UPPER VALLEY PROFESSIONAL CORPORATION: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
UPPER VALLEY PROFESSIONAL CORPORATION (EIN 31-1400963)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-11-13
IRS object ID
201503179349308735
Schema version
2014v5.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2015-11-13T16:11:12-06:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1800 YARD ST 200AddressLine1Txt
CityGRANDVIEW HEIGHTSCityNm
State AbbreviationOHStateAbbreviationCd
ZIP43212ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN311400963EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Upper Valley Professional CorporationBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% J MICHAEL SIMSInCareOfNm
Business Name ControlUPPEBusinessNameControlTxt
Phone9374999942PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1110 N MAIN ST 500AddressLine1Txt
CityDAYTONCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45402ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTIMOTHY D SNIDERPersonNm
Person TitleVice-President & CFOPersonTitleTxt
Phone6142245678PhoneNum
Signature2015-11-12SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDIANE L BEANPreparerPersonNm
PTINP00104972PTIN
Phone6142245678PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerREBECCA RICEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line13130 N COUNTY RD 25AAddressLine1Txt
CityTROYCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45373ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$10,586,967GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.premierhealth.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1994FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or MissionTo provide primary health care services to the community served by Upper Valley Medical Center, a 501(C)(3) hospital.ActivityOrMissionDesc
Voting Members Governing Body6VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee235TotalEmployeeCnt
Total Volunteers6TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$9,970,588PYProgramServiceRevenueAmt
CY Program Service Revenue$10,352,851CYProgramServiceRevenueAmt
PY Investment Income$856PYInvestmentIncomeAmt
CY Investment Income$1,704CYInvestmentIncomeAmt
PY Other Revenue$252,592PYOtherRevenueAmt
CY Other Revenue$232,412CYOtherRevenueAmt
PY Total Revenue$10,224,036PYTotalRevenueAmt
CY Total Revenue$10,586,967CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$8,134,935PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$10,257,537CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$4,204,533PYOtherExpensesAmt
CY Other Expenses$2,195,737CYOtherExpensesAmt
PY Total Expenses$12,339,468PYTotalExpensesAmt
CY Total Expenses$12,453,274CYTotalExpensesAmt
PY Revenues Less Expenses-$2,115,432PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,866,307CYRevenuesLessExpensesAmt
Total Assets BOY$4,598,349TotalAssetsBOYAmt
Total Assets EOY$6,964,330TotalAssetsEOYAmt
Total Liabilities BOY$3,888,677TotalLiabilitiesBOYAmt
Total Liabilities EOY$4,514,568TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$709,672NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,449,762NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionUPPER VALLEY PROFESSIONAL CORPORATION, AS A SUBSIDIARY OF UVMC, SERVES AS AN INTEGRAL PART IN ACHIEVING UPPER VALLEY MEDICAL CENTER'S MISSION: UVMC WILL STRIVE TO PROVIDE QUALITY CARE THAT UPHOLDS THE DIGNITY OF ALL INDIVIDUALS. CARE WILL BE GIVEN IN A HOLISTIC MANNER WITHOUT REGARD TO RACE, RELIGION, CREED, NATIONAL ORIGIN, OR SOCIAL STATUS. OUR HEALTH CARE DELIVERY SYSTEM IS STRUCTURED TO OPTIMIZE THE DELIVERY OF SAFE, EFFICIENT, AND COST-EFFECTIVE HEALTH CARE.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$10,699,345ExpenseAmt
Grant$0GrantAmt
Revenue$10,585,263RevenueAmt
DescSee Schedule ODesc
Total Program Service Expenses$10,699,345TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgYes (true)TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document21IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee235EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members6GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (true)DelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldOHStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJ MICHAEL SIMSPersonNm
Phone9374999942PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1110 N MAIN ST SUITE 500AddressLine1Txt
CityDAYTONCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45402ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
ARTHUR R DISBROW
BOARD VICE-CHAIR0.52.5Yes (X)Yes (X)$0$0$0
CRAIG C BUNDSCHUH
BOARD SECRETARY0.52.5Yes (X)Yes (X)$0$0$0
DOUGLAS R MURRAY
TRUSTEE0.52.5Yes (X)$0$0$0
WILLIAM E LUKENS
TRUSTEE0.52.5Yes (X)$0$0$0
PETER E NIMS MD
TRUSTEE0.52.5Yes (X)$0$0$0
ROWAN R NICKOL MD
BOARD CHAIR0.52.5Yes (X)Yes (X)$0$0$0
TIM D SNIDER- SEE SCHED O
BOARD TREASURER & CFO1.518.5Yes (X)$0$230,534$36,855
JENNA M DOWNEY ESQ
RECORDING SECRETARY0.52.5Yes (X)$0$0$0
REBECCA A RICE
UPPER VALLEY MED CTR PRES &CEO3.037.0Yes (X)$0$309,563$46,312
CASS CULLIS MD
PHYSICIAN40.00.0$478,348$0$32,741Yes (X)
WILLIAM CZAJKA MD
PHYSICIAN40.00.0$480,959$0$33,056Yes (X)
DON DELCAMP MD
PHYSICIAN40.00.0$450,210$0$30,643Yes (X)
POLLY F TRAIN MD
PHYSICIAN: SPECIALTY40.00.0$464,234$0$12,384Yes (X)
MARK ZUNKIEWICZ MD
PHYSICIAN40.00.0$530,911$0$31,988Yes (X)
THOMAS PARKER
FORMER TRUSTEE & OFFICER0.08.0$0$454,750$28,492Yes (X)
MICHAEL J MAIBERGER
FORMER TRUSTEE & OFFICER0.08.0$0$564,224$46,894Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,404,662TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,559,071TotReportableCompRltdOrgAmt
Total Other Compensation$299,365TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K44IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
MEDICAL DOCTOR ASSOC
PO BOX 277185ATLANTAGA30384Medical Services$334,822
WEATHERBY LOCUMS
PO BOX 972633DALLASTX75397STAFFING SERVICES$184,395
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
Total Contributions$0TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE621990$9,966,824$9,966,824
REIMBURSEMENT FOR SERVICES561000$385,871$385,871
PURCHASE DISCOUNTS900099$156$156
FieldValueIRS element (for citing)
Total Program Service Revenue$10,352,851TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,704TotalRevenueColumnAmt
Exclusion$1,704ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescEMR INCENTIVEDesc
Business900099BusinessCd
Total Revenue Column$232,412TotalRevenueColumnAmt
Related Or Exempt Func Income$232,412RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$232,412OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$10,586,967TotalRevenueColumnAmt
Related Or Exempt Func Income$10,585,263RelatedOrExemptFuncIncomeAmt
Exclusion$1,704ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$8,694,830TotalAmt
Program Services$7,457,556ProgramServicesAmt
Management And General$1,237,274ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$187,585TotalAmt
Program Services$160,892ProgramServicesAmt
Management And General$26,693ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$654,135TotalAmt
Program Services$561,052ProgramServicesAmt
Management And General$93,083ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$720,987TotalAmt
Program Services$618,391ProgramServicesAmt
Management And General$102,596ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$3,600TotalAmt
Management And General$3,600ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$109,749TotalAmt
Management And General$109,749ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$1,148TotalAmt
Program Services$1,148ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$179,450TotalAmt
Program Services$153,914ProgramServicesAmt
Management And General$25,536ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$44,380TotalAmt
Program Services$38,065ProgramServicesAmt
Management And General$6,315ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$651,963TotalAmt
Program Services$559,189ProgramServicesAmt
Management And General$92,774ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$40,524TotalAmt
Program Services$34,757ProgramServicesAmt
Management And General$5,767ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$67,415TotalAmt
Program Services$57,822ProgramServicesAmt
Management And General$9,593ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$92,282TotalAmt
Program Services$79,150ProgramServicesAmt
Management And General$13,132ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
OPERATING SUPPLIES$809,747$809,747
PURCHASED SERVICES$151,850$130,242$21,608
TRAINING & EDUCATION$12,227$10,487$1,740
REPAIRS AND MAINTENANCE$6,697$5,744$953

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$24,705TotalAmt
Program Services$21,189ProgramServicesAmt
Management And General$3,516ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$12,453,274TotalAmt
Program Services$10,699,345ProgramServicesAmt
Management And General$1,753,929ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,325BOYAmt
EOY$2,325EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,159,410BOYAmt
EOY$3,085,984EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$637,583BOYAmt
EOY$792,747EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$97,847BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$8,978BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$69,595BOYAmt
EOY$116,962EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$1,051,471LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$589,573LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$434,517BOYAmt
EOY$461,898EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$1,887,871BOYAmt
EOY$2,166,515EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$300,223BOYAmt
EOY$337,899EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$4,598,349BOYAmt
EOY$6,964,330EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,583,572BOYAmt
EOY$3,764,103EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$305,105BOYAmt
EOY$750,465EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,888,677BOYAmt
EOY$4,514,568EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$709,672BOYAmt
EOY$2,449,762EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$709,672BOYAmt
EOY$2,449,762EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,598,349BOYAmt
EOY$6,964,330EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$1,866,307ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$3,606,397OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,121,939CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$7,888,961CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,464,736CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$10,219,180CurrentTaxYearMinus1YearAmt
Current Tax Year$10,585,263CurrentTaxYearAmt
Total$45,280,079TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,121,939CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$7,888,961CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,464,736CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$10,219,180CurrentTaxYearMinus1YearAmt
Current Tax Year$10,585,263CurrentTaxYearAmt
Total$45,280,079TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$45,280,079PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$856CurrentTaxYearMinus1YearAmt
Current Tax Year$1,704CurrentTaxYearAmt
Total$2,560TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,833CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,916CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,277CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,000CurrentTaxYearMinus1YearAmt
Total$11,026TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,833CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,916CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,277CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,856CurrentTaxYearMinus1YearAmt
Current Tax Year$1,704CurrentTaxYearAmt
Total$13,586TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Total$0TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,124,772CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$7,890,877CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,467,013CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$10,224,036CurrentTaxYearMinus1YearAmt
Current Tax Year$10,586,967CurrentTaxYearAmt
Total$45,293,665TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99970PublicSupportCY509Pct
Public Support PY5090.99952PublicSupportPY509Pct
Investment Income CY0.00030InvestmentIncomeCYPct
Investment Income PY0.00048InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp
LandLandGrp
BuildingsBuildingsGrp

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$13,200OtherCostOrOtherBasisAmt
Depreciation$73DepreciationAmt
Book Value$13,127BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,025,235OtherCostOrOtherBasisAmt
Depreciation$589,500DepreciationAmt
Book Value$435,735BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$13,036OtherCostOrOtherBasisAmt
Book Value$13,036BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$461,898TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
DUE TO AFFILIATES$731,465
MISCELLANEOUS LIABILITIES$19,000
FieldValueIRS element (for citing)
Total Liability$750,465TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule D, Part X, Line 2:FormAndLineReferenceDesc
ExplanationTHE FOLLOWING FOOTNOTE IS FROM THE AUDITED COMBINED FINANCIAL STATEMENTS FOR PREMIER HEALTH AND AFFILIATES. UVMC IS THE PARENT ORGANIZATION OF UPPER VALLEY PROFESSIONAL CORP. PREMIER HEALTH (PREMIER), MEDAMERICA HEALTH SYSTEMS (MAHS), ATRIUM HEALTH SYSTEM (AHS), AND UVMC HAVE BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE TO BE TAX-EXEMPT NONPROFIT CORPORATIONS AND PUBLIC CHARITIES UNDER SECTIONS 501(C)(3) AND 509(A), RESPECTIVELY, OF THE INTERNAL REVENUE CODE. SAMARITAN HEALTH PARTNERS (SHP) IS TAX-EXEMPT UNDER SECTION 501(C)(3) AND IS A PUBLIC CHARITY BY REASON OF BEING INCLUDED IN THE GROUP RULING ISSUED TO THE U.S. CATHOLIC CHURCH. AS TAX-EXEMPT ORGANIZATIONS, THEIR INCOME IS EXEMPT FROM FEDERAL INCOME TAX EXCEPT TO THE EXTENT OF ANY UNRELATED BUSINESS ACTIVITIES. TAXES PAYABLE AT DECEMBER 31, 2014 AND 2013 FOR SUCH UNRELATED BUSINESS ACTIVITIES ARE NOT SIGNIFICANT. PREMIER, MAHS, SHP, AHS, AND UVMC ALSO OWN OR CONTROL CERTAIN SUBSIDIARIES, WHICH ARE FOR PROFIT CORPORATIONS SUBJECT TO FEDERAL INCOME TAXES. THESE ARE: PREMIER HEALTH INSURING COMPANY (PHIC) (A WHOLLY OWNED SUBSIDIARY OF PREMIER HEALTH) PREMIER HEALTH PLAN (PHPLAN) (A WHOLLY OWNED SUBSIDIARY OF PHIC) MVHE, INC. AND PREMIER HEALTH SPECIALISTS, INC. (FORMERLY HEALTH SPECIALISTS OF DAYTON, INC.) (SUBSIDIARIES OF MAHS) SAMARITAN FAMILY CARE (SUBSIDIARY OF SHP) AND SAMARITAN NORTH SURGERY CENTER LIMITED (A JOINT-VENTURE PARTNERSHIP OF WHICH GSH IS AN 80% OWNER) MIDDLETOWN SURGERY CENTER, LLC (A JOINT VENTURE PARTNERSHIP OF WHICH AMC IS AN 80.5% OWNER) (SUBSIDIARY OF AHS) UVMC MANAGEMENT CORPORATION AND AFTER HOURS FAMILY CARE, INC. (SUBSIDIARIES OF UVMC) MANAGEMENT ANNUALLY REVIEWS THE TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
THOMAS PARKER
FORMER TRUSTEE & OFFICER$0$353,725$0$77,093$0$23,932$0$24,748$0$3,744$0$483,242$0$0
TIM D SNIDER- SEE SCHED O
BOARD TREASURER & CFO$0$197,727$0$31,660$0$1,147$0$12,268$0$24,587$0$267,389$0$0
CASS CULLIS MD
PHYSICIAN$453,720$0$0$0$24,628$0$8,595$0$24,146$0$511,089$0$0$0
WILLIAM CZAJKA MD
PHYSICIAN$449,743$0$0$0$31,216$0$4,754$0$28,302$0$514,015$0$0$0
DON DELCAMP MD
PHYSICIAN$428,911$0$0$0$21,299$0$5,039$0$25,604$0$480,853$0$0$0
POLLY F TRAIN MD
PHYSICIAN: SPECIALTY$327,289$0$136,286$0$659$0$1,725$0$10,659$0$476,618$0$0$0
MARK ZUNKIEWICZ MD
PHYSICIAN$529,818$0$0$0$1,093$0$7,620$0$24,368$0$562,899$0$0$0
MICHAEL J MAIBERGER
FORMER TRUSTEE & OFFICER$0$320,114$0$103,541$0$140,569$0$15,964$0$30,930$0$611,118$0$36,545
REBECCA A RICE
UPPER VALLEY MED CTR PRES &CEO$0$263,033$0$21,943$0$24,587$0$31,742$0$14,570$0$355,875$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 3:FormAndLineReferenceDesc
ExplanationTHE CEO'S COMPENSATION IS ESTABLISHED BY THE COMPENSATION COMMITTEE OF PREMIER HEALTH, OF WHICH UVMC (THE PARENT OF UPPER VALLEY PROFESSIONAL CORPORATION) IS AN AFFILIATE, AND PAID BY UPPER VALLEY MEDICAL CENTER. PART I, LINE 4B: DUE TO RESTRICTIONS IMPOSED BY THE INTERNAL REVENUE CODE, CERTAIN PERSONS ARE LIMITED IN THE AMOUNT OF BENEFIT THAT CAN BE EARNED UNDER A QUALIFIED RETIREMENT PLAN. LIKE MANY EMPLOYERS, UPPER VALLEY PROFESSIONAL CORPORATION (UVPC), COMPENSATES FOR THIS LIMITATION AND SUPPLEMENTS THE AFFECTED EXECUTIVES' QUALIFIED PENSION THROUGH CERTAIN NONQUALIFIED PLANS. UVPC SUPPLEMENTS THE AFFECTED EXECUTIVES THROUGH A PENSION RESTORATION PLAN AND A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE BENEFITS UNDER THESE SUPPLEMENTAL NONQUALIFIED PLANS ARE SUBJECT TO MULTI-YEAR VESTING AND A PARTICIPANT CAN FORFEIT BENEFITS EARNED IF VESTING REQUIREMENTS ARE NOT SATISFIED. UNDER THE TERMS OF THE SUPPLEMENTAL PLANS, AND BECAUSE OF TAX RULES PERTAINING TO TAXATION OF THE EARNED BENEFITS UPON VESTING, CERTAIN INDIVIDUALS RECEIVED A PAYOUT OF THE CUMULATIVE VESTED BENEFITS UNDER THEIR SUPPLEMENTAL PLAN DURING 2014. THERE WERE NO INDIVIDUALS MEETING THE MULTI-YEAR VESTING REQUIREMENT UNDER THE PENSION RESTORATION PLAN 2014. THE INDIVIDUAL LISTED BELOW HAS MET THE MULTI-YEAR VESTING REQUIREMENT UNDER THE SERP AND RECEIVED THE ASSOCIATED PAYMENT IN 2014: MICHAEL MAIBERGER $36,545. BASED ON THE GUIDANCE PROVIDED IN THE INSTRUCTIONS TO THE FORM 990, ANY PAYMENTS TO THE PARTICIPANTS RELATED TO THESE PLANS THAT WERE MADE WITHIN 2-1/2 MONTHS AFTER THE END OF THE ORGANIZATION'S TAX YEAR ARE NOT TREATED AS DEFERRED COMPENSATION FOR PURPOSES OF SCHEDULE J. SUCH AMOUNTS ARE PROPERLY REPORTED AS COMPENSATION FOR FORM 990 PURPOSES WHEN INCLUDED IN THE PARTICIPANTS' FORM W-2 WAGES. ANY PAYMENTS MADE AFTER THE 2-1/2 MONTHS WERE PROPERLY REPORTED ON PRIOR YEARS' FILED IRS FORM 990 RETURNS, DISCLOSING COMPENSATION EARNED BY THESE INDIVIDUALS UNDER THE PLANS FOR EACH SUCH YEAR. Schedule J, Part II, Line 2: Timothy Snider serves as an officer for both Upper Valley Medical Center and another unrelated hospital. However, 100% of his compensation is paid by Upper Valley Medical Center. Mr. Snider spends approximately one-half of his working hours at each Hospital. The compensation reported on Part VII & Schedule J, Part II includes all of his reportable compensation, even though Upper Valley Medical Center is reimbursed by the unrelated hospital for his time spent at that institution.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART III, LINE 4A:FormAndLineReferenceDesc
ExplanationTHE PRIMARY EXEMPT PURPOSE OF UPPER VALLEY PROFESSIONAL CORPORATION (UVPC) IS TO PROVIDE PRIMARY HEALTH CARE SERVICES TO INDIVIDUALS IN THE COMMUNITY SERVED BY UPPER VALLEY MEDICAL CENTER, A RELATED, TAX-EXEMPT HOSPITAL. AS A PART OF THE UVMC HEALTH SYSTEM, UPPER VALLEY PROFESSIONAL CORPORATION PROVIDES CHARITY CARE TO ITS PATIENTS AND IS COMMITTED TO PRESERVING LONG-TERM ACCESS TO QUALITY HEALTH CARE SERVICES FOR MIAMI COUNTY AND THE SURROUNDING AREA. THIS ORGANIZATION WAS FORMED IN 1994 TO ASSURE ACCESS TO APPROPRIATE CARE AT AN ACCEPTABLE COST FOR PATIENTS IN A MANAGED CARE ENVIRONMENT. DURING 2014, UPPER VALLEY PROFESSIONAL CORPORATION PROVIDED CARE AT EIGHT LOCATIONS IN MIAMI AND DARKE COUNTIES. SERVICES INCLUDE FAMILY MEDICINE, INTERNAL MEDICINE, AND PEDIATRICS. THERE WERE 90,947 OFFICE VISITS TO PHYSICIANS, AS WELL AS ADDITIONAL VISITS FOR NURSE PROCEDURES, SUPPLIES, AND LAB WORK. MEDICAL SERVICES ARE PROVIDED TO ALL INDIVIDUALS, REGARDLESS OF ABILITY TO PAY. FORM 990, PART VI, SECTION A, QUESTION 3: PREMIER HEALTH (PREMIER) AS THE OPERATOR OF UVMC (THE PARENT COMPANY OF UPPER VALLEY PROFESSIONAL CORPORATION) DEVELOPS AND OVERSEES THE IMPLEMENTATION OF THE STRATEGIC PLAN FOR UVMC, WHICH INCLUDES (BUT IS NOT LIMITED TO) SUCH MATTERS AS LOCATION OF CLINICAL AND ADMINISTRATIVE SERVICES AND THE CONSOLIDATION OF SUCH SERVICES. UVMC SHALL COMPLY WITH AND IMPLEMENT THIS PLAN AND SHALL NOT TAKE ANY ACTION THAT MATERIALLY DEPARTS FROM THIS PLAN WITHOUT PREMIER'S APPROVAL. UVMC SHALL IMPLEMENT THE CAPITAL AND OPERATING BUDGET SO APPROVED AND/OR REVISED FOR IT BY PREMIER. UVMC SHALL IMPLEMENT ANY BUSINESS PLAN APPROVED BY PREMIER. PREMIER IS THE SOLE AGENT TO NEGOTIATE ALL RELATIONSHIPS WITH PAYORS ON BEHALF OF UVMC WITH ALL THIRD PARTY PAYORS AND ALTERNATIVE DELIVERY SYSTEMS INCLUDING, BUT NOT LIMITED, TO INSURERS. UVMC MUST HAVE APPROVAL FROM PREMIER TO BORROW IN ANY FISCAL YEAR, GUARANTEE IN ANY YEAR, OR INCUR ANY LIEN OR OTHER ENCUMBRANCE ON ANY PROPERTY IN AN AMOUNT EQUAL TO OR GREATER THAN $1,000,000. UVMC MUST SEEK PREMIER'S APPROVAL FOR ANY ACQUISITIONS, SALE OR TRANSFER OF ANY MATERIAL ASSET USED IN PREMIER'S ACTIVITIES. FORM 990, PART VI, SECTION A, QUESTION 6: UVMC IS THE SOLE SHAREHOLDER OF THE 375 SHARES OF COMMON STOCK OF UPPER VALLEY PROFESSIONAL CORPORATION, WHICH INCLUDES UVPC SPECIALISTS, INC. AND AFTER HOURS FAMILY CARE, INC. UNDER A "SHARE CONTROL AGREEMENT", THE SHAREHOLDER AGREES TO VOTE EACH SHARE OF THE CORPORATION'S CAPITAL STOCK ON ANY MATTER SUBMITTED FOR A VOTE, ONLY AS APPROVED IN ADVANCE AND IN WRITING BY UPPER VALLEY PROFESSIONAL CORPORATION. THE SHAREHOLDER RECEIVES NO ECONOMIC BENEFIT FROM HIS OWNERSHIP OF THE CORPORATION. FORM 990, PART VI, SECTION A, QUESTION 7A: THE SHAREHOLDER SHALL ELECT ONLY PERSONS APPROVED BY UPPER VALLEY PROFESSIONAL CORPORATION (UVPC) AS DIRECTORS OF UVPC. UVPC SHALL HAVE THE POWER TO REQUIRE THE SHAREHOLDER TO INITIATE ANY AND ALL ACTIONS AS TO THE ELECTION AND REMOVAL OF DIRECTORS OF UVPC AND THE FILLING OF VACANCIES ON THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, QUESTION 7B: SEE THE RESPONSE ABOVE FOR FORM 990, PART VI, SECTION A, QUESTION 3. FORM 990, PART VI, SECTION B, QUESTION 11B: THIS 990 TAX RETURN AND ATTACHED SCHEDULES (THE RETURN) ARE PREPARED BY A STAFF MEMBER IN THE TAX DEPARTMENT OF PREMIER HEALTH (PREMIER), OF WHICH UVMC (THE PARENT OF UPPER VALLEY PROFESSIONAL CORPORATION) IS AN AFFILIATE. THE RETURN IS REVIEWED BY THE TAX MANAGER AND DIRECTOR OF TAX COMPLIANCE OF PREMIER. THE RETURN IS CONCURRENTLY SENT TO ERNST & YOUNG U.S. LLP FOR THEIR REVIEW. AFTER ALL CHANGES FROM THE ABOVE GROUPS ARE MADE, THE RETURN IS REVIEWED BY THE VICE PRESIDENT/CONTROLLER OF PREMIER AND THE CHIEF FINANCIAL OFFICER OF THIS ENTITY. A FINAL VERSION OF THE RETURN IS SENT TO ERNST & YOUNG U.S. LLP FOR A FINAL REVIEW AND THEN PROVIDED TO THE BOARD OF TRUSTEES FOR REVIEW. AT A BOARD OF TRUSTEES MEETING, THE VICE PRESIDENT/CONTROLLER OF PREMIER (OR DESIGNEE) SHARES DETAILED INFORMATION ON COMPENSATION AND OTHER KEY AREAS, AS WELL AS ADDRESSES ANY OTHER QUESTIONS FROM THE BOARD OF TRUSTEES, PENDING THEIR REVIEW. THE 990 TAX RETURN IS ALSO SHARED WITH THE AUDIT COMMITTEE OF PREMIER. FORM 990, PART VI, SECTION B, QUESTION 12C: PREMIER HEALTH (PREMIER), OF WHICH UVMC (THE PARENT OF UPPER VALLEY PROFESSIONAL CORPORATION) IS AN AFFILIATE, REQUIRES ALL BOARD MEMBERS, OFFICERS, EXECUTIVE DIRECTORS, VICE PRESIDENTS, DIRECTORS, PURCHASING DEPARTMENT STAFF, AUTHORIZED PURCHASERS, MEDICAL DIRECTORS, DEPARTMENT AND SECTIONS CHAIRS, AND ALL EMPLOYED PHYSICIANS TO ANNUALLY REVIEW THE PREMIER COMPREHENSIVE CONFLICT OF INTEREST STATEMENT, AN EXPLANATORY MEMORANDUM, THE ANTITRUST COMPLIANCE POLICY, AND COMPLETE AN INDIVIDUAL QUESTIONNAIRE DISCLOSING ANY POTENTIAL CONFLICTS AS DEFINED IN THE CONFLICT OF INTEREST POLICY. THIS IS ACCOMPLISHED EITHER BY WAY OF AN ELECTRONIC COMMUNICATION SENT OUT DIRECTLY BY THE CORPORATE COMPLIANCE DEPARTMENT OR BY WAY OF A MEMO SENT OUT FROM THE CHAIRMAN OF THE BOARD AND CHIEF EXECUTIVE OFFICER OF PREMIER. IT ALSO INCLUDES AN EXPLANATORY MEMORANDUM OF SPECIFIC ACTIVITIES THAT MIGHT GIVE CAUSE TO A CONFLICT AND AN INDIVIDUAL QUESTIONNAIRE TO DISCLOSE ALL SUCH ACTIVITIES. THIS QUESTIONNAIRE MUST BE COMPLETED AND SIGNED BY THE INDIVIDUAL. THIS CORRESPONDENCE INCLUDES A COPY OF THE ANTITRUST COMPLIANCE POLICY THAT MUST BE SIGNED BY THE INDIVIDUAL. ALL OF THESE DOCUMENTS ARE SENT TO THE CORPORATE COMPLIANCE DEPARTMENT. THE CORPORATE COMPLIANCE DEPARTMENT ENSURES ALL FORMS ARE RETURNED AND RETAINS THE DOCUMENTS FOR FIVE YEARS. IN ADDITION, AT EACH MEETING OF THE BOARD OR ANY BOARD COMMITTEE, FOLLOWING APPROVAL OF THE PREVIOUS MEETING'S MINUTES, THE BOARD OR COMMITTEE CHAIR SHALL REQUEST ANY BOARD MEMBER WHO PERCEIVES A POTENTIAL CONFLICT OF INTEREST ON ANY OF THE MEETING'S AGENDA ITEMS TO DISCLOSE THE POTENTIAL CONFLICT. ADDITIONALLY, AT ANY BOARD OR BOARD COMMITTEE MEETING WHERE THE SUBJECT OF CONFLICT OF INTEREST IS DISCUSSED, THE MINUTES SHALL CONTAIN THE NAME OF THE PARTY DISCUSSING A POTENTIAL CONFLICT OF INTEREST, THE NATURE OF THE POTENTIAL CONFLICT OF INTEREST AND WHETHER A CONFLICT OF INTEREST WAS FOUND TO EXIST. IF A CONFLICT OF INTEREST IS DETERMINED BY THE BOARD TO EXIST, THE MEMBER WILL BE EXCUSED FROM PARTICIPATING IN ANY DISCUSSION OR VOTING ON THE PARTICULAR AGENDA ITEM. THE CHIEF COMPLIANCE AND ENTERPRISE RISK OFFICER REPORTS THE RESULTS OF THE PREMIER CONFLICT OF INTEREST QUESTIONNAIRES NO LESS THAN ANNUALLY TO THE BOARD OF TRUSTEES BY WAY OF THE COMPLIANCE AND AUDIT COMMITTEE. THIS REVIEW IS DOCUMENTED IN THE MINUTES OF THE MEETING. PERIODICALLY, THE INTERNAL AUDIT DEPARTMENT WILL REVIEW A SAMPLE OF COMPLETED CONFLICT OF INTEREST QUESTIONNAIRES AND REPORT THE RESULTS TO THE COMPLIANCE AND AUDIT COMMITTEE. THE ANNUAL CONFLICT OF INTEREST QUESTIONNAIRES ARE INDIVIDUALLY SUMMARIZED IN A DOCUMENT AND SENT ELECTRONICALLY TO THE FINANCE DEPARTMENT FOR ANY NECESSARY DISCLOSURES REQUIRED ON THE 990 TAX RETURN. FORM 990, PART VI, SECTION B, QUESTION 15A AND 15B: PREMIER HEALTH, OF WHICH UVMC (THE PARENT OF UPPER VALLEY PROFESSIONAL CORPORATION) IS AN AFFILIATE, FOLLOWS A MARKET BASED COMPENSATION PHILOSOPHY DESIGNED TO ATTRACT AND RETAIN THE EXECUTIVE TALENT REQUIRED TO MEET THE HIGH PERFORMANCE STANDARDS OF OUR BOARD AND OUR COMMUNITY. PREMIER ANNUALLY REVIEWS EXECUTIVE COMPENSATION SURVEY DATA FOR A REGIONAL PEER GROUP OF SYSTEMS AND HOSPITALS THAT ARE SIMILAR IN SIZE AND COMPLEXITY TO PREMIER AND ITS AFFILIATES. THE DATA FOR THE SURVEY IS PROVIDED BY A THIRD PARTY CONSULTANT GROUP THAT IS INDEPENDENT OF PREMIER. THIS REPORT INCLUDES COMPARABILITY FOR KEY EXECUTIVES, VICE PRESIDENTS, AND DIRECTOR LEVEL POSITIONS. THE INDEPENDENT COMPARABILITY DATA IS REVIEWED BY THE EXECUTIVE COMPENSATION COMMITTEE ON AN ANNUAL BASIS. THIS COMMITTEE IS COMPRISED OF THREE MEMBERS, ALL OF WHOM ARE INDEPENDENT. THIS COMMITTEE REVIEWS IN DETAIL THE COMPENSATION FOR THE PREMIER CEO, COO, CFO, CHIEF STRATEGY OFFICER, AND THE HOSPITAL CEOS. OTHER POSITIONS ARE REVIEWED AT A HIGH LEVEL FOR REASONABLENESS. ALL THE MEETING MINUTES ARE DOCUMENTED AND KEPT ON FILE ALONG WITH ANY COMPARABILITY DATA AND THE CONSULTANT REPORT. AFTER THE COMPENSATION COMMITTEE REVIEWS AND APPROVES THE COMPENSATION ACTIONS, THE PROCESS IS AUDITED BY THE INTERNAL AUDIT DEPARTMENT. THE EXECUTIVE COMPENSATION COMMITTEE PRESENTS THE COMPENSATION ACTIONS TO THE PREMIER BOARD ANNUALLY. FORM 990, PART VI, SECTION C, QUESTION 19: THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC WHEN REQUIRED BY LAW OR FOR ACCREDITATION PURPOSES. THE CONFLICT OF INTEREST POLICY IS AVAILABLE ON THE COMPANY WEBSITE. Form 990, Part VII, Line 1a, Item 7: Timothy Snider serves as an officer for both Upper Valley Medical Center and another unrelated hospital. However, 100% of his compensation is paid by Upper Valley Medical Center. Mr. Snider spends approximately one-half of his working hours at each HosExplanationTxt

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
UVMC
110 N MAIN ST SUITE 500DaytonOH45402341850683ParentOH501(C)(3)11-III-FINAfalse
Med-Terra Inc
110 N MAIN ST SUITE 500DAYTONOH45402311232074Holding Co.OH501(C)(2)N/AUVMCYes (true)
UVMC Nursing Care Inc
110 N MAIN ST SUITE 500DAYTONOH45402311224064Nursing HomesOH501(C)(3)9UVMCYes (true)
Upper Valley Medical Center
110 N MAIN ST SUITE 500DAYTONOH45402310537095HospitalOH501(C)(3)3UVMCYes (true)
UVPC Specialists Inc
110 N MAIN ST SUITE 500DAYTONOH45402203687536HealthcareOH501(C)(3)9UV PROF CORPYes (true)

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationInd
UVMC Management Corporation
110 N MAIN ST 500DAYTONOH45402311360489MGT CompanyOHUVMCC Corp$0$00.00000Yes (true)
After Hours Family Care Inc
31 Stanfield RdTroyOH45373311269483HealthcareOHProf CorpC Corp$726,592$280,6161.00000Yes (true)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangeYes (true)AssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (12 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
UPPER VALLEY MEDICAL CENTER
C$4,892,871FMV
UPPER VALLEY MEDICAL CENTER
O$2,278,931FMV
UPPER VALLEY MEDICAL CENTER
P$239,847FMV
UPPER VALLEY PROFESSIONAL CORP - SPECIALISTS
L$4,201,560FMV
UPPER VALLEY PROFESSIONAL CORP - SPECIALISTS
Q$336,093FMV
UPPER VALLEY PROFESSIONAL CORP - SPECIALISTS
S$87,147FMV
MED-TERRA INC
K$342,349FMV
AFTER HOURS FAMILY CARE INC
L$54,000FMV
AFTER HOURS FAMILY CARE INC
O$330,341FMV
UVMC MANAGEMENT CORP
O$267,844FMV
UPPER VALLEY PROFESSIONAL CORP - SPECIALISTS
C$1,000,000FMV
UVMC MANAGEMENT CORP
B$286,474FMV

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