2024-11-15T12:48:14-06:00 2023-12-31 454084437 WARREN AVERETT LLC 2500 ACTON ROAD BIRMINGHAM AL 35243 990 2023-01-01 825388429 UNITY MEDICAL CENTER INC UNIT 6153088800 481 INTERSTATE DRIVE MANCHESTER TN 37355 ASHOKE MUKHERJI CHAIRMAN 6153088800 2024-11-15 1 1 MEGAN RANDOLPH P00989558 2059794100 2024-11-15 2023 2024-10-15 13:58:12Z PAM JERNIGAN 481 INTERSTATE DRIVE MANCHESTER TN 37355 51912118 0 X UNITYMEDICALMANCHESTER.COM X 2018 TN TO PROVIDE IMPROVED HEALTHCARE TO LOCAL RESIDENTS. PROVIDE LEADERSHIP AND DEVELOPMENT OF ADDITIONAL SERVICES TO THE COMMUNITY. 7 4 368 8 0 0 1216934 246734 47692972 50786264 480 17039 0 684286 48910386 51734323 3000 3600 0 0 17801880 19782412 0 0 0 29042476 31561283 46847356 51347295 2063030 387028 54267464 58177217 36996505 45207038 17270959 12970179 TO PROVIDE QUALITY, COMPASSIONATE, COST-EFFECTIVE HEALTHCARE RESPONSIVE TO THE NEEDS OF THE COMMUNITIES WE SERVE, WHILE UPHOLDING THE HIGHEST ETHICAL STANDARDS. 0 0 44964901 3600 51470550 CLINICAL SERVICES INCLUDING NURSING HOME VISITS - 115,326, LABORATORY TESTS AND PROCEDURES - 111,902, EMERGENCY ROOM VISITS - 11,774, ICU PATIENT DAYS - 384, ROUTINE INPATIENT DAYS - 3,323. THERE WERE 134,772 PATIENT VISITS ACCOMADATED THROUGH THE FACILITIES TWO PROVIDER BASED RURAL HEALTH CLINICS. 44964901 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 1 0 1 0 1 0 0 0 0 1 0 1 0 0 0 1 86 0 1 368 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 4 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 0 1 0 X THE ORGANIZATION 6153088800 481 INTERSTATE DRIVE MANCHESTER TN 37355 ASHOKE MUKHERJI CHAIRMAN 40.00 0.00 X X 850625 0 20500 CHRISTY LEWIS BOARD MEMBER 0.65 0.00 X 0 0 0 KENNETH KIRBY BOARD MEMBER 0.65 0.00 X 0 0 0 MIKE NIEDERHAUSER BOARD MEMBER (THROUGH 07/2023) 0.65 0.00 X 0 0 0 KIM ROBERTS BOARD MEMBER (THROUGH 07/2023) 0.65 0.00 X 0 0 0 JAMES VANWINKLE BOARD MEMBER 0.65 0.00 X 0 0 0 BLAL ZAFAR BOARD MEMBER 0.65 0.00 X 418700 0 0 ART SNOW BOARD MEMBER 0.65 0.00 X 0 0 0 CHARLES DRUMMOND BOARD MEMBER 0.65 0.00 X 0 0 0 ROBERT COUCH COO 40.00 0.00 X 990484 0 45247 PAMELA JERNIGAN SR FINANCIAL ADVISOR 40.00 0.00 X 441148 0 38920 MARTHA HENLEY CEO 40.00 0.00 X 824583 0 22018 KENNETH WARE CHEIF CLINICAL OFFICER 40.00 0.00 X 138412 0 24831 JAMES BARMES SR FINANCIAL OFFICER 40.00 0.00 X 0 0 0 JODY MILLS CHIEF COMPLIANCE OFFICER 40.00 0.00 X 98451 0 5413 CLARISSA SAIN CFO 40.00 0.00 X 112155 0 26492 DENNY DANIEL PHYSICIAN 40.00 0.00 X 338564 0 22077 SARAH WILSON PHYSICIAN 40.00 0.00 X 268082 0 42147 GLENN DAVIS PHYSICIAN 40.00 0.00 X 297602 0 11552 JAMESON BOULDIN PHARMACY DIRECTOR 40.00 0.00 X 163324 0 0 HEATHER CARTER MD PHYSICIAN 40.00 0.00 X 200000 0 0 5142130 0 259197 16 0 1 0 DR ERIC HASEMEIER & ASSOCIATES PO BOX 1010 DANDREDGE TN 37725 PROFESSIONAL SERVICES 3321010 RAPHA CENTRE 482 INTERSTATE DRIVE MANCHESTER TN 37355 BEHAVIORAL HEALTH SERVICES 2569138 GERIATRIC CONSULTANTS 132 MAPLE ROW BLVD HENDERSONVILLE TN 37075 PROFESSIONAL SERVICES 1937540 HCA EMCARE HOLDINGS 13737 NOEL RD STE 1600 DALLAS TX 75240 EMERGENCY PROVIDER SERVICES 684890 JAMES POOLE 9865 CLOVERCROFT RD NOLENSVILLE TN 37110 HOSPITALIST PROFESSIONAL SERVICES 396960 18 246734 246734 NET PATIENT SERVICE REVENUE 621990 48642547 48642547 OTHER REVENUE 621990 2143717 2143717 50786264 898 898 193936 177795 16141 16141 16141 DEBT FORGIVENESS 900099 684286 684286 684286 51734323 51470550 0 17039 X 3600 3600 3455858 2764686 691172 13257147 10649830 2607317 3069407 2463627 605780 111265 111265 959 959 20116026 18975969 1140057 85104 85104 215714 134888 80826 1749474 1417425 332049 51495 18381 33114 50892 34492 16400 2266739 2266739 1848446 1543452 304994 522967 436677 86290 SUPPLIES AND DRUGS 3628623 3606169 22454 REPAIRS AND MAINTENANCE 590013 492661 97352 BANK FEES 64809 0 64809 EXCISE TAXES 50000 0 50000 208757 156305 52452 51347295 44964901 6382394 0 524975 4390714 11441752 8933296 5659 5659 675592 688552 145872 276661 37015597 19032454 19550781 17983143 21922833 25899192 54267464 58177217 9509774 10440694 2904097 2645864 24582634 27882711 0 4237769 36996505 45207038 X 17270959 12970179 17270959 12970179 54267464 58177217 387028 -4687808 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 959 959 0 PART II-B, LINE 1: PORTION OF HOSPITAL ASSOCIATION MEMBERSHIP DUES THAT ARE USED FOR LOBBYING. 1016215 1016215 16557803 6413531 10144272 352561 352561 17157124 12493211 4663913 1931894 125712 1806182 17983143 GOODWILL 21750557 DEPOSITS 30726 RIGHT OF USE ASSETS 4117909 25899192 OPERATING LEASE LIABILITIES 4237769 4237769 1 1 X 1 X 1 X 1 1 1 0 1 1 493180 667821 0 0.00000 5291949 1043845 4248104 0.08660 5785129 1711666 4248104 0.08660 5785129 1711666 4248104 0.08660 1 3887666 0 15457969 14767732 690237 X 1 1 1 1 UNITY MEDICAL CENTER 481 INTERSTATE DRIVE MANCHESTER TN 37355 0000000017 X X X UNITY MEDICAL CENTER INC 1 0 0 1 X X X X X X X X X 22 1 0 0 1 X WWW.UNITYMEDICALMANCHESTER.COM X 1 23 1 WWW.UNITYMEDICALMANCHESTER.COM 0 1 X 200.000000000000 400.000000000000 X X X X X X 0 1 X X X 1 X WWW.UNITYMEDICALMANCHESTER.COM/PRICE-TRANSPARENCY X WWW.UNITYMEDICALMANCHESTER.COM/PRICE-TRANSPARENCY X WWW.UNITYMEDICALMANCHESTER.COM/PRICE-TRANSPARENCY X X X 1 X X 1 X X X X 1 X 0 0 UNITY MEDICAL CENTER, INC. PART V, SECTION B, LINE 5: WITH A FOCUS ON THE DEMOGRAPHIC HEALTH INDICATORS, A COMMUNITY HEALTH COMMITTEE WAS FORMED BY UNITY MEDICAL CENTER TO REPRESENT THE BROAD INTEREST OF THE COMMUNITY TO WEIGH IN ON THE HEALTH ISSUES IMPACTING THE COMMUNITY. A SURVEY WAS GENERATED TO INQUIRE ABOUT THE COMMUNITY AND PRIORTIZE ISSUES THAT IMPACT HEALTH. THIS SURVEY WAS POSTED ONLINE AND DISTRIBUTED WITHIN THE COMMUNITY THROUGH AVENUES SUCH AS THE HOSPITAL, CHAMBER OF COMMERCE, PUBLIC SCHOOL BOARD, LOCAL CHURCH, EMERGENCY RESPONDERS, AND OTHER CIVIC GROUP EMAIL SERVICES. THE METHODOLOGY UTILIZED IN THIS ASSESSSMENT INCORPORATED BOTH QUANTITATIVE AND QUALITATIVE SOURCES. QUANTITATIVE DATA INCLUDED THE PRIMARY RESEARCH (THE SURVEY) AND SECONDARY RESEARCH (VITAL STATISTICS AND EXISTING HEALTH-RELATED DATA). QUALITATIVE DATA INCLUDED PRIMARY RESEARCH GATHERED THROUGH THE ONLINE SURVEY IN ADDITION TO THE EXPERTISE PROVIDED BY THE COMMUNITY HEALTH COMMITTEE THAT WAS FORMED BY THE HOSPITAL. UNITY MEDICAL CENTER, INC. PART V, SECTION B, LINE 11: THE COMMUNITY HEALTH NEEDS COMMITTEE WAS PRESENTED THE TOP TEN MOST SIGNIFICANT HEALTH ISSUES. THE 2023 COMMUNITY HEALTH PRIORITIES IDENTIFIED BY THE COMMITTEE AND APPROVED BY THE HOSPITAL BOARD OF DIRECTORS ARE: CANCER, HEART DISEASE AND STROKE. THE COMMUNITY HEALTH NEEDS COMMITTEE ELIMINATED HEALTH INSURANCE AND PRESCRIPTION DRUG AFFORDABILITY BECAUSE THEY ARE NATIONAL HEALTH CONCERNS AND WOULD LIKELY BE MET WITH MINIMAL POSITIVE RESULTS. PART III, LINE 2: THE MEDICAL CENTER'S ESTIMATE OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED PRIMARILY ON THE TYPE AND AGE OF THE PATIENT'S ACCOUNTS RECEIVABLE. THE POLICY IS TO RESERVE A PORTION OF ALL SELF-PAY ACCOUNTS, INCLUDING AMOUNTS DUE FROM UNINSURED PATIENTS AND AMOUNTS RELATED TO CO-PAYMENTS AND DEDUCTIBLES. ON A MONTHLY BASIS, THE MEDICAL CENTER REVIEWS ITS ESTIMATE AND PERFORMS ANALYTICAL PROCEDURES, INCLUDING REVIEW OF THE ACCOUNTS RECEIVABLE AGING AND PAYOR MIX. THE MEDICAL CENTER ALSO PERFORMS RETROSPECTIVE REVIEWS OF WRITE-OFFS AND COLLECTIONS TO ENSURE THE ESTIMATE IS REASONABLE GOING FORWARD. PART III, LINE 3: THE ORGANIZATION DID NOT REPORT PATIENTS ELIGIBLE UNDER THE FINANCIAL POLICY AS BAD DEBT EXPENSE. PART III, LINE 4: GENERALLY, PATIENTS WHO ARE COVERED BY THIRD-PARTY PAYERS ARE RESPONSIBLE FOR RELATED DEDUCTIBLES AND COINSURANCE, WHICH VARY IN AMOUNT. THE ORGANIZATION ALSO PROVIDES SERVICES TO UNINSURED PATIENTS WHO DO NOT QUALIFY FOR CHARITY CARE, AND OFFERS THOSE UNINSURED PATIENTS A DISCOUNT, EITHER BY POLICY OR LAW, FROM STANDARD CHARGES. THE ORGANIZATION ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND COINSURANCE, AND FROM THOSE WHO ARE UNINSURED, BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS AND IMPLICIT PRICE CONCESSIONS. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE. BAD DEBT EXPENSE FOR THE YEARS ENDED DECEMBER 31, 2023 WAS NOT SIGNIFICANT. PART III, LINE 9B: PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE ARE NOT SUPPOSED TO HAVE ACCOUNTS PLACED WITH A COLLECTION AGENCY AFTER THEY QUALIFY FOR FINANCIAL ASSISTANCE. PART VI, LINE 2: THE HOSPITAL ANALYZES DATA RECEIVED FROM LOCAL, REGIONAL, AND STATE AGENCIES IN ORDER TO ACCURATELY AND ADEQUATELY INDENTIFY THE NEEDS OF THE COMMUNITY THROUGH SERVICES PROVIDED BY UNITY HOSPITAL. PART VI, LINE 3: INFORMATION TO INFORM AND EDUCATE PATIENTS REGARDING ASSISTANCE UNDER FEDERAL, STATE OR LOCAL PROGRAMS AND UNITY POLICIES IS AVAILABLE UPON ADMISSION AND IS POSTED IN PATIENT ROOMS. HOSPITAL BUSINESS OFFICE REPRESENTATIVES ARE AVAILABLE BEFORE, DURING AND FOLLOWING PATIENT STAYS TO DISCUSS PAYMENT ARRANGEMENTS, FINANCIAL ASSISTANCE, AND QUESTIONS ABOUT BILLING. FOR INPATIENT AND SUBACUTE REFERRALS, THE NURSE LIASONS ARE THE FIRST POINT OF CONTACT FOR INFORMATION DISSEMINATION TO PROSPECTIVE PATIENTS REGARDING AVAILABILITY OF ASSISTANCE, ELIGIBILITY CRITERIA AND APPLICATION INFORMATION. PART VI, LINE 4: UNITY SERVES MIDDLE TENNESSEE. PART VI, LINE 7, REPORTS FILED WITH STATES TN X 1 1 X X 1 0 0 0 0 0 0 0 0 ROBERT COUCH COO 348207 0 366102 0 276175 0 13200 0 32047 0 1035731 0 0 0 ASHOKE MUKHERJI CHAIRMAN 367573 0 193097 0 289955 0 20500 0 0 0 871125 0 0 0 MARTHA HENLEY CEO 358031 0 193097 0 273455 0 20500 0 1518 0 846601 0 0 0 PAMELA JERNIGAN SR FINANCIAL ADVISOR 306924 0 0 0 134224 0 16881 0 22039 0 480068 0 0 0 BLAL ZAFAR BOARD MEMBER 418700 0 0 0 0 0 0 0 0 0 418700 0 0 0 DENNY DANIEL PHYSICIAN 338564 0 0 0 0 0 0 0 22077 0 360641 0 0 0 SARAH WILSON PHYSICIAN 240482 0 27600 0 0 0 10045 0 32102 0 310229 0 0 0 GLENN DAVIS PHYSICIAN 297602 0 0 0 0 0 11552 0 0 0 309154 0 0 0 HEATHER CARTER MD PHYSICIAN 200000 0 0 0 0 0 0 0 0 0 200000 0 0 0 JAMESON BOULDIN PHARMACY DIRECTOR 163324 0 0 0 0 0 0 0 0 0 163324 0 0 0 KENNETH WARE CHEIF CLINICAL OFFICER 138412 0 0 0 0 0 5445 0 19386 0 163243 0 0 0 PART I, LINE 1A CHAIRMAN ASHOKE MUKJHERJI RECEIVED A $15,500 HOUSING ALLOWANCE. PART I, LINE 4A THE FOLLOWING OFFICERS RECEIVED CHANGE OF CONTROL PAYMENTS IN 2023: -MARTHA HENLEY $260,000 -ROBERT COUCH $260,000 -ASHOKE MUKHERJI $260,000 -PAMELA JERNIGAN $260,000 ROBERT COUCH OFFICER HOSPITAL FINANCING X 109150 94368 0 1 1 ASHOKE BAPPA MUKHERJI OFFICER HOSPITAL FINANCING X 544275 470563 0 1 1 MARTHA HENLEY OFFICER HOSPITAL FINANCING X 495600 428480 0 1 1 PAMELA JERNIGAN OFFICER HOSPITAL FINANCING X 675255 583804 0 1 1 MIKE NIEDERHAUSER BOARD MEMBER HOSPITAL FINANCING X 29500 25505 0 1 1 JAMES VANWINKLE BOARD MEMBER HOSPITAL FINANCING X 241900 209139 0 1 1 EVELYN CASE TRUST FAMILY MEMBER HOSPITAL FINANCING X 265650 221891 0 1 1 IMMEDIATE RELATIVE ASOKE MUKHERJI HOSPITAL FINANCING X 708000 612114 0 1 1 2645864 RAPHA CHAIRMAN ASHOKE MUKHERJI IS A MAJORITY OWNER 2977476 CLINIC ADDICTION 0 COFFEE ASSOCIATES PROPERTY CHAIRMAN ASHOKE MUKHERJI IS A MAJORITY OWNER 171600 LEASED SPACE 0 MIDDLE TENNESSEE SURGICAL BOARD MEMBER JAMES VANWINKLE IS THE OWNER 170000 CONTRACTED SERVICES 0 BLAL ZAFAR BLAL ZAFAR IS BOARD MEMBER 420512 HOSPITALIST SERVICES 0 INTERSTATE DRIVE HOLDING LLC COMPANY OWNED BY ROBERT COUCH, MARTHA HENLEY, AND ASHOK MUKHERJI 642355 LEASED SPACE 0 RURAL HEALTH CONSULTANTS COO, ROBERT COUCH OWNER. 416210 CONTRACTED SERVICES 0 FORM 990, PART VI, SECTION B, LINE 11B THE BOARD WILL REVIEW THE TAX RETURN BEFORE THE RETURN IS FILED. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST IS MONITORED BY THE COMPLIANCE OFFICER. FORM 990, PART VI, SECTION B, LINE 15B ALL CONTRACTS ARE REVIEWED BY THE CHIEF COMPLIANCE OFFICER AND OUTSIDE COUNSEL. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 18,975,969. MANAGEMENT AND GENERAL EXPENSES 1,140,057. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 20,116,026. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS NOT CHANGED ITS OVERSIGHT OR SELECTION PROCESS. COFFEE MEDICAL GROUP LLC 481 INTERSTATE DRIVE MANCHESTER TN 37355 460485169 HOSPITAL MEDICAL CARE TN 51032998 58177217 UNITY MEDICAL CENTER INC