2013-11-13T05:34:01-08:00 2012-12-31 990 2012-01-01 581343550 University Health Care Foundation Inc UNIV 7067229011 1350 Walton Way Augusta GA 30901 David A Belkoski 2013-11-13 2012 2016-03-07 17:11:31Z LAURIE SMITH 2100 CENTRAL AVE STE D1 AUGUSTA GA 30904 21667134 false false X www.universityhealth.org X 1978 GA Support of University Hospital relating to hospital services as well as providing assistance to the indigent population. 13 12 0 88 0 2435474 2156273 0 523286 1925542 73595 13556 3032355 4095371 0 0 0 0 464958 2040473 3808201 2040473 3808201 991882 287170 29528218 32537062 474638 403866 29053580 32133196 Support of University Hospital relating to hospital services as well as providing assistance to the indigent population. false false 2850970 Support of University Hospital relating to hospital services as well as providing assistance to the indigent population. 2850970 true true false false false false false false false true true false false false true true false true false false false false false false true false false false false true false false false false false false false false false false false true false false false false true false false false false true 22 0 true 0 false false false false false false false true true false 0 false false false false false false false false false false X 13 12 false false false false false false false true true false true true true true true true true true true true false GA X X Dave Belkoski CFO UHI 7067747710 1350 Walton Way Augusta GA 309012629 WILLIAM H WOODWARD 1.00 0.00 X 0 0 0 MARK J WILLS 1.00 0.00 X 0 0 0 W CRAIG SMITH 1.00 0.00 X 0 0 0 ELAIN CLARK SMITH 1.00 0.00 X 0 0 0 CATHERINE D KNOX 1.00 0.00 X 0 0 0 JED W HOWINGTON MD 1.00 0.00 X 0 0 0 SUSAN HUNNICUTT 1.00 0.00 X 0 0 0 AVIS B YOUNT 1.00 0.00 X 0 0 0 PETE CAYE JR 1.00 0.00 X 0 0 0 NATALIE SCHWEERS 1.00 0.00 X 0 0 0 RUSSELL MOBLEY 1.00 0.00 X 0 0 0 RICHARD A FAIREY 1.00 0.00 X X 0 0 0 MAC BOWMAN MD 1.00 59.00 X 0 1082677 13591 DAVID A BELKOSKI 5.00 50.00 X 0 739265 22277 LAURIE SMITH 25.00 30.00 X 0 192820 6999 2014762 42867 0 false true false 0 710815 1445458 88413 2156273 0 908641 908641 0 0 0 18506451 17489550 1016901 1016901 1016901 95769 710815 82213 13556 0 0 0 4095371 1016901 908641 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88094 13498 40122 34474 4914 4914 0 26798 4106 12205 10487 0 0 13744 1922 6914 4908 0 0 32716 3052 9073 20591 0 2708549 2708549 42547 6519 19378 16650 0 Dues & Memberships 26471 26471 Revaluation of Annuity Liabili 36156 36156 Supplies 106377 2725 8280 95373 Purchased Labor 683802 104771 311438 267593 38033 5828 17322 14882 3808201 2850970 492273 464958 0 2515504 1707780 982753 946820 0 0 0 0 0 5125 44893 832726 474348 400924 358378 25437801 29219927 66255 139409 0 0 119856 119855 29528218 32537062 78813 15078 176 395825 388612 474638 403866 X 269433 530592 10018723 12304425 18765424 19298179 29053580 32133196 29528218 32537062 X 287170 2023560 768886 X false true X true false X 1988022 1096592 2187987 2435475 2156273 9864349 0 0 1988022 1096592 2187987 2435475 2156273 9864349 1835006 8029343 804831 729399 767852 779994 908641 3990717 0 366523 3260 369783 14224849 0.56450 0.58640 X Part II, Line 10--Fundraising events and raffle ticket sales were previously included in the Gifts, Grants, and Contributions line, but in 2008 were broken out seperately as required by Part VIII on form 990. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 23411726 473183 3599313 24400 394316 84228 26981278 24425233 400349 -850995 27500 407602 127759 23411726 20992851 674386 3196451 30000 339369 69086 24425233 16482594 249749 4538485 10900 205556 61521 20992851 0.71000 0.29000 false false false 116300 116300 520000 322400 197600 79806 56049 23757 108187 87466 20721 8433 8433 358378 Fidelity Investments 40481 F Rounding 2 Due To University Health Services, Inc 17000 Charitable Gift Annuity Liability 371610 388612 X 6118930 2023560 -1 2023559 4095371 4095371 3808199 -2 -2 3808201 3808201 Part X Part X : FIN48 Footnote University Health Care Foundation is exempt from federal income tax under Section 501(a) as organizations described in Section 501(c)(3) of the Internal Revenue Code of 1986, as amended. Accordingly, the accompanying financial statements do not reflect a provision or liability for federal and state income taxes. University Health Care Foundation has evaluated their tax positions and determined that they do not have any material unrecognized tax benefits or obligations as of December 31, 2012. Fiscal years ended on or after December 31, 2009 remain subject to examination by federal and state authorities. Part V, Line 4 Part V, Line 4: Intended uses of the endowment fund. To assist University Health Care System meet their goals in providing quality health care services to the citizens of the community through patient and staff education, quality of life initiatives, and support of the underserved and indigent population. false Miracle Mile Walk 408647 402604 6043 650 24677 Jernigan Golf Tournament 241655 191156 50499 1200 11330 16952 55 8566 2 156282 117055 39227 9028 9755 806584 710815 95769 1200 11330 17602 9083 42998 82213 13556 X true true false true false false false false true false false false MAC BOWMAN MD 802114 23625 256938 2500 11091 1096268 LAURIE SMITH 151464 23678 17678 6781 218 199819 DAVID A BELKOSKI 384150 74266 280849 11075 11202 761542 Sch J, Part III, Additional Information Part III, Additional Information The organization relied on the Compensation Committee of University Health Services, Inc. (58-1581103) Sch J, Part I, Line 6b Part I, Line 6b: Explanation of organization compensation contingent on net earnings from related or The bonus plan for management is calculated based on Strategic Initiatives as determined by the Compensation Committee. These initiatives are goals that must be achieved during the year in order for bonus payout. For 2012 these initiatives were weighted as displayed in the following schedule and applies to System Executives & Vice Presidents of the related organization, University Health Services Inc: UNIVERSITY HEALTH SERVICES, Inc. 2012 Strategic InitiativesWeight Quality20% Value Based Purchasing-% recovered Growth10% Aiken/Grovetown-Board Ready Plans10% McDuffie CON Documents Finance20% Operating Margin People5% Nursing Turnover Systems20% EPIC Go-Live15% Personal100% Each goal that was achieved represented that percentage of bonus payoutout of a possible 100% based on a Threshold level, Target Level, or an Exceed Level. Sch J, Part I, Line 1a Part I, Line 1a: Relevant information in regards to selections on 1a. Social Club Dues- The related organization pays membership fees for the CFO (David Belkoski) to the Augusta Country Club and West Lake Country Club. These membership fees are paid so the organization can have access to the meeting facilities and catering services these organizations provide for meetings that are held off campus. Any personal use related to these memberships are included in the wages of the CFO. X 9022 Cost X 2 8490 Cost X 11 16981 Cost X 1 5600 Cost X Cruise 1 3790 Cost X Golf Clubs 4 938 Cost X Golf Carts 2 5514 Cost X Gift Certificat 32 4134 Cost X Costume Jeweler 1 250 Cost X Trip and Insurance Policy 1 7500 Cost X Golf Cart 1 7484 Cost false false false Form 990, Part XI, Line 9 Other Changes In Net Assets Or Fund Balances - Other Increases Rounding = $1 Form 990, Part XI, Line 9 Other Changes In Net Assets Or Fund Balances - Other Increases Equity Transfer from UHS = $768885 Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available All governing documents, policies, financial statements, and informational returns are available upon request.The 990 is also available at www.Guidestar.org. Form 990, Part VI, Line 15b Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees The Organization follows the process described in Treasury Regulation 4958 (6) c for establishing the rebuttable presumption of reasonableness in the review, approval, and documentation of officer, key management, and director compensation. Annually, a compensation committee of the University Health Services Board, comprised of three independent board members, reviews the compensation of the CEO and other senior management members. The review is conducted in the context of a Board approved executive compensation philosophy. Both the development of the compensation philosophy and the review involve the advice and assistance of an independent compensation consulting firm. Minutes of the compensation committee are recorded. The compensation committee reports to the University Health Services Board Executive Committee. All of the staff of University Health Care Foundation are employed and therefore paid by University Health Services, Inc. Since all staff members are employed by University Health Services, Inc., University Health Care Foundation complies with above mentioned procedure. Form 990, Part VI, Line 12c Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts The conflict of interest policy is as follows:I. POLICY1. Each corporate board of the University Health Care System has adopted a conflict of interest policy binding upon the board's members and the corporation chief executive officer. As a result of the diverse interests and backgrounds of administrative, supervisory, and staff employees, at times there may arise instances when an individual's personal or outside interests conflict with those of the System or a constituent organization (for example, but not limited to University Health Services d/b/a University Hospital, University Extended Care d/b/a Kentwood and Westwood, University Health, and University Health Resources). Possible conflicts of interest can occur in the following instances:A. Financial Investments and OwnershipWhen an employee or his/her immediate family has a material financial investment or ownership interest in any organization or institution (a Source) from which the System purchases goods or services, with which the System competes in the provision of goods and services, or for which the System provides goods or services. An investment or ownership interest with a value of $2,500.00 or more is presumed material; a smaller interest may be material depending upon the circumstances. Ownership of publicly traded stock is not considered a material interest unless the owner exercises discretionary authority with respect to the System's business dealing with the company in which the person owns stock worth $5,000.00 or more. Normally, only an individual at or above the department head level would be in a position to exercise the requisite discretionary authority.B. Consulting and Management ServicesWhen an employee or his/her immediate family provides managerial, consultative, or advisory services to any person, organization, or institution (a Source) from which the System purchases goods or services, with which the System competes in the provision of goods or services, or for which the System provides goods or services other than individual or family hospitalization and other personal medical care services.C. GiftsWhen a System employee or his/her immediate family accepts gifts, gratuities, entertainment, or favors including seminars, factory visits, or site visits from a person, organization, or institution (a Source) from which the System purchases goods or services, with which the System competes in the provision of goods or services, or for which the System provides goods or services other than individual or family hospitalization and other personal medical care services. This does not include the acceptance of items of nominal value, which could not be construed as intended to influence the individual in the performance of his or her duties. Disclosure is required with respect to any single gift, gratuity, entertainment, or favor which has a fair market value in excess of $150.00 and with respect to all such items received during any calendar year from a single Source if the cumulative market value of those items exceeds $250.00. Disclosure is not required with respect to participation in Hospital-sponsored events, for example, when someone pays an employee's participation fee in a Hospital-sponsored event like the Jernigan Cancer Golf Tournament. All vendor funded travel (including site visits, factory visits, and seminars) is prohibited. This prohibition is not applicable to vendor funded travel approved by the CEO using the Potential Conflict of Interest Disclosure Form, pursuant to a Hospital contract, or funded by a group purchasing organization in which Hospital is a member.D. Employment and GiftsWhen an employee has any outside employment that might interfere with performance of his or her University job. Each management level employee must disclose any outside employment, including self-employment, which has generated or is reasonably expected to generate more than $10,000.00 in gross income during the calendar year. Investment income is not considered to be derived from employment.E. Non-Public Information When an employee is in a relationship (either personal or business) in which he/she would gain personal advantage by disclosure of non-public System information to a person, organization, or institution (a Source) from which the System purchases goods or services, with which the System competes in the provision of goods and services, or for which the System provides or could provide goods or services other than individual or family hospitalization and other medical care services. F. Hiring Process When an employee participating in a hiring process could gain a personal benefit from the hiring decision. 2. All System employees have an obligation to disclose relevant information about potential conflicts of interest. All System employees have an obligation to avoid actual conflicts of interest. Avoiding conflicts of interest includes avoiding or disengaging from activities and relationships whose appearance undermines confidence in the integrity of the System. 3. Employees who fail to disclose or continue to engage in activities that have been deemed to be a conflict of interest will be subject to disciplinary action. 4. Definitions A. Immediate family means ones spouse, ones descendants (children, grandchildren, etc.) ones ancestors (parents, grandparents, etc.), ones siblings, the spouse of any of the forgoing, and ones parents-in-law. This policy does not obligate a System employee to make any inquiries concerning the activities of and ownership interests of his/her immediate family, but the policy does require a System employee who is aware of or should be aware of a potential conflict of interest through a family member to report that potential conflict. B. Fair market value means the amount at which particular goods or services are sold to the general public. C. System means University Hospital and also any other organizational element of the University Health, Inc. family (e.g., University Extended Care, Inc.) over which an employee exercises discretionary authority with respect to purchases or sales of goods or services. D. Source means a person, institution or organization from which the System purchases or is considering purchasing goods or services, with which the System competes in the provision of goods and services, or for which the System provides goods or services. Separate business organizations and owners which are part of the same corporate family are one Source. The value of all entertainment, gifts, etc. received from the different members of one corporate family must be aggregated for purposes of compliance with this policy. Form 990, Part VI, Line 11b Form 990, Part VI, Line 11b: Form 990 Review Process A copy of the 990 form and all related schedules was provided to the governing board before filing in electronic form. An email was sent to all members of the governing body containing a link to a password-protected web site on which the entire 990 could be viewed. The email explained that the Form 990 was available for review on the web site. University McDuffie County Regional Medi 1350 Walton Way Augusta GA 30901 454166209 Hospital GA 501 (c)(3) 3 University Health Inc false University Hospice Inc 1350 Walton Way Augusta GA 30901 275008428 End of Life Support GA 501 (c) 3 9 University Health Inc false University Health Services Inc 1350 Walton Way Augusta GA 30901 581581103 Hospital GA 501 (c) 3 3 University Health Inc false University Extended Care Inc 1350 Walton Way Augusta GA 30901 581581105 Skilled Nursing Facilities GA 501 (c) 3 3 University Health Inc false Augusta Resource Center on Aging Inc 4275 Owens Rd Evans GA 30809 581728812 Nonprofit Life Care Community GA 501 (c) 3 9 University Health Inc false Richmond County Hospital Authority 1350 Walton Way Augusta GA 30901 586001901 Leased Facilities GA 501 (c) 3 3 N/A false University Health Inc 1350 Walton Way Augusta GA 30901 581581102 Consolidating Parent GA 501 (c) 3 9 N/A false University Health Resources Inc 1350 Walton Way Augusta GA 30901 581601372 Services to Physicians GA N/A C false false false false false false false false false false false false false false false false false true false false