2018-08-13T15:40:26-05:00 2016-09-30 271235638 MCM CPAS & ADVISORS LLP 462 S FOURTH ST SUITE 2600 LOUISVILLE KY 402023445 990 2015-10-01 311375125 MARIETTA HEALTHCARE PHYSICIANS INC MARI 7403741400 401 MATTHEW STREET MARIETTA OH 45750 ERIC YOUNG TREASURER 7403741400 2018-08-02 1 BOB MORELAND CPA P00418596 5027491900 2015 2018-06-14 16:35:46Z X ERIC YOUNG 401 MATTHEW STREET MARIETTA OH 45750 85521205 0 X WWW.MHSYSTEM.ORG X 1995 OH PHYSICIAN HEALTH CARE SERVICE FORMED BY MARIETTA MEMORIAL HOSPITAL TO FURTHER ITS SECTIONS 501(C)3 CHARITABLE PURPOSES. MHCPI LIKE MMH DOES PARTICIPATE IN MEDICARE AND MEDICAID PROGRAMS AND SERVICES ARE PROVIDED TO PATIENTS WITHOUT DISCRIMINATION AS TO ABILITY TO PAY. 5 5 309 5 0 0 0 0 74672588 85518475 163 2730 0 0 74672751 85521205 0 0 0 0 86169388 96979299 0 0 0 12312589 13007140 98481977 109986439 -23809226 -24465234 9392208 9851204 9394567 9853563 -2359 -2359 PHYSICIAN HEALTH CARE SERVICE FORMED BY MARIETTA MEMORIAL HOSPITAL TO FURTHER ITS SECTIONS 501(C)3 CHARITABLE PURPOSES. MHCPI LIKE MMH DOES PARTICIPATE IN MEDICARE AND MEDICAID PROGRAMS AND SERVICES ARE PROVIDED TO PATIENTS WITHOUT DISCRIMINATION AS TO ABILITY TO PAY. 0 0 104130447 85518475 THE CORPORATION WAS FORMED BY MARIETTA MEMORIAL HOSPITAL FOR THE PURPOSE OF PROVIDING PHYSICIAN CARE IN THE SERVICE AREA OF THE HOSPITAL SINCE THERE ARE AN INSUFFICIENT NUMBER OF PHYSICIANS TO MEET THE COMMUNITY'S NEEDS.CHARITY CARE AND COLLECTION POLICIES FOR THE CORPORATION ARE IDENTICAL TO MARIETTA MEMORIAL HOSPITAL. TOTAL CHARITY PROVIDED WAS $503,043.THE CORPORATION PROVIDED 423,743 PATIENT VISITS IN 2016.THE PATIENT PAYER MIX WAS 43.3% MEDICARE, 19.8% WELFARE, AND 2.8% SELF PAY. 104130447 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 309 1 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 OH X ERIC YOUNG 7403741641 401 MATTHEW STREET MARIETTA OH 45750 JOHN MATTHEWS CHAIRMAN 2.00 X X 0 0 0 CHARLOTTE HATFILED DIRECTOR 2.00 X 0 0 0 KIM MCGREW DIRECTOR 2.00 X 0 0 0 JAY STOWE DIRECTOR 2.00 X 0 0 0 MATTHEW MACATOL MD SHAREHOLDER 2.00 X 0 0 0 J SCOTT CANTLEY SECRETARY 2.00 X 0 836499 50748 ERIC YOUNG TREASURER 2.00 X 0 432489 51346 VIVEK ABHYANKAR MD VICE PRESIDENT 40.00 X 653454 0 33318 SRINI VASAN MD PHYSICIAN 40.00 X 1684178 0 30475 MATTHEW YOAK MD PHYSICIAN 40.00 X 1256880 0 31378 GILBERT KUKIELKA PHYSICIAN 40.00 X 935662 0 33738 ROMAN PETROV MD PHYSICIAN 40.00 X 1025556 0 33738 RAJENDRA BHATI MD PHYSICIAN 40.00 X 1208868 0 33738 6764598 1268988 298479 6 0 1 0 MEDONE SYSTEMS LLC 3525 OLENTAGY ROAD COLUMBUS OH 43214 HOSPITALIST MANAGEMENT 1700391 LOCUMTENENSCOM 3650 MANSEL ROAD SUITE 310 ALPHARETTA GA 30005 PHYSICIAN STAFFING 1068628 LINDE HEALTHCARE STAFFING INC PO BOX 915241 DALLAS TX 75391 PHYSICIAN STAFFING 506458 COMPHEALTH MEDICAL STAFFING PO BOX 972670 ATLANTA GA 30328 PHYSICIAN STAFFING 279525 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 75397 PHYSICIAN STAFFING 246197 5 MEDICARE, MEDICAID, INSURANCE & S 621110 85518475 85518475 0 85518475 2730 2730 85521205 85518475 0 2730 653454 653454 84128138 80865409 3262729 578534 555393 23141 7881276 7566025 315251 3737897 3588381 149516 1234 1068 166 17536 17302 234 1005121 956318 48803 204283 20597 183686 857989 842596 15393 142291 102197 40094 549067 543817 5250 630006 630006 122059 57295 64764 PURCHASED SERVICES 7435653 6130942 1304711 0 SUPPLIES MEDICAL 1410742 1410742 0 0 POSTAGE/PRINTING/DUES 517750 76454 441296 0 UTILITIES 113409 112451 958 0 109986439 104130447 5855992 0 0 0 6649973 7277442 7270037 4696275 2742235 2573762 9392208 9851204 9394567 9853563 9394567 9853563 X -2359 -2359 -2359 -2359 9392208 9851204 X -24465234 24465234 X 0 1 X 1 0 X 51103020 57978347 64551634 74672588 85518475 333824064 51103020 57978347 64551634 74672588 85518475 333824064 0 0 0 333824064 163 2730 2893 163 2730 2893 51103020 57978347 64551634 74672751 85521205 333826957 1.00000 1.00000 0.00000 0.00000 X 7270037 4696275 2573762 2573762 PAYABLE TO MARIETTA MEMORIAL HOSPITAL 9853563 9853563 X PART X, LINE 2: THE SYSTEM, EXCLUDING MSC AND MOHP, IS ORGANIZED AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE UNITED STATES INTERNAL REVENUE CODE. MSC AND MOHP ARE ORGANIZED AS LIMITED LIABILITY COMPANIES, WHEREBY, NET TAXABLE INCOME IS TAXED DIRECTLY TO THE MEMBERS AND NOT MSC OR MOHP. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE SYSTEM AND RECOGNIZE A TAX LIABILITY IF THE SYSTEM HAS TAKEN AN UNCERTAIN POSITION 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 THE SYSTEM, AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2016 AND 2015, 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. AS SUCH, THE SYSTEM IS GENERALLY EXEMPT FROM INCOME TAXES. HOWEVER, THE SYSTEM, EXCLUDING MSC AND MOHP, IS REQUIRED TO FILE FEDERAL FORM 990 - RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX WHICH IS AN INFORMATIONAL RETURN ONLY. THE SYSTEM, MSC, AND MOHP HAVE FILED THEIR TAX RETURNS FOR PERIODS THROUGH 2015. THE RETURNS FOR MSC AND MOHP 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). THE SYSTEM, MSC AND MOHP ARE SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS. HOWEVER, AS OF THE DATE THE CONSOLIDATED FINANCIAL STATEMENTS WERE ISSUED, THERE WERE NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. X X X X X 0 0 0 0 0 0 0 0 0 J SCOTT CANTLEY SECRETARY 0 670599 0 165900 0 0 0 18000 0 32748 0 887247 0 0 ERIC YOUNG TREASURER 0 367489 0 65000 0 0 0 18000 0 33346 0 483835 0 0 VIVEK ABHYANKAR MD VICE PRESIDENT 605454 0 48000 0 0 0 2120 0 31198 0 686772 0 0 0 SRINI VASAN MD PHYSICIAN 1684178 0 0 0 0 0 0 0 30475 0 1714653 0 0 0 MATTHEW YOAK MD PHYSICIAN 1103691 0 153189 0 0 0 0 0 31378 0 1288258 0 0 0 GILBERT KUKIELKA PHYSICIAN 662828 0 272834 0 0 0 2120 0 31618 0 969400 0 0 0 ROMAN PETROV MD PHYSICIAN 605873 0 419683 0 0 0 2120 0 31618 0 1059294 0 0 0 RAJENDRA BHATI MD PHYSICIAN 1208868 0 0 0 0 0 2120 0 31618 0 1242606 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 BOARD MEMBERS REVIEW THE FOFM 990 AFTER IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C ANNUAL SURVEYS ARE COMPLETED AND REVEIWED BY CORPORATE INTEGRITY COMMITTEE. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS SET BY COMMITTEE AT MEDIAN IN THE MARKET AREA FOR EXECUTIVES. COMPENSATION IS SET BY COMMITTEE AT A MAXIMUM OF 75% MGMA FOR PHYSICIANS. FORM 990, PART VI, SECTION C, LINE 19 THE DOCUMENTS ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST AT THE HOSPITAL'S ADMINISTRATIVE OFFICE. FORM 990, PART XI, LINE 9: TRANSFER FROM MARIETTA MEMORIAL HOSPITAL 24,465,234. PART VII SECTION A THE AMOUNTS FOR COLUMN F, ESTIMATED AMOUNT OF COMPENSATION FROM THE ORGANIZATION AND RELATED ORGANIZATIONS, WAS INADVERTANTLY OMITTED FROM THE ORIGINAL RETURN. THE DETAILS WERE REPORTED ON SCHEDULE J OF THE ORIGINAL RETURN, JUST NOT ON PART VII. PART X THE END OF YEAR BALANCE SHEET INFORMATION WAS INADVERTANTLY OMITTED FROM THE ORIGINAL TAX RETURN. IT HAS BEEN INCLUDED ON THIS AMENDED RETURN. IN ADDITION, SUPPORT INFORMATION FOR THE PRIOR AND CURRENT YEARS WAS OMITTED FROM SCHEDULE A. MARIETTA MEMORIAL HOSPITAL 401 MATTHEW STREET MARIETTA OH 45750 314379509 HOSPITAL OH 501(C)(3) LINE 3 MARIETTA AREA HEALTHCARE INC 0 SELBY GENERAL HOSPITAL 1106 COLEGATE DR MARIETTA OH 45750 314413259 HOSPITAL OH 501(C)(3) LINE 3 MARIETTA AREA HEALTHCARE INC 0 MEMORIAL HEALTH FOUNDATION PO BOX 97 MARIETTA OH 45750 311011321 SUPPORTING ORG OH 501(C)(3) LINE 11B, II MARIETTA AREA HEALTHCARE INC 0 MARIETTA AREA HEALTHCARE 401 MATTHEW STREET MARIETTA OH 45750 311126451 MANAGEMENT OH 501(C)(3) LINE 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0