2017-04-10T11:33:19-05:00 2016-06-30 621199757 LBMC PC PO BOX 1869 BRENTWOOD TN 370241869 990 2015-07-01 621438461 UNIVERSITY COMMUNITY HEALTH SERVICESINC UNIV 6159327625 601 BENTON AVENUE NASHVILLE TN 372042303 CAROLINE JENKINS SUZANNE HURLEY EXECUTIVE DIRECTORS 6159327625 2017-03-27 1 JILL HUDSON P00061190 6153774600 2017-03-22 2015 2021-01-29 14:40:06Z CAROLINE P JENKINS SUZA 601 BENTON AVENUE NASHVILLE TN 372042303 5718858 0 X WWW.UCHSHEALTH.ORG X 1990 TN TO PROVIDE ACCESSIBLE AFFORDABLE, HOLISTIC HEALTHCARE TO PATIENTS ACROSS THE LIFESPAN WITH A SPECIAL FOCUS ON VULNERABLE POPULATIONS, WITHIN A FINANCIALLY SUSTAINABLE DELIVERY MODEL. FURTHER, UCHS SUPPORTS HEALTH PROFESSIONS EDUCATION, CLINICAL AND HEALTH SERVICES RESEARCH. 11 11 72 0 0 0 1337404 1770612 4694506 3945935 -75577 -20175 0 0 5956333 5696372 0 0 0 0 3559583 3582592 0 0 0 2581640 1768801 6141223 5351393 -184890 344979 1616091 1704905 605550 303405 1010541 1401500 X TO PROVIDE ACCESSIBLE, AFFORDABLE, HOLISTIC HEALTHCARE TO PATIENTS ACROSS THE LIFESPAN WITH A SPECIAL FOCUS ON VULNERABLE POPULATIONS, WITHIN A FINANCIALLY SUSTAINABLE DELIVERY MODEL. FURTHER, UCHS SUPPORTS HEALTH PROFESSIONS EDUCATION, CLINICAL, AND HEALTH SERVICES RESEARCH. 0 0 3974383 3925760 UNIVERSITY COMMUNITY HEALTH SERVICES OPERATES A NETWORK OF NURSE MANAGED PRIMARY CARE CLINICS SOME OF WHICH ARE LOCATED IN LOW INCOME AREAS IN NASHVILLE. THESE CLINICS ARE PART OF THE STATE SAFETY NET NETWORK AND SERVICES ARE PROVIDED UNDER AN AFFORDABLE SLIDING SCALE BASED ON POVERTY LEVEL AND INSURANCE COVERAGE. CARE WAS PROVIDED IN OVER 48,000 VISITS FOR THE YEAR ENDED JUNE 30, 2016. PRIMARY CARE SERVICES ARE ALSO PROVIDED IN ON SITE CLINICS EMBEDED IN WITH EMPLOYERS, INCLUDING THE STATE OF TENNESSEE. MANY OF THE EMPLOYEES SERVED AT THESE SITES ARE UNINSURED OR UNDER INSURED AS WELL. TO PROVIDE ACCESSIBLE AFFORDABLE, HOLISTIC HEALTHCARE TO PATIENTS ACROSS THE LIFESPAN WITH A SPECIAL FOCUS ON VULNERABLE POPULATIONS, WITHIN A FINANCIALLY SUSTAINABLE DELIVERY MODEL. 3974383 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 28 0 1 72 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X CAROLINE PORTIS JENKINS & SUZANNE HURLEY 6159327634 601 BENTON AVE NASHVILLE TN 37204 AMY RADCLIFF PRESIDENT 1.00 X X 0 0 0 KATHRYN HAEUPTLE SECRETARY 1.00 X X 0 0 0 JAMES ARMSTRONG BOARD MEMBER 1.00 X 0 0 0 SHANA BERKELEY BOARD MEMBER 1.00 X 0 0 0 MAMIE BRINKLEY BOARD MEMBER 1.00 X 0 0 0 BARBARA CANNON BOARD MEMBER 1.00 X 0 0 0 KEVIN CONARD BOARD MEMBER 1.00 X 0 0 0 RACHEL ZAMATA ODOM PAST PRESIDENT 1.00 X X 0 0 0 ANITA SANDERS BOARD MEMBER 1.00 X 0 0 0 BRENT TAYLOR BOARD MEMBER 1.00 X 0 0 0 HANNAH LAURENSON BOARD MEMBER 1.00 X 0 0 0 SUZANNE HURLEY CO-CEO 40.00 X 114538 0 5098 CAROLINE PORTS-JENKINS CO-CEO 40.00 X 114676 0 6707 LILLIAN BEARID-GAINES PHYSICIAN 40.00 X 127260 0 9840 356474 0 21645 3 0 0 0 W SQUARED 5500 MARYLAND WAY SUITE 200 BRENTWOOD TN 37027 ACCOUNTING AND HR SERVICES 225027 ALLSCRIPTS LLC 24630 NETWORK PLACE CHICAGO IL 606731246 TECHNOLOGY SERVICE 139755 MCA INC 6048 CENTURY OAKS DRIVE CHATTANOOGA TN 37416 TECHNOLOGY SERVICE 133963 3 1606566 164046 1770612 PATIENT SERVICE FEES 900099 3945935 3945935 3945935 2311 22486 -20175 -20175 -20175 5696372 3925760 0 0 241018 241018 2789136 2495934 293202 61927 57193 4734 255926 221900 34026 234585 193953 40632 642 642 194850 194850 298654 232614 66040 26592 23102 3490 58018 43116 14902 240684 34311 206373 150209 148317 1892 5571 5007 564 703 703 162979 162979 71004 71004 MEDICAL SUPPLIES 272512 272512 BAD DEBT EXPENSE 99312 99312 UTILITIES 70172 59961 10211 MISCELLANEOUS 35363 25113 10250 81536 61335 20201 5351393 3974383 1377010 0 690 700 461199 706805 151447 192557 389246 345446 41588 67679 1905883 1514165 571921 391718 1616091 1704905 571768 298786 33782 0 4619 605550 303405 X 1010541 1401500 1010541 1401500 1616091 1704905 344979 45980 0 X X 0 1 X 1 1 1 X 823412 866850 938920 1337404 1770612 5737198 6732624 6653124 7059186 4694506 3945935 29085375 7556036 7519974 7998106 6031910 5716547 34822573 0 739933 739300 858574 1238892 1549401 5126100 739933 739300 858574 1238892 1549401 5126100 29696473 37 1541 27 0 1605 37 1541 27 1605 7556073 7519974 7999647 6031937 5716547 34824178 0.85280 0.93210 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1365996 1063905 302091 539887 450260 89627 391718 CAPITAL LEASE OBLIGATION 4619 4619 X 5679848 62612 20176 82788 5597060 99312 99312 5696372 5288889 16632 20176 36808 5252081 99312 99312 5351393 PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM INCOME TAXES ON INCOME FROM RELATED ACTIVITIES UNDER SECTION 501(C)(3) OF THE U.S. INTERNAL REVENUE CODE AND CORRESPONDING STATE TAX LAW. ACCORDINGLY, NO PROVISION HAS BEEN MADE FOR FEDERAL OR STATE INCOME TAXES. A TAX POSITION IS RECOGNIZED AS A BENEFIT ONLY IF IT IS "MORE LIKELY THAN NOT" THAT THE TAX POSITION WOULD BE SUSTAINED IN A TAX EXAMINATION, WITH A TAX EXAMINATION BEING PRESUMED TO OCCUR. THE AMOUNT RECOGNIZED IS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED ON EXAMINATION. FOR TAX POSITIONS NOT MEETING THE "MORE LIKELY THAN NOT" TEST, NO TAX BENEFIT IS RECORDED. DUE TO ITS TAX-EXEMPT STATUS, THE ORGANIZATION IS GENERALLY NOT SUBJECT TO U.S. FEDERAL INCOME TAX OR STATE INCOME TAX. THE ORGANIZATION'S FORM 990 HAS NOT BEEN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE OR THE STATE OF TENNESSEE FOR THE LAST THREE YEARS. THE ORGANIZATION DOES NOT EXPECT THE TOTAL AMOUNT OF UNRECOGNIZED TAX BENEFITS TO SIGNIFICANTLY CHANGE IN THE NEXT 12 MONTHS. THE ORGANIZATION RECOGNIZES INTEREST AND/OR PENALTIES RELATED TO INCOME TAX MATTERS IN INCOME TAX EXPENSE. THE ORGANIZATION DID NOT HAVE ANY AMOUNTS ACCRUED FOR INTEREST AND PENALTIES AT JUNE 30, 2016. PART XI, LINE 2D - OTHER ADJUSTMENTS: GAIN/LOSS FROM DISPOSITION OF ASSET PROVISION FOR BAD DEBT PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT PART XII, LINE 2D - OTHER ADJUSTMENTS: GAIN/LOSS FROM DISPOSITION OF ASSET PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT SCHEDULE D, PART XI, LINES 2D AND 4B LOSS FROM DISPOSITION OF FIXED ASSETS X FURNITURE, EQUIPMENT AND FIXTURES 1 980 FAIR MARKET VALUE 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE CEO REVIEWS THE FORM 990. BEFORE THE FORM 990 IS FILED WITH THE IRS, THE CEO DISTRIBUTES THE FORM AND PRESENTS IT TO THE BOARD FOR APPROVAL. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY WHICH IS REQUIRED FOR ALL BOARD MEMBERS AND OFFICERS TO SIGN A STATEMENT AFFIRMING THAT THEY HAVE NO CONFLICTS OF INTEREST WITH THE ORGANIZATION. THE CEO MONITORS THE CONFLICT OF INTEREST STATEMENTS AND NOTIFIES THE BOARD IN THE EVENT A POTENTIAL CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST EXISTS, THE BOARD MEMBER IS EXCLUDED FROM PARTICIPATING IN THE DELIBERATIONS OF THE TRANSACTION. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICIES ARE NOT REQUIRED DISCLOSURES PURSUANT TO IRC SECTION 6104. THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. FORM 990, PART XII, LINE 2C: UCHS HAS NOT CHANGED EITHER ITS OVERSIGHT OR SELECTION PROCESS DURING THE YEAR.