2018-11-12T15:37:28-07:00 2017-12-31 990 2017-01-01 340714771 The Union Hospital Association UNIO 3303433311 659 Boulevard Dover OH 44622 Eugene A Thorn III CFO 3303640805 2018-11-07 98.103.157.92 2017 2019-02-21 02:37:17Z Union Hospital R Bruce James 659 Boulevard Dover OH 44622 133885133 0 X www.unionhospital.org X 1906 OH To provide excellent quality health care to the community at a competitive price through highly competent people and an integrated provider network. 17 16 1276 154 163354 50698 361033 343433 86286350 86668475 3967330 5445696 17461543 15325902 108076256 107783506 0 0 0 0 57663884 58081624 0 0 0 47647882 47665938 105311766 105747562 2764490 2035944 193889586 196450752 59555888 60101247 134333698 136349505 Patient Care: The Union Hospital Association provides quality medical health care regardless of race, creed, sex, national origin, handicap, age or ability to pay. 0 0 79504223 0 86369257 The Union Hospital Association provided quality medical health care regardless of race, creed, age, sex, national origin, handicap, or the ability to pay. Hospital medical services provided 4,724 inpatients a total of 18,595 patient days and 272,319 outpatient visits a total of 301,211 procedures. 323617 0 135864 The Hospital is dedicated in helping the elderly and disabled citizens of our community. We provide services, or assist with services, to these populations. One service is the Helpline program that provides quick medical or emergency assistance to the elderly and disabled. In 2017, this program enabled 546 subscribers to remain in their homes feeling safe and secure. During the year the hospital provided 60,843 meals through Mobile Meals, a volunteer group that delivers meals to residents unable to prepare their own meals due to medical limitations. The Hospital provided these meals Mobile Meals at a cost of $119,860. We are committed to helping our community with such works as co-sponsoring annual events that provide laboratory tests and blood pressure checks for the residents of the community; these services are provided at or below cost. During 2017, these events provided 9,529 community members with discounted cost testing services. We also operate a mobile medical vehicle that provides screenings to areas that would have been underserved. We host and support various groups such as, Down Syndrome, RSD, Pain Management, and multiple cancer support groups to ensure the health and wellbeing of our entire population. We also provide babysitting and AARP driving courses to the community. Our sports medicine department provides athletic training to area schools to promote healthy athletes and a safe sports environment. They also work with local physicians to provide low cost physicals for these athletes. Since the Hospital doesn't provide a full array of mental health services as part of its normal operations, we lease building space to a mental health nonprofit organization at a cost well below the average market rate. Thus, the rental range and related in kind support provided by the Hospital are justified in continuance of our mission. The Hospital is dedicated to helping members of the community that are in need of low cost medical services by working with a couple of local charities and agencies. One program, called the Rainbow Connection, is a nonprofit charity that is dedicated to emitting the needs of the disadvantaged and disabled residents of Tuscarawas County. The Hospital writes off 50% of charges for these patients while the program pays the remaining 50% of the charges. For the other program, Hospice of Tuscarawas County, which is dedicated in providing comfort care to patients throughout the end stages of life; the Hospital writes off specified charges for patients in this program. In 2017 we wrote off $113,229 for 229 patient accounts for both of these programs. The Hospital is dependent on its volunteer network; in 2017 we had 154 volunteers donate 21,076 hours toward the common purpose of serving health care needs of the community. The value of these hours ($221,298) is returned to the community through lower cost of patient services. 0 0 0 79827840 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 104 0 1 1276 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 17 16 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 OH X Eugene A Thorn III 3303640805 659 Boulevard Dover OH 44622 John R Herzig Board Member 4 0 X 0 0 0 James J Pringle Board Member 4 0 X 0 0 0 Anne E Geib Dorris Board Member 4 0 X 0 0 0 Agnes Swigart Board Member 4 0 X 0 0 0 Robert Horn Chairman 4 0 X 0 0 0 Craig Laughlin Vice Chairman& Treasurer 4 0 X 0 0 0 Lois E Andreas Board Member 4 0 X 0 0 0 C Jason Deeds Board Member 4 0 X 0 0 0 John E Dooling Board Member 4 0 X 0 0 0 Perry L Hershberger Board Member 4 0 X 0 0 0 James E Knisely Board Member 4 0 X 0 0 0 Kevin Gray Board Member 4 0 X 0 0 0 Pat Warther Board Member 4 0 X 0 0 0 Michael W Soehnlen Medical Staff Vice President 4 0 X 0 0 0 William V Swoger Medical Staff 4 0 X 0 0 0 R Bruce James President and CEO & Secretary 40 0 X X 400342 0 27866 Joseph N Zemis Medical Staff President Physician 40 0 X 753940 0 34730 Chris Beck Vice President 40 0 X 141686 0 26849 Eugene A Thorn III Vice President and CFO 40 0 X 226405 0 28297 Darwin K Smith Vice President 40 0 X 160143 0 20507 Diana L Boyd Vice President 40 0 X 162563 0 15824 Todd A Meyerhoefer Vice President 40 0 X 279709 0 32558 Robert Craig Vice President 40 0 X 176056 0 17077 Alok Bhagat Physician 40 0 X 322196 0 21506 Lindsay Moore Physician 40 0 X 713412 0 32090 William Burgette Physician 40 0 X 541867 0 31458 Robert Levitt Physician 40 0 X 742960 0 32090 Thomas Teater Physician 40 0 X 487001 0 40710 5108280 0 361562 66 0 1 0 Emergimed Inc 659 Boulevard Dover OH 44622 Emergency services 5690404 Concordance Healthcare PO Box 399 Tiffin OH 44883 medical supplies 3171905 Cardinal Health 5490 Collections Center Drive Chicago IL 60693 pharmaceuticals 5552238 Anesthesia Care of Union Hospital 659 Boulevard Dover OH 44622 Anesthesia and pain care 2187511 Hospitalists Medicine Physicians of OH Sound Physicians of OHIO II PO Box 742936 Los Angeles CA 90074 physician services provider 1384823 98 0 0 0 0 0 343433 0 343433 Net patient revenue 622000 86505121 86505121 0 0 Laboratory services 621500 77270 0 77270 0 Income from taxable partnership 621999 86084 0 86084 0 0 0 0 0 86668475 5838525 0 0 5838525 0 0 0 0 0 0 0 0 903023 0 552281 0 350742 0 350742 0 0 350742 10972236 2928746 11328904 2964907 -356668 -36161 -392829 0 0 -392829 0 21929866 11255535 10674331 10674331 0 0 Other Income 900099 471812 471812 0 0 Helpline 900099 124753 124753 0 0 Contract Rebate 900099 378580 378580 0 0 3325684 3325684 0 0 4300829 107783506 101480281 163354 5796438 X 0 0 0 0 0 0 0 0 5108280 3561377 1546903 0 0 0 0 0 40823013 33480980 7342033 0 2513939 2061806 452133 0 5598518 4591623 1006895 0 4037874 3288450 749424 0 0 0 0 0 922775 0 922775 0 56124 0 56124 0 0 0 0 0 0 0 0 0 0 0 22321263 18130659 4190604 0 378783 24980 353803 0 2690177 2057346 632831 0 1710510 1402874 307636 0 0 0 0 0 1873985 1025535 848450 0 157803 70488 87315 0 0 0 0 0 51913 14842 37071 0 1567946 938886 629060 0 0 0 0 0 5425474 3144447 2281027 0 688945 0 688945 0 Physician expense 628381 0 628381 0 medical supplies 6603936 5885941 717995 0 Taxes 1608368 0 1608368 0 Employee expenses 308823 27231 281592 0 670732 120375 550357 0 105747562 79827840 25919722 0 3064182 3085721 0 0 0 0 15838590 17512236 0 0 0 1992949 1957065 1671130 1470246 157821637 98001538 61277166 59820099 40955920 41903195 2000271 1856524 769511 769511 66319867 68076155 193889586 196450752 4893228 3593746 45060000 45030000 634355 76785 8968305 11400716 59555888 60101247 X 122105094 123169788 335314 284167 11893290 12895550 134333698 136349505 193889586 196450752 X 2035944 0 0 0 0 -20137 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 7517 7517 0 Schedule C, Part II-B, Line 1 Union Hospital Association pays annual dues to Ohio Hospital Association and American Hospital Association. 4.3% of OHA dues and 22.98% of AHA dues are for lobbying expenses. 0 1105252 1105252 0 72443363 30796927 41646436 0 2790166 2511154 279012 0 81173980 64693457 16480523 0 308876 0 308876 59820099 Asset whose use is limited by donor specification 73735 Assets held by trustees under bond indenture 138 Trust agreements 12895550 Other receivable 53437403 Interest in Joint Venture 1459398 Contribution receivable 209931 68076155 0 Interest Payable 72207 Workers compensation payable 174944 Interest rate swap agreements 3450923 Accrued payroll withholdings 5879169 Other Payables 1823473 11400716 X Schedule D, Part X, Line 2 Federal Income Taxes The Association is organized as a tax-exempt organization under Section 501(c)(3) of the United States Internal Revenue Code. UPS and UHMS are limited liability companies whereby income is passed through to the Association as the sole member of each of these companies. TASC is also a limited liability company. Therefore, income or loss is reported to its members for inclusion in its respective tax return. The Association recorded no provision for federal and state income tax in the consolidated financial statements due to its tax-exempt status. TASC has filed their federal and state income tax returns for periods through December 31, 2016. These income tax returns are generally open to examination by the relevant taxing authorities for a period of three years from the later of the date the return was filed or its due date (including approved extensions). Accounting principles generally accepted in the United States of America require management to evaluate tax positions taken and recognize a tax liability if an uncertain position has been taken that more likely than not would not be sustained upon examination by various federal and state taxing authorities. Management has analyzed the tax positions taken by these entities, and has concluded that as of December 31, 2017 and 2016, there are no uncertain positions taken or expected to be taken that would require recognition of a liability or disclosure in the accompanying consolidated financial statements. The entities are subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. 1 1 X 1 X 1 X 1 1 1 0 0 1717500 0 1717500 0.0162 17066511 7290472 9776039 0.09 0 0 18784011 7290472 11493539 0.1062 252379 135864 116515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71238 0 71238 0 0 0 323617 135864 187753 0.0000 0 0 19107628 7426336 11681292 0.1062 1 5737068 25817 29951687 24017055 5934632 X 1 1 Tuscarawas Ambulatory Surgery Center ambulatory surgery center 0.7 0 0.3 1 1 The Union Hospital Association 659 Boulevard Dover OH 44622 www.unionhospital.org X X X The Union Hospital Association 1 0 0 1 X X X X X X X X X 15 1 1 1 1 X www.unionhospital.org X 1 16 1 www.unionhospital.org 0 0 1 X 100 200 X X X 1 1 X X X 1 X www.unionhospital.org X www.unionhospital.org X www.unionhospital.org X X X X X X 1 X 0 X X X X 1 X 0 0 Schedule H, Part V, Section B, Line 5-The Union Hospital Association The Hospital's panel includes local family physicians, dentists, mental health and addiction counselors from the ADAMHS Board, Local YMCA leaders, and hospital leaders, . The panel met multiple times to discuss health concerns in the community. Once the concerns were identified they were ranked by impact on the community's health and the ability to address the concerns. Schedule H, Part V, Section B, Line 6a-The Union Hospital Association The community health needs assessment was conducted with Trinity Twin City Hospital, an unrelated facility. Schedule H, Part V, Section B, Line 6b-The Union Hospital Association Healthy Tusc, Tuscarawas County Health Department, New Philadelphia Health Department, ADAMHS Board, Tuscarawas County Senior Center, United Way of Tuscarawas County Schedule H, Part V, Section B, Line 11-The Union Hospital Association the Union Hospital Association's ("Union") Community Health Needs Assessment ("CHNA") identified Adult and Youth Obesity, Adult and Youth Mental Health and Bullying, Youth Substance Abuse and Access to Dental Care as the community top health needs. Union's implementation strategy for addressing these need can be summarized as follows: Decrease Obesity 1) by incorporating Ohio Hospital Association health eating guidelines into Union's existing nutrition outreach program 2) Extend Union's Community Health and Wellness program through collaboration with community partners. The program includes blood screening events. Mental Health and Bullying - Union's Behavioral Health Center continues to leverage its efforts through the use of social workers and supports school based programs to stop bullying. Such support includes credentialed personnel working with these programs. Decrease Substance Abuse - Union provides a smoking cessation program with a certified tobacco specialist. Union does not any other specific substance abuse programs but does refer those in need to area providers specializing in such assistance. Union does not have a dental program but does support area providers specializing in such assistance. Schedule H, Part V, Section B, Line 13h-The Union Hospital Association The policy lists criteria for all charges. 6 Tuscarawas Ambulatory Surgery Center 320 Oxford Street Dover OH 44622 Ambulatory surgery center Tuscarawas Valley Regional Cancer Center 659 Boulevard Dover OH 44622 Physician oncology center Union Physician Services LLC 300 Medical Park Drive Suite 101 C Dover OH 44622 Physician offices DASCO UH Home Medical Equipment LLC 375 North West Street Westerville OH 43082 Home medical equipment sales UHMS LLC Union Hospital Medical Services LLC 659 Boulevard Dover OH 44622 Physician offices Union Pharmacy Care 659 Boulevard Dover OH 44622 Pharmaceutical Schedule H, Part I, Line 7 Used the ratio of patient cost to charge from Worksheet 2 to calculate charity care. Schedule H, Part III, Section A, Line 4 Patient accounts are due in full when billed. Accounts are considered deliquent and subsequently written off a bad debt based on individual credit evualations and circumstances of the account. Line 2 represents 2.3% of gross patient revenue as seen as being uncollectible by self pay patients based on historical trending. A bad debt expense footnote is not presented in the Notes to the Financial Statements. Schedule H, Part III, Section B, Line 8 Amounts are generated by the Medicare cost report which utilizes department cost to charge methodology. Schedule H, Part III, Section C, Line 9b The Hospital refunds any monies collected on accounts deemed charity or that qualifies for financial assistance once the assessment has been determined. The account is then written off to such classification and any or all collections cease after determination has been made. Schedule H, Part VI, Line 2 The Hospital's community wellness department is committed to addressing the health assessments and concerns of our community by seeking valuable insight from members and organizations of the community. The department compiled the data by utilizing secondary sources such as the CDC and Ohio obesity prevention. We have identified obesity (youth and adult), mental health and bullying (adult and youth), youth substance abuse, and access to dental care. Schedule H, Part VI, Line 3 Patients are given informational booklets that contain patient account contact information, accepted insurances and other payment options for the insured and underinsured upon admission. The Hospital also employs a financial specialist who meets with the patient and or family to discuss factor of qualifying information. Financial assistance is provided with the first billing. Schedule H, Part VI, Line 4 Union Hospital considers its community served as Tuscarawas County. Schedule H, Part VI, Line 5 Union Hospital's board is made up of 17 members with 16 being independent and members of the community. Their backgrounds vastly vary from each other and are a representation of the community. The Hospital's senior management team and its governing board members sit on various other boards with in the community to help bridge the gap between the Hospital and its community served. The Hospital is bound by law to reinvest any surplus back into the community. X X 0 0 0 0 0 0 0 0 0 R Bruce James President and CEO 350241 0 50101 0 0 0 15000 0 12866 0 428208 0 0 0 Chris Beck Vice President 136224 0 5461 0 0 0 7431 0 19418 0 168534 0 0 0 Eugene A Thorn III Vice President and CFO 205901 0 20504 0 0 0 12912 0 15386 0 254703 0 0 0 Darwin K Smith Vice President 146339 0 13804 0 0 0 9072 0 11436 0 180651 0 0 0 Diana L Boyd Vice President 147855 0 14707 0 0 0 9168 0 6657 0 178387 0 0 0 Todd A Meyerhoefer Vice President 253948 0 25761 0 0 0 15000 0 17558 0 312267 0 0 0 Robert Craig Vice President 160406 0 15650 0 0 0 9623 0 7454 0 193133 0 0 0 Alok Bhagat Physician 322195 0 0 0 0 0 15000 0 6506 0 343701 0 0 0 Lindsay Moore Physician 497261 0 216151 0 0 0 15000 0 17090 0 745502 0 0 0 William Burgette Physician 541867 0 0 0 0 0 15000 0 16458 0 573325 0 0 0 Robert Levitt Physician 699344 0 43616 0 0 0 15000 0 17090 0 775050 0 0 0 Joseph N Zemis Medical Staff President Physician 582799 0 171141 0 0 0 15000 0 19730 0 788670 0 0 0 Thomas Teater Physcian 468839 0 18162 0 0 0 32250 0 26460 0 545711 0 0 0 A Tuscarawas County Ohio 346002853 2014-09-24 45060000 ED project and refinancing arrangements 0 1 0 A 0 25707957 45060000 0 950217 0 0 0 250153 0 0 0 2014 0 1 1 1 A 0 0 0 0 0 0 0 0 0 1 A 1 1 1 RBS Citizens NA 32 0 0 0 0 1 Form 990, Part VI, Section A, Line 6 The Association has a 17 member board of trustees who oversee the management of the hospital. All monthly financial reporting is presented to the board of trustees. The trustees also oversee the hiring of any upper management and the approval of all operating and capital budgets. Form 990, Part VI, Section B, Line 11b The 990 is prepared internally by the Director of Accounting; the ledger is reconciled to the appropriate schedules on the return and to the audited financial statements. It is then forwarded to the Chief Financial Officer who reviews it for completeness and accuracy. After his review it is then submitted to the board of trustees for review. The Association's independent accounting firm also reviews the 990 before submission. Form 990, Part VI, Section B, Line 12c Members of the board and officers are required annually to review the conflict of interest policy and make known any conflicts that may have arose or any other event that may require disclosure. If any notable event is disclosed it is reported to the Hospital CEO and Chairman of the Board. Additionally all financial transactions are reviewed through the Hospital's accounting systems. Form 990, Part VI, Section B, Line 15 Compensation is established and based on the appropriate healthcare industry standards and related surveys. Compensation amounts for key management positions are reviewed by the Executive Committee of the Board. Form 990, Part VI, Section C, Line 19 The public at any time during normal business office hours may inquire at the administrative offices of the Association and ask for a copy of the 990. The public may view the community benefit report and the annual report on the Hospital's website. Form 990, Part IX, Line 11g professional fees for medical services, contract labor for medical and support services, and maintenance agreements Form 990, Part XI, Line 9 Reclassification of net assets released from restriction. Union Hospital Medical Services llc 659 Boulevard Dover OH 44622 270273520 Physician offices OH 348877 104558 Union Hospital Association Union Physician Services llc 659 Boulevard Dover OH 44622 264215547 Physician office OH 12534150 3937149 Union Hospital Association Tuscarawas Valley Regional Cancer Center 659 Boulevard Dover OH 44622 340000100 Physician and Hospital Organization OH 501c3 3 N/A 0 Union Hospital Auxillary 659 Boulevard Dover OH 44622 341204928 Fundraising for the Hospital OH 501c3 11-III-FI N/A 0 Tuscarawas Ambulatory Surgery Center LLC 320 Oxford St Dover OH 44622 311525875 Ambulatory surgery center OH N/A Related 684772 1623545 0 0 0 0.7 Dasco Union Hospital Home Medical Equipment LLC 375 N West St Westerville OH 43082 270495743 Durable medical equipment sales OH N/A Unrelated 86369 312431 0 86084 0 0.5 Valley Healthcare Inc 659 Boulevard Dover OH 44622 341654921 Inactive OH N/A C 0 0 1 1 Union Care Corporation 659 Boulevard Dover OH 44622 341556177 Inactive OH N/A C 0 0 1 1 Union Pharmaceutical Care 659 Boulevard Dover OH 44622 043588229 Retail pharmacy sales OH N/A C -48485 24990 1 1 1 0 1 0 0 1 0 0 0 1 0 0 0 0 0 0 1 0 0 Dasco Union Hospital Home Medical Equipment LLC s 80000 Distribution received from DASCO Tuscarawas Ambulatory Surgery Center LLC s 723135 Distribution received from TASC Tuscarawas Valley Regional Cancer Center f 600000 Distribution of monies received from TVRCC Union Hospital Auxillary c 253147 Annual donation Tuscarawas Ambulatory Surgery Center LLC a-iv 400505 Rent received from TASC Tuscarawas Ambulatory Surgery Center LLC j 400505 Rent received for leased building Dasco Union Hospital Home Medical Equipment LLC a-iv 13600 Rent received Dasco Union Hospital Home Medical Equipment LLC j 13600 Rent received for leased property To file an accurate return