UNITY MEDICAL CENTER INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
UNITY MEDICAL CENTER INC (EIN 82-5388429)
Tax period
2022-01-01 to 2022-12-31
Filed
2023-11-15
IRS object ID
202303199349330760
Schema version
2022v5.0
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2023-11-15T20:39:18-06:00ReturnTs
Tax Period End2022-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN454084437PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WARREN AVERETT LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12500 ACTON ROADAddressLine1Txt
CityBIRMINGHAMCityNm
State AbbreviationALStateAbbreviationCd
ZIP35243ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN825388429EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1UNITY MEDICAL CENTER INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlUNITBusinessNameControlTxt
Phone6153088800PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1481 INTERSTATE DRIVEAddressLine1Txt
CityMANCHESTERCityNm
State AbbreviationTNStateAbbreviationCd
ZIP37355ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonASHOKE MUKHERJIPersonNm
Person TitleCHAIRMANPersonTitleTxt
Phone6153088800PhoneNum
Signature2023-11-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstASHOKEPersonFirstNm
Person LastMUKHERJIPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (1)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMEGAN RANDOLPHPreparerPersonNm
PTINP00989558PTIN
Phone2059794100PhoneNum
Preparation2023-11-15PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerPAM JERNIGANPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1481 INTERSTATE DRIVEAddressLine1Txt
CityMANCHESTERCityNm
State AbbreviationTNStateAbbreviationCd
ZIP37355ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$48,910,386GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressUNITYMEDICALMANCHESTER.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2018FormationYr
Legal Domicile StateTNLegalDomicileStateCd
Activity Or MissionTO PROVIDE IMPROVED HEALTHCARE TO LOCAL RESIDENTS. PROVIDE LEADERSHIP AND DEVELOPMENT OF ADDITIONAL SERVICES TO THE COMMUNITY.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee333TotalEmployeeCnt
Total Volunteers9TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$5,066,967PYContributionsGrantsAmt
CY Contributions Grants$1,216,934CYContributionsGrantsAmt
PY Program Service Revenue$48,819,211PYProgramServiceRevenueAmt
CY Program Service Revenue$47,692,972CYProgramServiceRevenueAmt
PY Investment Income$173PYInvestmentIncomeAmt
CY Investment Income$480CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$53,886,351PYTotalRevenueAmt
CY Total Revenue$48,910,386CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$3,000CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$18,738,210PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$17,801,880CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$27,989,388PYOtherExpensesAmt
CY Other Expenses$29,042,476CYOtherExpensesAmt
PY Total Expenses$46,727,598PYTotalExpensesAmt
CY Total Expenses$46,847,356CYTotalExpensesAmt
PY Revenues Less Expenses$7,158,753PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,063,030CYRevenuesLessExpensesAmt
Total Assets BOY$57,842,404TotalAssetsBOYAmt
Total Assets EOY$54,267,464TotalAssetsEOYAmt
Total Liabilities BOY$42,634,475TotalLiabilitiesBOYAmt
Total Liabilities EOY$36,996,505TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$15,207,929NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$17,270,959NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE QUALITY, COMPASSIONATE, COST-EFFECTIVE HEALTHCARE RESPONSIVE TO THE NEEDS OF THE COMMUNITIES WE SERVE, WHILE UPHOLDING THE HIGHEST ETHICAL STANDARDS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$41,204,393ExpenseAmt
Grant$3,000GrantAmt
Revenue$47,692,972RevenueAmt
DescHOSPITAL SERVICES INCLUDING HASEMEIER GROUP NURSING HOME VISITS - 76,392, LABORATORY TESTS AND PROCEDURES - 108,496, EMERGENCY ROOM VISITS - 12,268, ICU PATIENT DAYS - 411, ROUTINE INPATIENT DAYS - 3,655, INTERMEDIATE CARE DAYS - 641.Desc
Total Program Service Expenses$41,204,393TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan OutstandingYes (1)LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org MemYes (1)BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntYes (1)BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document89IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee333EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE ORGANIZATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6153088800PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1481 INTERSTATE DRIVEAddressLine1Txt
CityMANCHESTERCityNm
State AbbreviationTNStateAbbreviationCd
ZIP37355ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
ROBERT COUCH
COO40.000.00Yes (X)Yes (X)$749,593$0$36,986
ASHOKE MUKHERJI
CHAIRMAN40.000.00Yes (X)Yes (X)$635,940$0$11,252
MARTHA HENLEY
CEO40.000.00Yes (X)Yes (X)$623,090$0$12,524
KIM ROBERTS
BOARD MEMBER0.650.00Yes (X)$0$0$0
MIKE NIEDERHAUSER
BOARD MEMBER0.650.00Yes (X)$0$0$0
JAMES VANWINKLE
BOARD MEMBER0.650.00Yes (X)$0$0$0
BLAL ZAFAR
BOARD MEMBER0.650.00Yes (X)$450,500$0$0
ART SNOW
BOARD MEMBER0.650.00Yes (X)$0$0$0
CHRISTY LEWIS
BOARD MEMBER0.650.00Yes (X)$0$0$0
KENNETH KIRBY
BOARD MEMBER0.650.00Yes (X)$0$0$0
CHARLES DRUMMOND
BOARD MEMBER0.650.00Yes (X)$0$0$0
PAMELA JERNIGAN
SR FINANCIAL ADVISOR40.000.00Yes (X)$528,597$0$31,094
JAMES BARMES
SR FINANCIAL OFFICER40.000.00Yes (X)$101,960$0$0
KENNETH WARE
CHEIF CLINICAL OFFICER40.000.00Yes (X)$137,446$0$4,325
JODY MILLS
CHIEF COMPLIANCE OFFICER40.000.00Yes (X)$79,472$0$2,430
CLARISSA SAIN
CFO40.000.00Yes (X)$122,136$0$24,011
DENNY DANIEL
PHYSICIAN40.000.00$338,564$0$21,981Yes (X)
GLENN DAVIS
PHYSICIAN40.000.00$289,158$0$7,954Yes (X)
JAMES POOLE
HOSPITALIST40.000.00$363,820$0$0Yes (X)
RENE AGUIRRE
HOSPITALIST40.000.00$327,280$0$0Yes (X)
SARAH WILSON
PHYSICIAN40.000.00$240,464$0$39,183Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$4,988,020TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$191,740TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K30IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
DR HASEMEIER & ASSOCIATES
PO BOX 1010DANDREDGETN37725STAFFING NURSING HOME VISITS$5,171,936
HOUSECALL TODAY INC
5221 RAVENS GLENNASHVILLETN37211STAFFING NURSING HOME VISITS$3,275,414
RAPHA CENTRE
482 INTERSTATE DRIVEMANCHESTERTN37355STAFFING ADDICTION CLINIC VISITS$2,577,520
GERIATRIC CONSULTANTS
132 MAPLE ROW BLVDHENDERSONVILLETN37075STAFFING NURSING HOME VISITS$1,825,894
SENIOR HEALTH PARTNERS
5221 RAVENS GLENNASHVILLETN37211STAFFING NURSING HOME VISITS$569,096
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K7CntrctRcvdGreaterThan100KCnt
Government Grants$1,216,934GovernmentGrantsAmt
Total Contributions$1,216,934TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE621990$46,222,829$46,222,829
OTHER REVENUE621990$1,470,143$1,470,143
FieldValueIRS element (for citing)
Total Program Service Revenue$47,692,972TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$480TotalRevenueColumnAmt
Exclusion$480ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$48,910,386TotalRevenueColumnAmt
Related Or Exempt Func Income$47,692,972RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$480ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$3,000TotalAmt
Program Services$3,000ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$4,046,420TotalAmt
Program Services$3,266,965ProgramServicesAmt
Management And General$779,455ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$11,113,806TotalAmt
Program Services$8,972,974ProgramServicesAmt
Management And General$2,140,832ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,641,654TotalAmt
Program Services$2,132,797ProgramServicesAmt
Management And General$508,857ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$102,245TotalAmt
Management And General$102,245ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$19,687,327TotalAmt
Program Services$18,457,388ProgramServicesAmt
Management And General$1,229,939ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$69,540TotalAmt
Management And General$69,540ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$197,797TotalAmt
Program Services$125,689ProgramServicesAmt
Management And General$72,108ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,043,078TotalAmt
Program Services$870,970ProgramServicesAmt
Management And General$172,108ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$41,315TotalAmt
Program Services$29,388ProgramServicesAmt
Management And General$11,927ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$47,906TotalAmt
Program Services$38,536ProgramServicesAmt
Management And General$9,370ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,705,446TotalAmt
Program Services$1,705,446ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$956,594TotalAmt
Program Services$798,756ProgramServicesAmt
Management And General$157,838ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$518,177TotalAmt
Program Services$432,678ProgramServicesAmt
Management And General$85,499ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
SUPPLIES AND DRUGS$3,312,079$3,301,754$10,325
REPAIRS AND MAINTENANCE$595,049$496,866$98,183
UTILITIES$471,977$394,101$77,876
MISCELLANEOUS$293,946$177,085$116,861

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$46,847,356TotalAmt
Program Services$41,204,393ProgramServicesAmt
Management And General$5,642,963ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$8,060,175BOYAmt
EOY$524,975EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$7,607,747BOYAmt
EOY$11,441,752EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$5,659BOYAmt
EOY$5,659EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$679,921BOYAmt
EOY$675,592EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$247,908BOYAmt
EOY$145,872EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$36,115,644LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$16,564,863LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$19,293,786BOYAmt
EOY$19,550,781EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$21,947,208BOYAmt
EOY$21,922,833EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$57,842,404BOYAmt
EOY$54,267,464EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$6,628,876BOYAmt
EOY$9,509,774EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$2,952,945BOYAmt
EOY$2,904,097EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$25,990,522BOYAmt
EOY$24,582,634EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,062,132BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$42,634,475BOYAmt
EOY$36,996,505EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$15,207,929BOYAmt
EOY$17,270,959EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$15,207,929BOYAmt
EOY$17,270,959EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$57,842,404BOYAmt
EOY$54,267,464EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$2,063,030ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$2,017OtherActivitiesAmt
Total Lobbying Expenditures$2,017TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationPORTION OF HOSPITAL ASSOCIATION MEMBERSHIP DUES THAT ARE USED FOR LOBBYING.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,259,036OtherCostOrOtherBasisAmt
Book Value$1,259,036BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$16,710,467OtherCostOrOtherBasisAmt
Depreciation$4,753,124DepreciationAmt
Book Value$11,957,343BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$150,000OtherCostOrOtherBasisAmt
Book Value$150,000BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$16,652,724OtherCostOrOtherBasisAmt
Depreciation$11,716,862DepreciationAmt
Book Value$4,935,862BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,343,417OtherCostOrOtherBasisAmt
Depreciation$94,877DepreciationAmt
Book Value$1,248,540BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$19,550,781TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
GOODWILL$21,750,557
DEPOSITS$53,069
RELATED PARTY RECIEVABLE$119,207
FieldValueIRS element (for citing)
Total Book Value Other Assets$21,922,833TotalBookValueOtherAssetsAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically Indigent0FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$508,808TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$651,710DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,477,759TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,585,687DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,892,072NetCommunityBenefitExpnsAmt
Total Expense0.05870TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,986,567TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,237,397DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,892,072NetCommunityBenefitExpnsAmt
Total Expense0.05870TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,986,567TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,237,397DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,892,072NetCommunityBenefitExpnsAmt
Total Expense0.05870TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$4,319,018BadDebtExpenseAmt
Bad Debt Expense Attributable$1,959,836BadDebtExpenseAttributableAmt
Reimbursed By Medicare$14,885,937ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$14,228,855CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$657,082MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection Policy0WrittenDebtCollectionPolicyInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1UNITY MEDICAL CENTERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1481 INTERSTATE DRIVEAddressLine1Txt
CityMANCHESTERCityNm
State AbbreviationTNStateAbbreviationCd
ZIP37355ZIPCd
FieldValueIRS element (for citing)
State License0000000017StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1UNITY MEDICAL CENTER INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted22CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART V, PAGE 8OwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy Adopt0ImplementationStrategyAdoptInd
Organization Incur Excise TaxYes (1)OrganizationIncurExciseTaxInd
Form4720 FiledYes (1)Form4720FiledInd
Excise Report Form4720 For All$50,000ExciseReportForm4720ForAllAmt
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained Basis0ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLHTTPS://WWW.UNITYMEDICALMANCHESTER.COM/INSURANCEFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLHTTPS://WWW.UNITYMEDICALMANCHESTER.COM/INSURANCEFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLHTTPS://WWW.UNITYMEDICALMANCHESTER.COM/INSURANCEFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit Report To Credit AgencyYes (X)PermitReportToCreditAgencyInd
Permit Legal Judicial ProcessYes (X)PermitLegalJudicialProcessInd
Collection ActivitiesYes (1)CollectionActivitiesInd
Reporting To Credit AgencyYes (X)ReportingToCreditAgencyInd
Engaged Legal Judicial ProcessYes (X)EngagedLegalJudicialProcessInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr PrvtYes (X)LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
UNITY MEDICAL CENTER, INC.PART V, SECTION B, LINE 5: WITH A FOCUS ON THE DEMOGRAPHIC HEALTH INDICATORS, A COMMUNITY HEALTH COMMITTEE WAS FORMED BY UNITY MEDICAL CENTER TO REPRESENT THE BROAD INTEREST OF THE COMMUNITY TO WEIGH IN ON THE HEALTH ISSUES IMPACTING THE COMMUNITY. A SURVEY WAS GENERATED TO INQUIRE ABOUT THE COMMUNITY AND PRIORTIZE ISSUES THAT IMPACT HEALTH. THIS SURVEY WAS POSTED ONLINE AND DISTRIBUTED WITHIN THE COMMUNITY THROUGH AVENUES SUCH AS THE HOSPITAL, CHAMBER OF COMMERCE, PUBLIC SCHOOL BOARD, LOCAL CHURCH, EMERGENCY RESPONDERS, AND OTHER CIVIC GROUP EMAIL SERVICES. THE METHODOLOGY UTILIZED IN THIS ASSESSSMENT INCORPORATED BOTH QUANTITATIVE AND QUALITATIVE SOURCES. QUANTITATIVE DATA INCLUDED THE PRIMARY RESEARCH (THE SURVEY) AND SECONDARY RESEARCH (VITAL STATISTICS AND EXISTING HEALTH-RELATED DATA). QUALITATIVE DATA INCLUDED PRIMARY RESEARCH GATHERED THROUGH THE ONLINE SURVEY IN ADDITION TO THE EXPERTISE PROVIDED BY THE COMMUNITY HEALTH COMMITTEE THAT WAS FORMED BY THE HOSPITAL.
UNITY MEDICAL CENTER, INC.PART V, SECTION B, LINE 11: THE COMMUNITY HEALTH NEEDS COMMITTEE WAS PRESENTED THE TOP TEN MOST SIGNIFICANT HEALTH ISSUES. THE 2022 COMMUNITY HEALTH PRIORITIES IDENTIFIED BY THE COMMITTEE AND APPROVED BY THE HOSPITAL BOARD OF DIRECTORS ARE: CANCER, HEART DISEASE AND STROKE. THE COMMUNITY HEALTH NEEDS COMMITTEE ELIMINATED HEALTH INSURANCE AND PRESCRIPTION DRUG AFFORDABILITY BECAUSE THEY ARE NATIONAL HEALTH CONCERNS AND WOULD LIKELY BE MET WITH MINIMAL POSITIVE RESULTS.
PART V, SECTION B, LINE 7AWWW.UNITYMEDICALMANCHESTER.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENT

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART III, LINE 2:THE MEDICAL CENTER'S ESTIMATE OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED PRIMARILY ON THE TYPE AND AGE OF THE PATIENT'S ACCOUNTS RECEIVABLE. THE POLICY IS TO RESERVE A PORTION OF ALL SELF-PAY ACCOUNTS, INCLUDING AMOUNTS DUE FROM UNINSURED PATIENTS AND AMOUNTS RELATED TO CO-PAYMENTS AND DEDUCTIBLES. ON A MONTHLY BASIS, THE MEDICAL CENTER REVIEWS ITS ESTIMATE AND PERFORMS ANALYTICAL PROCEDURES, INCLUDING REVIEW OF THE ACCOUNTS RECEIVABLE AGING AND PAYOR MIX. THE MEDICAL CENTER ALSO PERFORMS RETROSPECTIVE REVIEWS OF WRITE-OFFS AND COLLECTIONS TO ENSURE THE ESTIMATE IS REASONABLE GOING FORWARD.
PART III, LINE 3:THE COST OF BAD DEBT IS DETERMINED BY APPLYING THE RATIO OF PATIENT CARE COST TO CHARGES TO THE TOTAL BAD DEBT.
PART III, LINE 4:GENERALLY, PATIENTS WHO ARE COVERED BY THIRD-PARTY PAYERS ARE RESPONSIBLE FOR RELATED DEDUCTIBLES AND COINSURANCE, WHICH VARY IN AMOUNT. THE ORGANIZATION ALSO PROVIDES SERVICES TO UNINSURED PATIENTS WHO DO NOT QUALIFY FOR CHARITY CARE, AND OFFERS THOSE UNINSURED PATIENTS A DISCOUNT, EITHER BY POLICY OR LAW, FROM STANDARD CHARGES. THE ORGANIZATION ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND COINSURANCE, AND FROM THOSE WHO ARE UNINSURED, BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS AND IMPLICIT PRICE CONCESSIONS. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE. BAD DEBT EXPENSE FOR THE YEARS ENDED DECEMBER 31, 2022 WAS NOT SIGNIFICANT.
PART VI, LINE 2:THE HOSPITAL ANALYZES DATA RECEIVED FROM LOCAL, REGIONAL, AND STATE AGENCIES IN ORDER TO ACCURATELY AND ADEQUATELY INDENTIFY THE NEEDS OF THE COMMUNITY THROUGH SERVICES PROVIDED BY UNITY HOSPITAL.
PART VI, LINE 3:INFORMATION TO INFORM AND EDUCATE PATIENTS REGARDING ASSISTANCE UNDER FEDERAL, STATE OR LOCAL PROGRAMS AND UNITY POLICIES IS AVAILABLE UPON ADMISSION AND IS POSTED IN PATIENT ROOMS. HOSPITAL BUSINESS OFFICE REPRESENTATIVES ARE AVAILABLE BEFORE, DURING AND FOLLOWING PATIENT STAYS TO DISCUSS PAYMENT ARRANGEMENTS, FINANCIAL ASSISTANCE, AND QUESTIONS ABOUT BILLING. FOR INPATIENT AND SUBACUTE REFERRALS, THE NURSE LIASONS ARE THE FIRST POINT OF CONTACT FOR INFORMATION DISSEMINATION TO PROSPECTIVE PATIENTS REGARDING AVAILABILITY OF ASSISTANCE, ELIGIBILITY CRITERIA AND APPLICATION INFORMATION.
PART VI, LINE 4:UNITY SERVES MIDDLE TENNESSEE.
PART VI, LINE 7, REPORTS FILED WITH STATESTN

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractYes (X)WrittenEmploymentContractInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ROBERT COUCH
COO$749,593$0$0$0$0$0$4,942$0$32,044$0$786,579$0$0$0
ASHOKE MUKHERJI
CHAIRMAN$635,940$0$0$0$0$0$11,252$0$0$0$647,192$0$0$0
MARTHA HENLEY
CEO$623,090$0$0$0$0$0$11,510$0$1,014$0$635,614$0$0$0
PAMELA JERNIGAN
SR FINANCIAL ADVISOR$528,597$0$0$0$0$0$9,032$0$22,062$0$559,691$0$0$0
BLAL ZAFAR
BOARD MEMBER$450,500$0$0$0$0$0$0$0$0$0$450,500$0$0$0
JAMES POOLE
HOSPITALIST$363,820$0$0$0$0$0$0$0$0$0$363,820$0$0$0
DENNY DANIEL
PHYSICIAN$338,564$0$0$0$0$0$0$0$21,981$0$360,545$0$0$0
RENE AGUIRRE
HOSPITALIST$327,280$0$0$0$0$0$0$0$0$0$327,280$0$0$0
GLENN DAVIS
PHYSICIAN$289,158$0$0$0$0$0$7,954$0$0$0$297,112$0$0$0
SARAH WILSON
PHYSICIAN$240,464$0$0$0$0$0$7,214$0$31,969$0$279,647$0$0$0

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (8 entries)

Relationship With OrgRelationshipWithOrgTxtLoan PurposeLoanPurposeTxtLoan To OrganizationLoanToOrganizationIndOriginal PrincipalOriginalPrincipalAmtBalance DueBalanceDueAmtDefaultDefaultIndBoard Or Committee ApprovalBoardOrCommitteeApprovalIndWritten AgreementWrittenAgreementInd
ROBERT COUCH
OFFICERHOSPITAL FINANCINGYes (X)$111,000$101,3380Yes (1)Yes (1)
ASHOKE BAPPA MUKHERJI
OFFICERHOSPITAL FINANCINGYes (X)$643,695$595,5140Yes (1)Yes (1)
MARTHA HENLEY
OFFICERHOSPITAL FINANCINGYes (X)$504,000$460,1280Yes (1)Yes (1)
PAMELA JERNIGAN
OFFICERHOSPITAL FINANCINGYes (X)$686,700$626,9240Yes (1)Yes (1)
MIKE NIEDERHAUSER
BOARD MEMBERHOSPITAL FINANCINGYes (X)$30,000$27,3890Yes (1)Yes (1)
JAMES VANWINKLE
BOARD MEMBERHOSPITAL FINANCINGYes (X)$246,000$224,5860Yes (1)Yes (1)
EVELYN CASE TRUST
FAMILY MEMBERHOSPITAL FINANCINGYes (X)$261,000$238,2810Yes (1)Yes (1)
IMMEDIATE RELATIVE
ASOKE MUKHERJIHOSPITAL FINANCINGYes (X)$720,000$629,9370Yes (1)Yes (1)
FieldValueIRS element (for citing)
Total Balance Due$2,904,097TotalBalanceDueAmt

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
RAPHA
CHAIRMAN ASHOKE MUKHERJI IS A MAJORITY OWNER$2,718,542CLINIC ADDICTION0
COFFEE ASSOCIATES PROPERTY
CHAIRMAN ASHOKE MUKHERJI IS A MAJORITY OWNER$171,600LEASED SPACE0
MIDDLE TENNESSEE SURGICAL
BOARD MEMBER JAMES VANWINKLE IS THE OWNER$120,000CONTRACTED SERVICES0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE BOARD WILL REVIEW THE TAX RETURN BEFORE THE RETURN IS FILED.
FORM 990, PART VI, SECTION B, LINE 12CCONFLICT OF INTEREST IS MONITORED BY THE COMPLIANCE OFFICER.
FORM 990, PART VI, SECTION B, LINE 15BALL CONTRACTS ARE REVIEWED BY THE CHIEF COMPLIANCE OFFICER AND OUTSIDE COUNSEL.
FORM 990, PART VI, SECTION C, LINE 19DOCUMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART IX, LINE 11GCONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 18,457,388. MANAGEMENT AND GENERAL EXPENSES 1,229,939. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,687,327.
FORM 990, PART IV, LINE 20B:THE AUDIT OF THE FINANCIAL STATEMEMTS OF THE CURRENT TAX YEAR HAVE NOT BEEN COMPLETED AS OF THE FILING DATE OF THE TAX RETURN.
FORM 990, PART XII, LINE 2C:THE ORGANIZATION HAS NOT CHANGED ITS OVERSIGHT OR SELECTION PROCESS.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1COFFEE MEDICAL GROUP LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1481 INTERSTATE DRIVEAddressLine1Txt
CityMANCHESTERCityNm
State AbbreviationTNStateAbbreviationCd
ZIP37355ZIPCd
FieldValueIRS element (for citing)
EIN460485169EIN
Primary ActivitiesHOSPITAL MEDICAL CAREPrimaryActivitiesTxt
Legal Domicile StateTNLegalDomicileStateCd
Total Income$2,582,781TotalIncomeAmt
End Of Year Assets$54,267,464EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1UNITY MEDICAL CENTER INCBusinessNameLine1Txt

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