2023-11-14T16:28:14-06:00 2022-12-31 990 2022-01-01 311581859 UVMC FOUNDATION UVMC 9374999942 110 NORTH MAIN STREET SUITE 500 DAYTON OH 45402 J MICHAEL SIMS VP, TREAS & CORP CONTROLLER 9374999942 2023-11-14 J MICHAEL SIMS 999009999 0 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z DUANNA R OSTING 3130 NORTH COUNTY ROAD 25A TROY OH 45373 18282090 0 X WWW.UVMC.COM X 1997 OH SEE PART III, LINE 1 19 19 2 19 0 64568 574469 576691 0 0 1332207 669677 23547 9466 1930223 1255834 265177 286200 0 0 217351 222665 0 0 127542 131745 93623 614273 602488 1315950 653346 24911225 20216415 215393 267090 24695832 19949325 ENHANCE THE PATIENT AND FAMILY EXPERIENCE AT UPPER VALLEY MEDICAL CENTER BY RAISING COMMUNITY SUPPORT FOR PROGRAMS AND SERVICES WHICH HELP BUILD HEALTHY COMMUNITIES. 0 0 64930 64930 THE UVMC FOUNDATION PROVIDES PROGRAM SUPPORT TO CANCER PATIENTS. IN 2022, THE UVMC FOUNDATION DEFRAYED THE COSTS OF MEDICAL MASSAGE AND OTHER THERAPIES BY PROVIDING THESE SERVICES FREE OF CHARGE TO CANCER PATIENTS. 59499 59499 THE UVMC FOUNDATION PROVIDED 73 SCHOLARSHIPS TO 45 STUDENTS. THESE STUDENTS ARE EITHER PURSUING A CAREER IN HEALTHCARE OR ARE CHILDREN OF EMPLOYEES. 27300 27300 THE UVMC FOUNDATION HAS PARTENRED WITH MIAMI COUNTY EDUCATIONAL SERVICES TO PROVIDE MENTAL HEALTH AID TO MIAMI COUNTY SCHOOLS THROUGH HOPE SQUAD. HOPE SQUAD IS A SCHOOL-BASED, PEER-TO-PEER, SUICIDE PREVENTION PROGRAM FOR STUDENTS WITH A THREE-YEAR CURRICULUM THAT EMPHASIZES SUICIDE PREVENTION FUNDAMENTALS, SELF-CARE, AND ANTI-BULLYING. 198195 134471 198195 134471 349924 1 1 0 0 0 0 0 0 0 1 0 1 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 2 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 19 19 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X J MICHAEL SIMS 9374999942 110 NORTH MAIN STREET SUITE 500 DAYTON OH 45402 GEORGE LOVETT BOARD CHAIR 0.50 X X 0 0 0 YAGNESH RAVAL MD BOARD VICE-CHAIR 0.50 X X 0 0 0 DAN SUTHERLY BOARD TREASURER 0.50 X X 0 0 0 JEAN HEATH BOARD SECRETARY 0.50 X X 0 0 0 J DOUG BURCHFIELD TRUSTEE 0.50 X 0 0 0 NATHAN CEDARLEAF TRUSTEE 0.50 X 0 0 0 ARTHUR R DISBROW TRUSTEE 0.50 X 0 0 0 BETH EARHART TRUSTEE 0.50 X 0 0 0 JOHN F EVANS TRUSTEE 0.50 X 0 0 0 TIM EVANS TRUSTEE 0.50 X 0 0 0 MICHAEL GUTMANN TRUSTEE 0.50 X 0 0 0 L STEWART LOWRY MD TRUSTEE 0.50 X 0 0 0 WILLIAM E LUKENS TRUSTEE 0.50 X 0 0 0 WILLIAM J MCGRAW III TRUSTEE 0.50 X 0 0 0 ANN MOYER DAVIES TRUSTEE 0.50 X 0 0 0 DIANNE RUHENKAMP TRUSTEE 0.50 X 0 0 0 LARRY P RYAN TRUSTEE 0.50 X 0 0 0 GREG TAYLOR TRUSTEE 0.50 X 0 0 0 MICHAEL TINKLER DDS TRUSTEE 0.50 X 0 0 0 DUANNA R OSTING PRESIDENT & EXECUTIVE DIRECTOR 30.00 X 137012 0 20820 137012 0 20820 1 0 1 0 0 306 6700 569685 51036 576691 577468 577468 17089256 16997047 92209 92209 92209 38675 6700 29209 9466 9466 1255834 0 0 679143 226701 226701 59499 59499 157832 39458 39458 78916 53142 13286 13286 26570 11691 2923 2923 5845 61298 61298 1993 498 498 997 98 98 OPERATING SUPPLIES 26 7 7 12 30208 7552 7552 15104 602488 349924 125022 127542 50421 83144 40422 40487 22205300 17636660 2615082 2456124 24911225 20216415 41457 31838 173936 235252 215393 267090 X 20041264 15677200 4654568 4272125 24695832 19949325 24911225 20216415 X 653346 -4040869 -1358984 X 0 1 X 1 0 X 515111 605801 665846 574469 576691 2937918 515111 605801 665846 574469 576691 2937918 56991 2880927 556963 475286 731534 673066 577468 3014317 5952235 109055 0.48400 0.49890 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4654568 620782 22371 1025596 4272125 4834979 617307 57946 855664 4654568 4709926 661714 198698 735359 4834979 4580274 569049 61254 500651 4709926 4359085 474462 47081 300354 4580274 0.00000 0.33680 0.66320 0 0 0 ALTERNATIVE INVESTMENTS 2456124 F 2456124 AFFILIATES PAYABLE 235252 235252 X PART V, LINE 4: THE UVMC FOUNDATION (UVMCF) MAKES EVERY EFFORT TO ALWAYS FOLLOW THE INTENT AND WISHES OF ALL ITS DONORS. THE INTENDED USES OF THE ORGANIZATION'S ENDOWMENT FUNDS AND/OR EARNINGS FROM ENDOWMENT FUNDS ARE DRIVEN BY THE WISHES/RESTRICTIONS PLACED ON THE FUNDS BY THE DONOR. A PERMANENT ENDOWMENT RESULTS WHEN A DONATION IS RECEIVED WITH A RESTRICTION THAT THE PRINCIPAL OR GIFT AMOUNT IS TO BE RETAINED IN PERPETUITY AND CANNOT BE SPENT. THE EARNINGS FROM THE PERMANENT ENDOWMENT ARE USED FOR THE PURPOSE SPECIFIED BY THE DONOR. TEMPORARY ENDOWMENTS ARE FUNDS IN WHICH ALL OR PART OF THE PRINCIPAL MAY BE EXPENDED ONLY AFTER THE EXPIRATION OF A STATED PERIOD OF TIME OR OCCURRENCE OF A SPECIFIED EVENT, DEPENDING ON THE DONOR'S WISHES. EARNINGS FROM TEMPORARILY RESTRICTED ENDOWMENTS CAN BE EITHER UNRESTRICTED OR RESTRICTED. THE UVMCF USES THE TEMPORARILY RESTRICTED ENDOWMENTS FOR THE INTENDED PURPOSE SET UP BY THE DONOR, ONLY AFTER THE PERIOD OF TIME OR SPECIFIED EVENT SET BY THE DONOR HAS BEEN MET. THE CATEGORIES OF RESTRICTED ENDOWMENTS ARE AS FOLLOWS: PROVIDE FOR LONG-TERM CARE AND REHABILITATION (16%); EDUCATION (17%); OTHER HOSPITAL PROGRAMS (17%); CANCER CARE/CENTER (9%); WOMEN'S SERVICES (1%); CARDIOPULMONARY (7%) AND MISCELLANEOUS (33%). PART X, LINE 2: THE FOLLOWING FOOTNOTE IS FROM THE 2022 CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR PREMIER HEALTH (PHP) AND AFFILIATES. PHP HAS BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE TO BE A TAX-EXEMPT NON-PROFIT CORPORATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS A TAX-EXEMPT ORGANIZATION, ITS INCOME IS EXEMPT FROM FEDERAL INCOME TAX EXCEPT TO THE EXTENT OF ANY UNRELATED BUSINESS ACTIVITIES. PHP CONSOLIDATES CERTAIN SUBSIDIARIES, WHICH ARE FOR-PROFIT CORPORATIONS SUBJECT TO FEDERAL INCOME TAXES. THESE ARE: * PREMIER HEALTH INSURING CO. (PHIC), AND PREMIER HEALTH HOLDING COMPANY (PHHC) (WHOLLY OWNED SUBSIDIARIES OF PHP) * PREMIER HEALTH PLAN (PHPLAN) (A WHOLLY OWNED SUBSIDIARY OF PHP) * MVHE, INC., SAMARITAN FAMILY CARE, INC., PREMIER HEALTH SPECIALISTS, INC. AND PREMIER HEALTH URGENT CARE, INC. (SUBSIDIARIES OF PHHC) * PREMIER HEALTH ACO OF OHIO AND UVMC MANAGEMENT CORPORATION - CLOSED JUNE 2022 (SUBSIDIARIES OF PHP) MANAGEMENT ANNUALLY REVIEWS THE TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS. UVMC GOLF CLASSIC 45375 6700 38675 6700 400 19308 2801 45375 6700 38675 6700 400 19308 2801 29209 9466 1 UPPER VALLEY MEDICAL CENTER 110 NORTH MAIN ST 500 DAYTON OH 45402 310537095 501(C)(3) 131307 38892 FMV EMPLOYEE FOOD OPERATIONS SUPPORT MIAMI COUNTY SCHOOLS 2000 W STANFIELD RD TROY OH 45373 596000572 501(C)(3) 27300 0 SUPPORT PREMIER HEALTH 110 NORTH MAIN ST 500 DAYTON OH 45402 311446699 501(C)(3) 15992 0 SUPPORT 3 0 EDUCATIONAL SCHOLARSHIP 73 59499 PART I, LINE 2: UVMC FOUNDATION MONITORS THE USE OF GRANT FUNDS BY REQUIRING THE SUBMISSION OF AN INVOICE FOR PAYMENT, WHETHER IT IS FOR CAPITAL, PROGRAM NEEDS, INDIGENT PATIENT BILLS OR SCHOLARSHIPS. AFTER THE INVOICE IS RECEIVED, THE PRESIDENT OF THE FOUNDATION DETERMINES THAT IT IS AN EXPENSE THAT HAS BEEN APPROVED BY THE BOARD OF TRUSTEES AS MEETING THE CRITERIA SET FORTH IN ITS FUND DOCUMENTS. 0 0 0 0 0 0 0 0 0 DUANNA R OSTING PRESIDENT & EXECUTIVE DIRECTOR 105231 0 31268 0 513 0 4542 0 16278 0 157832 0 0 0 PART I, LINE 3: COMPENSATION FOR UVMCF'S CEO IS REVIEWED AND APPROVED BY PREMIER, WITH WHICH UVMCF IS FINANCIALLY INTERRELATED. SEE EXPLANATION ON SCHEDULE O FOR FORM 990, PART VI, SECTION B, LINE 15. X 1 4944 PUBLICLY TRADED X EMPLOYEE FOOD 12 44292 FMV X AUCTION ITEMS/EVENTS 11 1800 FMV 0 0 1 0 FORM 990, PART VI, SECTION B, LINE 11B THIS 990 FILING AND ATTACHED SCHEDULES (THE RETURN) ARE PREPARED BY A STAFF MEMBER IN THE TAX DEPARTMENT OF PREMIER, WITH WHICH UVMCF IS FINANCIALLY INTERRELATED. THE RETURN IS REVIEWED BY THE MANAGER AND DIRECTOR OF TAX COMPLIANCE OF PREMIER. AFTER ALL CHANGES FROM THE ABOVE PERSONS ARE MADE, THE RETURN IS REVIEWED BY THE VICE PRESIDENT/CONTROLLER OF PREMIER. A FINAL VERSION OF THE RETURN IS 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 FILING IS ALSO SHARED WITH THE AUDIT COMMITTEE OF PREMIER. FORM 990, PART VI, SECTION B, LINE 12C PREMIER, WITH WHICH UVMCF IS FINANCIALLY INTERRELATED, REQUIRES ALL BOARD MEMBERS, BOARD COMMITTEE MEMBERS, MEDICAL DIRECTORS, SUPPLY CHAIN DIVISION MEMBERS, AUTHORIZED SIGNERS, DIRECTORS, EXECUTIVES, MEDICAL EXECUTIVE COMMITTEE MEMBERS, MEDICAL DEPARTMENT AND SECTION CHAIRS, PHYSICIAN PARTNERSHIP COMMITTEE MEMBERS, PHYSICIAN GUIDANCE GROUP MEMBERS, 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 FILING. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR UVMCF'S PRESIDENT IS REVIEWED AND APPROVED BY PREMIER, WITH WHICH UVMCF IS FINANCIALLY INTERRELATED, ON AN ANNUAL BASIS. THE REVIEW PROCESS PERFORMED BY PREMIER 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 AND NATIONAL 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 DATA 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 CONTAINS THREE MEMBERS, ALL OF WHOM ARE INDEPENDENT. THIS COMMITTEE REVIEWS IN DETAIL THE COMPENSATION FOR THE PREMIER CEO, COO, CFO, CCO AND OTHER TOP EXECUTIVES. 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, LINE 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 UPON REQUEST. FORM 990, PART XI, LINE 9: CAPITAL DONATIONS -1,359,068. PLEDGE RESERVE 84.