2017-05-25T10:13:20-05:00 2016-12-31 341310124 REA & ASSOCIATES INC 1166 MILITARY ROAD SUITE A ZANESVILLE OH 43701 990 2016-01-01 208814374 MUSKINGUM VALLEY HEALTH CENTER MUSK 7408919000 716 ADAIR AVENUE ZANESVILLE OH 437012836 REBECCA CARR CFO 7408919000 2017-05-24 1 CHAD A BICE CPA P00831863 7404543198 98.102.154.154 2017-05-24 11:59:46 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 B4AAD542CBB7734BE66E80FA2A80CD8EAB44765E 2016 2021-01-29 14:40:06Z REBECCA CARR 716 ADAIR AVENUE ZANESVILLE OH 437012836 21789023 0 X www.mvhccares.org X 2007 OH TO PROVIDE AFFORDABLE, ACCESSIBLE AND QUALITY HEALTHCARE. 14 14 274 0 0 0 2736464 3692359 14591149 17701642 -2230 16722 343353 337898 17668736 21748621 0 0 0 0 10772028 12133005 0 0 46151 5414987 6195842 16187015 18328847 1481721 3419774 15116698 18174089 3510562 3117547 11606136 15056542 TO PROVIDE AFFORDABLE, ACCESSIBLE AND QUALITY HEALTHCARE. 0 0 12625329 14029347 MUSKINGUM VALLEY HEALTH CENTER PROVIDES NUMEROUS SERVICES, INCLUDING ADULT PRIMARY CARE, PEDIATRICS, DENTAL, MENTAL HEALTH, OB/GYN AND PODIATRY SERVICES. THE THREE LARGEST SERVICE PROGRAMS ARE ADULT HEALTH, DENTAL AND PEDIATRICS. DURING THE YEAR, THE CENTER PROVIDED SERVICES FOR APPROXIMATELY 31,633 PATIENTS RESULTING IN 115,966 VISITS, AND PROVIDED A SLIDING FEE SCALE ADJUSTMENT IN THE AMOUNT OF $502,545. 1956621 3672295 MUSKINGUM VALLEY HEALTH CENTERS PARTICIPATES IN A 340B PRESCRIPTION DRUG PROGRAM WHICH PROVIDES PRESCRIPTIONS AT A DISCOUNT TO QUALIFYING PATIENTS OF THE ORGANIZATION. 378300 MUSKINGUM VALLEY HEALTH CENTERS PERFORMS CONTRACT SERVICES FOR OTHER ORGANIZATIONS AND PARTICPATES IN ACTIVITIES THAT GENERATE ADDITIONAL FUNDING SOURCES RELATED TO THEIR MISSION. 14581950 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 5 0 1 274 1 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 OH X RECECCA CARR 7408919090 716 ADAIR AVENUE ZANESVILLE OH 43701 CAROLYN JENKINS DIRECTOR 1.00 X 0 0 0 JAN SNOUFFER SECRETARY 1.00 X X 0 0 0 JIM WILSON DIRECTOR 1.00 X 0 0 0 JASON T HEINS TREASURER 1.00 X X 0 0 0 CAROL HOWDYSHELL DIRECTOR 1.00 X 0 0 0 SUSAN SMALL DIRECTOR 1.00 X 0 0 0 COREY HAMILTON VICE CHAIR 1.00 X X 0 0 0 SCOTT SILVESTRI DIRECTOR 1.00 X 0 0 0 DEAN WRIGHT DIRECTOR 1.00 X 0 0 0 RHONDA SMITH DIRECTOR 1.00 X 0 0 0 HEATHER COEN CHAIR 1.00 X X 0 0 0 BRIAN DUNLAP DIRECTOR 1.00 X 0 0 0 SLOAN ALBERT DIRECTOR 1.00 X 0 0 0 SHELLEY MCPEEK DIRECTOR 1.00 X 0 0 0 MARY GREEN DIRECTOR 1.00 X 0 0 0 REBECCA CARR CFO 40.00 X 108361 0 5099 DAN ATKINSON CEO 40.00 X 158154 0 6308 DAVID KLEIN CMO 40.00 X 218752 0 5136 COURTNEY FLANIGAN PHYSICIAN 40.00 X 181269 0 14058 MICHAEL BOBB PHYSICIAN 40.00 X 221382 0 20951 BIJAN GOODARZI PHYSICIAN 40.00 X 275121 0 12748 BILLIMAGGA RANGASWAMY PHYSICIAN 40.00 X 162342 0 13993 DONOVAN CAMPBELL PHYSICIAN 40.00 X 159740 0 11501 1485121 0 89794 8 0 1 0 SHRIVER'S PHARMACY 406 BRIGHTEN BLVD ZANESVILLE OH 43701 PHARMACY SERVICE FEES 682905 NORTHSIDE PHARMACY 2899 BELL STREET ZANESVILLE OH 43701 PHARMACY SERVICE FEES 373644 OHIO PSYCHIATRIC ASSOCIATES INC 975 BETHESDA DRIVE ZANESVILLE OH 43701 CONTRACT PHYSICIAN SERVICES 289390 COSHOCTON COUNTY MEMORIAL HOSPITAL 1460 ORANGE STREET COSHOCTON OH 43812 CONTRACT PHYSICIAN SERVICES 159075 WALGREENS PHARMACY 1415 LAKE COOK RD DEERFIELD IL 60015 PHARMACY SERVICE FEES 142442 5 63685 3451041 177633 3692359 NET PATIENT SERVICES 623000 14029347 14029347 340B PRESCRIPTION DRUG PROGRAM 623000 3672295 3672295 17701642 16722 16722 17720 7916 9804 9804 9804 31125 63685 32486 -1361 -1361 OTHER REVENUE 623000 179200 179200 CONTRACT SERVICES 623000 150255 150255 329455 21748621 18031097 0 25165 X 501810 401448 100362 9586221 7668977 1917244 1270399 1016319 254080 774575 619660 154915 79506 79506 50167 50167 2042770 1916376 125632 762 105371 16345 82396 6630 106366 40539 65702 125 242144 194141 48003 368494 332265 35958 271 79528 35405 43873 250 26937 6285 20652 95813 95813 548399 359605 188794 67175 41798 25377 SUPPLIES 2072780 1799037 264191 9552 RENT 102088 73588 28500 STAFF DEVELOPMENT 57503 40847 16656 DUES AND SUBSCRIPTIONS 42455 6895 31599 3961 108346 12420 71326 24600 18328847 14581950 3700746 46151 1388657 1006079 1555716 2730530 10705 342718 1469768 1725350 349232 446450 103958 93047 13119032 2722332 10217255 10396700 1433215 21407 0 15116698 18174089 916269 806923 2594293 2310624 3510562 3117547 X 11517952 14928532 88184 128010 11606136 15056542 15116698 18174089 3419774 30632 0 X 0 1 X 1 1 1 X 1261875 353754 2034518 2736464 3692359 10078970 9830519 3249290 11911580 14591149 17701642 57284180 11092394 3603044 13946098 17327613 21394001 67363150 0 0 0 67363150 1065 376 1144 2550 25165 30300 1065 376 1144 2550 25165 30300 94400 41009 175692 343353 329455 983909 11187859 3644429 14122934 17673516 21748621 68377359 0.98520 0.98680 0.00040 0.00010 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 974902 974902 9352260 789690 8562570 443056 237517 205539 2348814 1695125 653689 10396700 X 21819655 30632 40402 71034 21748621 0 21748621 18369249 0 18369249 -40402 -40402 18328847 Part X, Line 2: The Organization is exempt from federal, state, and city income taxes derived principally by it being classified as a 501(c)(3) organization in the Internal Revenue Code. However, the Organization may be subjected to tax on unrelated business income. For the years ended December 31, 2016 and 2015, the Organization earned no unrelated business income. Accordingly, no provision for income taxes has been recorded within the financial statements. Generally accepted accounting principles required the Organization to evaluate the level of uncertainty related to whether tax positions taken will be sustained upon examination. Any positions taken that do not meet the more-likely-than-not threshold must be quantified and recorded as a liability for unrecognized tax benefits in the accompanying statement of financial position along with any associated interest and penalties that would be payable to the taxing authorities upon examination. Management believes that none of the tax positions taken would materially impact the financial statements and no such liabilities have been recorded. Part XI, Line 2d - Other Adjustments: Rent expense and fundraising expense reported on page 9 Part XII, Line 4b - Other Adjustments: Rent expense and fundraising expense reported on page 9 SCHEDULE D PAGE 4 PART XI LINES 2D AND 4 B Rent expense and fundraising expense reported on page 9 WILD NIGHT FOR WELLNESS EVENT 94810 63685 31125 6664 9188 700 15934 94810 63685 31125 6664 9188 700 15934 32486 -1361 0 0 0 0 0 0 0 0 0 DAN ATKINSON CEO 158154 0 0 0 0 0 6283 0 25 0 164462 0 0 0 DAVID KLEIN CMO 218752 0 0 0 0 0 0 0 5136 0 223888 0 0 0 COURTNEY FLANIGAN PHYSICIAN 181269 0 0 0 0 0 7427 0 6631 0 195327 0 0 0 MICHAEL BOBB PHYSICIAN 221382 0 0 0 0 0 7224 0 13727 0 242333 0 0 0 BIJAN GOODARZI PHYSICIAN 275121 0 0 0 0 0 9453 0 3295 0 287869 0 0 0 BILLIMAGGA RANGASWAMY PHYSICIAN 162342 0 0 0 0 0 6598 0 7395 0 176335 0 0 0 DONOVAN CAMPBELL PHYSICIAN 159740 0 0 0 0 0 6573 0 4928 0 171241 0 0 0 Form 990, Part VI, Section B, line 11b THE CFO REVIEWS FORM 990 AND AN ELECTRONIC COPY IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING. Form 990, Part VI, Section B, line 12c BOARD MEMBERS SIGN CONFLICT OF INTEREST AND CONFIDENTIALITY STATEMENTS ANNUALLY. FORMS ARE MAINTAINED BY MANAGEMENT. BOARD MEMBERS DISCLOSE CONFLICTS OF INTEREST THAT MIGHT INFLUENCE JUDGEMENT IN THEIR DECISION MAKING PROCESS. FOLLOWING DISCLOSURE, THE BOARD'S EXECUTIVE COMMITTEE SHALL DETERMINE APPROPRIATE ACTION,RANGING FROM ABSTAINING FROM SPECIFIC BOARD DECISIONS, TO STEPPING DOWN FROM MEMBERSHIP. Form 990, Part VI, Section B, line 15 COMPENSATION FOR OFFICERS AND KEY EMPLOYEES IS MONITORED AND DETERMINED BY THE BOARD OF DIRECTORS. COMPENSATION PACKAGES ARE BENCHMARKED BASED ON THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS SURVEY INFORMATION. COMPENSATION RANGES ARE REVIEWED AND APPROVED ON AN ANNUAL BASIS AND DOCUMENTED IN THE BOARD MEETING MINUTES. Form 990, Part VI, Section C, line 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND THE FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. Form 990, Part IX, line 11g PROFESSIONAL CONTRACT SERVICES: Program service expenses 713,785. Management and general expenses 120,537. Fundraising expenses 512. Total expenses 834,834. SERVICE CONTRACT FEE: Program service expenses 1,198,991. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,198,991. TRANSPORTATION: Program service expenses 3,600. Management and general expenses 5,095. Fundraising expenses 250. Total expenses 8,945.