THE UNION HOSPITAL ASSOCIATION: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- THE UNION HOSPITAL ASSOCIATION (EIN 34-0714771)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-14
- IRS object ID
- 201743199349303289
- Schema version
- 2016v3.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
- Reasonable Cause Explanation
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-14T08:09:39-07:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 340714771 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE UNION HOSPITAL ASSOCIATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | UNIO | BusinessNameControlTxt |
| Phone | 3303433311 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 659 Boulevard | AddressLine1Txt |
| City | Dover | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44622 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Eugene A Thorn III | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 3303640805 | PhoneNum |
| Signature | 2017-04-10 | SignatureDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 98.103.157.92 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2018-03-14 21:41:22Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Union Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Eugene A Thorn III | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 659 Boulevard | AddressLine1Txt |
| City | Dover | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44622 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $120,003,242 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.unionhospital.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1906 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | To provide excellent quality health care to the community at a competitive price through highly competent people and an integrated provider network. | ActivityOrMissionDesc |
| Voting Members Governing Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 1208 | TotalEmployeeCnt |
| Total Volunteers | 120 | TotalVolunteersCnt |
| Total Gross UBI | $91,046 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$14,461 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $725,360 | PYContributionsGrantsAmt |
| CY Contributions Grants | $361,033 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $89,472,612 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $86,286,350 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,430,690 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,967,330 | CYInvestmentIncomeAmt |
| PY Other Revenue | $13,272,858 | PYOtherRevenueAmt |
| CY Other Revenue | $17,461,543 | CYOtherRevenueAmt |
| PY Total Revenue | $105,901,520 | PYTotalRevenueAmt |
| CY Total Revenue | $108,076,256 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $55,673,832 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $57,663,884 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $116,408 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $44,871,229 | PYOtherExpensesAmt |
| CY Other Expenses | $47,647,882 | CYOtherExpensesAmt |
| PY Total Expenses | $100,545,061 | PYTotalExpensesAmt |
| CY Total Expenses | $105,311,766 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $5,356,459 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,764,490 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $195,834,042 | TotalAssetsBOYAmt |
| Total Assets EOY | $193,889,586 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $64,247,479 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $59,555,888 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $131,586,563 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $134,333,698 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Patient Care: The Union Hospital Association provides quality medical health care regardless of race, creed, sex, national origin, handicap, age or ability to pay. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $69,762,900 | ExpenseAmt |
| Revenue | $86,286,349 | RevenueAmt |
| Desc | 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 4,944 inpatients a total of 19,622 patient days and 266,474 outpatient visits a total of 290,105 procedures. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $395,398 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $131,147 | RevenueAmt |
| Desc | Patient and family support programs, general and other: During 2016 Union Hospital provided 52,149 meals for residents who were unable to prepare meals for themselves due to medical limitations. These meals are provided at cost and are delivered by a volunteer group, Mobile Meals. The Hospital had 138 volunteers donate 21,976 hours toward the common purpose of serving the health care needs of the community. The value of these hours is $230,748 which is returned to the community through lower cost of patient services. The Hospital co sponsors annual events that provides laboratory tests and blood pressure checks for the residents of the community; these services are provided at or below cost. Medicare and Medicaid made up 55% of patient care provided. The Hospital also participates in a local program called Rainbow Connection, a non profit charity that is dedicated to emitting the needs of disadvantaged and disabled resident of Tuscarawas County; we write off 50% of all charges for those patients while the program pays the remaining 50%. We also provided to the local Hospice agency a writ e off specified charges for individuals under this program (42 patients, $51,998). We sponsor a Helpline program that enabled 750 elderly and disabled consumers the opportunity to remain in their homes and feel safe in that setting. Since the Hospital does not provide mental health services as part of its normal operations, we lease building space to Community Professional Services, a mental health non profit organization at $2.04 per square foot, well below the average rate of $11.75 per square foot. Thus the rental rate and related in kind support provided by the Hospital are justified as a continuance of our mission. We operate a 35ft mobile medical vehicle that provides screenings to the areas that would have been underserved. An outreach sports medicine program provides training to various school to promote healthy athletes and physicals at a fraction of the cost. The Hospital supports and hosts various groups such as Down Syndrome, RSD, pain management, cancer supports,etc. We also provide babysitting and AARP driving courses to the community and sent out 55,000 biannual healthy newsletters to the community. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $0 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $0 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $0 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $70,158,298 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | 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 | 0 | 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 | 0 | 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 | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | 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 | 150 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 1208 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | 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 | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | OH | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Eugene A Thorn III | PersonNm |
| Phone | 3303640805 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 659 Boulevard | AddressLine1Txt |
| City | Dover | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44622 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (28 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 | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| John R Herzig | ||||||||
| Board Member | 4 | 0 | Yes (X) | $0 | $0 | $0 | ||
| James J Pringle | ||||||||
| Board Member | 4 | 0 | Yes (X) | $0 | $0 | $0 | ||
| Anne E Geib | ||||||||
| Board Member | 4 | 0 | Yes (X) | $0 | $0 | $0 | ||
| Agnes Swigart | ||||||||
| Board Member | 4 | 0 | Yes (X) | $0 | $0 | $0 | ||
| Robert Horn | ||||||||
| Chairman | 4 | 0 | Yes (X) | $0 | $0 | $0 | ||
| Craig Laughlin | ||||||||
| Treasurer | 4 | 0 | Yes (X) | $0 | $0 | $0 | ||
| Lois E Andreas | ||||||||
| Board Member | 4 | 0 | Yes (X) | $0 | $0 | $0 | ||
| C Jason Deeds | ||||||||
| Board Member | 4 | 0 | Yes (X) | $0 | $0 | $0 | ||
| John E Dooling | ||||||||
| Board Member | 4 | 0 | Yes (X) | $0 | $0 | $0 | ||
| Perry L Hershberger | ||||||||
| Board Member | 4 | 0 | Yes (X) | $0 | $0 | $0 | ||
| James E Knisely | ||||||||
| Board Member | 4 | 0 | Yes (X) | $0 | $0 | $0 | ||
| Kevin Gray | ||||||||
| Board Member | 4 | 0 | Yes (X) | $0 | $0 | $0 | ||
| Pat Warther | ||||||||
| Board Member | 4 | 0 | Yes (X) | $0 | $0 | $0 | ||
| Mark Kubina | ||||||||
| Medical Staff | 4 | 0 | Yes (X) | $0 | $0 | $0 | ||
| William V Swoger | ||||||||
| Medical Staff President | 4 | 0 | Yes (X) | $0 | $0 | $0 | ||
| R Bruce James | ||||||||
| President and CEO | 40 | 0 | Yes (X) | $414,945 | $0 | $27,806 | Yes (X) | |
| Joseph N Zemis | ||||||||
| Medical Staff Vice President | 40 | 0 | Yes (X) | $1,054,336 | $0 | $34,358 | Yes (X) | |
| Jody Stoldt | ||||||||
| Executive Director | 40 | 0 | $219,452 | $0 | $8,749 | Yes (X) | ||
| Chris Beck | ||||||||
| Vice President | 40 | 0 | $118,074 | $0 | $20,976 | Yes (X) | ||
| Eugene A Thorn III | ||||||||
| Vice President and CFO | 40 | 0 | $236,376 | $0 | $25,783 | Yes (X) | ||
| Darwin K Smith | ||||||||
| Vice President | 40 | 0 | $160,569 | $0 | $19,871 | Yes (X) | ||
| Diana L Boyd | ||||||||
| Vice President | 40 | 0 | $169,050 | $0 | $15,310 | Yes (X) | ||
| Todd A Meyerhoefer | ||||||||
| Vice President | 40 | 0 | $292,701 | $0 | $34,357 | Yes (X) | ||
| Robert Craig | ||||||||
| Vice President | 40 | 0 | $178,698 | $0 | $20,748 | Yes (X) | ||
| Alok Bhagat | ||||||||
| Physician | 40 | 0 | $558,880 | $0 | $21,062 | Yes (X) | ||
| Lindsay Moore | ||||||||
| Physician | 40 | 0 | $625,136 | $0 | $31,717 | Yes (X) | ||
| William Burgette | ||||||||
| Physician | 40 | 0 | $650,000 | $0 | $31,717 | Yes (X) | ||
| Robert Levitt | ||||||||
| Physician | 40 | 0 | $775,506 | $0 | $31,718 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $5,453,723 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $324,172 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 70 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Emergimed Inc | |||||
| 659 Boulevard | Dover | OH | 44622 | Emergency services | $6,138,335 |
| Stryker Orthopaedics | |||||
| PO BOX 93213 | Chicago | IL | 60673 | Seller of medical equipment | $1,712,036 |
| Cardinal Health | |||||
| 5490 Collections Center Drive | Chicago | IL | 60693 | Seller of medical drugs | $5,813,709 |
| Anesthesia Care of Union Hospital | |||||
| 659 Boulevard | Dover | OH | 44622 | Anesthesia and pain care associates | $2,185,062 |
| Hammond Construction | |||||
| 1278 PARK AVE SW | CANTON | OH | 44706 | Construction contractor | $4,908,774 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 84 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $0 | FederatedCampaignsAmt |
| Membership Dues | $0 | MembershipDuesAmt |
| Fundraising | $0 | FundraisingAmt |
| Related Organizations | $0 | RelatedOrganizationsAmt |
| Government Grants | $0 | GovernmentGrantsAmt |
| All Other Contributions | $361,033 | AllOtherContributionsAmt |
| Noncash Contributions | $0 | NoncashContributionsAmt |
| Total Contributions | $361,033 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| Net patient revenue | 622000 | $86,195,304 | $86,195,304 | $0 | $0 |
| Laboratory services | 621500 | $91,046 | $0 | $91,046 | $0 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $86,286,350 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,969,039 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,969,039 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $946,441 | RealAmt |
| Personal | $0 | PersonalAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $532,793 | RealAmt |
| Personal | $0 | PersonalAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $413,648 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $413,648 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $413,648 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | -$1,709 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | -$1,709 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,709 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$1,709 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Rpt Fundraising Event | $0 | ContriRptFundraisingEventAmt |
| Gross Sales Of Inventory | $23,698,443 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $11,394,193 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,304,250 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $12,304,250 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| Health promotion | 900099 | $66,763 | $66,763 | $0 | $0 |
| Helpline program | 900099 | $129,003 | $129,003 | $0 | $0 |
| Athletic training | 900099 | $126,191 | $126,191 | $0 | $0 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,421,688 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,421,688 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $4,743,645 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $108,076,256 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $107,212,238 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $91,046 | UnrelatedBusinessRevenueAmt |
| Exclusion | $411,939 | 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 | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,789,865 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $1,789,865 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,606,638 | TotalAmt |
| Program Services | $35,517,567 | ProgramServicesAmt |
| Management And General | $8,986,019 | ManagementAndGeneralAmt |
| Fundraising | $103,052 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,555,037 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $2,555,037 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,163,065 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $5,163,065 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,549,279 | TotalAmt |
| Program Services | $2,570,400 | ProgramServicesAmt |
| Management And General | $970,605 | ManagementAndGeneralAmt |
| Fundraising | $8,274 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $116,759 | TotalAmt |
| Program Services | $27,655 | ProgramServicesAmt |
| Management And General | $89,104 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,986 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $50,986 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,395,799 | TotalAmt |
| Program Services | $13,866,010 | ProgramServicesAmt |
| Management And General | $3,528,131 | ManagementAndGeneralAmt |
| Fundraising | $1,658 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $366,136 | TotalAmt |
| Program Services | $346,854 | ProgramServicesAmt |
| Management And General | $19,282 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,039,268 | TotalAmt |
| Program Services | $7,607,560 | ProgramServicesAmt |
| Management And General | $4,431,306 | ManagementAndGeneralAmt |
| Fundraising | $402 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,661,070 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $1,661,070 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,021,137 | TotalAmt |
| Program Services | $6,256,975 | ProgramServicesAmt |
| Management And General | $764,162 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $172,519 | TotalAmt |
| Program Services | $85,170 | ProgramServicesAmt |
| Management And General | $87,349 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,602 | TotalAmt |
| Program Services | $29,602 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,390,944 | TotalAmt |
| Program Services | $832,898 | ProgramServicesAmt |
| Management And General | $555,535 | ManagementAndGeneralAmt |
| Fundraising | $2,511 | FundraisingAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,089,207 | TotalAmt |
| Program Services | $2,845,228 | ProgramServicesAmt |
| Management And General | $2,243,979 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $635,260 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $635,260 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Physician related expenses | $734,851 | $0 | $734,851 | $0 |
| Dues | $184,567 | $13,223 | $170,833 | $511 |
| Meals | $58,810 | $43,924 | $14,886 | $0 |
| Education Expense | $61,961 | $0 | $61,961 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $639,006 | TotalAmt |
| Program Services | $115,232 | ProgramServicesAmt |
| Management And General | $523,774 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,311,766 | TotalAmt |
| Program Services | $70,158,298 | ProgramServicesAmt |
| Management And General | $35,037,060 | ManagementAndGeneralAmt |
| Fundraising | $116,408 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,033,248 | BOYAmt |
| EOY | $3,064,182 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,969,842 | BOYAmt |
| EOY | $15,838,590 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,144,871 | BOYAmt |
| EOY | $1,992,949 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,396,162 | BOYAmt |
| EOY | $1,671,130 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $155,543,855 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $94,266,689 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,884,975 | BOYAmt |
| EOY | $61,277,166 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,968,882 | BOYAmt |
| EOY | $40,955,920 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,659,735 | BOYAmt |
| EOY | $2,000,271 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $769,511 | BOYAmt |
| EOY | $769,511 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $67,006,816 | BOYAmt |
| EOY | $66,319,867 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $195,834,042 | BOYAmt |
| EOY | $193,889,586 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,784,464 | BOYAmt |
| EOY | $4,893,228 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,060,000 | BOYAmt |
| EOY | $45,060,000 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,976,016 | BOYAmt |
| EOY | $634,355 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,426,999 | BOYAmt |
| EOY | $8,968,305 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,247,479 | BOYAmt |
| EOY | $59,555,888 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $118,767,503 | BOYAmt |
| EOY | $122,105,094 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,026,963 | BOYAmt |
| EOY | $335,314 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,792,097 | BOYAmt |
| EOY | $11,893,290 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $131,586,563 | BOYAmt |
| EOY | $134,333,698 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $195,834,042 | BOYAmt |
| EOY | $193,889,586 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $2,764,490 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $0 | NetUnrlzdGainsLossesInvstAmt |
| Donated Services And Use Fclts | $0 | DonatedServicesAndUseFcltsAmt |
| Investment Expense | $0 | InvestmentExpenseAmt |
| Prior Period Adjustments | $0 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$17,355 | 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 D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $1,105,252 | OtherCostOrOtherBasisAmt |
| Book Value | $1,105,252 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $72,433,151 | OtherCostOrOtherBasisAmt |
| Depreciation | $29,166,167 | DepreciationAmt |
| Book Value | $43,266,984 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $2,644,151 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,433,264 | DepreciationAmt |
| Book Value | $210,887 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $79,361,301 | OtherCostOrOtherBasisAmt |
| Depreciation | $62,667,258 | DepreciationAmt |
| Book Value | $16,694,043 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $61,277,166 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (6 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Asset whose use is limited by donor specification | $54,988 |
| Assets held by trustees under bond indenture | $3,463,306 |
| Trust agreements | $11,893,290 |
| Other receivable | $49,148,248 |
| Interest in TVRCC | $1,479,710 |
| Contribution receivable | $280,325 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $66,319,867 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| Interest Payable | $54,893 |
| Workers compensation payable | $204,442 |
| Interest rate swap agreements | $3,867,071 |
| Accrued payroll withholdings | $4,449,329 |
| Other Payables | $392,570 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $8,968,305 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule D, Part X, Line 2 | FormAndLineReferenceDesc |
| Explanation | The Hospital is a not for profit corporation exempt form federal income taxes under Section 501c3 of the Internal Revenue Code; therefore no provision has been made for federal income taxes in the accompanying financial statements. In addition, the IRS has determined that the Hospital is not a "private foundation" within the meaning of section 509a of the code. | ExplanationTxt |
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 |
| Percent100 | Yes (X) | Percent100Ind |
| 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 | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| 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 | $1,587,716 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,587,716 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,315,430 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,212,231 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,103,199 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.9 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $18,903,146 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,212,231 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $11,690,915 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.98 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $388,498 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $131,147 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $257,351 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $6,900 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,900 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $395,398 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $131,147 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $264,251 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $19,298,544 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,343,378 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $11,955,166 | NetCommunityBenefitExpnsAmt |
| Total Expense | 1.00 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $5,618,396 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $24,721 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $31,870,552 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $25,734,525 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $6,136,027 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Tuscarawas Ambulatory Surgery Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | ambulatory surgery center | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.7 | OrgProfitOrOwnershipPct |
| Ofcr Etc Profit Or Ownership | 0 | OfcrEtcProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.3 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | The Union Hospital Association | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 659 Boulevard | AddressLine1Txt |
| City | Dover | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44622 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.unionhospital.org | WebsiteAddressTxt |
| 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 | The Union Hospital Association | 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 |
| CHNA Conducted | 15 | 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 | www.unionhospital.org | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | www.healthytusc.org | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.unionhospital.org | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| 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 | 100 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300 | FPGFamilyIncmLmtDscntCarePct |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| 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 Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 5-The Union Hospital Association | The Hospital's panel includes medical leaders and physicians encompassing all aspects of healthcare from mental health to dental care. They ranged from family doctors to drug and alcohol counselors. The information obtained was used to discover and address the community's health needs. |
| Schedule H, Part V, Section B, Line 6a-The Union Hospital Association | Trinity Twin City Hospital |
| Schedule H, Part V, Section B, Line 6b-The Union Hospital Association | Healthy Tusc, Tuscarawas County Health Dept., New Philadelphia Health Dept.,ADAMHS Board, Tuscarawas County Senior Center, United Way of Tuscarawas County |
| Schedule H, Part V, Section B, Line 11-The Union Hospital Association | The Hospital and surrounding community activists have taken all of the risks and needs into consideration and have focused on the items that could be successfully impacted. |
| Schedule H, Part V, Section B, Line 13h-The Union Hospital Association | The policy lists criteria for charges |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 6 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt | Address Line2USAddress/AddressLine2Txt |
|---|---|---|---|---|---|
| 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 | Dover | OH | 44622 | Physician offices | Suite 101 C |
| DASCO UH Home Medical Equipment LLC | |||||
| 375 North West Street | Westerville | OH | 43082 | Home medical equipment sales | |
| UHMS LLC | |||||
| 659 Boulevard | Dover | OH | 44622 | Physician offices | |
| Union Pharmacy Care | |||||
| 659 Boulevard | Dover | OH | 44622 | Pharmaceutical | |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 delinquent and subsequently written off as bad debt based on individual credit evaluation 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 foot note 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 will refund any monies paid on an account deemed charity or that qualifies for financial assistance once that assessment has been determined. The account is then written off to such classification and any or all collections will cease after the determination has been made. |
| Schedule H, Part VI, Line 2 | Our community wellness department is committed to addressing the health assessments and concerns of our community. The department compiled the data by utilizing secondary sources such as the CDC and Ohio obesity prevention. We have identified Obesity (adult and youth), mental health and bullying (adult and youth), youth substance abuse, and access to dental care. |
| Schedule H, Part VI, Line 3 | Patients are given an informational booklet that contains patient accounts 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 factors of qualifying information. Financial assistance is provided with the first billing. |
| Schedule H, Part VI, Line 4 | Tuscarawas county is one of 88 counties in the state of Ohio. The county's population is approximately 91,000 with 24% under the age of 18 and 18% is over the age of 62. It is predominately Caucasian with 6% having a foreign language as their first language,. The county is a rural setting with 13% living in poverty and 9% without health insurance. |
| Schedule H, Part VI, Line 5 | We provide low cost clinics for blood pressure, cholesterol screenings, cancer screenings and diabetes clinics to the population served to help the community stay healthy and prevent diseases. We offer health fairs and promote health speakers on various topics ranging from breast cancer to teen self esteem issues at no cost. |
| Schedule H, Part VI, Line 7 | none |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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 (13 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Jody Stoldt | ||||||||||||||
| Executive Director | $197,758 | $0 | $21,694 | $0 | $0 | $0 | $7,378 | $0 | $1,371 | $0 | $228,201 | $0 | $0 | $0 |
| R Bruce James | ||||||||||||||
| President and CEO | $348,006 | $0 | $66,939 | $0 | $0 | $0 | $15,000 | $0 | $12,806 | $0 | $442,751 | $0 | $0 | $0 |
| Chris Beck | ||||||||||||||
| Vice President | $113,223 | $0 | $4,851 | $0 | $0 | $0 | $2,069 | $0 | $18,907 | $0 | $139,050 | $0 | $0 | $0 |
| Eugene A Thorn III | ||||||||||||||
| Vice President and CFO | $210,483 | $0 | $25,893 | $0 | $0 | $0 | $12,629 | $0 | $13,154 | $0 | $262,159 | $0 | $0 | $0 |
| Darwin K Smith | ||||||||||||||
| Vice President | $145,109 | $0 | $15,460 | $0 | $0 | $0 | $8,707 | $0 | $11,164 | $0 | $180,440 | $0 | $0 | $0 |
| Diana L Boyd | ||||||||||||||
| Vice President | $150,138 | $0 | $18,912 | $0 | $0 | $0 | $8,655 | $0 | $6,655 | $0 | $184,360 | $0 | $0 | $0 |
| Todd A Meyerhoefer | ||||||||||||||
| Vice President | $257,961 | $0 | $34,740 | $0 | $0 | $0 | $15,000 | $0 | $19,357 | $0 | $327,058 | $0 | $0 | $0 |
| Robert Craig | ||||||||||||||
| Vice President | $158,574 | $0 | $20,124 | $0 | $0 | $0 | $9,515 | $0 | $11,233 | $0 | $199,446 | $0 | $0 | $0 |
| Alok Bhagat | ||||||||||||||
| Physician | $558,880 | $0 | $0 | $0 | $0 | $0 | $15,000 | $0 | $6,062 | $0 | $579,942 | $0 | $0 | $0 |
| Lindsay Moore | ||||||||||||||
| Physician | $500,011 | $0 | $125,125 | $0 | $0 | $0 | $15,000 | $0 | $16,717 | $0 | $656,853 | $0 | $0 | $0 |
| William Burgette | ||||||||||||||
| Physician | $650,000 | $0 | $0 | $0 | $0 | $0 | $15,000 | $0 | $16,717 | $0 | $681,717 | $0 | $0 | $0 |
| Robert Levitt | ||||||||||||||
| Physician | $775,506 | $0 | $0 | $0 | $0 | $0 | $15,000 | $0 | $16,718 | $0 | $807,224 | $0 | $0 | $0 |
| Joseph N Zemis | ||||||||||||||
| Medical Staff Vice President | $842,019 | $0 | $212,317 | $0 | $0 | $0 | $15,000 | $0 | $19,358 | $0 | $1,088,694 | $0 | $0 | $0 |
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 | Tuscarawas County Ohio | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 346002853 | BondIssuerEIN |
| Bond Issued | 2014-09-24 | BondIssuedDt |
| Issue Price | $45,060,000 | IssuePriceAmt |
| Purpose | ED project and refinancing arrangements | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | Yes (1) | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $0 | RetiredAmt |
| Bond Defeased | $25,707,957 | BondDefeasedAmt |
| Total Proceeds | $45,060,000 | TotalProceedsAmt |
| In Reserve Fund | $0 | InReserveFundAmt |
| Capitalized Interest | $950,217 | CapitalizedInterestAmt |
| Refunding Escrow | $0 | RefundingEscrowAmt |
| Issuance Costs From Proceeds | $0 | IssuanceCostsFromProceedsAmt |
| Credit Enhancement | $0 | CreditEnhancementAmt |
| Working Capital Expenditures | $250,153 | WorkingCapitalExpendituresAmt |
| Capital Expenditures | $0 | CapitalExpendituresAmt |
| Other Spent Proceeds | $0 | OtherSpentProceedsAmt |
| Unspent | $0 | UnspentAmt |
| Substantial Completion | 2014 | SubstantialCompletionYr |
| Current Refunding | 0 | CurrentRefundingInd |
| Advance Refunding | Yes (1) | AdvanceRefundingInd |
| 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 | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0 | 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 | Yes (1) | Form8038TFiledInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | Yes (1) | HedgeIdentifiedInBksAndRecInd |
Hedge Provider Name HedgeProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RBS Citizens NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 32 | TermOfHedgePct |
| Superintegrated Hedge | 0 | SuperintegratedHedgeInd |
| Hedge Terminated | 0 | HedgeTerminatedInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Jim Pringle | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | Board member | RelationshipDescriptionTxt |
| Transaction | $48,007 | TransactionAmt |
| Transaction | Attorney fees | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 A, Line 7a | Board members have the opportunity to elect other members. |
| Form 990, Part VI, Section B, Line 11b | The 990 is prepared internally by the Manager of Accounting, the general 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 990 is also reviewed by the Association's independent accounting firm. |
| 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 any known conflicts that may have or 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 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 anytime 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 annual report and community benefit report on the Hospital's website. |
| Form 990, Part IX, Line 11g | purchased maintenance agreements, contract labor, outside technical services |
| Form 990, Part XI, Line 9 | -17346 reclassification of net assets 9 rounding. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|
| Union Hospital Medical Services | |||||||||
| 659 Boulevard | Dover | OH | 44622 | 270273520 | Physician offices | OH | -$404,958 | $117,100 | N/A |
| Union Physician Services | |||||||||
| 659 Boulevard | Dover | OH | 44622 | 264215547 | Physician office | OH | -$6,397,890 | $3,373,781 | N/A |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| 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 |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | UBI Code VUBICodeVAmt | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Tuscarawas Ambulatory Surgery Center | ||||||||||||||
| 320 Oxford St | Dover | OH | 44622 | 311525875 | Ambulatory surgery center | OH | N/A | Related | $719,535 | $1,645,857 | 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 | -$34,677 | $306,491 | 0 | 0 | 0.5 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Valley Healthcare Inc | ||||||||||||
| 659 Boulevard | Dover | OH | 44622 | 341654921 | Inactive | OH | N/A | C | $0 | $0 | 1 | |
| Union Care Corporation | ||||||||||||
| 659 Boulevard | Dover | OH | 44622 | 341556177 | Inactive | OH | N/A | C | $0 | $0 | 1 | |
| Union Pharmaceutical Care | ||||||||||||
| 659 Boulevard | Dover | OH | 44622 | 043588229 | Retail pharmacy sales | OH | N/A | C | $2,728 | $31,400 | 1 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | 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 | Yes (1) | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Tuscarawas Valley Regional Cancer Center | ||
| f | $850,000 | Distribution from TVRCC |
| Union Hospital Auxillary | ||
| c | $203,000 | Annual donation |
| Tuscarawas Ambulatory Surgery Center | ||
| a-iv | $400,505 | Rent Received from TASC |
| Tuscarawas Ambulatory Surgery Center | ||
| j | $400,505 | Leased building from UH |
| Dasco Union Hospital Home Medical Equipment LLC | ||
| a-iv | $13,600 | REnt |
Reasonable Cause Explanation ReasonableCauseExplanation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | Obtained an extension to file an accurate report. | ExplanationTxt |