements through a Supplemental Employee Retirement Plan (The UVMC Supplemental Executive Retirement Plan or "SERP"). The benefits under the SERP are subject to multi-year vesting and a participant can forfeit benefits earned if vesting requirements are not satisfied. The SERP is a non-qualified deferred compensation plan subject to the requirements of the Internal Revenue Code Section 409A. The 2010 Participant in the SERP with a vested amount is: Michael Maiberger, and his vested amount of SERP for 2010 is $19,130.48. Additionally, the 451 Deferred Compensation Plan is offered to a select group of key management or highly compensated employees. This plan is intended to be a nonqualified deferred compensation arrangement which complies with the requirements of the Internal Revenue Code Section 409A. This plan is funded solely by the plan participants and maintained by a related organization. The 2010 participant is Michael Maiberger. The amount of his deferral under the Plan for 2010 is $41,422.25. |
| Compensation Contingent on Net Earnings | Schedule J, Part I, Lines 6a & 6b | Premier Health Partners (PHP), of which Upper Valley Medical Center is a part, has an incentive component for all executive and director level employees that ties a portion of their total compensation to organizational and individual objectives and outcomes. The incentive payout is computed based on a percentage of the employee's salary. The organizational criterion is weighted according to balanced scorecard categories: positive work environment (15%), quality (30%), customer satisfaction (25%), financial (20%), and major initiatives (10%). The financial category of the scorecard is based upon net earnings of the individual hospital and the net earnings of the system as a whole. This financial target is set based on the margin required to maintain the system AA credit rating. Vice Presidents and above incentive objectives are weighted 50% on organizational criteria and 50% on individual criteria. Directors are weighted 25% on organizational criteria and 75% on individual criteria. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | County of Miami Ohio | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 316000055 | IssuerEIN |
| CUSIP Number | 593328EV5 | CUSIPNumber |
| Date Issued | 2006-06-29 | DateIssued |
| Issue Price | 57502248 | IssuePrice |
| Description Of Purpose | see schedule part V | DescriptionOfPurpose |
| Defeased | false | Defeased |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Pool Financing | false | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amount Retired | 3855000 | AmountRetired |
| Amount Bond Defeased | 0 | AmountBondDefeased |
| Total Proceeds | 59635389 | TotalProceeds |
| Amount In Reserve Fund | 5374550 | AmountInReserveFund |
| Capitalized Interest | 153212 | CapitalizedInterest |
| Refunding Escrow | 0 | RefundingEscrow |
| Issuance Costs From Proceeds | 663253 | IssuanceCostsFromProceeds |
| Credit Enhancement | 0 | CreditEnhancement |
| Working Capital Expenditures | 0 | WorkingCapitalExpenditures |
| Capital Expenditures | 19591181 | CapitalExpenditures |
| Other Spent Proceeds | 0 | OtherSpentProceeds |
| Amount Unspent | 0 | AmountUnspent |
| Year Of Subst Completion | 2009 | YearOfSubstCompletion |
| Current Refunding | true | CurrentRefunding |
| Advance Refunding | false | AdvanceRefunding |
| Final Allocation Made | true | FinalAllocationMade |
| Adequate Books And Recds Maintaind | true | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | false | OwningBondFinancedProperty |
| Any Lease Arrangements | true | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | true | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | false | AnyResearchAgreements |
| Bond Counsel Routinely Engaged | true | BondCounselRoutinelyEngaged |
| Prcntge Prvt Business Use By Others | 0.00100 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0.00200 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.00300 | TotalPrivateBusinessUse |
| Post Issuance Compliance Procdrs | true | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | false | Form8038TFiled |
| Variable Rate Issue | false | VariableRateIssue |
| Hedge Identified In Books And Recds | false | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | true | GrossProceedsInvested |
| Exception To Rebate | false | ExceptionToRebate |
Form990 Schedule K Part V Form990ScheduleKPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SEE SCHEDULE O | Identifier |
Schedule L IRS990ScheduleL
Loan Table LoanTable (2 entries)
| Purpose Of LoanPurposeOfLoan | Loan From OrganizationLoanFromOrganization | Original PrincipalOriginalPrincipalAmount | Balance DueBalanceDue | DefaultDefault | Approved By BoardApprovedByBoard | Written AgreementWrittenAgreement |
|---|---|---|---|---|---|---|
| DANIEL BAILEY DPM | ||||||
| LINE OF CREDIT | X | $4,800 | 1731 | false | true | true |
| DIGESTIVE SPECIALTY | ||||||
| LINE OF CREDIT | X | $52,847 | 43446 | false | true | true |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 45177 | TotalBalanceDue |
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Digestive Specialty Care | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | >35% OWNED-ABBOUD (FORM.) | Relationship |
| Amount Of Transaction | 300000 | AmountOfTransaction |
| Description Of Transaction | GASTROENTEROLOGY SERVICES | DescriptionOfTransaction |
| Sharing Of Revenues | false | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (25 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| MISSION STATEMENT | PART III, LINE 1 | Upper Valley Medical Center, as a subsidiary of UVMC, serves as an integral part in achieving UVMC's mission: UVMC will strive to provide quality care that upholds the dignity of all individuals. Care will be given in a holistic manner without regard to race, religion, creed, national origin or social status. Our health care delivery system will be structured to optimize the delivery of safe, efficient and cost-effective health care. |
| PROGRAM SERVICES | PART III, LINE 4A | Upper Valley Medical Center (UVMC) was founded in 1986 as the umbrella corporation for the merger of Miami County's three hospitals that had operated as independent and competitive entities located within a 10-mile radius. In 1998, acute care services were consolidated into a centrally located facility. Currently, the hospital is licensed for 139 acute care beds and 39 behavioral health beds. UVMC's vision is committed to preserving long-term access to quality health care services for Miami County and the surrounding area. Quality customer service is a priority at UVMC. Our culture is defined by "Caring Plus" which is UVMC's commitment to quality, kindness and compassion for our patients, their families, visitors, physicians, and co-workers. In 2010, UVMC began the process of implementing AIDET -- a powerful, proven communication tool designed to reinforce our Caring Plus customer service. AIDET is an acronym that represents how we can gain trust and communicate with patients who are nervous, anxious and feeling vulnerable about their illness by remembering these keys: Acknowledge, Introduce, Duration, Explanation and Thank-you. In January 2009, a joint operating agreement was implemented in which Upper Valley Medical Center became a part of the Premier Health Partners (PHP), a comprehensive health system serving southwestern Ohio through member and affiliate organizations in seven counties. The association with PHP, a not-for-profit corporation, allows for more flexibility in accessing specialty services not provided locally. It also gives local residents more access to community health services, such as expanded wellness programs provided in conjunction with Premier Community Health and the CareFinders physician referral network. Upper Valley Medical Center is a member of PHP along with three other hospitals: Miami Valley Hospital, Good Samaritan Hospital, and Atrium Medical Center. Each hospital has the authority to determine the amounts it contributes to community building and other indigent programs. The policies for bad debts and charity collections are established by PHP. The hospital was granted tax exempt status as a hospital in February of 1935. |
| PROGRAM SERVICES | PART III, LINE 4A | The primary exempt purpose of Upper Valley Medical Center is to provide comprehensive inpatient, outpatient and emergency health care services to the residents of Miami and surrounding counties. The hospital furthers its tax-exempt purpose by promoting the health of the community in many ways. Upper Valley Medical Center, as a subsidiary of UVMC, serves as an integral part in achieving UVMC's mission: UVMC will strive to provide quality care that upholds the dignity of all individuals. Care will be given in a holistic manner without regard to race, religion, creed, national origin or social status. Our health care delivery system will be structured to optimize the delivery of safe, efficient and cost-effective health care. A principal financial contribution that Upper Valley Medical Center makes to the community is its provision of acute health care services to patients regardless of their ability to pay. The hospital operates a 24-hour emergency room 365 days per year that is open to all individuals. It also participates in government-sponsored health care programs such as Medicare, Medicaid, TRICARE, and has an active charity care program. The board of Directors for Upper Valley Medical Center consists of 19 members of the community. The majority of them are neither employees nor contractors of the organization. None of the board members receive compensation from the organization for services provided in the role as a board member. The Medical Center extends medical staff privileges to all qualified physicians in its community for the majority of its departments. The medical staff consists of 218 physicians and the health system continues to actively recruit new doctors to Miami County in important primary and specialty areas of medicine. In 2010, UVMC successfully recruited new physicians in the areas of cardiology, gastroenterology, neuroradiology, orthopedic surgery/sports medicine, internal medicine, and family practice/hospitalists. |
| PROGRAM SERVICES | PART III, LINE 4A | COMMUNITY BENEFIT APPROACH Upper Valley Medical Center is located between Troy and Piqua, Ohio and serves the northern Miami Valley area with acute care services, community health and wellness programs and more. It is the sole hospital system operating within Miami County. The hospital also offers easy access to quality care by providing outpatient services throughout the Miami County area. Satellite locations provide Laboratory, Radiology, Surgical, Sports Medicine, Occupational Health, Dialysis, and Rehabilitative services. In addition, Upper Valley Medical Center provides Home Health/Home Care visits to community residents in their homes, where the greatest possible individual freedom and dignity are maintained. 2010 operating statistics for Upper Valley Medical Center follow: Patient Days: -Acute Care (Excluding Newborns) 28,776 -Behavioral Health 8.635 Other Volume Indicators: -Laboratory Tests 552,664 -Radiology/Imaging Exams 111,453 -Cardiopulmonary Procedures 100,823 -Rehabilitation Services Visits 50,410 -Emergency Room Visits 40,929 -Occupational Health Procedures 34,708 -Cancer Care Visits 13,036 -Home Care Services Visits 16,928 -Dialysis Treatments 11,995 -Outpatient Surgeries 8,189 -Inpatient Surgeries 1,788 -Behavioral Health Outpatient Visits 9,089 -Births 757 The population of Upper Valley Medical Center's primary service area is approximately 130,000. Including the adjacent counties which are also served (Shelby, Darke, and Champaign Counties), the hospital's total primary and secondary service area population approaches 300,000 residents. Approximately 49% of the hospital's gross revenues are generated from Medicare patients, while another 18% of the revenues are generated from either uninsured patients or Medicaid recipients. The primary purpose of the UVMC Community Benefit Plan is to work toward improved health in the communities that we serve by responding to community needs with programs that increase access to health care. This is accomplished through identifying community needs, making prudent choices for the use of resources, building and strengthening relationships in the community, and demonstrating accountability and transparency. UVMC works with the community on programs that address the underlying causes of persistent health problems as part of a comprehensive strategy to improve the health status and quality of life for members of the community who may be economically disadvantaged, disenfranchised and/or have disproportionate unmet health needs. UVMC strives to work with Premier Health Partners, the UVMC Board of Directors, executive management, managers, staff members, community groups, and individuals to provide a collaborative approach to the governance and management of community benefit activities. |
| PROGRAM SERVICES | PART III, LINE 4A | As a member of Premier Health Partners, Upper Valley Medical Center is committed to improving health care in the community, and being a good corporate neighbor in Miami County. The hospital focuses on four main aspects: - Investing in the Community - UVMC invests time and resources into the community by providing health screenings, health fairs, immunization clinics and support groups. By doing so, UVMC has invested in the community by providing over 3,500 screenings and benefited thousands of individuals in seeking health care education, services and support. In February, the hospital, along with Premier Community Health, held its second Heart Health event that provided important health tests and wellness information. In November, more than 300 people attended the UVMC Health Symposium focusing on diabetes management and prevention. These health education and wellness initiatives were provided free of charge and were open to the public. - Prevention and Wellness - UVMC is dedicated to educating the citizens of Miami County about health issues as well as providing resources to build a healthier community. UVMC continued to partner with Edison Community College to host its HealthWise Outdoor Fitness Center on the Edison campus in Piqua. The unique exercise fitness facility is free and open to the public. UVMC also hosts a free Lifeclinic self-monitoring station at Edison to provide quick and easy measurement of blood pressure, heart rate, weight and body mass along with information regarding hypertension and other medical conditions. A total of 5,142 screenings were provided in 2010. - Commitment to the under-served - UVMC has programs that assist the needs of those with minimal or no insurance. Charity care was provided by UVMC, along with a host of community health outreach programs that go beyond traditional medical care. UVMC also provides a local charity care program to help uninsured and under-insured Miami County patients who do not qualify for other assistance. - Community Engagement - UVMC prides itself on being an active member of the Miami County community. UVMC continued to partner with Edison Community College with support of the Health Sciences Center expansion, which accommodates important nursing and allied health programs. The hospital contributed another $120,000 towards its pledge for this program. In addition, the UVMC Auxiliary donated $23,000 to a scholarship fund that benefited 19 local students pursuing an associate or bachelor's degree in a health care related field. The Auxiliary also contributed $20,000 towards a permanently restricted scholarship fund. UVMC served as a learning site for four "Project Search" interns from Miami and Shelby counties. The "Project Search" high school transition program is designed to provide training and education on the road to employment for individuals with disabilities. This is a collaborative program with Upper Valley JVS, The Miami and Shelby Counties Boards of Developmental Disabilities and the state Bureau of Vocational Rehabilitation. UNCOMPENSATED CARE - Upper Valley Medical Center provides a significant amount of free care during the year. The cost of charity care provided by the organization in 2010 was $6.7 million. The hospital also incurred $3.0 million in unreimbursed costs for services provided to Medicaid patients, which represented approximately 18 percent of the patients served. The cost of providing services to Medicaid patients is often greater than the payments received from the Medicaid program. Upper Valley Medical Center informs and educates patients who may be billed for services concerning their eligibility for assistance under federal, state, or local government programs or under the Medical Center's charity care policy. First, notification of such available assistance is clearly posted in all registration areas, as well as the maternity and emergency departments. Next, patient financial advocates in the inpatient and emergency departments meet with uninsured and underinsured to discuss eligibility for assistance. Advocates also meet with uninsured patients and those who have unpaid account balances, who are scheduled for large dollar procedures to discuss eligibility options. Finally, when a patient receives a bill from Upper Valley Medical Center, the reverse side of the bill contains information about the State of Ohio Free Care Program (Care Assurance). Also included with that bill is another form which details the financial assistance options available. |
| PROGRAM SERVICES | PART III, LINE 4A | COMMUNITY OUTREACH FOR THE BROADER COMMUNITY - Thousands of individuals throughout Miami and surrounding counties benefited from Upper Valley Medical Center's health-focused programs during 2010, such as health fairs, screenings, immunizations, support groups and other services. Many of these programs are free to the public or offered at a reduced price. Free presentations are available to area civic, service and social groups, professional organizations, schools, churches, and industries through the UVMC speaker's bureau. Speakers are available on a wide variety of medical/healthcare topics and are able to provide accurate, up-to-date information to the community. Members of the leadership team began conducting administrative patient rounds in 2010. The purpose of Patient Rounds is to directly interact with patients and to listen to their comments about services. The goals of the program are: to increase visibility and access for the patient; to respond quickly to any identified concerns; and to openly demonstrate to our patients our leadership's commitment to high levels of patient satisfaction, safety and quality outcomes. Upper Valley Medical Center subsidizes the outpatient services for Behavioral Health. It provides traditional, private outpatient therapy and medication management for adults, adolescents and children. Clients include those who either have no insurance or qualify for Medicaid services. In addition, the Tri-County Crisis Center is located on the main campus of UVMC, and provides all levels of emergency intervention/assessment services 24 hours a day. These are part of Upper Valley Medical Center's commitment to provide a cost effective continuum of mental health services. The net community benefit expense for 2010 was $295,000 for this service. Also included in subsidized health services are revenues and expenses related to an obstetrics clinic which is subsidized by both the Miami County Health Department and Upper Valley Medical Center. The obstetrics clinic serves the prenatal, delivery and postnatal medical needs of women in the hospital's Miami County service area who either have no medical insurance or qualify for Medicaid services. The net community benefit expense for 2010 was $65,000 for this service. Nearly 300 people took time to visit the first "Go Red Goes North" expo at Edison Community College in September. The event was presented by UVMC in conjunction with the American Heart Association's "Go Red" initiatives focused on promoting women's heart health. UVMC provided a Cardiology question and answer panel, which included two cardiologists and a certified nurse practioner. In addition, they provided free health screenings, fitness/nutritional counseling and informational handouts. UVMC increased support of the local "Health Partners" Free Clinic in the form of a $10,000 contribution as part of both organizations' common mission to assure access to needed health care services in our communities. More than 250 people attended the annual Bill and Ruth McGraw Cancer Awareness Symposium in June. Bruce Feiler, a New York Times best-selling author, talked of his cancer journey and the Council of Dads concept. When Feiler was diagnosed with cancer in 2008, the father of two young girls was worried what his death might mean to them. To ensure there were connections as his daughters moved through passages of their lives, he asked six men who had been associated with his life to act as a "Council of Dads" and be present for the girls during those passages. Although his daughters many never need the Council of Dads, the concept has already had an impact on their lives of others by inspiring them to reach out to friends in a new way. The symposium was sponsored by the UVMC Cancer Care Center and the UMVC Foundation along with contributions from the McGraw family. The event was free and open to the public. The Nutrition Services department encompasses all components of food production for patient meals, cafeteria services, vending foods and internal catering. The clinical team of dietitians and diet technicians accommodate inpatient and outpatient as well as community nutrition therapy and education. Nutrition Services also prepares meals in the Altrusa Mobile Meals and Piqua Meals on Wheels programs. The number of meals prepared was 15,983 and 13,978 respectively. The subsidy to these programs was over $10,000. People of different ages have the opportunity to contribute their time and skills to various departments within the hospital such as the gift shop, emergency services, escort services, surgical services, chaplaincy, reception, etc. During 2010, 180 UVMC volunteers provided 30,815 hours of service throughout the hospital system. These volunteers generously give of their time to perform services that benefit our patients, visitors, and staff. The UVMC Auxiliary also sponsors an important community program called Lifeline, a low-cost medical alert service designed to reduce the risk of living alone. Lifeline began in 1985 with 25 clients and now serves over 500 clients in a seven county area. The hospital offers this program office and storage space. The Department of Pastoral Care has staff chaplains and community clergy volunteers who provide spiritual care at all UVMC facilities 24 hours a day. In addition, nondenominational worship services are provided for patients, their family members, visitors, and staff. There is no fee to patients for the services that the UVMC Pastoral Care staff provides. Teams from UVMC participated in the Miami County Relay for Life held in May. The event celebrates cancer survivorship, helps increase awareness of cancer prevention and treatment, and raises funds for important cancer research and programs. UVMC Center for Sports Medicine offers many services and special programs throughout the year to the community. In February, it held a Symposium: "Upper Extremity Injury Management and Sports Performance" at a local college. Sportsmetrics Knee Injury Reduction Program is designed to reduce the risk of injury and enhance performance for female athletes. Also offered was Explosive Speed & Power for local athletes that want to improve speed, agility, vertical jump, strength, and flexibility. The caring professionals of Upper Valley Medical Center have shown their commitment to the needs of the community through the annual United Way Fund campaign for many years. Employees demonstrate their commitment to the community by contributing to the local chapters of the United Way Fund in order to benefit the many important services provided by local agencies. The 2010 fund drive brought in nearly $19,000 in contributions. The Caring Plus Holiday Food Drive collected 387 food items for this annual event. Items were donated to the Bethany Center in Piqua and St. Patrick Soup Kitchen in Troy. The hospital offers interpreters, at no cost to the patient, to serve hearing-impaired or non-English speaking patients. |
| PROGRAM SERVICES | Part III, Line 4a | EDUCATION - Both the Ohio Board of Nursing and the Ohio Counselor/Social Worker Board approved Upper Valley Medical Center as a provider of continuing education credits. This distinction enables the Education and Development Department to meet its responsibility to assist in the maintenance and improvement of healthcare education. This is significant for those in search of opportunities to maintain and improve their professional skills and fulfill educational needs and requirements. The department coordinates education programs, provides resources and satellite teleconferences, and provides continuing education credits for a variety of disciplines. The scope of the department's services includes coordination of: Advanced Cardiac Life Support Education Fair Continuing Education In-Services CPR Nursing Orientation Education on managing diabetes is available for inpatients and outpatients who have the disease. This department also teaches community diabetes classes and coordinates a support group. The subsidy for offering all of the above programs was $346,000 in 2010. The Health Sciences Library, located on the Lower Level, is open to the public during normal business hours, or by making special arrangements with the librarian. A Health Education Center, adjacent to the Library, offers educational materials to help promote wellness and understanding about diseases. Information is available via computer, videos, and pamphlets. The subsidy for offering this service was $63,000. EMS Education provides initial training and continuing education that local EMS providers require. First Responder is a 40-hour program designed to fit the needs of those who are often "first-on-the-scene", such as police officers and industrial health personnel. A 130-hour class provides the foundation for pre-hospital care for a basic Emergency Medical Technician. Refresher classes are also offered for EMS levels. This program was subsidized by the hospital in the amount of $69,000 in 2010. RESEARCH PROGRAMS - Participation in National Cancer Institute sponsored clinical trials is an option available to cancer patients at UVMC through the Dayton Clinical Oncology Program (DCOP). All of the clinical trials are reviewed by an Institutional Review Board from Wright State University. Clinical Trials are designed to answer questions regarding new ways to prevent, detect, diagnose, and treat cancer. The mission of DCOP is "to reduce cancer incidence and mortality through improved treatment and prevention by offering national state-of-the-art cancer research to the local communities." There are different phases of clinical trials, but UVMC participates in Phase II & Phase III trials. Phase II trials study the effectiveness of the drugs on the cancer and measure any side effects of the treatments being tested. Phase III trials compare the results of the new treatment regimen with the current standard of care. Patients on cancer clinical trials are monitored closely and kept informed of any changes. The trials are scrutinized for patient safety and ensure the patient is constantly informed and knowledgeable regarding treatment decisions. AWARDS AND RECOGNITION - Upper Valley Medical Center (UVMC) has received many awards and recognitions that demonstrate our commitment to excellence, to our patients, and to our employees. - UVMC's Rehabilitation Services completed a two-day CARF (Commission on Accreditation of Rehabilitation Facilities) survey in May with no recommendations. This was the first time the three surveyors, in the approximately 20 years of surveying, have provided no recommendations. - Emergency Medical Services (EMS) Education Department received a new three-year accreditation from the State of Ohio Department of Public Safety, division of Emergency Medical Services. Noted program strengths were the high passing rate for students taking the National Registry Exam for the first time and having a hospital-based program that facilitates access for student clinical time. The administrative support of the program and the organization's ability to provide community oriented services were also praised. -UVMC Occupational Health and Employee Health programs received high praise on an ISO 9001-2008 survey. The survey cited outstanding and noteworthy improvements from year to year with regard to improved workflow, clinic flow efficiency for patients and staff, exceeding customer expectations, and incorporation and development of best practices. ISO 9001-2008 is an internationally recognized set of quality standards used extensively in business/industry. -The Emergency Department received special recognition from Press Ganey for outstanding improvement in overall satisfactions scores. Other areas receiving recognition on either in-house or Press Ganey surveys were several Inpatient Nursing units, Adult Behavioral Health, Outpatient Behavioral Health, Cancer Care Center, Laboratory, Occupational Health, and Inpatient Rehabilitation. - The UVMC Home Care Services received the 2010 HomeCare Elite Top 500 award that recognizes the top 5% of home health agencies in the country. The study is based on publically available information on quality, improvement and financial performance. - The Renal Network recognized UVMC Dialysis for Fistula rates that are equal to or greater than 66% which is the Fistula First Program's goal. The rate for July was 71% which was a UVMC record as well as the Renal Network record. The Fistula First Program, consisting of the Centers for Medicare & Medicaid Services (CMS), ESRD Networks and the entire renal community, works together to ensure that every suitable patient receives the most optimal form of vascular access. This quality outcome focuses on reducing catheter use, vascular complications, and infection rates. GROWTH AND ENHANCEMENTS - Upper Valley Medical Center invested over $10 million in important technological advancements to enhance the range of services offered. Highlights include: Cancer Care Linear Accelerator Power Plant and Infrastructure Upgrade C-Arm Imaging Equipment Patient Room Upgrades Information Systems Upgrades Imaging Services Voice Recognition System |
| DID THE ORGANIZATION HAVE MEMBERS OR STOCKHOLDERS? | PART VI, QUESTION 6 | Upper Valley Medical Center has two members. One member is UVMC, the parent company of the hospital. The second member is Premier Health Partners, an Ohio nonprofit corporation, formed pursuant to the Joint Operating Agreement. UVMC has the sole authority to elect the Board of Trustees of the corporation. Premier Health Partners has the general authority to operate and manage the operations of the Premier Health Partners activities of the corporation. |
| MEMBERS/STOCKHOLDERS WHO MAY ELECT GOVERNING BODY MEMBERS | PART VI, QUESTION 7A | UVMC has the sole authority to elect the board of trustees for Upper Valley Medical Center (hospital.) UVMC has the authority to remove trustees at any regular or special board meeting or by written consent. In addition to removal by UVMC, a trustee may be removed from office with approval by UVMC, by the affirmative vote of not less than two-thirds of the entire board of trustees. Premier Health Partners (PHP) has the right to request that UVMC remove a trustee of the corporation if PHP has determined that such trustee is frustrating the goals and purposes of the Premier Health Partners network. Such request shall not be unreasonably refused by UVMC. |
| APPROVAL OF GOVERNING BODY DECISIONS | PART VI, QUESTION 7B | Premier Health Partners (PHP) develops and oversees the implementation of the strategic plan for Upper Valley Medical Center (hospital), which addresses such matters as location of clinical and administrative services and the consolidation of such services. Hospital shall comply with and implement this plan and shall not take any action that materially departs from this plan without PHP approval. Hospital develops and submits an annual capital and operating budget to PHP for approval. Hospital shall adopt and implement the capital and operating budget so approved and/or revised for it by PHP. Hospital periodically develops and submits a business plan to PHP for approval. Hospital shall implement the business plan approved by PHP. PHP is the sole agent to negotiate all relationships with payors on behalf of hospital with all third party payors and alternative delivery systems including, but not limited to insurers. Hospital must have approval from PHP to borrow in any fiscal year, guarantee in any year, or incur any lien or other encumbrance on any property in an amount equal to or greater than $500,000. Hospital must seek PHP approval for any acquisitions, sale or transfer of any material asset used in PHP activities. |
| REVIEW OF FORM 990 | PART VI, SECTION B, LINE 11B | The 990 tax return and attached schedules are prepared by staff members of the UVMC Finance department. Draft returns are reviewed by the Budget and Reimbursement Manager, Controller and Chief Financial Officer. After revisions are made, the draft returns are sent to Ernst & Young (E&Y) for review and evaluation. Review notes are made available by E&Y, changes are made, and then the returns are reviewed again by the finance management team. An electronic version of the return is provided to the UVMC Board of Directors at least one week prior to the board meeting. At that meeting, the Chief Financial Officer of UVMC presents detailed information on compensation and community benefits, as well as addresses questions from the board. The board then approves the return and associated schedules for filing. In addition, an electronic version is sent out at least one week prior to the Premier Health Partners (PHP) audit committee meeting. At the meeting, the Vice President/Controller of PHP shares detailed information on compensation and community benefits, as well as addresses any questions from the committee. The Audit Committee then approves the return and schedules for filing. |
| CONFLICTS OF INTEREST PROCESS | PART VI, LINE 12C | Premier Health Partners (PHP), of which Upper Valley Medical Center is included, requires all board members, officers, executives and management personnel to annually review the PHP Comprehensive Conflict of Interest Statement, an explanatory memorandum, the Antitrust Compliance Policy and complete an individual questionnaire disclosing any potential conflicts as defined in the Conflicts of Interest Policy. This is accomplished with a memo sent out annually from the Chairman of the Board and Chief Executive Officer of PHP to all board members, executive directors, management directors and above personnel, purchasing department staff and authorized purchasers. It also includes an explanatory memorandum of specific activities that might give cause to a conflict and an individual questionnaire to disclose all such activities. This questionnaire must be completed and signed by the individual. Last, this memo includes a copy of the Antitrust Compliance Policy that must be signed by the individual. All of these documents are sent to the Corporate Compliance Officer. The Corporate Compliance Department ensures all forms are returned and retains the documents for five years. In addition, at each meeting of the Board or any Board committee, following approval of the minutes, the Board Committee Chair shall request any board member who perceives a potential conflict of interest on any of the meeting's agenda items to disclose such conflict. Additionally, any Board or Board Committee meeting where the subject of conflicts of interest is discussed, the normally taken minutes shall contain the name of the party discussing a potential conflict of interest, the nature of the potential conflict of interest and whether a conflict of interest was found to exist. If a conflict of interest does exist, the board member will be excused from participating in any discussion or voting on the particular agenda item. The Corporate Compliance Officer reports the results of the PHP Conflicts of Interest questionnaires no less than annually to the Board of Trustees by way of the Compliance and Audit Committee. This review is documented in the minutes of the meeting. Periodically, the Internal Audit department will review a sample of completed Conflict of Interest questionnaires and report the results to the Compliance and Audit Committee. The annual conflicts of interest questionnaires are summarized by person in a word document and sent electronically to the Finance department for any necessary disclosures required on the 990 tax return. |
| OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN | PART VI, SECTION B, LINE 15A & 15B | Premier Health Partners, of which UVMC is a part, follows a market-based compensation philosophy designed to attract and retain the executive talent required to meet the high performance standards of our board and our community. PHP annually reviews executive compensation survey data for a regional peer group of systems and hospitals that are similar in size and complexity to PHP and its subsidiaries. The data for the survey is provided by a third party consultant group that is independent of PHP. The report includes comparability for key executives, vice presidents and director level positions. The independent comparability data is reviewed by the executive compensation committee on an annual basis. This committee is comprised of three members, all of which are independent. This committee reviews in detail the compensation for the PHP CEO, PHP CFO and the hospital CEOs. Other positions are reviewed at a high level for reasonableness. All the meeting minutes are documented and kept on file along with any comparability data and the consultant report. After the compensation committee reviews and approves the compensation actions, the process is audited by the internal audit department. The executive compensation committee presents the compensation actions to the PHP board annually. |
| AVAILABILITY OF DOCUMENTS | PART VI, LINE 19 | The governing documents, conflict of interest policy, and financial statements are made available to the public when required by law or for accreditation purposes. |
| Other Changes in Net Assets | Part XI, Line 5 | Change in Foundation General Funds 1,032,293 Unrealized Gain/(Loss) on Investments 520,494 Pension Adjustment 366,508 Change in Foundation Restricted Funds 261,886 Change in Foundation Endowment Funds 148,701 Change in Temporarily Restricted Funds (277) Amortization of Investment Premiums/Discounts (373,373) Net Transfer with Affiliates (4,032,645) Total (2,076,413) |
| PURPOSE OF BOND | Schedule K, Part I, Line A, Column F | The bond issue of 6/29/2006 was used to refund the 1996 Series Bonds and to provide capital for hospital improvements and equipment purchases. |
| FILINGS FOR ARBITRAGE PURPOSES | Schedule K, Part IV, Line 1 | The Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate for the Series 2006 Bonds will be filed after a normal 5 year review in 2011. |
| GROSS PROCEEDS INVESTED BEYOND AN AVAILABLE TEMPORARY PERIOD | Schedule K, Part IV, Line 5 | On June 1, 2006, Upper Valley Medical Center issued $56,130,000 of Hospital Facilities Revenue Refunding and Improvement Bonds Series 2006 for the purpose of financing the acquisition, construction, renovation and installation of Hospital Facilities (approximately $17M) and for refunding the current 1996A, B & C issues (approximately $39M). The bond series included funding a debt service reserve for the Series 2006 Bonds and paying certain issuance costs in connection with the Series 2006 Bonds. By the end of July, 2006, the Series 1996 A, B & C were refunded. At the time of the issuance, it was expected that the approximately $17M intended for the acquisition, construction, renovation and installation of Hospital Facilities would be fully expended by May 15, 2008. Of the $17M, $13.2M was intended for a building expansion for Medical/Surgical and Behavioral Health Units to the existing acute care hospital facility. The remaining $4.25M was earmarked for certain specified capital equipment purchases. After the bond issuance in 2006, as Upper Valley Medical Center began to prepare and plan for the expansion, market conditions changed. Management and the Board of Directors of Upper Valley Medical Center made the decision to re-evaluate the need for the expansion to the existing acute care facility. Upon further analysis, it was determined that the Medical/Surgical expansion would not be a prudent business decision and that the Behavioral Health Unit could be accomplished through an addition and renovation of the existing Youth Services Building on a much smaller scale and at a much lower cost. On October 29, 2007, the board approved a revised plan to spend approximately $5.5M of the original $13.2M to renovate and expand the Youth Services Building for Behavioral Health Services. The remaining $7.7M would then be used for other capital acquisitions. Between September 2006 and November 2009, all of the $17M and the interest earned thereon, was spent on capital acquisitions, construction, renovation and installation of Hospital Facilities. |
| Financial Statements | Part IV, Line 20b | Attaching a copy of the audited financial statements is only required under the tax law for tax years beginning after March 23, 2010. Upper Valley Medical Center's tax year began January 1, 2010, therefore it has not attached the audited financial statements to its 2010 Form 990. |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Rowan R. Nickol, M.D. TITLE:First Vice Chair HOURS:40 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:L. Stewart Lowry, M.D. TITLE:Director HOURS:40 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Victoria O'Campo, M.D. TITLE:Director HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Michael J. Maiberger TITLE:President/CEO HOURS:3 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Thomas Parker TITLE:Executive Vice President/COO HOURS:3 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Timothy Snider TITLE:Vice President/CFO HOURS:3 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| UVMC | |||||||||
| 3130 NORTH COUNTY ROAD 25A | TROY | OH | 45373 | 341850683 | PARENT | OH | 501(c)(3) | 11, I | NA |
| UVMC Foundation | |||||||||
| 3130 North County Road 25A | Troy | OH | 45373 | 311581859 | Foundation | OH | 501(c)(3) | 11, III-O | NA |
| Miami County Mental Health Center | |||||||||
| 3130 North County Road 25A | Troy | OH | 45373 | 260841036 | MENTAL HEALTH | OH | 501(c)(3) | 9 | UVMC |
| Med-Terra Inc | |||||||||
| 3130 North County Road 25A | Troy | OH | 45373 | 311232074 | HOLDING CO | OH | 501(c)(2) | N/A | UVMC |
| Premier Health Partners | |||||||||
| 40 West Fourth Street | Dayton | OH | 45402 | 311446699 | JOA Parent | OH | 501(c)(3) | 11, I | NA |
| Upper Valley Professional Corporation | |||||||||
| 3130 North County Road 25A | Troy | OH | 45373 | 311400963 | Health Care | OH | 501(c)(3) | 9 | UVMC |
| UVPC Specialists Inc | |||||||||
| 3130 North County Road 25A | Troy | OH | 45373 | 203687536 | Health Care | OH | 501(c)(3) | 9 | UVPC |
| UVMC NURSING CARE INC | |||||||||
| 3130 NORTH COUNTY ROAD 25A | TROY | OH | 45373 | 311224064 | NURSING HOME | OH | 501(c)(3) | 9 | UVMC |
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity |
|---|---|---|---|---|---|---|---|---|
| UVMC MANAGEMENT CORPORATION | ||||||||
| 3130 NORTH COUNTY ROAD 25A | TROY | OH | 45373 | 311360489 | MGT COMPANY | OH | UVMC | C CORP |
| After Hours Family Care Inc | ||||||||
| 31 Stanfield Rd | Troy | OH | 45373 | 311269483 | Health Care | OH | UVPC | C Corp |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | true | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | true | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | true | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (19 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| Med-Terra Inc | |
| a (i) | 2872 |
| Med-Terra Inc | |
| a(iv) | 1280 |
| Med-Terra Inc | |
| j | 730898 |
| Med-Terra Inc | |
| o | 214466 |
| Med-Terra Inc | |
| p | 166005 |
| Med-Terra Inc | |
| r | 492025 |
| Miami County Mental Health Center | |
| a(iv) | 57677 |
| Miami County Mental Health Center | |
| l | 142145 |
| Miami County Mental Health Center | |
| p | 78927 |
| Upper Valley Professional Corporation | |
| a(iv) | 16000 |
| Upper Valley Professional Corporation | |
| e | 1000000 |
| Upper Valley Professional Corporation | |
| p | 467588 |
| Upper Valley Professional Corporation | |
| r | 1002295 |
| UVMC Management Corporation | |
| l | 649504 |
| UVMC Nursing Care Inc | |
| p | 56879 |
| UVPC Specialists Inc | |
| l | 133167 |
| UVPC Specialists Inc | |
| p | 89096 |
| Upper Valley Professional Corp | |
| q | 3484822 |
| Miami County Mental Health Center | |
| b | 605445 |