UPPER VALLEY MEDICAL CENTER: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- UPPER VALLEY MEDICAL CENTER (EIN 31-0537095)
- Tax period
- 2023-01-01 to 2023-12-31
- Filed
- 2024-11-14
- IRS object ID
- 202403199349303285
- Schema version
- 2023v5.1
- 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 F
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-11-14T09:01:56-06:00 | ReturnTs |
| Tax Period End | 2023-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 310537095 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UPPER VALLEY MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | UPPE | BusinessNameControlTxt |
| Phone | 9374999942 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 N MAIN ST 200 | AddressLine1Txt |
| City | DAYTON | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45402 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | J MICHAEL SIMS | PersonNm |
| Person Title | SYSTEM VP & CORP. CONTROLLER | PersonTitleTxt |
| Phone | 9374999942 | PhoneNum |
| Signature | 2024-11-14 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
| Tax | 2023 | TaxYr |
| Build TS | 2024-10-15 13:58:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KEVIN HARLAN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3130 N COUNTY RD 25 A | AddressLine1Txt |
| City | TROY | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45373 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $208,089,443 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PREMIERHEALTH.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1926 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | SEE PART III, LINE 1 | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 1 | VotingMembersIndependentCnt |
| Total Employee | 1322 | TotalEmployeeCnt |
| Total Volunteers | 49 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,420,937 | PYContributionsGrantsAmt |
| CY Contributions Grants | $174,338 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $156,626,029 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $155,108,597 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,286,745 | PYInvestmentIncomeAmt |
| CY Investment Income | $5,602,288 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,316,535 | PYOtherRevenueAmt |
| CY Other Revenue | $2,615,687 | CYOtherRevenueAmt |
| PY Total Revenue | $164,650,246 | PYTotalRevenueAmt |
| CY Total Revenue | $163,500,910 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $2,301,916 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $3,225,075 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $57,973,966 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $61,417,156 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $76,653,597 | PYOtherExpensesAmt |
| CY Other Expenses | $74,380,029 | CYOtherExpensesAmt |
| PY Total Expenses | $136,929,479 | PYTotalExpensesAmt |
| CY Total Expenses | $139,022,260 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $27,720,767 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $24,478,650 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $183,380,421 | TotalAssetsBOYAmt |
| Total Assets EOY | $195,749,465 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $111,904,429 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $119,267,829 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $71,475,992 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $76,481,636 | NetAssetsOrFundBalancesEOYAmt |
| Mission | WE CARE. WE TEACH. WE INNOVATE. WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $134,008,703 | ExpenseAmt |
| Grant | $3,225,075 | GrantAmt |
| Revenue | $155,108,597 | RevenueAmt |
| Desc | THE PRIMARY EXEMPT PURPOSE OF UPPER VALLEY MEDICAL CENTER IS TO PROVIDE COMPREHENSIVE INPATIENT, OUTPATIENT, AND EMERGENCY HEALTH CARE SERVICES TO THE RESIDENTS OF CHAMPAIGN, DARKE, MIAMI, AND SHELBY COUNTIES. THE HOSPITAL FURTHERS ITS TAX-EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY IN MANY WAYS. SEE SCHEDULE H FOR MORE INFORMATION. | Desc |
| Total Program Service Expenses | $134,008,703 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | Yes (1) | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 3 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1322 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 1 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | J MICHAEL SIMS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9374999942 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 N MAIN ST 200 | AddressLine1Txt |
| City | DAYTON | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45402 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (35 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| MICHAEL C RIORDAN | ||||||||||
| PREMIER PRESIDENT & CEO | 0.50 | 39.50 | Yes (X) | $0 | $1,373,331 | $35,711 | ||||
| ROBERT M KOHUT MD | ||||||||||
| TRUSTEE | 0.50 | 39.50 | Yes (X) | $0 | $669,257 | $16,045 | ||||
| KEVIN W HARLAN | ||||||||||
| PRESIDENT | 19.50 | 20.00 | Yes (X) | $0 | $607,513 | $42,343 | Yes (X) | |||
| LAKMALI C RANATHUNGA MD | ||||||||||
| TRUSTEE & CMO (FROM JULY) | 20.00 | 20.00 | Yes (X) | $209,009 | $318,213 | $27,407 | ||||
| SCOTT B KANAGY DO | ||||||||||
| TRUSTEE & CMO (TO JULY) | 20.00 | 20.00 | Yes (X) | $219,600 | $240,850 | $61,360 | ||||
| JIGAR PATEL MD | ||||||||||
| TRUSTEE | 0.50 | 39.50 | Yes (X) | $0 | $358,601 | $40,509 | ||||
| TRISHA L WACKLER | ||||||||||
| TRUSTEE & CNO | 40.00 | 0.00 | Yes (X) | $341,504 | $0 | $34,468 | ||||
| SCOTT SWABB DO | ||||||||||
| TRUSTEE | 0.50 | 0.00 | Yes (X) | $0 | $172,888 | $0 | ||||
| APRIL ANDERSON MD | ||||||||||
| TRUSTEE | 0.50 | 0.00 | Yes (X) | $0 | $32,083 | $0 | ||||
| EBBA RAJAB MD | ||||||||||
| BOARD CHAIR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| BENJAMIN A WATSON ESQ | ||||||||||
| BOARD SECRETARY (FROM MAY TO SEP) | 0.50 | 39.50 | $0 | $166,904 | $14,504 | Yes (X) | ||||
| DIANNE RUHENKAMP | ||||||||||
| BOARD TREASURER | 39.00 | 1.00 | $147,459 | $0 | $30,539 | Yes (X) | ||||
| ELIZABETH D WILFONG | ||||||||||
| BOARD SECRETARY (FROM OCT) | 0.50 | 39.50 | $0 | $93,483 | $361 | Yes (X) | ||||
| ANDREA L FLAUTE | ||||||||||
| BOARD SECRETARY (TO FEB) | 0.50 | 39.50 | $0 | $28,257 | $7,424 | Yes (X) | ||||
| GEOFFREY P WALKER ESQ - SR | ||||||||||
| SPECIAL ADVISORY COUNSEL/SECRETARY | 9.00 | 31.00 | $0 | $940,274 | $50,389 | Yes (X) | ||||
| KEITH D BRICKING MD | ||||||||||
| VP & CHIEF CLINICAL OFFICER | 10.00 | 30.00 | $0 | $848,781 | $116,118 | Yes (X) | ||||
| MARY M CLANCY | ||||||||||
| CHIEF DIGITAL & INFORMATION OFFICER | 10.00 | 30.00 | $0 | $684,404 | $59,015 | Yes (X) | ||||
| J MICHAEL SIMS | ||||||||||
| SYS VP & CORPORATE CONTROLLER | 10.00 | 30.00 | $0 | $659,279 | $54,727 | Yes (X) | ||||
| LISA M GOSSETT | ||||||||||
| VP NURSING/CNO/PATIENT EXP | 10.00 | 30.00 | $0 | $446,599 | $26,242 | Yes (X) | ||||
| CARA W POWERS | ||||||||||
| CHIEF LEGAL OFFICER | 10.00 | 30.00 | $0 | $355,315 | $58,871 | Yes (X) | ||||
| AMANDA K ADKINS-RICCI | ||||||||||
| SYSTEM VP REVENUE CYCLE | 10.00 | 30.00 | $0 | $307,434 | $24,778 | Yes (X) | ||||
| MIKI L GILLESPIE | ||||||||||
| RESP THERP II - REG | 40.00 | 0.00 | $193,036 | $0 | $54,435 | Yes (X) | ||||
| RYAN E MCELDOWNEY | ||||||||||
| CLINICAL STAFF PHARMACIST I | 40.00 | 0.00 | $202,741 | $0 | $38,982 | Yes (X) | ||||
| MARSHA S HESS | ||||||||||
| CLINICAL STAFF PHARMACIST I | 40.00 | 0.00 | $195,943 | $0 | $34,316 | Yes (X) | ||||
| DUANNA R OSTING | ||||||||||
| PRES/EXEC DIR-UVMC FOUNDATION | 10.00 | 0.00 | $183,501 | $0 | $28,448 | Yes (X) | ||||
| DENISE R HERKINS | ||||||||||
| DIR-NURSING-SURGERY/TELE-UVMC | 40.00 | 0.00 | $171,786 | $0 | $29,446 | Yes (X) | ||||
| FAYEZ D ABBOUD MD | ||||||||||
| FORMER TRUSTEE & OFFICER | 0.00 | 40.00 | $0 | $635,157 | $38,754 | Yes (X) | ||||
| DIANE L PLEIMAN | ||||||||||
| FORMER OFFICER | 0.00 | 40.00 | $0 | $817,582 | $28,467 | Yes (X) | ||||
| BARBARA A JOHNSON | ||||||||||
| FORMER KEY EMPLOYEE | 0.00 | 40.00 | $0 | $1,064,584 | $627,482 | Yes (X) | ||||
| JENNIFER J HAULER DO | ||||||||||
| FORMER KEY EMPLOYEE | 0.00 | 40.00 | $0 | $957,363 | $303,885 | Yes (X) | ||||
| MARC R BELCASTRO DO | ||||||||||
| FORMER KEY EMPLOYEE | 0.00 | 40.00 | $0 | $786,594 | $356,425 | Yes (X) | ||||
| GARY G GINTER | ||||||||||
| FORMER KEY EMPLOYEE | 0.00 | 40.00 | $0 | $563,645 | $263,863 | Yes (X) | ||||
| ELAINE LAINIE M DEAN | ||||||||||
| FORMER KEY EMPLOYEE | 0.00 | 40.00 | $0 | $516,325 | $48,793 | Yes (X) | ||||
| BILLIE L LUCENTE-BAKER | ||||||||||
| FORMER KEY EMPLOYEE | 0.00 | 40.00 | $0 | $292,774 | $37,045 | Yes (X) | ||||
| MARGARET PEGGY W MARK | ||||||||||
| FORMER KEY EMPLOYEE | 0.00 | 0.00 | $0 | $142,194 | $15,361 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,864,579 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $14,079,684 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $2,606,513 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 91 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $174,338 | AllOtherContributionsAmt |
| Noncash Contributions | $27,361 | NoncashContributionsAmt |
| Total Contributions | $174,338 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621110 | $79,688,300 | $79,688,300 |
| MEDICARE / MEDICAID | 621110 | $75,046,263 | $75,046,263 |
| HOSP FRANCHISE TAX RECOVERIES | 900099 | $256,103 | $256,103 |
| ATHLETIC TRAINING | 900099 | $86,779 | $86,779 |
| MEDICAL RECORDS | 900099 | $31,152 | $31,152 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $155,108,597 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,425,991 | TotalRevenueColumnAmt |
| Exclusion | $1,425,991 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,929,895 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,185,888 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $744,007 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $744,007 | TotalRevenueColumnAmt |
| Exclusion | $744,007 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $44,677,049 | SecuritiesAmt |
| Other | $701,156 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $40,796,890 | SecuritiesAmt |
| Other | $405,018 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,880,159 | SecuritiesAmt |
| Other | $296,138 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,176,297 | TotalRevenueColumnAmt |
| Exclusion | $4,176,297 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $200,738 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $200,737 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1 | TotalRevenueColumnAmt |
| Exclusion | $1 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| PENSION INCOME | 900099 | $1,623,321 | $1,623,321 |
| FEMA REVENUE | 900099 | $88,690 | $88,690 |
| STERILE PROCESSING | 900099 | $22,466 | $22,466 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $137,202 | TotalRevenueColumnAmt |
| Exclusion | $137,202 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,871,679 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $163,500,910 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $155,108,597 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $8,217,975 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,225,075 | TotalAmt |
| Program Services | $3,225,075 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,019,179 | TotalAmt |
| Program Services | $841,181 | ProgramServicesAmt |
| Management And General | $177,998 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,332,451 | TotalAmt |
| Program Services | $47,839,478 | ProgramServicesAmt |
| Management And General | $2,492,973 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,316,655 | TotalAmt |
| Program Services | $2,196,158 | ProgramServicesAmt |
| Management And General | $120,497 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,899,303 | TotalAmt |
| Program Services | $3,696,487 | ProgramServicesAmt |
| Management And General | $202,816 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,849,568 | TotalAmt |
| Program Services | $3,649,339 | ProgramServicesAmt |
| Management And General | $200,229 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $182,739 | TotalAmt |
| Program Services | $182,739 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $196,150 | TotalAmt |
| Management And General | $196,150 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,432 | TotalAmt |
| Management And General | $5,432 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $148,263 | TotalAmt |
| Management And General | $148,263 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,270,786 | TotalAmt |
| Program Services | $32,452,238 | ProgramServicesAmt |
| Management And General | $818,548 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $315,030 | TotalAmt |
| Program Services | $315,030 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $588,990 | TotalAmt |
| Program Services | $276,429 | ProgramServicesAmt |
| Management And General | $312,561 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $758,941 | TotalAmt |
| Program Services | $627,478 | ProgramServicesAmt |
| Management And General | $131,463 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,786,931 | TotalAmt |
| Program Services | $4,747,631 | ProgramServicesAmt |
| Management And General | $39,300 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,070 | TotalAmt |
| Program Services | $30,001 | ProgramServicesAmt |
| Management And General | $4,069 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,629,038 | TotalAmt |
| Program Services | $1,629,038 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,011,142 | TotalAmt |
| Program Services | $9,011,142 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $546,367 | TotalAmt |
| Program Services | $522,341 | ProgramServicesAmt |
| Management And General | $24,026 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| OPERATING SUPPLIES | $16,711,309 | $16,711,309 | |
| HOSPITAL FRANCHISE TAX | $4,212,939 | $4,212,939 | |
| REPAIRS AND MAINTENANCE | $1,303,074 | $1,303,074 | |
| MINOR EQUIPMENT | $242,207 | $241,467 | $740 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $436,621 | TotalAmt |
| Program Services | $298,129 | ProgramServicesAmt |
| Management And General | $138,492 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $139,022,260 | TotalAmt |
| Program Services | $134,008,703 | ProgramServicesAmt |
| Management And General | $5,013,557 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,560 | BOYAmt |
| EOY | $2,560 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,293,431 | BOYAmt |
| EOY | $616,219 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,709,345 | BOYAmt |
| EOY | $24,688,757 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,153,487 | BOYAmt |
| EOY | $1,230,000 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,251,423 | BOYAmt |
| EOY | $1,211,605 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $936,774 | BOYAmt |
| EOY | $1,840,737 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $229,115,490 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $153,137,771 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $71,472,776 | BOYAmt |
| EOY | $75,977,719 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,491,018 | BOYAmt |
| EOY | $62,847,819 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,883,359 | BOYAmt |
| EOY | $26,716,606 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,186,248 | BOYAmt |
| EOY | $617,443 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $183,380,421 | BOYAmt |
| EOY | $195,749,465 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,496,092 | BOYAmt |
| EOY | $11,984,777 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,851,461 | BOYAmt |
| EOY | $813,277 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,904,415 | BOYAmt |
| EOY | $53,652,265 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $693,307 | BOYAmt |
| EOY | $537,668 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,959,154 | BOYAmt |
| EOY | $52,279,842 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $111,904,429 | BOYAmt |
| EOY | $119,267,829 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $71,475,992 | BOYAmt |
| EOY | $76,481,636 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $71,475,992 | BOYAmt |
| EOY | $76,481,636 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $183,380,421 | BOYAmt |
| EOY | $195,749,465 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $24,478,650 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $3,922,600 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$23,395,606 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| 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) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (1) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $5,432 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $5,432 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1, LOBBYING ACTIVITIES: | FormAndLineReferenceDesc |
| Explanation | PAYMENTS FOR LOBBYING ACTIVITIES INCLUDE DUES PAID TO GREATER DAYTON AREA HOSPITAL ASSOCIATION AND OHIO HOSPITAL ASSOCIATION. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,785,926 | OtherCostOrOtherBasisAmt |
| Book Value | $1,785,926 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $152,163,201 | OtherCostOrOtherBasisAmt |
| Depreciation | $99,735,398 | DepreciationAmt |
| Book Value | $52,427,803 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $64,813,258 | OtherCostOrOtherBasisAmt |
| Depreciation | $53,402,373 | DepreciationAmt |
| Book Value | $11,410,885 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,353,105 | OtherCostOrOtherBasisAmt |
| Book Value | $10,353,105 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $75,977,719 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ALTERNATIVE INVESTMENTS | Desc |
| Book Value | $26,716,606 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $26,716,606 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (9 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO AFFILIATES | $36,713,091 |
| PENSION OBLIGATION & DEFERRED COMP | $10,224,342 |
| MALPRACTICE INSURANCE | $3,265,439 |
| LOAN GUAR & OTHER LTL | $1,067,424 |
| SETTLEMENT - 3RD PARTY PAYOR | $543,047 |
| RETAINAGE FOR CONSTRUCTION | $297,292 |
| WORKERS COMPENSATION | $80,512 |
| MEDICAL STAFF FEE ACCRUAL | $75,733 |
| OTHER | $12,962 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $52,279,842 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE FOLLOWING FOOTNOTE IS FROM THE 2023 CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR PREMIER HEALTH (PHP) AND AFFILIATES. PHP IS THE SOLE MEMBER OF UPPER VALLEY MEDICAL CENTER (UPPER VALLEY). PHP HAS BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE TO BE A TAX-EXEMPT NON-PROFIT CORPORATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS A TAX-EXEMPT ORGANIZATION, ITS INCOME IS EXEMPT FROM FEDERAL INCOME TAX EXCEPT TO THE EXTENT OF ANY UNRELATED BUSINESS ACTIVITIES. PHP CONSOLIDATES CERTAIN SUBSIDIARIES WHICH ARE FOR-PROFIT CORPORATIONS SUBJECT TO FEDERAL INCOME TAXES. THESE ARE: * PREMIER HEALTH HOLDING COMPANY (PHHC) (WHOLLY OWNED SUBSIDIARY OF PHP) * MVHE, INC., (AND ITS WHOLLY OWNED SUBSIDARY EXTENDED CARE), SAMARITAN FAMILY CARE, INC., PREMIER HEALTH SPECIALISTS, INC. AND PREMIER HEALTH URGENT CARE, INC. (WHOLLY OWNED SUBSIDIARIES OF PHHC) MANAGEMENT ANNUALLY REVIEWS THE TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS. | ExplanationTxt |
Schedule F IRS990ScheduleF
Account Activities Outside US AccountActivitiesOutsideUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, | RegionTxt |
| Offices | 0 | OfficesCnt |
| Employee | 0 | EmployeeCnt |
| Type Of Activities Conducted | PROGRAM SERVICES | TypeOfActivitiesConductedTxt |
| Specific Services Provided | INSURANCE | SpecificServicesProvidedTxt |
| Region Total Expenditures | $33,000 | RegionTotalExpendituresAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Offices | 0 | SubtotalOfficesCnt |
| Subtotal Employees | 0 | SubtotalEmployeesCnt |
| Continuation Total Office | 0 | ContinuationTotalOfficeCnt |
| Continuation Total Employee | 0 | ContinuationTotalEmployeeCnt |
| Total Office | 0 | TotalOfficeCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Subtotal Spent | $33,000 | SubtotalSpentAmt |
| Continuation Spent | $0 | ContinuationSpentAmt |
| Total Spent | $33,000 | TotalSpentAmt |
| Transfer To Foreign Corp | 0 | TransferToForeignCorpInd |
| Interest In Foreign Trust | 0 | InterestInForeignTrustInd |
| Foreign Corp Ownership | 0 | ForeignCorpOwnershipInd |
| Passive Foreign Investmest Co | 0 | PassiveForeignInvestmestCoInd |
| Foreign Partnership | 0 | ForeignPartnershipInd |
| Boycott Countries | 0 | BoycottCountriesInd |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,226,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $627,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,599,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01150 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $16,157,103 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $256,103 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $15,901,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11440 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $838,131 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,131 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $836,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00600 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,221,234 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $885,234 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $18,336,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.13190 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $617,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $83,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $534,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00380 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,413,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,413,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01740 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,785,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,785,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01280 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,815,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $83,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,732,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03400 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $24,036,234 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $968,234 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $23,068,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.16590 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $6,070,759 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $26,669,000 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $28,801,000 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,132,000 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | Yes (X) | CostAccountingSystemInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UPPER VALLEY MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3130 N COUNTY RD 25-A | AddressLine1Txt |
| City | TROY | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45373 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.PREMIERHEALTH.COM | WebsiteAddressTxt |
| State License | SEE PART V SEC C | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UPPER VALLEY MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 21 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, SECTION C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 23 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, SECTION C | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, SEC C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, SEC C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, SEC C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, SECTION A, LINE 1: | THE STATE OF OHIO DOES NOT LICENSE HOSPITALS, BUT THE OHIO DEPARTMENT OF HEALTH DOES REGISTER HOSPITALS. AS PART OF THIS REGISTRATION PROCESS, HOSPITALS IN THE STATE OF OHIO ARE REQUIRED TO COMPLETE AND SUBMIT THE ANNUAL HOSPITAL REGISTRATION AND PLANNING REPORT (AHR) EACH CALENDAR YEAR. UPPER VALLEY MEDICAL CENTER'S (UPPER VALLEY) REGISTRATION NUMBER IS 1036. |
| PART V, SECTION B, LINE 3E: | UPPER VALLEY'S SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND WERE IDENTIFIED THROUGH THE CHNA. |
| PART V, SECTION B, LINE 5: | THE REGIONAL CHNA METHODOLOGY AND RESULTS WERE GENERATED THROUGH AN INCLUSIVE, COMPREHENSIVE, AND BALANCED DATA COLLECTION STRATEGY FOR ANSWERING THE RESEARCH QUESTIONS.THE NEEDS ASSESSMENT UTILIZED A MIXED-METHOD APPROACH TO DATA COLLECTION INCLUDING SECONDARY QUANTITATIVE DATA AND PRIMARY QUANTITATIVE (REGIONAL CHNA COMMUNITY AND PROVIDER SURVEYS) AND QUALITATIVE (FOCUS GROUPS AND INTERVIEWS) DATA.SECONDARY DATA COLLECTION, BEGINNING IN JANUARY OF 2021, SOUGHT TO UNDERSTAND THE GREATEST HEALTH CONDITIONS OF THE REGION, INCLUDING PREVALENCE AND IMPACT ON COMMUNITY MEMBERS. THESE RESULTS INFORMED THE CREATION OF SURVEY ITEMS THAT WERE ORGANIZED AROUND A SET OF CO-CREATED RESEARCH QUESTIONS.EACH DATA COLLECTION STRATEGY ADHERED TO A RECRUITMENT PLAN TO ENSURE A REPRESENTATIVE SAMPLE WAS CAPTURED WITH INPUT FROM COMMUNITY MEMBERS, VOICES OF MARGINALIZED POPULATIONS, AND PROVIDERS ACROSS THE HEALTH AND SOCIAL SERVICES SECTORS. ALL RESULTS ARE SUMMARIZED FOR THE REGION WHICH INCLUDES THE CINCINNATI METROPOLITAN STATISTICAL AREA (MSA), DAYTON-KETTERING MSA (TO INCLUDE CLARK COUNTY WHICH IS NOT PART OF THE DAYTON MSA BUT IS SIMILAR IN THAT IT BORDERS THE DAYTON MSA AND IS NOT A RURAL COUNTY), AND OTHER RURAL COUNTIES IN THE GEOGRAPHIC SERVICE AREA THAT ARE PREDOMINATELY RURAL AND NOT INCLUDED IN OTHER MSAS.OVERALL, THE SCOPE OF DATA COLLECTION WAS ROBUST AND INFORMED THE RESULTS OF THIS REGIONAL CHNA. THIS INCLUDED:8,321 COMMUNITY SURVEYS AVAILABLE IN FIVE LANGUAGES. WITHIN THIS SAMPLE, REPRESENTATION WAS SEEN ACROSS 26 COUNTIES, MALES, FEMALES, AGES 18-65+, BLACK/AFRICAN AMERICAN, MULTIRACIAL, ASIAN, AMERICAN INDIAN, ALASKAN NATIVE, WHITE, AND HISPANIC/LATINO POPULATIONS.859 PROVIDER SURVEYS INCLUSIVE OF BEHAVIORAL HEALTH, EDUCATION, EMERGENCY MEDICAL SERVICES, FAITH-BASED ORGANIZATIONS, FEDERALLY QUALIFIED HEALTH CENTERS, JUSTICE/CORRECTIONS, MEDICAL CARE (ADULT, GERIATRIC, PEDIATRIC), ORAL HEALTH, ORGANIZATIONS ADDRESSING HEALTH RELATED SOCIAL NEEDS AND SOCIAL DETERMINANTS OF HEALTH, PHARMACEUTICAL, AND PUBLIC HEALTH DEPARTMENTS. * PROVIDERS ALSO REPRESENTED ADMINISTRATION, DIRECT PATIENT CARE, ACADEMIC, SUPPORT STAFF, AND SUPERVISORS/MANAGEMENT. * PROVIDERS REPORTED SERVING A VARIETY OF POPULATIONS INCLUDING CHILDREN/YOUTH, PEOPLE WITH DISABILITIES, ETHNIC MINORITIES, PEOPLE EXPERIENCING HOMELESSNESS, PEOPLE IN THE JUSTICE SYSTEM, VETERANS, YOUNG ADULTS, LOW-INCOME POPULATIONS, AND LGBTQ+ POPULATIONS.51 FOCUS GROUPS WITH 234 PEOPLE WERE HELD, REPRESENTING ALL THREE MSAS. SPECIFICALLY, RECRUITMENT FOR THESE FOCUS GROUPS WERE BASED ON ADVISORY COMMITTEE IDENTIFICATION OF POPULATIONS WHO ARE TRADITIONALLY UNDERREPRESENTED, MARGINALIZED, OR EXPERIENCE GREATEST HEALTH DISPARITIES. * POPULATIONS REPRESENTED IN THESE FOCUS GROUPS INCLUDE ADULT MEN, THOSE EXPERIENCING FOSTER CARE OR FOSTER PARENTING, YOUTH, AND ADULTS WITH DISABILITIES, ETHNIC, CULTURAL AND LANGUAGE MINORITIES, FIRST AND SECOND-GENERATION IMMIGRANTS, PEOPLE EXPERIENCING HOMELESSNESS, THOSE INVOLVED IN THE JUSTICE SYSTEM, LOW-INCOME FAMILIES AND INDIVIDUALS, PARENTS, VETERANS, OLDER ADULTS, COMMUNITY MEMBERS WITH LIVED EXPERIENCE OF MENTAL HEALTH AND/OR ADDICTION, AND FIRST RESPONDERS.38 STAKEHOLDER INTERVIEWS WERE HELD ACROSS HEALTH AND SOCIAL SERVICE PROVIDERS, SPECIFICALLY WITH THE FOLLOWING BEING REPRESENTED: MENTAL HEALTH AND SUBSTANCE USE DISORDER (SUD), PUBLIC HEALTH, HOSPITAL SYSTEMS, FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS), TRANSPORTATION, HOUSING, FOOD ACCESS, HEALTHCARE ACCESS AND POLICY, SCHOOL-BASED HEALTH AND CHILDREN'S HEALTH CARE, MATERNAL AND INFANT CARE, LGBTQ+ HEALTH CARE, PHARMACY ACCESS, AND HEALTHCARE WORKFORCE DEVELOPMENT.DATA COLLECTION WAS ALSO COMPREHENSIVE IN THAT COMMUNITY MEMBERS, SOCIAL SERVICE PROVIDERS AND HEALTHCARE PROFESSIONALS WERE NOT ONLY ASKED "WHAT COULD BE BETTER," BUT ALSO "WHAT IS WORKING." AS A RESULT, THIS REGIONAL CHNA INCLUDES A COLLECTION OF ASSETS AND RECOMMENDED POLICY AND PRACTICE INITIATIVES IDENTIFIED BY THE COMMUNITY THAT DIRECTLY TIE TO SYSTEM BARRIERS. |
| PART V, SECTION B, LINES 6A & 6B: | UPPER VALLEY MEDICAL CENTER PARTNERED WITH BON SECOURS MERCY HEALTH ANDERSON HOSPITAL, BON SECOURS MERCY HEALTH CLERMONT HOSPITAL, BON SECOURS MERCY HEALTH FAIRFIELD HOSPITAL, BON SECOURS MERCY HEALTH JEWISH HOSPITAL, BON SECOURS MERCY HEALTH WEST HOSPITAL, CINCINNATI CHILDREN'S BURNET CAMPUS, CINCINNATI CHILDREN'S LIBERTY CAMPUS, CINCINNATI CHILDREN'S COLLEGE HILL CAMPUS, THE C&F LINTER CENTER OF HOPE, THE CHRIST HOSPITAL, MT. AUBURN, TRIHEALTH GOOD SAMARITAN HOSPITAL, TRIHEALTH GOOD SAMARITAN EVENDALE HOSPITAL, TRIHEALTH BETHESDA NORTH HOSPITAL, TRIHEALTH BETHESDA BUTLER HOSPITAL, TRIHEALTH MCCULLOUGH HYDE MEMORIAL HOSPITAL, UC HEALTH UNIVERSITY OF CINCINNATI MEDICAL CENTER, UC HEALTH WEST CHESTER HOSPITAL, UC HEALTH DRAKE CENTER FOR POST-ACUTE CARE, KETTERING MEDICAL CENTER, SYCAMORE MEDICAL CENTER, KETTERING BEHAVIORAL MEDICAL CENTER, GRANDVIEW MEDICAL CENTER, SOUTHVIEW MEDICAL CENTER, SOIN MEDICAL CENTER, GREENE MEMORIAL HOSPITAL, FORT HAMILTON HOSPITAL, MIAMI VALLEY HOSPITAL, MIAMI VALLEY HOSPITAL SOUTH, MIAMI VALLEY HOSPITAL NORTH, ATRIUM MEDICAL CENTER, WILSON MEMORIAL HEALTH, WAYNE HEALTHCARE, MERCY HEALTH SPRINGFIELD REGIONAL MEDICAL CENTER, MERCY HEALTH URBANA HOSPITAL, ADAMS COUNTY REGIONAL MEDICAL CENTER, MARGARET MERCY HEALTH; THE LOCAL HEALTH DEPARTMENTS OF THE FOLLOWING CITIES: CINCINNATI, HAMILTON, NORWOOD, PIQUA, AND SPRINGDALE; THE LOCAL HEALTH DEPARTMENTS OF THE FOLLOWING COUNTIES: ADAMS, AUGLAIZE, BROWN, BUTLER, CHAMPAIGN, CLARK, CLERMONT, CLINTON, DARKE, FAYETTE, GREENE, HAMILTON, HIGHLAND, MIAMI, MONTGOMERY, PREBLE, SHELBY, AND WARREN; THE FOLLOWING INDIANA COUNTIES: FRANKLIN, DEARBORN, OHIO, RIPLEY, AND UNION; THE FOLLOWING KENTUCKY COUNTIES: CAMPBELL, BOONE, GRANT, KENTON; AND THE FOLLOWING OHIO COUNTIES: ADAMS, AUGLAIZE, BROWN, BUTLER, CHAMPAIGN, CLARK, CLERMONT, CLINTON, DARKE, GREENE, HAMILTON, HIGHLAND, MIAMI, MONTGOMERY, PREBLE, SHELBY, AND WARREN. |
| PART V, SECTION B, LINES 7A & 10A: | THE DIRECT WEBSITE ADDRESS WHERE THE CHNA AND THE RELATED IMPLEMENTATION STRATEGY CAN BE ACCESSED IS:HTTPS://WWW.PREMIERHEALTH.COM/ABOUT-PREMIER/COMMUNITY-INVOLVEMENT/COMMUNITY-HEALTH-IMPROVEMENT |
| PART V, SECTION B, LINE 11: | AMONG THE HEALTH NEEDS IDENTIFIED IN THE CHNA, UPPER VALLEY'S TOP PRIORITIES INCLUDE:* CARDIOVASCULAR HEALTH* MENTAL HEALTH AND SUBSTANCE ABUSE* ARTHRITIS AND OSTEOPOROSIS* DENTAL CARE* LUNG/RESPIRATORY HEALTH* MATERNAL HEALTH* PREVENTIONNEED: CARDIOVASCULAR HEALTHPROGRAM: BARBERSHOP HEALTH INITIATIVEMETRICS: ABOUT 100 PREVENTATIVE SCREENINGS PER YEAR THROUGH THE BARBERSHOP HEALTH INITIATIVE.INTERVENTION GOAL: THE GOAL IS TO INCREASE AWARENESS OF CHRONIC HEALTH CONDITIONS AND PROMOTE HEALTHY LIFESTYLE CHOICES WITHIN AFRICAN AMERICAN COMMUNITIES.DESCRIPTION: THERE ARE HEALTH DISPARITIES, ESPECIALLY FOR CHRONIC DISEASES, IN THE AFRICAN AMERICAN COMMUNITY. ACCORDING TO THE CDC, "NEW ANALYSIS SHOWS THAT YOUNGER AFRICAN AMERICANS ARE LIVING WITH OR DYING OF MANY CONDITIONS TYPICALLY FOUND IN WHITE AMERICANS AT OLDER AGES. CHRONIC DISEASES AND SOME OF THEIR RISK FACTORS MAY BE SILENT OR NOT DIAGNOSED DURING THESE EARLY YEARS. HEALTH DIFFERENCES ARE OFTEN DUE TO ECONOMIC AND SOCIAL CONDITIONS THAT ARE MORE COMMON AMONG AFRICAN AMERICANS THAN WHITES. FOR EXAMPLE, AFRICAN AMERICAN ADULTS ARE MORE LIKELY TO REPORT THEY CANNOT SEE A DOCTOR BECAUSE OF COST."BARBERSHOPS ARE A FREQUENTLY VISITED LOCATION FOR THE TARGET POPULATION. THERE ARE OFTEN TRUSTED RELATIONSHIPS CREATED BETWEEN THE BARBERS AND THEIR CLIENTS. THESE OPPORTUNITIES ALLOW BARBERS TO SERVE AS WELLNESS CHAMPIONS AND ENCOURAGE THEIR CLIENTS TO BE MORE INVOLVED IN THEIR HEALTH AND PRACTICE HEALTHY LIFESTYLE BEHAVIORS.THE BARBERSHOP HEALTH INITIATIVE IS A COMMUNITY-BASED PROGRAM DESIGNED TO PROVIDE FREE HEALTH SCREENINGS AND EDUCATION TO COMMUNITY MEMBERS WHO MAY NOT HAVE ACCESS TO HEALTHCARE AND/OR A PHYSICIAN. PREMIER COMMUNITY HEALTH PARTNERS WITH LOCAL BARBERSHOPS AND PROVIDES THESE SERVICES IN THE MOBILE CLINIC AT EACH BARBERSHOP LOCATION.PARTNERING WITH THE LOCAL HEALTH DEPARTMENT, PUBLIC HEALTH-DAYTON & MONTGOMERY COUNTY, WILL HELP EXPAND SERVICES FOR THE COMMUNITY. BARBERS (AND SALON OWNERS) HAVE A CLOSE BOND WITH THEIR CLIENTS. THEY CAN SERVE AS MODELS OF GOOD HEALTH AND/OR HELP CONNECT THEIR CLIENTS TO HEALTH SERVICES. THE PROGRAM PROVIDES FREE, VOLUNTARY, AND CONVENIENT HEALTH SCREENINGS AT THE SHOPS. HEALTH FAIRS, EVENTS, AND FUN CHALLENGES ALSO OCCUR.PARTNERS: MAN UP BARBER SHOP, CITY STARS UNLIMITED BARBER AND BEAUTY SHOP, DEEEZ CUTTZ BARBERSHOP, HEADLINERS BARBERSHOP AND STYLZES BARBER AND NAIL CARENEED: MENTAL HEALTH AND SUBSTANCE ABUSEPROGRAM: ONEFIFTEENMETRICS: ANNUAL NUMBER OF PATIENTS SERVED: 2021: 2,891; 2022: 2,477INTERVENTION GOAL: THE GOAL IS TO REMOVE BARRIERS TO TREATMENT REGARDLESS OF PAYOR SOURCE; PROVIDE ON-DEMAND SERVICES 24/7; AND REFER TO ONGOING TREATMENT BASED UPON THE ASSESSMENT PROCESS FOLLOWING THE ASAM (AMERICAN SOCIETY OF ADDICTION MEDICINE) CRITERIA.DESCRIPTION: ONE FIFTEEN IS A BEACON OF HOPE FOR PEOPLE SUFFERING WITH SUBSTANCE ABUSE ISSUES. SUBSTANCE ABUSE SERVICES PROVIDED BY SBHI ARE DESIGNED TO PROVIDE A SEAMLESS CONTINUUM THAT FLOWS FROM THE ASSESSMENT THROUGH MENTAL HEALTH AND SUBSTANCE USE DISORDERS LEVELS OF CARE DESIGNED TO INTEGRATE AND MEET THE NEEDS OF THE CLIENT IN DEVELOPING A RECOVERY-BASED LIFESTYLE. ACCESS CAN BE VIA A REFERRAL FROM THE AREA HOSPITALS AND EMERGENCY ROOMS, EMTS, WALK-INS OR VIA POLICE ESCORT. IN ADDITION, THERE IS AN INPATIENT SETTING THAT DEDICATES A PORTION OF BEDS TO MEDICALLY COMPLICATED CLIENTS IN NEED OF DETOX TREATMENT FROM ALCOHOL, BENZODIAZEPINES, AND OPIATES. IN THE CRISIS STABILIZATION UNIT, THE PATIENT RECEIVES A DIAGNOSIS AND IS THEN REFERRED TO OUTPATIENT TREATMENT AT SBHI THAT INCLUDES INDIVIDUAL AND GROUP THERAPY AND MEDICATED ASSISTED TREATMENT. THE PHYSICIANS PRESCRIBE VIVITROL AND SUBOXONE. ALL SUBSTANCE USE DISORDERS ARE TREATED. APPROPRIATE LEVELS OF CARE ARE BASED ON THE ASAM CRITERIA: TREATMENT CRITERIA FOR ADDICTIVE, SUBSTANCE-RELATED, AND CO-OCCURRING CONDITIONS. THE CRITERIA PROVIDE RESEARCH-VALIDATED STANDARDS FOR OUTCOME-ORIENTED CARE IN ADDICTION TREATMENT.PARTNERS: ADAMHS, GDAHA, KETTERING HEALTH NETWORK, SAMARITAN BEHAVIORAL HEALTH, INC.NEED: LUNG/RESPIRATORY HEALTHPROGRAM: SMOKING CESSATION PROGRAMMETRICS: NUMBER OF PEOPLE ENROLLED AND NUMBER OF PEOPLE THAT COMPLETED THE PROGRAM.INTERVENTION GOAL: THE GOAL IS PROVIDING COUNSELING AND SUPPORT TO PATIENTS, TO HELP THEM QUIT SMOKING.DESCRIPTION: IN 2020, THE CDC REPORTED THAT 19.3% OF ADULTS IN OHIO SMOKED COMPARED TO THE NATIONAL RATE OF 15.5%. THE CDC ESTIMATES 47.9% OF DAILY ADULT SMOKERS IN OHIO QUIT SMOKING FOR ONE OR MORE DAYS IN 2019.THE SMOKING CESSATION PROGRAM FOCUSES ON SUPPORTIVE CONVERSATION REVOLVING AROUND THE HEALTH ISSUES RELATED TO TOBACCO USE, HOW TO PINPOINT AND DEAL WITH PERSONAL TRIGGERS AND OVERALL WELL-BEING DURING THE QUIT JOURNEY. THE PROGRAM MEETS IN A GROUP SETTING, ONCE A WEEK FOR FIVE WEEKS.PARTNERS: PREMIER HEALTH PHYSICIAN NETWORK, COMMUNITY HEALTH CENTERS |
| PART V, SECTION B, LINE 11: (CONTINUED) | NEED: LUNG/RESPIRATORY HEALTHPROGRAM: LUNG NODULE EVALUATION PROGRAMMETRICS: 7,581 PATIENTS EVALUATED, 1,422 ENROLLED IN REGISTRY PROGRAM FOR LUNG NODULE SURVEILLANCE, AND 211 REFERRALS FOR ADVANCED EVALUATION BY A PULMONOLOGIST. -STAGE SHIFT TO EARLIER STAGE DIAGNOSIS OF LUNG CANCER FOR THE COMMUNITY. -DECREASED LENGTH OF TIME BETWEEN FIRST NODULE DETECTION AND TREATMENT INITIATION. 29 PATIENTS COMPLETED THE PROGRAM AND NO LONGER NEED FOLLOW UP.INTERVENTION GOAL: THE GOAL IS TO BUILD A FOUNDATION FOR A ROBUST LUNG CANCER SCREENING PROGRAM TO IMPACT: TIMELY CAPTURE OF INCIDENTAL LUNG NODULES, COHESIVE CARE BETWEEN PRACTITIONERS, AND STREAMLINED REFERRAL PROCESS THROUGH A MULTIDISCIPLINARY "VIRTUAL CLINIC" WITH ADVANCED PRACTICE PROVIDER TO COORDINATE CARE.DESCRIPTION: AN ESTIMATED 19% OF INCIDENTAL PULMONARY NODULES NEED FOLLOW UP CARE RANGING FROM FOLLOW-UP SURVEILLANCE IMAGING TO REFERRAL FOR IMMEDIATE DIAGNOSTIC INTERVENTION AND POTENTIAL TREATMENT. SUCCESSFUL PROGRAMS HAVE BEEN SHOWN TO MARKEDLY INCREASE COMPLIANCE WITH EVIDENCE-BASED BEST PRACTICE SURVEILLANCE. THE LUNG NODULE EVALUATION PROGRAM WILL ENSURE THAT ALL PATIENTS AGED 18 OR GREATER WHO HAVE AN INCIDENTAL FINDING OF A PULMONARY NODULE AT A PREMIER HEALTH FACILITY OR WHO ARE REFERRED TO THE PROGRAM, RECEIVE THE PROPER EVALUATION AND TREATMENT FOR LUNG NODULES IN ACCORDANCE WITH THE FLEISCHNER SOCIETY GUIDELINES FOR LUNG NODULES AND RECOMMENDED BEST-PRACTICE BY THE AMERICAN ACADEMY OF CARDIOTHORACIC SURGEONS. SERVICES PROVIDED ARE COMMUNICATED VIA EPIC IN-BASKET, MYCHART PATIENT COMMUNICATION, TELEPHONE OR MAIL COMMUNICATION AND COORDINATED WITH THE PATIENT'S CARE TEAM (PRIMARY CARE AND OTHER SPECIALTIES) BY THE APP OR PULMONOLOGIST. PATIENTS ARE FOLLOWED UNTIL THEY HAVE MET CRITERIA FOR COMPLETION OF RECOMMENDED SURVEILLANCE, BEGIN TREATMENT FOR MALIGNANCY, OR OPT OUT OF THE PROGRAM. THE LUNG NODULE EVALUATION PROGRAM PROVIDES AND IS NOT LIMITED TO PROVIDING THE FOLLOWING SERVICES: IMAGING STUDY ORDERS AND ASSOCIATED FOLLOW UP, REFERRAL TO PULMONOLOGIST FOR NODULE MANAGEMENT, EDUCATION ON LUNG HEALTH, SMOKING CESSATION, AND LUNG CANCER PREVENTION, AND GOALS OF CARE AS APPROPRIATE.PARTNERS: FUTURE PARTNERSHIPS BETWEEN FIDELITY HEALTH CARE AND COMMUNITY EMPLOYERS FOR PROGRAM GROWTH TO SUPPORT LUNG WELLNESS ARE ANTICIPATED.NEED: MATERNAL HEALTHPROGRAM: HELP ME GROW BRIGHTER FUTURESMETRICS: CASELOAD OF 3,567 FAMILIES, 34,228 TOTAL VISITS INCLUDING 5,274 HOME VISITS. 100% RECEIVING HOME VISIT SERVICES RECEIVE EDUCATION AND ASSESSMENT OF A SAFE SLEEP ENVIRONMENT. 100% OF ALL MOMS, PRENATAL TO AGE 1 OF THE CHILD, ARE SCREENED FOR DEPRESSION. 100% OF HEALTHY INFANTS SURVIVE TO FIRST BIRTHDAY. MORE THAN 80% OF MOMS, ENROLLED PRENATALLY, INITIATE BREASTFEEDING. 54% ARE STILL BREASTFEEDING AT 6 MONTHS. EXPANSION TO SERVE AT LEAST ONE MORE GEOGRAPHIC AREA.INTERVENTION GOAL: THERE ARE SIGNIFICANT RACIAL DIFFERENCES IN INFANT MORTALITY AND THE RATE OF AFRICAN AMERICAN INFANT MORTALITY IS OVER 2X THAT OF WHITE INFANTS. THE GOALS ARE TO REDUCE INFANT MORTALITY THROUGH HOME VISITS FROM BIRTH TO AGE 3 AND TO REACH A CASELOAD OF 1,770 FAMILIES FOR 2023-2025.DESCRIPTION: HOME VISITS INCLUDE EDUCATION ABOUT SAFE SLEEP, SMOKING CESSATION, REDUCING CHILD MALTREATMENT AND INJURY, AND ENCOURAGING MOTHERS TO BREASTFEED. MAKING CONNECTIONS TO RECRUIT PREGNANT FIRST-TIME MOMS EARLY IN PREGNANCY IS CRITICAL. ONE OF THE FORT HAMILTON STAFF HAS TRANSITIONED TO SERVE MONTGOMERY AND PREBLE COUNTIES. TWO STAFF ARE AVAILABLE TO SERVE PREBLE COUNTY, EXPECTING A GROWTH OF 25 CLIENTS. MIAMI COUNTY HAS EXPRESSED AN INTEREST IN ADDING THE NURSE FAMILY PARTNERSHIP TO THEIR SERVICES. HELP ME GROW BRIGHTER FUTURES WOULD LIKE TO PARTNER BY UTILIZING EXISTING STAFF TO SUPPORT MIAMI COUNTY.IN 2018 AND 2019, HELP ME GROW BRIGHTER FUTURES RECEIVED INCREASED FUNDING THROUGH MEDICAID TO EXPAND HOME VISITING FOR REDUCING INFANT MORTALITY. ENROLLMENT IN HOME VISITING INCREASED BY 200%. IN 2017, THE INFANT MORTALITY RATE WAS 7.7 IN MIAMI COUNTY, AND IN 2019 IT DECREASED TO 6.5. HELP ME GROW PROVIDED 2,171 YOUNG CHILDREN OR PREGNANT MOMS WITH HOME VISITS AND THERE WERE 28,124 HOME VISITS COMPLETED WITH FAMILIES IN 2022. THE NURSE FAMILY PARTNERSHIP EXPANDED INTO BUTLER COUNTY IN 2020 ADDING STAFF AT ATRIUM MEDICAL CENTER AND FORT HAMILTON HOSPITAL, TO SERVE 100 FIRST TIME PREGNANT WOMEN. THE PROGRAM EXPANDED TO 10 COUNTIES, ADDING CLARK, DARKE, SHELBY AND WARREN COUNTIES IN 2022. HELP ME GROW ALSO ADDED A NEW PROGRAM, PARENTS AS TEACHERS, FOR FAMILIES WHO MISSED ELIGIBILITY FOR OTHER PROGRAMS BUT STILL HAVE NEEDS FOR PARENTING SUPPORT AND SCHOOL READINESS. HELP ME GROW HAS 84 HOME VISITING STAFF INCLUDING 35 NURSES, 24 SOCIAL WORKERS, AND 25 TEACHERS.PARTNERS: GREATER DAYTON AREA HOSPITAL ASSOCIATION, KETTERING HEALTH NETWORK, LIFE STAGES CENTERING, FIVE RIVERS HEALTH CENTERS, SOUTHVIEW WOMEN'S CENTER, GRANDVIEW WOMEN'S CENTER, PUBLIC HEALTH, PHYSICIAN OFFICES, AND A VARIETY OF COMMUNITY PROGRAMS SUCH AS THE WESLEY CENTER, ELIZABETH'S NEW LIFE CENTER, MIAMI VALLEY CHILD DEVELOPMENT CENTER, PROMISE TO HOPE, LIFE RESOURCE CENTER, AND FAMILY SERVICE AGENCY.NEED: MATERNAL HEALTHPROGRAM: PROMISE TO HOPEMETRICS: TOTAL CLIENTS SERVED PER YEAR.INTERVENTION GOAL: TO ENSURE HEALTHY OUTCOMES, PREGNANT WOMEN WITH SUBSTANCE USE DISORDER OR OPIATE USE DISORDER REQUIRE A MULTIDISCIPLINARY APPROACH WITH CONNECTION TO COMMUNITY RESOURCES. THE GOALS ARE: 1) DECREASE THE NUMBER OF UNINTENTIONAL DEATHS DUE TO SUBSTANCE OVERDOSE IN MONTGOMERY COUNTY, THEREBY DECREASING THE MATERNAL AND INFANT MORTALITY RATES. 2) INCREASE THE PERCENTAGE OF MOTHERS WHO CAN SUCCESSFULLY PARENT THEIR INFANTS FOLLOWING DELIVERY, AS OPPOSED TO PLACEMENT BY CHILDREN SERVICES. 3) DECREASE THE AVERAGE HOSPITAL LENGTH OF STAY FOR INFANTS WHO ARE DIAGNOSED WITH NEONATAL ABSTINENCE SYNDROME (NAS) AND/OR PRENATAL SUBSTANCE EXPOSURE. 4) CONTINUE TO INCREASE THE BREASTFEEDING RATE FOR MOTHERS ACTIVE IN RECOVERY AT DELIVERY.DESCRIPTION: A TEAM OF PHYSICIANS, A REGISTERED NURSE, AND A LICENSED INDEPENDENT SOCIAL WORKER WORK COLLABORATIVELY TO MEET THE UNIQUE NEEDS OF PREGNANT WOMEN WITH OPIATE USE DISORDER AND/OR SUBSTANCE USE DISORDER AND THEIR INFANTS. MIAMI VALLEY HOSPITAL OFFERS THE FACILITIES, THE HIGHLY SPECIALIZED EQUIPMENT, AND THE EXPERIENCED PHYSICIANS, NURSES, AND RELATED STAFF TO PROVIDE CARE FOR BOTH THE MOTHER AND INFANT. TO ENSURE THE HEALTHIEST OUTCOMES POSSIBLE FOR BOTH MOTHER AND CHILD, PERSONALIZED MEDICAL CARE AND WRAPAROUND SOCIAL SUPPORT ARE PROVIDED. PROMISE TO HOPE INITIATES MEDICATION ASSISTED TREATMENT (MAT) - (THE USE OF FDA-APPROVED MEDICATIONS, IN COMBINATION WITH INDIVIDUAL AND GROUP THERAPIES, TO TREAT OPIATE USE DISORDER AND/OR SUBSTANCE USE DISORDER) AND CONNECTS THE MOTHER WITH A RECOVERY AGENCY OF HER CHOICE IN THE COMMUNITY FOR ONGOING TREATMENT.PROMISE TO HOPE HAS SERVED 776 PREGNANT WOMEN WITH OPIATE USE DISORDER SINCE ITS INCEPTION IN MAY 2015. IT PROVIDES TREATMENT DURING PREGNANCY AND FOR UP TO A YEAR AFTER BIRTH. IN 2020, PROMISE TO HOPE EXPANDED TO INCLUDE PREGNANT WOMEN WITH ANY TYPE OF SUBSTANCE USE DISORDER RATHER THAN JUST TARGETING OPIATES. THE PROMISE TO HOPE PROGRAM HAS JOINED THE OHIO PERINATAL QUALITY COLLABORATIVE AND IS WORKING WITH HOSPITALS IN CINCINNATI, DAYTON, TOLEDO, ATHENS, CLEVELAND, AND COLUMBUS TO IMPROVE OUTCOMES FOR MOMS AND INFANTS.PARTNERS: ADAMHS BOARD OF MONTGOMERY COUNTY; JOSHUA RECOVERY MINISTRIES; FIVE RIVERS HEALTH CENTERS; NOVA BEHAVIORAL HEALTH; SAMARITAN BEHAVIORAL HEALTH; RECOVERY WORKS HEALING CENTER; AND TCN BEHAVIORAL HEALTH |
| PART V, SECTION B, LINE 11: (CONTINUED): | NEED: DENTAL CAREPROGRAM: MIAMI COUNTY DENTAL CLINICMETRICS: THE GOAL IS TO SUSTAIN THREE FULLY OPERATIONAL DENTAL CHAIRS WITH THE SUPPORT OF STAFF AND DENTAL STUDENTS AND PROVIDE CARE TO AT LEAST 500 STUDENTS IN MIAMI COUNTY DURING THE UPCOMING SCHOOL YEAR.INTERVENTION GOAL: THE GOAL IS TO ENSURE ORAL HEALTH CARE FOR UNDERSERVED AND UNINSURED OR UNDER-INSURED RESIDENTS.DESCRIPTION: MIAMI COUNTY HAS ABOUT 50% FEWER DENTISTS PER CAPITA THAN THE NATION. NOT ALL DENTISTS ACCEPT PATIENTS WITH MEDICAID AND/OR MEDICARE, FURTHER NARROWING THE OPTIONS.UPPER VALLEY MEDICAL CENTER HAD PROVIDED FUNDING FOR THE MIAMI COUNTY DENTAL CLINIC SINCE 2011. THE CLINIC SERVES AS A DENTAL HOME FOR OVER 8,800 PATIENTS THAT ARE ON MEDICAID OR ARE UNINSURED. PATIENTS CAN ACCESS CARE THROUGH THE CLINIC OR A MOBILE DENTAL CLINIC THAT GOES TO SCHOOLS, HOMELESS SHELTERS, COMMUNITY AGENCIES, ETC. TO PROVIDE DENTAL CARE TO PATIENTS IN THEIR COMMUNITIES.THE MIAMI COUNTY DENTAL CLINIC OPENED IN 2008 AND PROVIDES QUALITY DENTAL CARE AND ORAL HEALTH EDUCATION TO THOSE IN THE COMMUNITY BENEFITING FROM AFFORDABLE, COMPASSIONATE, AND ACCESSIBLE DENTAL SERVICES. SERVICES ARE OFFERED ON A SLIDING SCALE. MOST OF THE PATIENTS HAVE MEDICAID OR ARE UNINSURED.PARTNERS: UPPER VALLEY MEDICAL CENTER AND MIAMI COUNTY DENTALNEED: PREVENTIONPROGRAM: COMMUNITY HEALTH VOUCHER PROGRAMMETRICS: FOR THE 3-YEAR PERIOD, A PROJECTED 275 WOMEN SYSTEM-WIDE WILL BE SERVED BY THE PROGRAM. AT UVMC, IT IS ESTIMATED THAT 24 WOMEN WILL BE SERVED. THE ENROLLMENT NUMBERS FOR CLIENTS WHO RECEIVE SERVICES AT UVMC HAVE REMAINED STEADY REGARDLESS OF CHANGES IN BCCP (BREAST AND CERVICAL CANCER PROJECT) ELIGIBILITY AND THE HEALTHCARE MARKETPLACE. HOWEVER, PREMIER HEALTH IS TRYING TO ESTABLISH CONTRACTS WITH PROVIDERS AT THE CAMPUS FOR CERVICAL SERVICES. WHEN THIS IS ACCOMPLISHED, IT WILL INCREASE THE CAPACITY FOR THE NUMBER OF WOMEN SERVED.INTERVENTION GOAL: THE VOUCHER PROGRAM'S MISSION IS TO PROVIDE FINANCIAL ASSISTANCE TO DETECT BREAST AND CERVICAL CANCERS AT THE EARLIEST STAGE TO UNINSURED AND UNDER-INSURED COMMUNITY RESIDENTS.DESCRIPTION: THIS PROGRAM SUPPLEMENTS THE STATE OF OHIO'S FUNDING TO ENCOURAGE WOMEN TO BE SCREENED FOR BREAST CANCER AND CERVICAL CANCER. IT PROVIDES FINANCIAL ASSISTANCE TO WOMEN WHO ARE NOT ELIGIBLE FOR THE STATE PROGRAM, AND IT ALSO COVERS DIAGNOSTIC TESTING AND BIOPSIES.THIS PROGRAM IS FUNDED THROUGH THE UVMC FOUNDATION AND OTHER COMMUNITY DONATIONS. CLIENTS MUST BE UNINSURED OR UNDERINSURED (COPAYMENT, DEDUCTIBLE, COINSURANCE) WITH INCOME AT OR BELOW 400% OF FEDERAL POVERTY LEVEL.THE FOLLOWING SERVICES ARE COVERED BY THIS PROGRAM: SCREENING MAMMOGRAMS; DIAGNOSTIC MAMMOGRAMS; BREAST ULTRASOUNDS; BREAST BIOPSY; SURGICAL CONSULT (BREAST); PAP TESTS; CLINICAL BREAST EXAMS; COLPOSCOPIES; AND EDUCATIONAL MATERIALS.PARTNERS: ATRIUM MEDICAL CENTER FOUNDATION, GOOD SAMARITAN FOUNDATION - DAYTON, UVMC FOUNDATION, MIAMI VALLEY HOSPITAL FOUNDATION (HELP HER FIGHT), KROGER, BREAST CANCER FOUNDATION, KUHNS BROTHERS AND FIVE RIVERS HEALTH CENTERSNEED: PREVENTIONPROGRAM: COMMUNITY HEALTH AND MOBILE CLINIC PROGRAMMINGMETRICS: 300 EVENTS SCHEDULED, INCLUDING 127 MOBILE CLINIC EVENTS; 1,903 PREVENTATIVE SCREENINGS (I.E., HEALTH SCREENINGS, FLU VACCINATIONS, ETC.); NUMBER OF PEOPLE WHO RECEIVED HEALTH EDUCATION; PERCENT OF PEOPLE IDENTIFIED AS "AT RISK AND RECEIVING FOLLOW UP; AND THE NUMBER OF PEOPLE CONNECTED TO RESOURCES.INTERVENTION GOAL: THE GOAL IS TO BRING HEALTHCARE SERVICES TO UNDERSERVED COMMUNITIES IN MIAMI COUNTY. MANY COMMUNITY MEMBERS IN UNDERSERVED COMMUNITIES DO NOT HAVE EASY ACCESS TO HEALTHCARE. THE PURPOSE OF PREMIER COMMUNITY HEALTH'S MOBILE CLINIC PROGRAM IS TO MAKE QUALITY HEALTHCARE ACCESSIBLE AT FREQUENTLY VISITED LOCATIONS TO HELP COMMUNITY MEMBERS RECEIVE CARE WITHOUT HAVING TO TRAVEL LONG DISTANCES. THE MOBILE CLINIC PROGRAM PARTNERS WITH SEVERAL LOCATIONS (I.E., COMMUNITY CENTERS, LOCAL SCHOOLS, NON-PROFIT ORGANIZATIONS, ETC.) TO OFFER HEALTHCARE SERVICES ON A ROUTINE BASIS.DESCRIPTION: THE MOBILE CLINIC PROGRAM OFFERS HEALTH SCREENINGS AND ASSISTS WITH PHYSICIAN REFERRALS. THE HEALTH SCREENINGS INCLUDE BLOOD PRESSURE AND BLOOD GLUCOSE TESTS. THE SCREENINGS ARE ADMINISTERED BY A PREMIER COMMUNITY HEALTH NURSE WHO COMPLETES THE SERVICES BEING REQUESTED AND USES PAPER FORMS TO DOCUMENT. THE PATIENTS RECEIVE THEIR RESULTS IMMEDIATELY AFTER THE SCREENING AND DISCUSS THEIR SCREENING VALUES WITH THE NURSE. PATIENTS ALSO MAY UNDERGO SCREENINGS FOR CHOLESTEROL EVALUATIONS. SERVICES PRIMARILY FOCUS ON CARDIOVASCULAR HEALTH. LITERATURE ABOUT CHRONIC DISEASES AND HEALTHY LIFESTYLE ALTERNATIVES ARE PROVIDED TO PATIENTS.PARTNERS: LINCOLN COMMUNITY CENTER; TROY SENIOR CITIZENS CENTER; TIPP MONROE COMMUNITY SERVICES; J. R. CLARKE PUBLIC LIBRARY; MILTON UNION SENIOR CENTER; OAKES-BEITMAN MEMORIAL LIBRARY; PIQUA ACTIVITIES CENTER YMCA; YWCA PIQUA; AND PIQUA PUBLIC LIBRARY |
| PART V, SECTION B, LINE 11: (CONTINUED): | NEED: PREVENTIONPROGRAM: THE DAILY MILEMETRICS: REENGAGE AND EXPAND TO AT LEAST TWO ADDITIONAL SCHOOL DISTRICTS IN THE REGION.INTERVENTION GOAL: THE GOAL IS TO PRESENT PHYSICAL ACTIVITY AS AN IMPORTANT OPPORTUNITY THAT SHAPES HEALTH, DEVELOPMENT, AND FUTURE PHYSICAL ACTIVITY BEHAVIOR IN CHILDREN. CHILDREN WILL EXPERIENCE HIGHER LEVELS OF FITNESS, LOWER BODY FAT, AND STRONGER BONES AND MUSCLES WITH AN INCREASE IN PHYSICAL ACTIVITY LEVELS.DESCRIPTION: REGULAR PHYSICAL ACTIVITY BENEFITS THE MENTAL AND SOCIAL HEALTH OF CHILDREN. THE DAILY MILE IS A WELLNESS INTERVENTION DEVELOPED IN SCOTLAND, DESIGNED TO INCREASE PHYSICAL ACTIVITY LEVELS DURING THE SCHOOL DAY BY ENCOURAGING CHILDREN TO PARTICIPATE IN A JOG OR RUN, AT THEIR OWN PACE, WITH WALKING KEPT TO A MINIMUM. THE DAILY MILE OBJECTIVES COINCIDE WITH HEALTHY PEOPLE 2020 OBJECTIVES: TO TARGET YOUNGER CHILDREN THROUGH PHYSICAL ACTIVITY IN CHILDCARE SETTINGS.THE DAILY MILE WAS DEVELOPED IN 2012 AND PRIMARILY FEATURED IN SCOTLAND AND ENGLAND SCHOOLS; HOWEVER, ITS POSITIVE IMPACT ON THE CHILDREN RESULTED IN PARTICIPATION FROM OVER 10,943 SCHOOLS AND NURSERIES WORLDWIDE AND 2,309,784 STUDENTS. PREMIER HEALTH AND THE INVOLVED PARTNERS INTRODUCED THE FIRST DAILY MILE PILOT PROGRAM IN 2018. THE PILOT PROGRAM RESULTED IN A 52.7% PARTICIPATION RATE IN WHICH 80% (OF THE STUDENTS PARTICIPATING) DEMONSTRATED GROWTH IN THEIR LEVEL OF ENDURANCE. THE PANDEMIC UNFORTUNATELY PUT THIS PROGRAM ON HOLD. FOR THE UPCOMING YEAR, THIS PROGRAM'S GOAL IS TO REENGAGE EXISTING SCHOOL PROGRAMS AND IMPLEMENT 4 NEW SCHOOLS OVER THE NEXT 3 YEARS. THE SUCCESS OF THE DAILY MILE CAN BE CREDITED TO THE PARTNERSHIP BETWEEN THE ORGANIZATIONS AND THE SCHOOL'S EDUCATORS. PREMIER AND THE COMMUNITY AGENCIES INVOLVED WITH THE PROJECT CONTINUE TO WORK TO EXPAND THE PROGRAM WITHIN LOCAL SCHOOL DISTRICTS.PARTNERS: DAYTON CHILDREN'S HOSPITAL; PUBLIC HEALTH DAYTON & MONTGOMERY COUNTY; FIVE RIVERS METROPARKS; CENTERVILLE CITY SCHOOL DISTRICT; MIAMISBURG CITY SCHOOL DISTRICT; AND CENTERVILLE-WASHINGTON PARK DISTRICTNEED: PREVENTIONPROGRAM: HEALTHY HEROESMETRICS: SERVE 30 LOCAL FIRE AND POLICE DEPARTMENTS - IN THE PROCESS OF ADDING 5 MORE.INTERVENTION GOAL: PREMIER HEALTH'S GOAL IS TO IMPROVE OVERALL HEALTH AND WELLNESS BY BUILDING RELATIONSHIPS WITH FIRST RESPONDERS AND INSPIRING THEM TO ENGAGE IN ACTIVITIES THAT PROMOTE IMPROVED INJURY RATES AND OVERALL AWARENESS OF OCCUPATION SPECIFIC HEALTHCARE NEEDS.DESCRIPTION: HEALTHY HEROES IS A COMPREHENSIVE WELLNESS AND FITNESS PROGRAM DESIGNED TO INCREASE THE EFFECTIVENESS, EFFICIENCY, AND DURABILITY OF FIRST RESPONDERS SUCH AS FIREFIGHTERS, EMS, AND LAW ENFORCEMENT. THIS PROGRAM PREPARES THE FIRST RESPONDER FOR THE PHYSICAL READINESS OF THE JOB AND HELPS FIGHT RISK FACTORS FOR INJURIES AND ILLNESSES ASSOCIATED WITH FIRST RESPONDERS. ATHLETIC TRAINERS PROVIDE ON-SITE WEEKLY INJURY EVALUATION CLINICS TO ASSESS AND TREAT MUSCULOSKELETAL INJURIES COMMON TO THE FIRST RESPONDERS. OUR GOAL IS TO PREVENT MINOR INJURIES FROM BECOMING MAJOR DISABILITIES. ATHLETIC TRAINERS ALSO PROVIDE EDUCATION ON VARIOUS HEALTH AND WELLNESS TOPICS SUCH AS NUTRITION, STRESS AND SLEEP, AND FITNESS SPECIFICS. HEALTHY HEROES ATHLETIC TRAINERS ARE STRENGTH AND CONDITIONING SPECIALISTS WHO CAN DEVELOP INDIVIDUAL WORKOUTS TO HELP FIRST RESPONDERS REACH THEIR SPECIFIC HEALTH AND WELLNESS GOALS.PARTNERS: COMMUNITY FIRE/EMT STATIONSNEED: PREVENTIONPROGRAM: COMMUNITY BENEFIT GRANT PROGRAMMETRICS: THE SIZE AND NUMBER OF CONTRIBUTION AWARDS.INTERVENTION GOAL: COMMUNITY HEALTH IMPROVEMENT: COMMUNITY ACTIVITIES OR PROGRAMS THAT RESPOND TO COMMUNITY NEEDS AND SEEK TO ACHIEVE OBJECTIVES INCLUDING IMPROVING ACCESS TO HEALTH SERVICES, ENHANCING PUBLIC HEALTH, AND ADVANCING INCREASED GENERAL KNOWLEDGE.COMMUNITY-BUILDING ACTIVITIES: COMMUNITY-BUILDING ACTIVITIES IMPROVE THE COMMUNITY'S HEALTH AND SAFETY BY ADDRESSING THE ROOT CAUSES OF HEALTH PROBLEMS, SUCH AS POVERTY, HOMELESSNESS, ENVIRONMENTAL HAZARDS, ETC. THESE ACTIVITIES STRENGTHEN THE COMMUNITY'S CAPACITY TO PROMOTE THE HEALTH AND WELL-BEING OF ITS RESIDENTS BY OFFERING THE EXPERTISE AND RESOURCES OF THE HEALTH CARE ORGANIZATION.DESCRIPTION: GRANT-MAKING POLICY AND SPECIFIC GRANT DECISIONS FOR COMMUNITY BENEFITS CONTRIBUTIONS ARE MADE BY THE COMMUNITY BENEFITS EXECUTIVE COMMITTEE (OR DESIGNEES). THE SIZE AND NUMBER OF CONTRIBUTION AWARDS ARE RELATED TO THE AMOUNT OF MONEY AVAILABLE EACH YEAR AND VARY YEAR TO YEAR. AWARDS ARE TYPICALLY IN THE RANGE OF $500 TO $8,000.ALL PROJECTS:* ADDRESS HEALTH SYSTEM PRIORITIES: PREMIER HEALTH'S PRIORITIES INCLUDE BEHAVIORAL HEALTH/SUBSTANCE ABUSE, BIRTH OUTCOMES, AND CHRONIC DISEASE MANAGEMENT.* ADDRESS SOCIAL DETERMINANTS: SOCIAL DETERMINANTS ARE ALL THE ENVIRONMENTAL FACTORS THAT INFLUENCE HEALTH, INCLUDING EARLY CHILDHOOD DEVELOPMENT, EMPLOYMENT OPPORTUNITIES, FOOD INSECURITY, AIR AND WATER QUALITY, TRANSPORTATION, EDUCATIONAL ATTAINMENT, PUBLIC SAFETY, AND HOUSING.* ADDRESS HEALTH EQUITY AND DISPARITIES: HEALTH EQUITY IS ACHIEVED WHEN IMMUTABLE CHARACTERISTICS SUCH AS RACE, GENDER, SEXUAL IDENTITY, AND MORE ARE NOT CORRELATED TO HIGHER RATES OF ADVERSE HEALTH OUTCOMES. HEALTH DISPARITIES ARE THE DIFFERENCES IN HEALTH OUTCOMES BASED ON RACE, ETHNICITY, SEXUAL ORIENTATION, AND/OR SOCIO-ECONOMIC STATUS.* UPSTREAM APPROACH: AN UPSTREAM APPROACH ADDRESSES THE COMMUNITY FACTORS THAT SHAPE HEALTH BEFORE ANY CLINICAL INTERVENTION IS NECESSARY (ALSO KNOWN AS SOCIAL DETERMINANTS OF HEALTH). THESE FACTORS CAN INCLUDE FIELDS AS DIVERSE AS AFFORDABLE HOUSING, PUBLIC SAFETY, ACCESS TO HEALTHY FOOD, AND ECONOMIC OPPORTUNITY.* INTEGRATION: PARTNERSHIPS THAT ALIGN THE PRACTICES AND PERSPECTIVES OF COMMUNITIES, HEALTH SYSTEMS AND PUBLIC HEALTH UNDER A SHARED VISION, ESTABLISHING NEW ROLES WHILE CONTINUING TO DRAW UPON THE STRENGTHS OF EACH PARTNER* LOCAL: PARTNERSHIPS THAT ENGAGE NEIGHBORHOOD RESIDENTS AND COMMUNITY LEADERS AS KEY VOICES AND THOUGHT LEADERS THROUGHOUT ALL STAGES OF PLANNING AND IMPLEMENTATION* DATA-DRIVEN AND EVIDENCE-BASED: PARTNERSHIPS THAT USE DATA FROM BOTH CLINICAL AND COMMUNITY SOURCES AS A TOOL TO IDENTIFY KEY NEEDS, MEASURE MEANINGFUL CHANGE, AND FACILITATE TRANSPARENCY AMONGST STAKEHOLDERS TO GENERATE ACTIONABLE INSIGHTS; MIRRORING PROVEN STRATEGIES THAT FACILITATE TANGIBLE CHANGE.PARTNERS: NONESIGNIFICANT HEALTH NEEDS NOT ADDRESSEDCURRENTLY, UPPER VALLEY MEDICAL CENTER DOES NOT OFFER ANY COMMUNITY BENEFIT PROGRAMS THAT ADDRESS ARTHRITIS/OSTEOPOROSIS FOR THE GENERAL PUBLIC. HOWEVER, THE PREMIER HOSPITAL SYSTEM OFFERS A ROBUST ARRAY OF SERVICES FOR THEIR PATIENTS THROUGH THEIR ORTHOPEDIC SERVICE LINE. |
| PART V, SECTION B, LINES 16 A, B, AND C: | THE DIRECT WEBSITE ADDRESS WHERE A COPY OF THE FINANCIAL ASSISTANCE POLICY, THE APPLICATION, AND A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY CAN BE ACCESSED IS:HTTPS://WWW.PREMIERHEALTH.COM/PATIENT-AND-VISITOR-GUIDE/PATIENT-GUIDE/COSTS-AND-INSURANCE/BILLING/FINANCIAL-ASSISTANCE |
| PART V, SECTION B, LINE 16J: | THE HOSPITAL WIDELY DISTRIBUTES INFORMATION ABOUT ITS FINANCIAL ASSISTANCE POLICY WITHIN THE AREA THAT IT SERVES. THIS INFORMATION INCLUDES THE METHOD OF APPLYING FOR AND ACCESSING FINANCIAL ASSISTANCE. NOTICES ARE PUBLICIZED IN PATIENTS' BILLS AND ARE POSTED IN THE EMERGENCY ROOM, ADMITTING AND REGISTRATION AREAS, AS WELL AS OTHER PUBLIC AREAS. THE FINANCIAL ASSISTANCE POLICY IS PUBLISHED ON THE HOSPITAL'S WEBSITE. FINANCIAL COUNSELORS, PATIENT ADVOCATES, AND CUSTOMER SERVICE REPRESENTATIVES DISCUSS THE FINANCIAL ASSISTANCE POLICY WITH ALL UNINSURED PATIENTS, AND ANY PATIENT WHO EXPRESSES FINANCIAL HARDSHIP WITH PAYING THEIR BILL. APPLICATIONS FOR FINANCIAL ASSISTANCE POLICY ARE AVAILABLE IN BOTH ENGLISH AND SPANISH. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 5 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - HYATT CENTER | ||||
| 450 N HYATT ST | TIPP CITY | OH | 45371 | DIAGNOSTICS AND IMAGING, SPORTS MEDICINE, PEDIATRICS, OUTPATIENT SURGERY |
| 2 - OUTPATIENT CARE CENTER NORTH | ||||
| 280 LOONEY RD | PIQUA | OH | 45356 | DIAGNOSTICS AND IMAGING, REHABILITATIVE THERAPY PEDIATRICS |
| 3 - OUTPATIENT CARE CENTER SOUTH | ||||
| 998 S DORSET RD | TROY | OH | 45373 | DIAGNOSTICS AND IMAGING,OCCUPATIONAL HEALTH,REHABILITATIVE THERAPY |
| 4 - STANFIELD PLACE | ||||
| 31 STANFIELD RD | TROY | OH | 45373 | IMAGING, ENT, LABORATORY RHEUMATOLOGY |
| 5 - UVMC SIDNEY CENTER | ||||
| 1529 FAIR RD | SIDNEY | OH | 45365 | PHYSICAL THERAPY, WOMEN'S SERVICES |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | FINANCIAL ASSISTANCE IS ONLY PROVIDED FOR CARE THAT IS DEEMED EMERGENCY CARE OR MEDICALLY NECESSARY CARE AND AFTER PATIENTS HAVE BEEN FOUND TO MEET ESTABLISHED FINANCIAL CRITERIA OUTLINED IN THE FINANCIAL ASSISTANCE POLICY. PREMIER HEALTH HOSPITALS OFFER BOTH FREE CARE AND DISCOUNTED CARE, DEPENDING ON AN INDIVIDUAL'S FAMILY SIZE AND INCOME AS A PERCENT OF THE FEDERAL POVERTY GUIDELINES. ADDITIONALLY, PREMIER HEALTH HOSPITALS MAY USE A FAMILY'S ASSETS TO DETERMINE WHETHER A PATIENT MEETS THE ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCE. PATIENTS RECEIVING A DISCOUNT ARE EXPECTED TO PAY THEIR REMAINING BALANCE, AND MAY WORK WITH PREMIER HEALTH HOSPITALS' FINANCIAL COUNSELORS TO SET UP A PAYMENT PLAN BASED ON THEIR FINANCIAL SITUATION. |
| PART I, LINE 6A: | THE COMMUNITY BENEFIT REPORT FOR UPPER VALLEY MEDICAL CENTER IS PART OF THE PREMIER HEALTH REPORT (EIN# 31-1446699). |
| PART I, LINE 7: | A COST TO CHARGE RATIO WAS USED TO CALCULATE THIS FINANCIAL ASSISTANCE AT COST. THIS CALCULATION TAKES TOTAL OPERATING EXPENSES LESS OTHER OPERATING REVENUES DIVIDED BY TOTAL GROSS REVENUES. UNREIMBURSED MEDICAID AND OTHER MEANS-TESTED GOVERNMENTAL PROGRAMS WERE CALCULATED USING A COST ACCOUNTING SYSTEM. THIS SYSTEM ADDRESSES ALL PATIENT SEGMENTS AND INCLUDES FULLY LOADED COSTS. FOR THE REMAINING ITEMS THE ORGANIZATION USED SPECIFIC NUMBERS FOR EXPENSE PAID DIRECTLY FOR THESE SERVICES. |
| PART I, LINE 7G: | UPPER VALLEY MEDICAL CENTER PROVIDES SUBSIDIZED EMERGENCY SERVICES BY OPERATING A 24-HOUR EMERGENCY ROOM 365 DAYS PER YEAR. THIS EMERGENCY ROOM IS OPEN TO ALL INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL INCURS EXPENSES RELATED TO CALL TIME AND PHYSICIAN SUBSIDIES DUE TO THE LARGE NUMBER OF INDIGENT PATIENTS COMING THROUGH THE EMERGENCY ROOM. FOR 2023, THE AMOUNT PAID FOR CALL AND SUBSIDIES WAS $2,393,000. |
| PART III, LINES 2 & 3: | BAD DEBT EXPENSE IS INCURRED WHEN AN ACCOUNT IS TAKEN OUT OF ACCOUNTS RECEIVABLE AND TURNED OVER TO A COLLECTION AGENCY. THIS ACTION MAY OCCUR IF A PATIENT REFUSES PAYMENT ARRANGEMENTS, REFUSES TO APPLY FOR FINANCIAL ASSISTANCE, AND THERE IS NOT AN INSURANCE BALANCE BEING CONTENDED. AN ACCOUNT IS WRITTEN OFF TO BAD DEBT AFTER 130 DAYS IF AN ATTEMPT TO COLLECT FROM THE PATIENT IS MADE WITHIN OUR COLLECTION POLICY. THE COLLECTION AGENCY ATTEMPTS TO COLLECT THE ACCOUNT IN ACCORDANCE WITH ESTABLISHED GUIDELINES. COLLECTION ATTEMPTS ARE CEASED AND THE ACCOUNT RETURNED TO THE ORGANIZATION IF THE PATIENT APPLIES FOR FINANCIAL ASSISTANCE. ANY AMOUNTS COLLECTED FROM THESE ACCOUNTS ARE CREDITED BACK AGAINST BAD DEBT EXPENSE. THE ORGANIZATION RECOGNIZES THERE ARE ACCOUNTS WRITTEN OFF TO BAD DEBT THAT MAY HAVE QUALIFIED FOR CHARITY CARE IF THE PATIENT HAD PROVIDED THE NECESSARY FINANCIAL INFORMATION. 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. A REPRESENTATIVE SAMPLE OF THESE ACCOUNTS IS THEN SENT TO OUR 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 RECLASSED 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, THE ORGANIZATION HAS USED BEST EFFORTS TO NOT REPORT BAD DEBT EXPENSE FOR PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY. |
| PART III, LINE 4: | THE ORGANIZATION DOES NOT HAVE A FOOTNOTE IN THE AUDITED FINANCIAL STATEMENTS WHICH DISCUSSES THIS CALCULATION. |
| PART III, SECTION B, LINES 5, 6, AND 7: | THE AMOUNTS REPORTED ON LINES 5, 6, AND 7 DO NOT INCLUDE CERTAIN MEDICARE PROGRAM REVENUES AND COSTS, AND THUS DO NOT REFLECT ALL OF THE ORGANIZATION'S REVENUES AND COSTS ASSOCIATED WITH ITS PARTICIPATION IN MEDICARE PROGRAMS. IN ADDITION TO THE AMOUNTS REPORTED ON LINE 5, 6, AND 7, THE ORGANIZATION RECEIVED REVENUE OF $31,267,000 AND INCURRED COST OF $46,786,000, FOR AN ADDITIONAL NET SHORTFALL OF $15,519,000 ASSOCIATED WITH THESE PROGRAMS. BELOW IS A RECONCILIATION OF THE AMOUNTS ASSOCIATED WITH MEDICARE PROGRAMS.ALLOWABLE MEDICARE REVENUE PER MEDICARE COST REPORT (PART III, SECTION B) $26,699,000MEDICARE REVENUE NOT REPORTED IN PART III, SECTION B $31,267,000TOTAL MEDICARE ASSOCIATED REVENUE $57,936,000ALLOWABLE MEDICARE COST PER MEDICARE COST REPORT (PART III, SECTION B) $28,801,000MEDICARE COST NOT REPORTED IN PART III, SECTION B $46,786,000TOTAL MEDICARE ASSOCIATED COST $75,587,000MEDICARE SHORTFALL PER PART III, SECTION B $ 2,132,000ADDITIONAL SHORTFALL NOT INCLUDED IN PART III, SECTION B $15,519,000TOTAL MEDICARE SHORTFALL $17,651,000 |
| PART III, LINE 8: | THE ORGANIZATION'S SHORTFALL SHOULD BE CONSIDERED CHARITY CARE BECAUSE IT IS PROVIDING HIGH-QUALITY CARE, IN EXCESS OF THE COST, TO OUR COMMUNITY RESIDENTS THAT NEED CARE. THE MEDICARE POPULATION AT THE ORGANIZATION IS IN EXCESS OF 50.0% OF NET PATIENT REVENUE. THE ORGANIZATION USED A COST ACCOUNTING SYSTEM TO CALCULATE THE MEDICARE ALLOWABLE COSTS. |
| PART III, LINE 9B: | THE ORGANIZATION MAKES REASONABLE EFFORTS TO DETERMINE WHETHER OR NOT AN INDIVIDUAL IS ELIGIBLE FOR ASSISTANCE UNDER THE STATE OR HOSPITAL FINANCIAL ASSISTANCE POLICY BEFORE ENGAGING IN EXTRAORDINARY COLLECTIVE ACTIONS AGAINST THAT INDIVIDUAL. PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE ARE OFFERED REASONABLE PAYMENT PLAN ARRANGEMENTS FOR ANY REMAINING BALANCES. ANY THIRD-PARTY COLLECTING SELF-PAY RECEIVABLES ON OUR BEHALF IS REQUIRED TO MAKE REASONABLE EFFORTS TO DETERMINE IF THE INDIVIDUAL MEETS THE QUALIFICATIONS OF THE STATE OR OF OUR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS.REASONABLE EFFORTS INCLUDE:A. VALIDATING THAT THE PATIENT OWES THE UNPAID BILLS AND THAT ALL SOURCES OF THIRD-PARTY PAYMENT HAVE BEEN IDENTIFIED AND BILLED BY THE HOSPITAL.B. DOCUMENTING THAT THE ORGANIZATION HAS OR HAS ATTEMPTED TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR CHARITY CARE UNDER ITS FINANCIAL ASSISTANCE POLICY.C. DOCUMENT THAT THE PATIENT DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE.D. DOCUMENT THAT THE PATIENT HAS BEEN OFFERED AND ACCEPTED TERMS FOR A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THAT PLAN.THE FINANCIAL COUNSELORS MEET WITH INPATIENT, OUTPATIENT, SELF-PAY, AND OTHER PATIENTS UPON REQUEST WHO MAY NEED FINANCIAL ASSISTANCE. IN ADDITION TO ASSISTING PATIENTS WHO WANT TO APPLY FOR ASSISTANCE THROUGH THE MEDICAID PROGRAM, THE FINANCIAL COUNSELOR WILL PROVIDE THE PATIENT WITH A FINANCIAL ASSISTANCE APPLICATION. |
| PART VI, LINE 2: | THE ORGANIZATION 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. THE ORGANIZATION STRIVES TO WORK WITH PREMIER, THE HOSPITAL BOARD OF TRUSTEES, EXECUTIVE MANAGEMENT, MANAGERS, STAFF MEMBERS, COMMUNITY GROUPS, AND INDIVIDUALS TO PROVIDE A COLLABORATIVE APPROACH TO THE GOVERNANCE AND MANAGEMENT OF COMMUNITY BENEFIT ACTIVITIES. |
| PART VI, LINE 3: | THERE ARE SEVERAL WAYS IN WHICH OUR ORGANIZATION INFORMS AND EDUCATES PATIENTS WHO MAY BE BILLED FOR SERVICES ABOUT ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS, OR UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. FIRST, NOTIFICATION OF SUCH AVAILABLE ASSISTANCE IS CLEARLY POSTED IN REGISTRATION AREAS, AS WELL AS MATERNITY AND EMERGENCY DEPARTMENTS. NEXT, PATIENT ADVOCATES, PATIENT ACCESS STAFF MEMBERS, AND FINANCIAL COUNSELORS IN THE INPATIENT AND EMERGENCY DEPARTMENTS MEET WITH UNINSURED AND UNDERINSURED PATIENTS, AND THOSE WITH ONLY MEDICARE COVERAGE TO DISCUSS ELIGIBILITY FOR ASSISTANCE. FINANCIAL COUNSELORS ALSO DISCUSS OPTIONS TO RESOLVE UNPAID ACCOUNT BALANCES WITH UNINSURED AND UNDERINSURED PATIENTS. THE FINANCIAL ASSISTANCE POLICY IS POSTED ON THE HOSPITAL'S WEBSITE, ALONG WITH INFORMATION ON HOW TO OBTAIN AN APPLICATION. WHEN A PATIENT RECEIVES A BILL, THE REVERSE SIDE OF THE BILL CONTAINS INFORMATION ABOUT THE STATE OF OHIO FREE CARE PROGRAM (CARE ASSURANCE) AND A FINANCIAL ASSISTANCE APPLICATION. THE BILLING STATEMENTS OFFER THE FINANCIAL ASSISTANCE OPTIONS AVAILABLE, AND THE CONTACT INFORMATION FOR ASSISTANCE. |
| PART VI, LINE 4: | UPPER VALLEY SERVES THE NORTHERN MIAMI VALLEY AREA WITH ACUTE CARE SERVICES, COMMUNITY HEALTH AND WELLNESS PROGRAMS AND MORE. UPPER VALLEY IS LOCATED IN MIAMI COUNTY, OHIO AND IS THE SOLE HOSPITAL SYSTEM OPERATING WITHIN THE COUNTY. THE POPULATION OF UPPER VALLEY'S PRIMARY SERVICE AREA IS APPROXIMATELY 111,000 PEOPLE. INCLUDING THE ADJACENT COUNTIES, WHICH ARE ALSO SERVED (SHELBY, DARKE, AND CHAMPAIGN COUNTIES), UPPER VALLEY'S TOTAL PRIMARY AND SECONDARY SERVICE AREA POPULATION APPROACHES 249,000 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 ABOVE $71,000 PER YEAR, WITH APPROXIMATELY 9.8% OF ITS CITIZENS LIVING BELOW THE FEDERAL POVERTY LEVEL. APPROXIMATELY 52.6% OF THE HOSPITAL'S GROSS REVENUES ARE GENERATED FROM MEDICARE PATIENTS, WHILE ANOTHER 15.2% OF THE REVENUES ARE GENERATED FROM EITHER UNINSURED PATIENTS OR MEDICAID RECIPIENTS. THE JULY 2023 UNEMPLOYMENT RATE OF MIAMI COUNTY IS APPROXIMATELY 3.1%. |
| PART VI, LINE 5: | UPPER VALLEY'S MOST VISIBLE CONTRIBUTION TO THE COMMUNITY IS IN THE FORM OF PROVIDING HIGH-QUALITY INPATIENT AND OUTPATIENT CARE TO OUR PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. OUR MISSION INCLUDES CONTINUALLY STRIVING TO ENRICH THE COMMUNITY BY TRAINING AND EDUCATING FUTURE HEALTHCARE WORKERS, OFFERING HEALTH AWARENESS AND EDUCATION TO THE COMMUNITY, SUCH AS PROMOTION OF BREAST CANCER SCREENINGS, WOMEN AND INFANT HEALTH, DIABETIC WELLNESS AND DRIVER SAFETY AWARENESS FOR HIGH-SCHOOL STUDENTS. THE HOSPITAL ALSO PROVIDES RELEVANT EDUCATION FOR EMS AND PRE-HOSPITAL CARE PROVIDERS THROUGHOUT THE REGION. THE TRAINING INCLUDES LOCAL CASE REVIEWS, LECTURES, HANDS-ON SIMULATION AND PANEL DISCUSSIONS PERTAINING TO THE EDUCATION ON USE OF TOOLS, PRIORITIES OF PATIENT CARE AND OTHER CRITICAL INFORMATION. UPPER VALLEY PARTNERS WITH MANY OF THE LOCAL SCHOOLS TO PROVIDE CERTIFIED AND LICENSED ATHLETIC TRAINERS AT THEIR CAMPUSES TO AID IN INJURY PREVENTION, RECOGNITION AND TREATMENT OF SPORTS-RELATED INJURIES. THE HOSPITAL ALSO SUPPORTS THE COMMUNITY THROUGH SPONSORSHIPS AND PARTICIPATION IN LOCAL FUNDRAISING EVENTS THAT PROMOTE HEALTHY LIFESTYLE CHOICES, PREVENTATIVE CARE, CHRONIC DISEASE MANAGEMENT AND GENERAL HEALTH EDUCATION. THE HEALTH SCIENCES LIBRARY AT UPPER VALLEY 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 EDUCATION MATERIALS TO HELP PROMOTE WELLNESS AND UNDERSTANDING ABOUT DISEASES. INFORMATION IS AVAILABLE VIA COMPUTER, VIDEOS, AND PAMPHLETS. WITHIN THE HOSPITAL, INTERPRETERS ARE OFFERED TO PATIENTS AT NO COST AS A RESULT OF INCREASED VOLUMES OF NON-ENGLISH-SPEAKING PATIENTS. UPPER VALLEY PROVIDES SPIRITUAL AND EMOTIONAL SUPPORT AND SERVICES TO PATIENTS AND THEIR FAMILY MEMBERS UTILIZING 6 TRAINED PROFESSIONAL CHAPLAINS, 24 HOURS A DAY, 7 DAYS A WEEK.THE HOSPITAL HAS AN OPEN MEDICAL STAFF, PARTICIPATES IN MEDICAID AND MEDICARE, AND HAS AN ACTIVE CHARITY CARE PROGRAM. UPPER VALLEY'S MISSION REFLECTS A COMMITMENT TO PROVIDE HIGH-QUALITY COST-EFFECTIVE HEALTH SERVICES TO THE DIVERSE COMMUNITIES THAT IT SERVES. AT THE CORE OF THE COMMITMENT IS THE BELIEF THAT IN ORDER TO MEET OUR PATIENTS' EXPECTATIONS AND TO IMPROVE TREATMENT OUTCOMES, IT IS NECESSARY FOR US TO UNDERSTAND THE PATIENT'S FRAME OF REFERENCE. A DIVERSE WORKFORCE ALLOWS US TO DRAW UPON THE RICHNESS OF OUR HUMAN RESOURCES, CREATE A POSITIVE WORK ENVIRONMENT, AND MEET THE EXPECTATIONS OF THOSE WE SERVE. UPPER VALLEY'S COMMITMENT TO DIVERSITY IS ACCOMPLISHED BY:* TAKING A LEADERSHIP ROLE IN CREATING AND SUSTAINING AN ORGANIZATIONAL ENVIRONMENT THAT ACTIVELY SUPPORTS DIVERSITY,* POSITIONING DIVERSITY AS A LONG-TERM COMPREHENSIVE ORGANIZATIONAL STRATEGY,* ESTABLISHING AND SUPPORTING RELATIONSHIPS WITH MINORITY AND DIVERSITY FOCUSED ORGANIZATIONS AND* PROVIDING EMPLOYMENT AND EDUCATION OPPORTUNITIES FOR INDIVIDUALS WITH SIGNIFICANT DISABILITIES. |
| PART VI, LINE 6: | PREMIER HEALTH (PREMIER) IS THE SOLE MEMBER OF UPPER VALLEY MEDICAL CENTER, TWO OTHER HOSPITAL ENTITIES (FIVE TOTAL LOCATIONS), AND SEVERAL OTHER HEALTH CARE SERVICE SUBSIDIARIES. PREMIER HAS THE AUTHORITY TO OPERATE EACH HOSPITAL WITH RESPECT TO MATTERS SUCH AS BUDGETING, STRATEGIC PLANNING, MANAGED CARE CONTRACTING, EMPLOYEE COMPENSATION, TRANSFER/SALE OF MATERIAL ASSETS, ETC. AS AN INTEGRATED HEALTHCARE SYSTEM, PREMIER PROVIDES A CONTINUUM OF CARE FOR THE RESIDENTS OF SOUTHWEST OHIO. AS A SYSTEM, PREMIER IS A COMMUNITY LEADER IN SUPPORTING VARIOUS COMMUNITY BENEFIT PROGRAMS THAT ALIGN WITH ITS CURRENT CHNA. RESOURCES ARE LEVERAGED IN EACH ENTITY WITHIN THE PREMIER SYSTEM TO SUPPORT THESE PROGRAMS IDENTIFIED AT THE PREMIER SYSTEM LEVEL. THE POLICIES FOR BAD DEBT AND CHARITY COLLECTIONS ARE ESTABLISHED BY PREMIER. |
| PART VI, LINE 7: | OHIO |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (29 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| MIAMI EAST LOCAL SCHOOL DISTRICT | ||||||||
| 3825 N SR 589 | CASSTOWN | OH | 45312 | 316007688 | GOVERNMENT | $539,510 | $0 | SUPPORT |
| TROY CHRISTIAN STADIUM | ||||||||
| 700 S DORSET RD | TROY | OH | 45373 | 812588393 | GOVERNMENT | $500,000 | $0 | SUPPORT |
| TROY HIGH SCHOOL | ||||||||
| 216 W FRANKLIN ST | TROY | OH | 45373 | 316018703 | GOVERNMENT | $500,000 | $0 | SUPPORT |
| PIQUA CITY SCHOOLS | ||||||||
| 215 LOONEY RD | PIQUA | OH | 45356 | 316000929 | GOVERNMENT | $375,100 | $0 | SUPPORT |
| MIAMI COUNTY DENTAL CLINIC | ||||||||
| 70 TROY TOWN DR | TROY | OH | 45373 | 204901192 | 501(C)(3) | $155,000 | $0 | SUPPORT |
| SAMARITAN BEHAVIORAL HEALTH | ||||||||
| 110 N MAIN ST 200 | DAYTON | OH | 45402 | 020633634 | 501(C)(3) | $142,500 | $0 | SUPPORT |
| THE ARBOGAST PERFORMING ARTS CENTER | ||||||||
| 500 S DORSET RD | TROY | OH | 45373 | 830889260 | 501(C)(3) | $137,545 | $0 | SUPPORT |
| ONEFIFTEEN RECOVERY | ||||||||
| 6636 LONGSHORE ST 200 | DUBLIN | OH | 43017 | 833504845 | 501(C)(3) | $135,000 | $0 | SUPPORT |
| HEALTH PARTNERS FREE CLINIC | ||||||||
| 1300 N CO RD 25A | TROY | OH | 45373 | 311596731 | 501(C)(3) | $125,000 | $0 | SUPPORT |
| EDISON FOUNDATION | ||||||||
| 1973 EDISON DR | PIQUA | OH | 45356 | 311379781 | 501(C)(3) | $110,100 | $0 | SUPPORT |
| TCN BEHAVIORAL HEALTH SERVICES INC | ||||||||
| 452 W MARKET ST | XENIA | OH | 45385 | 311305635 | 501(C)(3) | $92,000 | $0 | SUPPORT |
| MIAMI COUNTY PUBLIC HEALTH | ||||||||
| 110 N MAIN ST 200 | DAYTON | OH | 45402 | 310537504 | 501(C)(3) | $66,807 | $0 | SUPPORT |
| MIAMI VALLEY HOSPITAL | ||||||||
| 510 W WATER ST 130 | TROY | OH | 45373 | 316000055 | GOVERNMENT | $58,142 | $0 | SUPPORT |
| CITY OF TIPP CITY | ||||||||
| 260 S GARBER DR | TIPP CITY | OH | 45371 | 310792424 | GOVERNMENT | $33,147 | $0 | SUPPORT |
| YWCA PIQUA | ||||||||
| 418 N WAYNBE ST | PIQUA | OH | 45356 | 310537166 | 501(C)(3) | $32,345 | $0 | SUPPORT |
| PREMIER COMMUNITY HEALTH | ||||||||
| 110 N MAIN ST 200 | DAYTON | OH | 45402 | 311122883 | 501(C)(3) | $31,427 | $0 | SUPPORT |
| VILLAGE OF WEST MILTON | ||||||||
| 701 S MAIN ST | WEST MILTON | OH | 45383 | 316001093 | GOVERNMENT | $24,000 | $0 | SUPPORT |
| LINCOLN COMMUNITY CENTER | ||||||||
| 110 ASH ST | TROY | OH | 45373 | 310584315 | 501(C)(3) | $19,990 | $0 | SUPPORT |
| CITY OF TROY | ||||||||
| 100 S MARKET ST | TROY | OH | 45373 | 316000549 | GOVERNMENT | $18,471 | $0 | SUPPORT |
| TROY DEVELOPMENT COUNCIL | ||||||||
| 405 PUBLIC SQUARE 330 | TROY | OH | 45373 | 311736034 | 501(C)(3) | $15,000 | $0 | SUPPORT |
| ST PATRICK SOUP KITCHEN | ||||||||
| 25 N MULBERRY ST | TROY | OH | 45373 | 300391714 | 501(C)(3) | $8,000 | $0 | SUPPORT |
| REACH OUT MONTGOMERY COUNTY | ||||||||
| 25 E FORAKER ST | DAYTON | OH | 45409 | 311434282 | 501(C)(3) | $7,268 | $0 | SUPPORT |
| FIRST PLACE FOOD PANTRY INC | ||||||||
| 7210 LINCOLN AVE | TROY | OH | 45373 | 470994740 | 501(C)(3) | $7,040 | $0 | SUPPORT |
| SALVATION ARMY | ||||||||
| 1711 S UNIV BLVD | MIDDLETOWN | OH | 45402 | 580660607 | 501(C)(3) | $7,020 | $0 | SUPPORT |
| MIAMI VALLEY HOSPITAL FOUNDATION | ||||||||
| 110 N MAIN ST 200 | DAYTON | OH | 45402 | 311040231 | 501(C)(3) | $6,863 | $0 | SUPPORT |
| NEW PATH INC | ||||||||
| 7695 S COUNTY RD 25A | TIPP CITY | OH | 45371 | 311710997 | 501(C)(3) | $6,590 | $0 | SUPPORT |
| NEEDY BASKET SOUTHER MIAMI COUNTY INC | ||||||||
| 330 S 5TH ST | TIPP CITY | OH | 45371 | 311190924 | 501(C)(3) | $6,500 | $0 | SUPPORT |
| BETHANY CENTER | ||||||||
| PO BOX 131 | PIQUA | OH | 45356 | 310850373 | 501(C)(3) | $6,500 | $0 | SUPPORT |
| MEALS ON WHEELS OF PIQUA | ||||||||
| PO BOX 224 | PIQUA | OH | 45356 | 311709232 | 501(C)(3) | $6,500 | $0 | SUPPORT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 29 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | 1) DISBURSEMENTS ARE ANALYZED MONTHLY THROUGH VARIOUS REPORTS AND COMMITTEE MEETINGS. 2) INVOICES ARE RECEIVED IN ACCOUNTS PAYABLE AND APPROVED AND DISBURSED PER ORGANIZATIONAL POLICY. 3) GRANT SPENDING IS MONITORED AGAINST BUDGETED AMOUNTS ON AN ONGOING BASIS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (31 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BARBARA A JOHNSON | ||||||||||||||
| FORMER KEY EMPLOYEE | $0 | $444,660 | $0 | $170,112 | $0 | $449,812 | $0 | $616,360 | $0 | $11,122 | $0 | $1,692,066 | $0 | $0 |
| MICHAEL C RIORDAN | ||||||||||||||
| PREMIER PRESIDENT & CEO | $0 | $1,209,511 | $0 | $25,000 | $0 | $138,820 | $0 | $4,950 | $0 | $30,761 | $0 | $1,409,042 | $0 | $0 |
| JENNIFER J HAULER DO | ||||||||||||||
| FORMER KEY EMPLOYEE | $0 | $219,289 | $0 | $102,218 | $0 | $635,856 | $0 | $302,929 | $0 | $956 | $0 | $1,261,248 | $0 | $216,934 |
| MARC R BELCASTRO DO | ||||||||||||||
| FORMER KEY EMPLOYEE | $0 | $188,103 | $0 | $108,762 | $0 | $489,729 | $0 | $330,675 | $0 | $25,750 | $0 | $1,143,019 | $0 | $0 |
| GEOFFREY P WALKER ESQ - SR | ||||||||||||||
| SPECIAL ADVISORY COUNSEL/SECRETARY | $0 | $490,418 | $0 | $88,423 | $0 | $361,433 | $0 | $19,285 | $0 | $31,104 | $0 | $990,663 | $0 | $0 |
| KEITH D BRICKING MD | ||||||||||||||
| VP & CHIEF CLINICAL OFFICER | $0 | $694,422 | $0 | $138,952 | $0 | $15,407 | $0 | $82,268 | $0 | $33,850 | $0 | $964,899 | $0 | $0 |
| DIANE L PLEIMAN | ||||||||||||||
| FORMER OFFICER | $0 | $439,353 | $0 | $150,942 | $0 | $227,287 | $0 | $19,330 | $0 | $9,137 | $0 | $846,049 | $0 | $0 |
| GARY G GINTER | ||||||||||||||
| FORMER KEY EMPLOYEE | $0 | $111,178 | $0 | $73,099 | $0 | $379,368 | $0 | $234,965 | $0 | $28,898 | $0 | $827,508 | $0 | $0 |
| MARY M CLANCY | ||||||||||||||
| CHIEF DIGITAL & INFORMATION OFFICER | $0 | $475,333 | $0 | $86,305 | $0 | $122,766 | $0 | $23,477 | $0 | $35,538 | $0 | $743,419 | $0 | $0 |
| J MICHAEL SIMS | ||||||||||||||
| SYS VP & CORPORATE CONTROLLER | $0 | $370,642 | $0 | $66,308 | $0 | $222,329 | $0 | $22,390 | $0 | $32,337 | $0 | $714,006 | $0 | $0 |
| ROBERT M KOHUT MD | ||||||||||||||
| TRUSTEE | $0 | $634,379 | $0 | $13,750 | $0 | $21,128 | $0 | $10,613 | $0 | $5,432 | $0 | $685,302 | $0 | $0 |
| FAYEZ D ABBOUD MD | ||||||||||||||
| FORMER TRUSTEE & OFFICER | $0 | $573,282 | $0 | $31,250 | $0 | $30,625 | $0 | $11,850 | $0 | $26,904 | $0 | $673,911 | $0 | $0 |
| KEVIN W HARLAN | ||||||||||||||
| PRESIDENT | $0 | $500,254 | $0 | $77,008 | $0 | $30,251 | $0 | $30,980 | $0 | $11,363 | $0 | $649,856 | $0 | $0 |
| ELAINE LAINIE M DEAN | ||||||||||||||
| FORMER KEY EMPLOYEE | $0 | $413,535 | $0 | $77,991 | $0 | $24,799 | $0 | $32,634 | $0 | $16,159 | $0 | $565,118 | $0 | $0 |
| LAKMALI C RANATHUNGA MD | ||||||||||||||
| TRUSTEE & CMO (FROM JULY) | $198,467 | $261,277 | $2,710 | $46,058 | $7,832 | $10,878 | $4,205 | $9,516 | $6,317 | $7,369 | $219,531 | $335,098 | $0 | $0 |
| SCOTT B KANAGY DO | ||||||||||||||
| TRUSTEE & CMO (TO JULY) | $159,496 | $239,584 | $59,264 | $0 | $840 | $1,266 | $14,063 | $18,898 | $12,015 | $16,384 | $245,678 | $276,132 | $0 | $0 |
| LISA M GOSSETT | ||||||||||||||
| VP NURSING/CNO/PATIENT EXP | $0 | $406,141 | $0 | $36,459 | $0 | $3,999 | $0 | $11,178 | $0 | $15,064 | $0 | $472,841 | $0 | $0 |
| CARA W POWERS | ||||||||||||||
| CHIEF LEGAL OFFICER | $0 | $308,692 | $0 | $45,012 | $0 | $1,611 | $0 | $26,103 | $0 | $32,768 | $0 | $414,186 | $0 | $0 |
| JIGAR PATEL MD | ||||||||||||||
| TRUSTEE | $0 | $321,962 | $0 | $35,800 | $0 | $839 | $0 | $9,398 | $0 | $31,111 | $0 | $399,110 | $0 | $0 |
| TRISHA L WACKLER | ||||||||||||||
| TRUSTEE & CNO | $275,117 | $0 | $45,430 | $0 | $20,957 | $0 | $19,247 | $0 | $15,221 | $0 | $375,972 | $0 | $0 | $0 |
| AMANDA K ADKINS-RICCI | ||||||||||||||
| SYSTEM VP REVENUE CYCLE | $0 | $267,695 | $0 | $39,152 | $0 | $587 | $0 | $12,952 | $0 | $11,826 | $0 | $332,212 | $0 | $0 |
| BILLIE L LUCENTE-BAKER | ||||||||||||||
| FORMER KEY EMPLOYEE | $0 | $248,144 | $0 | $43,828 | $0 | $802 | $0 | $21,259 | $0 | $15,786 | $0 | $329,819 | $0 | $0 |
| MIKI L GILLESPIE | ||||||||||||||
| RESP THERP II - REG | $189,511 | $0 | $3,400 | $0 | $125 | $0 | $5,662 | $0 | $48,773 | $0 | $247,471 | $0 | $0 | $0 |
| RYAN E MCELDOWNEY | ||||||||||||||
| CLINICAL STAFF PHARMACIST I | $202,613 | $0 | $0 | $0 | $128 | $0 | $10,986 | $0 | $27,996 | $0 | $241,723 | $0 | $0 | $0 |
| MARSHA S HESS | ||||||||||||||
| CLINICAL STAFF PHARMACIST I | $195,780 | $0 | $0 | $0 | $163 | $0 | $6,827 | $0 | $27,489 | $0 | $230,259 | $0 | $0 | $0 |
| DUANNA R OSTING | ||||||||||||||
| PRES/EXEC DIR-UVMC FOUNDATION | $146,988 | $0 | $35,792 | $0 | $721 | $0 | $6,331 | $0 | $22,117 | $0 | $211,949 | $0 | $0 | $0 |
| DENISE R HERKINS | ||||||||||||||
| DIR-NURSING-SURGERY/TELE-UVMC | $153,133 | $0 | $17,922 | $0 | $731 | $0 | $10,165 | $0 | $19,281 | $0 | $201,232 | $0 | $0 | $0 |
| BENJAMIN A WATSON ESQ | ||||||||||||||
| BOARD SECRETARY (FROM MAY TO SEP) | $0 | $145,490 | $0 | $21,105 | $0 | $309 | $0 | $6,147 | $0 | $8,357 | $0 | $181,408 | $0 | $0 |
| DIANNE RUHENKAMP | ||||||||||||||
| BOARD TREASURER | $130,474 | $0 | $15,837 | $0 | $1,148 | $0 | $10,085 | $0 | $20,454 | $0 | $177,998 | $0 | $0 | $0 |
| SCOTT SWABB DO | ||||||||||||||
| TRUSTEE | $0 | $172,888 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $172,888 | $0 | $0 |
| MARGARET PEGGY W MARK | ||||||||||||||
| FORMER KEY EMPLOYEE | $0 | $0 | $0 | $0 | $0 | $142,194 | $0 | $6,662 | $0 | $8,699 | $0 | $157,555 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | COMPENSATION FOR UPPER VALLEY'S CEO IS REVIEWED AND APPROVED BY PREMIER, WITH WHICH UPPER VALLEY IS AN AFFILIATE. SEE EXPLANATION ON SCHEDULE O FOR FORM 990, PART VI, SECTION B, LINE 15. |
| PART I, LINE 4A: | THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE: MARC BELCASTRO, D.O. $437,592 IN 2023, AND WILL RECEIVE $319,324 IN 2024; GARY GINTER $357,696 IN 2023, AND WILL RECEIVE $214,618 IN 2024; JENNIFER HAULER, D.O. $344,571 IN 2023, AND WILL RECEIVE $233,419 IN 2024; BARBARA JOHNSON $363,235 IN 2023 AND WILL RECEIVE $605,392 IN 2024; MARGARET MARK $144,691 IN 2023. |
| 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, UPPER VALLEY MEDICAL CENTER'S (UPPER VALLEY) AND ITS AFFILIATED ORGANIZATIONS COMPENSATE FOR THIS LIMITATION AND SUPPLEMENT THE AFFECTED EXECUTIVES' QUALIFIED PENSION THROUGH CERTAIN NONQUALIFIED PLANS. UPPER VALLEY SUPPLEMENTS THE AFFECTED EXECUTIVES THROUGH A PENSION RESTORATION PLAN AND A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE BENEFITS UNDER THESE SUPPLEMENTAL NONQUALIFIED PLANS ARE SUBJECT TO MULTI-YEAR VESTING AND A PARTICIPANT CAN FORFEIT BENEFITS EARNED IF VESTING REQUIREMENTS ARE NOT SATISFIED. UNDER THE TERMS OF THE SUPPLEMENTAL PLANS, AND BECAUSE OF TAX RULES PERTAINING TO TAXATION OF THE EARNED BENEFITS UPON VESTING, CERTAIN INDIVIDUALS RECEIVED A PAYOUT OF THE CUMULATIVE VESTED BENEFITS UNDER THEIR SUPPLEMENTAL PLAN DURING 2023. THE INDIVIDUALS LISTED BELOW HAVE MET THE MULTI-YEAR VESTING REQUIREMENT UNDER THE PENSION RESTORATION PLAN RECEIVED THE ASSOCIATED PAYMENT IN 2023: MARY CLANCY $117,983; DIANE PLEIMAN $202,599; J. MICHAEL SIMS $193,261; GEOFFREY WALKER $353,909. THE INDIVIDUALS LISTED BELOW HAVE MET THE MULTI-YEAR VESTING REQUIREMENT UNDER THE SERP AND RECEIVED THE ASSOCIATED PLAN PAYMENT 2023: MARC BELCASTRO, D.O. $48,184; GARY GINTER $19,794; JENNIFER HAULER, D.O. $275,693; BARBARA JOHNSON $77,444; MICHAEL RIORDAN $79,256. IN ADDITION, THE FOLLOWING SERP AMOUNTS WERE DEFERRED ON THE PARTICIPANTS' BEHALF DURING THE YEAR AND WILL BE HELD UNTIL THE INCREMENTAL AMOUNTS ARE VESTED: KEITH BRICKING, M.D. $71,554; ELAINE DEAN $19,981; KEVIN HARLAN $19,935; JENNIFER HAULER, D.O. $58,759; SCOTT KANAGY $22,116; BILLIE LUCENTE-BAKER $2,095; CARA POWERS $10,188; TRISHA WACKLER $5,831. BASED ON THE GUIDANCE PROVIDED IN THE INSTRUCTIONS TO THE FORM 990, ANY PAYMENTS TO THE PARTICIPANTS RELATED TO THESE PLANS THAT WERE MADE WITHIN 2-1/2 MONTHS AFTER THE END OF THE ORGANIZATION'S TAX YEAR ARE AMOUNTS ARE PROPERLY REPORTED AS COMPENSATION FOR FORM 990 PURPOSES NOT TREATED AS DEFERRED COMPENSATION FOR PURPOSES OF SCHEDULE J. SUCH WHEN INCLUDED IN THE PARTICIPANTS' FORM W-2 WAGES. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COUNTY OF MONTGOMERY OHIO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 316000172 | BondIssuerEIN |
| CUSIP | 613520LO6 | CUSIPNum |
| Bond Issued | 2019-09-24 | BondIssuedDt |
| Issue Price | $24,859,875 | IssuePriceAmt |
| Purpose | REFUND SERIES 2016B BONDS | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | $24,859,875 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $228,930 | IssuanceCostsFromProceedsAmt |
| Other Spent Proceeds | $24,630,944 | OtherSpentProceedsAmt |
| Refunding Tax Exempt Bonds | Yes (1) | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | Yes (1) | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00070 | PrivateBusUseByOthersPct |
| Total Private Business Use | 0.00070 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | NOTE A PART I, LINE A, COLUMN E: | FormAndLineReferenceDesc |
| Explanation | ISSUE PRICE IS NOT IDENTICAL TO THE ISSUE PRICE LISTED ON FORM 8038 DUE TO THE SERIES 2019A BONDS' PROCEEDS BEING SPLIT BETWEEN UPPER VALLEY MEDICAL CENTER, ATRIUM MEDICAL CENTER AND MIAMI VALLEY HOSPITAL. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| SHARON POEPPELMAN | |||
| SIBLING TO DIANNE RUHENKAMP, OFFICER | $89,518 | EMPLOYMENT | 0 |
| KURT POEPPELMAN | |||
| BROTHER IN LAW TO DIANNE RUHENKAMP, OFFICER | $67,893 | EMPLOYMENT | 0 |
Schedule M IRS990ScheduleM
Clothing And Household Goods ClothingAndHouseholdGoodsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $12,103 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | EMPLOYEE FOOD | Desc |
| Contribution | 6 | ContributionCnt |
| Noncash Contributions Rpt F990 | $15,257 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | PREMIER HEALTH (PREMIER) AS THE OPERATOR OF UPPER VALLEY MEDICAL CENTER (UPPER VALLEY), DEVELOPS AND OVERSEES THE IMPLEMENTATION OF THE STRATEGIC PLAN FOR UPPER VALLEY, WHICH INCLUDES (BUT IS NOT LIMITED TO) SUCH MATTERS AS LOCATION OF CLINICAL AND ADMINISTRATIVE EXPENSES AND THE CONSOLIDATION OF SUCH SERVICES. UPPER VALLEY SHALL COMPLY WITH AND IMPLEMENT THIS PLAN AND SHALL NOT TAKE ANY ACTION THAT MATERIALLY DEPARTS FROM THIS PLAN WITHOUT PREMIER'S APPROVAL. UPPER VALLEY SHALL IMPLEMENT ANY CAPITAL AND OPERATING BUDGET SO APPROVED AND/OR REVISED FOR IT BY PREMIER. UPPER VALLEY SHALL IMPLEMENT THE BUSINESS PLAN APPROVED BY PREMIER. PREMIER IS THE SOLE AGENT TO NEGOTIATE ALL RELATIONSHIPS WITH PAYORS ON BEHALF OF UPPER VALLEY WITH ALL THIRD-PARTY PAYORS AND ALTERNATIVE DELIVERY SYSTEMS INCLUDING, BUT NOT LIMITED TO INSURERS. UPPER VALLEY MUST HAVE APPROVAL FROM PREMIER 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 $1,000,000. UPPER VALLEY MUST SEEK PREMIER'S APPROVAL FOR ANY ACQUISITIONS, SALE OR TRANSFER OF ANY MATERIAL ASSET USED IN UPPER VALLEY'S ACTIVITIES. |
| FORM 990, PART VI, SECTION A, LINE 6 | UPPER VALLEY HAS ONE CORPORATE MEMBER; PREMIER, AN OHIO NON-PROFIT CORPORATION |
| FORM 990, PART VI, SECTION A, LINE 7A | PREMIER HAS THE SOLE AUTHORITY TO ELECT THE BOARD OF TRUSTEES FOR UPPER VALLEY. PREMIER HAS THE AUTHORITY TO REMOVE SUCH TRUSTEES AT ANY REGULAR OR SPECIAL MEETING OR BY WRITTEN CONSENT. |
| FORM 990, PART VI, SECTION A, LINE 7B | SEE EXPLANATION FOR LINE 7A. |
| FORM 990, PART VI, SECTION B, LINE 11B | THIS 990 FILING RETURN AND ATTACHED SCHEDULES (THE RETURN) ARE PREPARED BY A STAFF MEMBER IN THE PREMIER TAX DEPARTMENT, OF WHICH UPPER VALLEY IS AN AFFILIATE. THE RETURN IS REVIEWED BY THE MANAGER AND DIRECTOR OF TAX COMPLIANCE OF PREMIER. AFTER ALL CHANGES FROM THE ABOVE PERSONS ARE MADE, THE RETURN IS REVIEWED BY THE VICE-PRESIDENT/CONTROLLER OF PREMIER. A FINAL VERSION OF THE RETURN IS PROVIDED TO THE BOARD OF TRUSTEES FOR REVIEW. AT A BOARD OF TRUSTEES MEETING, THE VICE PRESIDENT/CONTROLLER OF PREMIER (OR DESIGNEE) SHARES DETAILED INFORMATION ON COMPENSATION AND OTHER KEY AREAS, AS WELL AS ADDRESSES ANY QUESTIONS FROM THE BOARD OF TRUSTEES, PENDING THEIR REVIEW. THE 990 FILING IS ALSO SHARED WITH THE AUDIT COMMITTEE OF PREMIER. |
| FORM 990, PART VI, SECTION B, LINE 12C | PREMIER, WITH WHICH UPPER VALLEY IS AN AFFILIATE, REQUIRES ALL BOARD MEMBERS, BOARD COMMITTEE MEMBERS, MEDICAL DIRECTORS, SUPPLY CHAIN DIVISION MEMBERS, AUTHORIZED SIGNERS, DIRECTORS, EXECUTIVES, MEDICAL EXECUTIVE COMMITTEE MEMBERS, MEDICAL DEPARTMENT AND SECTION CHAIRS, PHYSICIAN PARTNERSHIP COMMITTEE MEMBERS, PHYSICIAN GUIDANCE GROUP MEMBERS, AND ALL EMPLOYED PHYSICIANS TO ANNUALLY REVIEW THE PREMIER 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 CONFLICT OF INTEREST POLICY. THIS IS ACCOMPLISHED EITHER BY WAY OF AN ELECTRONIC COMMUNICATION SENT OUT DIRECTLY BY THE CORPORATE COMPLIANCE DEPARTMENT OR BY WAY OF A MEMO SENT OUT FROM THE CHAIRMAN OF THE BOARD AND CHIEF EXECUTIVE OFFICER OF PREMIER. 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. THIS CORRESPONDENCE 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 DEPARTMENT. 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 PREVIOUS MEETING'S MINUTES, THE BOARD OR COMMITTEE CHAIR SHALL REQUEST ANY BOARD MEMBER WHO PERCEIVES A POTENTIAL CONFLICT OF INTEREST ON ANY OF THE MEETING'S AGENDA ITEMS TO DISCLOSE THE POTENTIAL CONFLICT. ADDITIONALLY, AT ANY BOARD OR BOARD COMMITTEE MEETING WHERE THE SUBJECT OF CONFLICT OF INTEREST IS DISCUSSED, THE 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 IS DETERMINED BY THE BOARD TO EXIST, THE MEMBER WILL BE EXCUSED FROM PARTICIPATING IN ANY DISCUSSION OR VOTING ON THE PARTICULAR AGENDA ITEM. THE CHIEF COMPLIANCE AND ENTERPRISE RISK OFFICER REPORTS THE RESULTS OF THE PREMIER CONFLICT 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 CONFLICT OF INTEREST QUESTIONNAIRES ARE INDIVIDUALLY SUMMARIZED IN A DOCUMENT AND SENT ELECTRONICALLY TO THE FINANCE DEPARTMENT FOR ANY NECESSARY DISCLOSURES REQUIRED ON THE 990 FILING. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION FOR UPPER VALLEY'S CEO IS REVIEWED AND APPROVED BY PREMIER, WITH WHICH UPPER VALLEY IS AN AFFILIATE, ON AN ANNUAL BASIS. THE REVIEW PROCESS PERFORMED BY PREMIER 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. PREMIER ANNUALLY REVIEWS EXECUTIVE COMPENSATION SURVEY DATA FOR A REGIONAL AND NATIONAL PEER GROUP OF SYSTEMS AND HOSPITALS THAT ARE SIMILAR IN SIZE AND COMPLEXITY TO PREMIER AND ITS AFFILIATES. THE DATA FOR THE SURVEY IS PROVIDED BY A THIRD-PARTY CONSULTANT GROUP THAT IS INDEPENDENT OF PREMIER. THIS REPORT INCLUDES COMPARABILITY DATA 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 CONTAINS THREE MEMBERS, ALL OF WHOM ARE INDEPENDENT. THIS COMMITTEE REVIEWS IN DETAIL THE COMPENSATION FOR THE PREMIER CEO, COO, CFO, CCO AND OTHER TOP EXECUTIVES. 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 PREMIER BOARD ANNUALLY. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC WHEN REQUIRED BY LAW OR FOR ACCREDITATION PURPOSES. THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 14,796,630. MANAGEMENT AND GENERAL EXPENSES 503,930. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,300,560. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 11,463,557. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,463,557. PURCHASED LABOR: PROGRAM SERVICE EXPENSES 3,341,087. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,341,087. CHI C/E DIRECT CHARGE: PROGRAM SERVICE EXPENSES 2,035,702. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,035,702. COLLECTION FEES: PROGRAM SERVICE EXPENSES 733,838. MANAGEMENT AND GENERAL EXPENSES 47,501. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 781,339. PROF/CONSULTING FEES: PROGRAM SERVICE EXPENSES 81,424. MANAGEMENT AND GENERAL EXPENSES 267,117. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 348,541. |
| FORM 990, PART XI, LINE 9: | EQUITY TRANSFERS WITH AFFILIATES -21,609,090. PENSION ADJUSTMENT -1,786,516. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (15 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| PREMIER HEALTH | |||||||||||
| 110 MAIN STREET SUITE 200 | DAYTON | OH | 45402 | 311446699 | PARENT | OH | 501 (C) (3) | 12B | N/A | 0 | |
| MEDAMERICA HEALTH SYSTEMS CO | |||||||||||
| 110 MAIN STREET SUITE 200 | DAYTON | OH | 45402 | 311040228 | SUPPORT ORG | OH | 501 (C) (3) | 12B | N/A | 0 | |
| MIAMI VALLEY HOSPITAL | |||||||||||
| 110 MAIN STREET SUITE 200 | DAYTON | OH | 45402 | 310537504 | HOSPITAL | OH | 501 (C) (3) | 3 | 0 | PREMIER HEALTH | |
| MIAMI VALLEY HOSPITAL FOUNDATION | |||||||||||
| 110 MAIN STREET SUITE 200 | DAYTON | OH | 45402 | 311040231 | FOUNDATION | OH | 501 (C) (3) | 7 | 0 | PREMIER HEALTH | |
| FIDELITY HEALTH CARE INC | |||||||||||
| 110 MAIN STREET SUITE 200 | DAYTON | OH | 45402 | 311075381 | HOME HEALTH | OH | 501 (C) (3) | 10 | 0 | PREMIER HEALTH | |
| PREMIER COMMUNITY HEALTH | |||||||||||
| 110 MAIN STREET SUITE 200 | DAYTON | OH | 45402 | 311122883 | HEALTH EDUCATION | OH | 501 (C) (3) | 10 | 0 | FIDELITY HEALTH CARE | |
| GOOD SAMARITAN FOUNDATION - DAYTON | |||||||||||
| 110 MAIN STREET SUITE 200 | DAYTON | OH | 45402 | 237296923 | FOUNDATION | OH | 501 (C) (3) | 7 | 0 | PREMIER HEALTH | |
| ATRIUM HEALTH SYSTEM | |||||||||||
| 110 MAIN STREET SUITE 200 | DAYTON | OH | 45402 | 310537492 | SUPPORT ORG | OH | 501 (C) (3) | 12B | N/A | 0 | |
| ATRIUM MEDICAL CENTER | |||||||||||
| 110 MAIN STREET SUITE 200 | DAYTON | OH | 45402 | 311079309 | HOSPITAL | OH | 501 (C) (3) | 3 | 0 | PREMIER HEALTH | |
| UVMC | |||||||||||
| 110 MAIN STREET SUITE 200 | DAYTON | OH | 45402 | 341850683 | SUPPORT ORG | OH | 501 (C) (3) | 12B | N/A | 0 | |
| UPPER VALLEY PROFESSIONAL CORP | |||||||||||
| 110 MAIN STREET SUITE 200 | DAYTON | OH | 45402 | 311400963 | HEALTH CARE | OH | 501 (C) (3) | 10 | 0 | PREMIER HEALTH HOLDING CO | |
| UVPC SPECIALISTS | |||||||||||
| 110 MAIN STREET SUITE 200 | DAYTON | OH | 45402 | 203687536 | HEALTH CARE | OH | 501 (C) (3) | 10 | 0 | PREMIER HEALTH HOLDING CO | |
| UVMC NURSING CARE INC | |||||||||||
| 110 MAIN STREET SUITE 200 | DAYTON | OH | 45402 | 311224064 | NURSING HOME | OH | 501 (C) (3) | 10 | 0 | PREMIER HEALTH | |
| COMPUNET CLINICAL LABORATORIES LLC | |||||||||||
| 110 MAIN STREET SUITE 200 | DAYTON | OH | 45402 | 311258010 | LAB | OH | 501 (C) (3) | 12B | 0 | PREMIER HEALTH | |
| SAMARITAN BEHAVIORAL HEALTH INC | |||||||||||
| 110 MAIN STREET SUITE 200 | DAYTON | OH | 45402 | 020633634 | BEHAVIORAL HEALTH | OH | 501 (C) (3) | 7 | 0 | PREMIER HEALTH | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|---|
| SWEITZER STREET LLC | ||||||||||
| 110 MAIN STREET SUITE 200 | DAYTON | OH | 45402 | 454700417 | REAL ESTATE | OH | MVHE INC | EXCLUDED | 0 | 0 |
| SWEITZER MOB LLC | ||||||||||
| 110 MAIN STREET SUITE 200 | DAYTON | OH | 45402 | 474554657 | REAL ESTATE | OH | MVHE INC | EXCLUDED | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (12 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MVHE INC | ||||||||||||||
| 110 MAIN STREET SUITE 200 | DAYTON | OH | 45402 | 311185270 | PHYSICIAN SVCS | OH | PREMIER HEALTH HOLDING CO | C | 0 | |||||
| PREMIER HEALTH SPECIALISTS | ||||||||||||||
| 110 MAIN STREET SUITE 200 | DAYTON | OH | 45402 | 061744704 | PHYSICIAN SVCS | OH | PREMIER HEALTH HOLDING CO | C | 0 | |||||
| SAMARITAN FAMILY CARE | ||||||||||||||
| 110 MAIN STREET SUITE 200 | DAYTON | OH | 45402 | 311299450 | PHYSICIAN SVCS | OH | PREMIER HEALTH HOLDING CO | C | 0 | |||||
| AFTER HOURS FAMILY CARE | ||||||||||||||
| 110 MAIN STREET SUITE 200 | DAYTON | OH | 45402 | 311269483 | HEALTH CARE | OH | UPPER VALLEY PROFESSIONAL CORP | C | 0 | |||||
| UVMC MANAGEMENT CORP | ||||||||||||||
| 110 MAIN STREET SUITE 200 | DAYTON | OH | 45402 | 311360489 | MANAGEMENT COMPANY | OH | PREMIER HEALTH | C | 0 | |||||
| PREMIER HEALTH URGENT CARE INC | ||||||||||||||
| 110 MAIN STREET SUITE 200 | DAYTON | OH | 45402 | 822079409 | URGENT CARE | OH | PREMIER HEALTH HOLDING CO | C | 0 | |||||
| PREMIER HEALTH PLAN INC | ||||||||||||||
| 110 MAIN STREET SUITE 200 | DAYTON | OH | 45402 | 463024049 | HEALTH INSURANCE | OH | PREMIER HEALTH INSURING CO | C | 0 | |||||
| GOOD SAMARITAN HOSPITAL | ||||||||||||||
| 110 MAIN STREET SUITE 200 | DAYTON | OH | 45402 | 310536981 | HOSPITAL | OH | PREMIER HEALTH | C | 0 | |||||
| PREMIER HEALTH INT'L INSURANCE | ||||||||||||||
| 980548485 | INSURANCE | PREMIER HEALTH | C | 0 | BUTTERFIELD BANK BLDG 6TH FLR 65 | HAMILTON | BD | HM12 | BD | |||||
| PREMIER HEALTH ACO OF OHIO | ||||||||||||||
| 110 MAIN STREET SUITE 200 | DAYTON | OH | 45402 | 474049773 | MEDICARE ACO | OH | PREMIER HEALTH | C | 0 | |||||
| PREMIER HEALTH HOLDING CO | ||||||||||||||
| 110 MAIN STREET SUITE 200 | DAYTON | OH | 45402 | 812419110 | HOLDING CO | OH | PREMIER HEALTH | C | 0 | |||||
| PREMIER HEALTH INSURING CO | ||||||||||||||
| 110 MAIN STREET SUITE 200 | DAYTON | OH | 45402 | 464766841 | HEALTH INSURANCE | OH | PREMIER HEALTH | C | 0 | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | Yes (1) | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
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