2012-04-04T09:02:50-05:00 2011-09-30 CLIFTONLARSONALLEN LLP 101 N TRYON STREET SUITE 1000 CHARLOTTE NC 28246 990 2010-10-01 383740839 UHS PHYSICIANS LLC UHSP 2528475129 2100 STANTONSBURG ROAD GREENVILLE NC 27835 TRAVIS DOUGLASS 2528475129 2012-04-04 1 GREGORY W JOHNS 7049985200 2010 2016-02-24 21:20:13Z TRAVIS DOUGLASS 2100 STANTONSBURG ROAD GREENVILLE NC 27835 34426837 0 X WWW.UHSEAST.COM X 2006 NC TO PROVIDE MEDICAL SERVICES IN EASTERN NORTH CAROLINA. 1 0 302 0 0 0 0 0 19217070 34419109 4515 7728 0 0 19221585 34426837 0 0 0 0 24452570 39106218 0 0 0 10642729 20529830 35095299 59636048 -15873714 -25209211 11922478 15458976 5197482 9148340 6724996 6310636 X TO PROVIDE MEDICAL SERVICES IN EASTERN NORTH CAROLINA TO SUPPORT THE CHARITABLE HEALTH CARE MISSION OF PITT COUNTY MEMORIAL HOSPITAL ("PCMH"), UNIVERSITY HEALTH SYSTEMS OF EASTERN CAROLINA ("UHSEC") AND OTHER TAX-EXEMPT ENTITIES IN THE REGION. MEDICAL SERVICES INCLUDE THE PROFESSIONAL SERVICES OF ADVANCED LEVEL PRACTITIONERS ("ALPS") AND PHYSICIANS WHO PERFORM EVALUATIONS, CLINICAL CARE MANAGEMENT AND MEDICALLY NECESSARY PROCEDURES FOR OUTPATIENTS AND INPATIENTS. 0 0 55325735 34419109 UHS PHYSICIANS PROFESSIONALS PROVIDED EVALUATIONS, CLINICAL CARE MANGAGEMENT AND MEDICALLY NECESSARY PROCEDURES FOR 292,248 ENCOUNTERS DURING THE YEAR. 55325735 1 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 302 1 0 0 0 0 0 0 0 0 0 0 X 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X CHRIS TOWNSEND 2528475129 2100 STANTONSBURG ROAD GREENVILLE NC 27835 TRAVIS DOUGLASS 40.00 X X 0 239156 47317 MICHAEL LAM 40.00 X 440989 0 189 GHIATH ALMASRI 40.00 X 460558 0 14889 EDOUARD MISSE 40.00 X 447300 0 6314 JON DUBOSE 40.00 X 417669 0 6193 MARK GIBBONS 40.00 X 351385 0 167 2117901 239156 75069 105 0 1 0 ECU SCHOOL OF MEDICINE PO BOX 75514 CHARLOTTE NC 282750514 PHYSICIAN SERVICES 2455610 EASTERN EMERGENCY PHYSICIANS INC 3102 STAR HILL FARM RD GREENVILLE NC 27834 PHYSICIAN SERVICES 2039041 MAG MUTUAL INS CO PO BOX 52979 ATLANTA GA 303550979 PROF LIABILITY INSURANCE 513247 TRIANGLE ANESTHESIA ASSOC PLLC 3650 ROGERS ROAD STE 295 WAKE FOREST NC 27587 ANESTHESIA SERVICES 316680 MARY HELEN JOHNSON MD 1073 WOODSIDE PLACE ASHEBORO NC 27205 PHYSICIAN SERVICES 247065 18 PATIENT REVENUE 621110 24095227 24095227 10323882 10323882 34419109 7728 7728 34426837 34419109 0 7728 35247711 33086900 2160811 274997 258139 16858 1718082 1612757 105325 1865428 1751071 114357 112640 93491 19149 16631160 15735048 896112 22266 22266 1357040 1126343 230697 251377 208643 42734 710259 589350 120909 138368 89939 48429 1991 1653 338 430066 356955 73111 832069 374431 457638 MEMBERSHIP DUES 22437 2019 20418 20157 16730 3427 59636048 55325735 4310313 0 0 0 2411983 2468589 6317918 6224479 112534 167742 532978 683374 3423744 579425 943859 2844319 2282 27984 1600924 3042489 11922478 15458976 5197482 9148340 5197482 9148340 X 6724996 6310636 6724996 6310636 11922478 15458976 X -25209211 24791851 X X 0 1 1 X 0 X X X X 0 0 0 UNIVERSITY HEALTH SYSTEM OF EASTERN CAROLINA INC 562141073 03 1 1 1 0 1 0 1075680 15202 1060478 58559 58559 2289505 564223 1725282 0 2844319 OTHER RECEIVABLES 3042489 3042489 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: UHS PHYSICIANS, LLC IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. X X X X X 0 0 0 0 0 0 0 0 0 TRAVIS DOUGLASS 0 236837 0 2319 0 0 0 44856 0 2461 0 286473 0 0 MICHAEL LAM 416001 0 0 0 24988 0 0 0 189 0 441178 0 0 0 GHIATH ALMASRI 460558 0 0 0 0 0 0 0 14889 0 475447 0 0 0 EDOUARD MISSE 447300 0 0 0 0 0 0 0 6314 0 453614 0 0 0 JON DUBOSE 417669 0 0 0 0 0 0 0 6193 0 423862 0 0 0 MARK GIBBONS 351385 0 0 0 0 0 0 0 167 0 351552 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE MANAGER APPOINTED BY THE SOLE MEMBER OF THE ORGANIZATION IS PROVIDED A COPY OF THE RETURN FOR REVIEW PRIOR TO FILING. THE RETURN IS ALSO PROVIDED TO THE CHIEF FINANCIAL OFFICER, CHIEF GENERAL COUNSEL AND THE CHIEF AUDIT AND COMPLIANCE OFFICER OF UNIVERSITY HEALTH SYSTEMS OF EASTERN CAROLINA, INC. PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE MANAGER WAS REQUIRED TO COMPLETE A COMPREHENSIVE CONFLICT OF INTEREST QUESTIONNAIRE IN HIS ROLE AS VP OF THE SOLE OWNER. THIS WAS REVIEWED BY LEGAL COUNSEL AND ANY POTENTIAL OR ACTUAL CONFLICTS ARE BROUGHT TO THE BOARD OF THE PARENT FOR DISPOSITION. BOARD MEMBERS ARE REQUIRED TO EXCUSE THEMSELVES FROM VOTING ON ISSUES IN WHICH THEY ARE DEEMED TO HAVE A CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 THE MANAGER'S COMPENSATION IS DETERMINED BY UNIVERSITY HEALTH SYSTEMS OF EASTERN CAROLINA, INC. ("UHSEC"), A RELATED TAX-EXEMPT ENTITY. UHSEC'S PROCESS IS AS FOLLOWS: COMPENSATION IS DETERMINED BY THE UHSEC BOARD USING COMPARATIVE DATA FROM LIKE ORGANIZATIONS AND INPUT FROM CONSULTANTS. THIS PROCESS IS PERFORMED EVERY THREE YEARS, THE LAST YEAR BEING 2010. IT IS EXPECTED TO BE PERFORMED AGAIN IN 2013. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: CAPITAL CONTRIBUTIONS AND TRANSFERS WITH AFFILIATES, NET 24,791,851. TOTAL TO FORM 990, PART XI, LINE 5: 24,791,851. FORM 990, PART XII, LINE 2C: NO CHANGES FOR APPROVING AUDITED FINANCIAL STATEMENTS OR SELECTION OF INDEPENDENT ACCOUNTANTS HAVE OCCURRED FROM THE PRIOR YEAR. UNIVERSITY HEALTH SYSTEMS OF EASTERN NORTH CAROLINA INC 2100 STANTONSBURG ROAD GREENVILLE NC 27835 562141073 HEALTHCARE NC 501(C)(3) LINE 11C, III-FI N/A 0 PITT COUNTY MEMORIAL HOSPITAL INC 2100 STANTONSBURG ROAD GREENVILLE NC 27835 560585243 HEALTHCARE NC 501(C)(3) LINE 3 N/A 0 EAST CAROLINA HEALTH-CHOWAN INC 2100 STANTONSBURG ROAD GREENVILLE NC 27835 562101090 HEALTHCARE NC 501(C)(3) LINE 3 N/A 0 EAST CAROLINA HEALTH-BERTIE 2100 STANTONSBURG ROAD GREENVILLE NC 27835 562072002 HEALTHCARE NC 501(C)(3) LINE 3 N/A 0 EAST CAROLINA HEALTH 2100 STANTONSBURG ROAD GREENVILLE NC 27835 562003393 HEALTHCARE NC 501(C)(3) 509(A)(3) N/A 0 EAST CAROLINA HEALTH-HERITAGE INC 2100 STANTONSBURG ROAD GREENVILLE NC 27835 562093700 HEALTHCARE NC 501(C)(3) LINE 3 N/A 0 EAST CAROLINA HEALTH-BEAUFORT INC 2100 STANTONSBURG ROAD GREENVILLE NC 27835 452436270 HEALTHCARE NC 501(C)(3) LINE 3 N/A 0 DUPLIN GENERAL HOSPITAL INC 2100 STANTONSBURG ROAD GREENVILLE NC 27835 566011594 HEALTHCARE NC 501(C)(3) LINE 3 N/A 0 THE OUTER BANKS HOSPITAL INC 2100 STANTONSBURG ROAD GREENVILLE NC 27835 562112733 HEALTHCARE NC 501(C)(3) LINE 3 N/A 0 0 1 1 0 0 0 0 0 0 1 1 1 0 1 1 1 0 0 EAST CAROLINA HEALTH-BEAUFORT B 78952 ACTUAL CASH PAYMENT EAST CAROLINA HEALTH-CHOWAN J 74480 ACTUAL CASH PAYMENT EAST CAROLINA HEALTH-CHOWAN K 74848 ACTUAL CASH PAYMENT EAST CAROLINA HEALTH-HERITAGE K 64000 ACTUAL CASH PAYMENT EAST CAROLINA HEALTH-RCH J 20007 ACTUAL CASH PAYMENT EAST CAROLINA HEALTH-RCH K 124043 ACTUAL CASH PAYMENT PITT COUNTY MEMORIAL HOSPITAL INC N 2109844 ACTUAL CASH PAYMENT UNIVERSITY HEALTH SYSTEMS OF EASTERN CAROLINA INC C 24406527 ACTUAL CASH PAYMENT UNIVERSITY HEALTH SYSTEMS OF EASTERN CAROLINA INC L 1332022 ACTUAL CASH PAYMENT UNIVERSITY HEALTH SYSTEMS OF EASTERN CAROLINA INC N 250595 ACTUAL CASH PAYMENT THE OUTER BANKS HOSPITAL INC K 113040 ACTUAL CASH PAYMENT DUPLIN GENERAL INC J 18000 ACTUAL CASH PAYMENT DUPLIN GENERAL INC O 50604 ACTUAL CASH PAYMENT DUPLIN GENERAL INC P 117333 ACTUAL CASH PAYMENT