Form990
Click to see list of attachments
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 01-01-2018 , and ending 12-31-2018
BCheck if applicable:
CName of organization
UNIVERSITY HEALTH SERVICES INC
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
1350 WALTON WAY
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
AUGUSTA, GA30901
D Employer identification number

58-1581103
E Telephone number

G Gross receipts $ 926,470,671
F Name and address of principal officer:
JAMES R DAVIS
1350 WALTON WAY
AUGUSTA,GA30901
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.UNIVERSITYHEALTH.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1984
M State of legal domicile: GA
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: THE MISSION OF UNIVERSITY HEALTH CARE SERVICES IS TO OPERATE AN ACUTE AND SUBACUTE CARE HOSPITAL PROVIDING HEALTH CARE SERVICES WHICH HELP THE CITIZENS OF OUR COMMUNITIES ACHIEVE AND MAINTAIN OPTIMAL HEALTH.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 15
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 13
5 Total number of individuals employed in calendar year 2018 (Part V, line 2a) ...... 5 4,577
6 Total number of volunteers (estimate if necessary) ............. 6 292
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 2,422,074
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b -1,498,779
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 2,588,433 2,741,444
9 Program service revenue (Part VIII, line 2g) ......... 524,452,965 542,332,520
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 15,835,249 13,603,624
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 12,757,585 9,961,589
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 555,634,232 568,639,177
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 1,077,377 1,210,826
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 209,804,129 215,484,811
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 299,797,443 316,842,000
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 510,678,949 533,537,637
19 Revenue less expenses. Subtract line 18 from line 12....... 44,955,283 35,101,540
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 885,788,560 847,437,230
21 Total liabilities (Part X, line 26)............. 400,881,577 388,416,279
22 Net assets or fund balances. Subtract line 21 from line 20..... 484,906,983 459,020,951
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2018)
Form 990 (2018)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: THE MISSION OF UNIVERSITY HEALTH CARE SERVICES IS TO OPERATE AN ACUTE AND SUBACUTE CARE HOSPITAL PROVIDING HEALTH CARE SERVICES WHICH HELP THE CITIZENS OF OUR COMMUNITIES ACHIEVE AND MAINTAIN OPTIMAL HEALTH.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 493,988,958 including grants of $ 1,210,826 ) (Revenue $ 543,758,118 )
OPERATION OF A GENERAL ACUTE CARE AND SUB-ACUTE CARE HOSPITAL WITH 812 LICENSED BEDS, TOTAL (812 ACUTE AND 0 SUB-ACUTE). PATIENT DAYS FOR ADULTS AND PEDIATRICS FOR 2018 WERE 129,538, NEWBORN DAYS WERE 12,739 (FOR BOTH TERM & ICU NURSERY), AND OUTPATIENT VISITS WERE 573,949. EMERGENCY ROOM REGISTRATIONS WERE 96,773, OBSERVATION STAYS WERE 14,182, CARDIOVASCULAR INTERVENTIONAL PROCEDURES WERE 8,574 AND RADIOLOGY PROCEDURES WERE 276,185, OCCUPATIONAL MEDICINE VISITS WERE 18,201 AND HOME HEALTH VISITS FOR 2018 WERE 54,570. WITHIN ALL THESE INDICATORS ARE THE EFFORTS OF UNIVERSITY HEALTH SERVICES, INC TO SERVICE THE NEEDS OF THE COMMUNITY, WHICH INCLUDE THE INDIGENT. IN 2018 THE COST OF INDIGENT AND CHARITY CARE PROVIDED, WITH NO LOCAL FUNDING, WAS $47,644,290. HOWEVER, THE HOSPITAL DID RECEIVE DISPROPORTIONATE SHARE (DSH) PAYMENTS TO HELP WITH THIS SERVICE OF $2,131,601 (NET) AND UPPER PAYMENT LIMITS (UPL) FUNDS OF $2,626,356 (NET). THE $47,644,290 INCLUDES THE COST FOR PROVIDING INPATIENT AND OUTPATIENT SERVICES FOR INDIGENT AND CHARITY CARE PATIENTS OF $27,767,999. ALSO $1,431,469 TO HELP SUPPORT COMMUNITY BASED CLINICS, $18,444,822 FOR UNCOMPENSATED PHYSICIAN SERVICES FOR INDIGENT AND CHARITY CARE PATIENTS. ALSO PROVIDED ARE PROGRAMS FOR CONGESTIVE HEART FAILURE AND ASTHMA/COPD, WHICH HELPED INDIGENT PATIENTS MANAGE THEIR CONDITION AND IMPROVE THE QUALITY OF THEIR LIVES. OTHER COMMUNITY OUTREACH SERVICES FOR 2018 INCLUDE DIABETES TESTING AND EDUCATION, PROSTATE SPECIFIC ANTIGEN (PSA) TESTING, SKIN CANCER SCREENINGS, FREE COUNSELING AND EDUCATION FOR WOMEN AND THEIR FAMILY MEMBERS THROUGH ALL THE STAGES OF BREAST CANCER, FREE MAMMOGRAMS, HEART HEALTH EDUCATION, AND SUPPORT GROUPS FOR CANCER, HEART ATTACK, AND STROKE. IN 2018 UNIVERSITY HOSPITAL REACHED MORE THAN 13,700 PEOPLE IN FREE SCREENINGS, COMMUNITY EDUCATION, PUBLICATIONS, AND MORE. ADDITIONALLY, IN 2018 OVER $1.5 MILLION WAS PROVIDED FOR HEALTH PROFESSIONAL EDUCATION FOR CARDIOVASCULAR AND RADIOLOGY SCHOOLS, AND INTERNS AND RESIDENTS, IN SUPPORT OF TOMORROW'S CAREGIVERS.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet493,988,958
Form 990 (2018)
Form 990 (2018)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment..............
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment.................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment..................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part IIIClick to see attachment.............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
Yes
 
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....Click to see attachment
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
 
No
Form 990 (2018)
Form 990 (2018)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I............
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I...................
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L,
Part IV
........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV.....................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV...
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I.
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II...........
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
 
No
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...
35b
 
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
270
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
 
 
Form 990 (2018)
Form 990 (2018)
Page 5
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
4,577
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletCJ
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? .........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? If "Yes," see instructions and file Form 4720, Schedule N .....
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income?
If "Yes," complete Form 4720, Schedule O ................
16
 
No
Form 990 (2018)
Form 990 (2018)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
15
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
13
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
 
No
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
 
No
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
Yes
 
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
Yes
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
GA , SC
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletDAVID A BELKOSKI1350 WALTON WAY   AUGUSTA,GA30901 (706) 828-2406
Form 990 (2018)
Form 990 (2018)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) LEVI W HILL IV......................................................................
BOARD CHAIRMAN
2.00
.................
1.00
X   X       0 0 0
(2) TERRY D ELAM......................................................................
BOARD MEMBER
2.00
.................
1.00
X           0 0 0
(3) W CRAIG SMITH......................................................................
BOARD MEMBER
2.00
.................
1.00
X           0 0 0
(4) NATALIE D SCHWEERS......................................................................
BOARD MEMBER
2.00
.................
1.00
X           0 0 0
(5) SANFORD LOYD......................................................................
BOARD MEMBER
2.00
.................
1.00
X           0 0 0
(6) BRIAN J MARKS......................................................................
BOARD SECRETARY
2.00
.................
1.00
X   X       0 0 0
(7) EUGENE F MCMANUS......................................................................
BOARD MEMBER
2.00
.................
1.00
X           0 0 0
(8) HUGH L HAMILTON......................................................................
BOARD MEMBER
2.00
.................
1.00
X           0 0 0
(9) JEFFREY L FOREMAN......................................................................
BOARD MEMBER
2.00
.................
1.00
X           0 0 0
(10) JAMES W BENNETT JR......................................................................
BOARD MEMBER
2.00
.................
1.00
X           0 0 0
(11) DANIEL H BOONE MD......................................................................
BOARD MEMBER
2.00
.................
50.00
X           0 220,729 15,752
(12) CHARLES G PETE CAYE JR......................................................................
BOARD MEMBER
2.00
.................
1.00
X           0 0 0
(13) CATHERINE D KNOX......................................................................
BOARD MEMBER
2.00
.................
1.00
X           0 0 0
(14) WILLIAM P DOUPE......................................................................
BOARD MEMBER
2.00
.................
1.00
X           0 0 0
(15) JAMES C SHERMAN MD......................................................................
BOARD MEMBER
2.00
.................
50.00
X           120,372 0 54,693
(16) DAVID A BELKOSKI......................................................................
UHS CFO
50.00
.................
5.00
    X       665,756 0 15,779
(17) JAMES R DAVIS......................................................................
UHS PRESIDENT & CEO
50.00
.................
5.00
    X       979,349 0 307,362
Form 990 (2018)
Form 990 (2018)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) MARILYN A BOWCUTT........................................................................
PRESIDENT OF UNIVERSITY HO
50.00
.......................5.00
    X       451,707 0 12,155
(19) WILLIAM L FARR JR........................................................................
CMO
50.00
.......................5.00
    X       545,056 0 25,671
(20) EDWARD L BURR........................................................................
SR. VP LEGAL & REGULATORY
50.00
.......................  
    X       545,817 0 19,183
(21) LAURIE OTT SMITH........................................................................
UHCF-VP HR & COMM SVC
50.00
.......................  
      X     374,348 0 17,306
(22) THOMAS E LOWENCAMP........................................................................
VP - CONTINUING CARE
25.00
.......................25.00
      X     406,301 0 26,694
(23) SHIRLEY K GABRIEL........................................................................
VP CHIEF INFORMATION OFFIC
50.00
.......................  
      X     408,436 0 13,879
(24) TERESA BUSCHBACHER........................................................................
VP -HVI
50.00
.......................  
      X     310,612 0 24,844
(25) SCOTT ANSEDE........................................................................
VP PROFESSIONAL SERVICES
50.00
.......................  
      X     423,099 0 22,349
(26) ELIZABETH R GALLUP........................................................................
VP CLINICAL OPERATIONS
50.00
.......................  
      X     366,426 0 23,720
(27) CLIFFORD B HARGROVE........................................................................
VP POST ACUTE CARE SERVICES
50.00
.......................  
      X     219,186 0 16,801
(28) CHRISTOPHER I WESTBROOK........................................................................
VP HUMAN RESOURCES
50.00
.......................  
      X     325,432 0 19,280
(29) LISA RITCH........................................................................
VP FINIANCE
50.00
.......................  
      X     244,344 0 17,845
(30) ROBERT J KEPSHIRE........................................................................
ADMINISTRATIVE CNO - MCDUF
50.00
.......................  
        X   192,009 0 5,451
(31) JACKIE KENDINGER........................................................................
EMPLOYEE
50.00
.......................  
        X   203,246 0 4,917
(32) DOUGLAS D PUGH II........................................................................
RN
50.00
.......................  
        X   195,833 0 18,816
(33) VELVETTE L JONES........................................................................
DIRECTOR UCA
50.00
.......................  
        X   187,571 0 12,992
(34) BENJAMIN GUEST........................................................................
NETWORK DEVELOPMENT
50.00
.......................  
        X   186,899 0 17,508
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 7,351,799 220,729 692,997
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet20
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
CROTHALL HEALTHCARE

13028 COLLECTION CENTER DRIVE
CHICAGO,IL60693
PLANT & HOUSEKEEPING 11,538,135
MORRISONS HEALTH CARE DIVISION

PO BOX 102289
ATLANTA,GA30368
MANAGEMENT SUPPORT 8,448,906
NOVANT HEALTH SHARED SERVICES

2085 FRONTIS PLAZA
WINSTON SALEM,NC27103
SYSTEM SUPPORT 6,440,067
EPIC SYSTEMS CORPORATION

PO BOX 88314
MILWAUKEE,WI532880314
SYSTEM SUPPORT 3,123,419
ARUP LABORATORIES

PO BOX 27964
SALT LAKE CITY,UT841270964
LAB TESTS 2,425,917
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet106
Form 990 (2018)
Form 990 (2018)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a 613,033
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d  
e Government grants (contributions)1e 92,811
f All other contributions, gifts, grants, and similar amounts not included above1f 2,035,600
g Noncash contributions included in lines 1a - 1f:$  
h Total. Add lines 1a-1f.......MediumBullet 2,741,444
 Program Service RevenueAmt Business Code
2a PATIENT SERVICE REVENUE 900099 533,497,089 533,497,089    
b HOME HEALTH SERVICES 621610 8,069,448 8,069,448    
c PHYSICIAN ANSWERING SERVICE 541900 374,681 374,681    
d OTHER PROGRAM SERVICES 900099 311,440 311,440    
e ASK-A-NURSE 541900 52,282 52,282    
f All other program service revenue. 27,580 27,580    
g Total. Add lines 2a–2f ....MediumBullet 542,332,520
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 11,321,535     11,321,535
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   4,430,825
b Less: rental expenses   3,623,355
c Rental income or (loss)   807,470
d Net rental income or (loss)......MediumBullet 807,470   59,260 748,210
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 356,475,656 14,572
b Less: cost or other basis and sales expenses 352,445,696 1,762,443
c Gain or (loss) 4,029,960 -1,747,871
d Net gain or (loss).....MediumBullet 2,282,089     2,282,089
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Business Code Miscellaneous Revenue
11a EMPLOYEE PHARMACY 446110 5,364,377     5,364,377
b OUTREACH LAB 900099 3,978,112   3,978,112  
c MISCELLANEOUS 900099 930,684 930,684    
d All other revenue .... -1,119,054 494,914 -1,615,298 1,330
e Total. Add lines 11a–11d ...... MediumBullet 9,154,119
12 Total revenue. See Instructions......MediumBullet 568,639,177 543,758,118 2,422,074 19,717,541
Form 990 (2018)
Form 990 (2018)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 1,210,826 1,210,826
2 Grants and other assistance to domestic individuals. See Part IV, line 22    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees ....        
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 7,240,286 2,026,600 5,213,686  
7 Other salaries and wages 150,778,597 146,289,924 4,488,673  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 3,677,644 3,451,837 225,807  
9 Other employee benefits ....... 39,770,859 37,328,928 2,441,931  
10 Payroll taxes ........... 14,017,425 13,156,755 860,670  
11 Fees for services (non-employees):        
a Management ...... 14,377,177 13,494,418 882,759  
b Legal ......... 1,044,654   1,044,654  
c Accounting ........... 277,846   277,846  
d Lobbying ........... 197,396   197,396  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 1,236,280   1,236,280  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 38,916,714 36,527,228 2,389,486  
12 Advertising and promotion .... 759,999 713,335 46,664  
13 Office expenses ....... 1,586,126 1,488,738 97,388  
14 Information technology ...... 8,558,618 8,033,119 525,499  
15 Royalties ..        
16 Occupancy ........... 7,019,920 6,588,897 431,023  
17 Travel ............ 769,000 721,783 47,217  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials . 21,286   21,286  
19 Conferences, conventions, and meetings ....        
20 Interest ........... 7,826,067   7,826,067  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 38,357,127 36,001,999 2,355,128  
23 Insurance ... 4,697,301 4,408,887 288,414  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MED SURG SUPPLIES 135,372,195 135,372,195    
b BAD DEBT EXPENSE 26,269,667 26,269,667    
c REPAIRS AND MAINTENANCE 12,939,010 12,144,555 794,455  
d GA DCH HOSPITAL TAX 7,176,254   7,176,254  
e All other expenses 9,439,363 8,759,267 680,096  
25 Total functional expenses. Add lines 1 through 24e 533,537,637 493,988,958 39,548,679 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2018)
Form 990 (2018)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 11,938,091 1 30,947,312
2 Savings and temporary cash investments .........   2  
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 88,412,394 4 88,028,834
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
  6  
7 Notes and loans receivable, net .... 10,226,137 7 8,902,385
8 Inventories for sale or use ........ 11,765,652 8 12,267,489
9 Prepaid expenses and deferred charges ...... 8,346,885 9 8,927,516
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 720,526,250
b Less: accumulated depreciation 10b 442,697,566 267,663,828 10c 277,828,684
11 Investments—publicly traded securities . 444,741,930 11 381,620,794
12 Investments—other securities. See Part IV, line 11 .....   12  
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 42,693,643 15 38,914,216
16 Total assets. Add lines 1 through 15 (must equal line 34)... 885,788,560 16 847,437,230
Liabilities 17 Accounts payable and accrued expenses ..... 29,466,122 17 26,061,860
18 Grants payable ...   18  
19 Deferred revenue .........   19  
20 Tax-exempt bond liabilities ......... 145,550,240 20 141,493,283
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..   22  
23 Secured mortgages and notes payable to unrelated third parties .. 127,736,809 23 105,110,334
24 Unsecured notes and loans payable to unrelated third parties ..   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D 98,128,406 25 115,750,802
26 Total liabilities. Add lines 17 through 25.. 400,881,577 26 388,416,279
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets 484,871,983 27 458,985,951
28 Temporarily restricted net assets ...........   28  
29 Permanently restricted net assets 35,000 29 35,000
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund ...   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 484,906,983 33 459,020,951
34 Total liabilities and net assets/fund balances ........ 885,788,560 34 847,437,230
Form 990 (2018)
Form 990 (2018)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
568,639,177
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
533,537,637
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
35,101,540
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
484,906,983
5
Net unrealized gains (losses) on investments ...............
5
-37,588,141
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-23,399,431
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
459,020,951
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2018)
Form 990 (2018)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
Name of the organization
UNIVERSITY HEALTH SERVICES INC
 
Employer identification number

58-1581103
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)
1
2
3
4
5
6
7
8
9

10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose            
3 Gross receipts from activities that are not an unrelated trade or business under section 513 .....            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge            
6 Total. Add lines 1 through 5            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support. (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    
Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors
(explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by .035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    
Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity
 
3 Administrative expenses paid to accomplish exempt purposes of supported organizations  
4 Amounts paid to acquire exempt-use assets  
5 Qualified set-aside amounts (prior IRS approval required)  
6 Other distributions (describe in Part VI). See instructions  
7Total annual distributions. Add lines 1 through 6.  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions
 
9 Distributable amount for 2018 from Section C, line 6  
10 Line 8 amount divided by Line 9 amount  
Section E - Distribution Allocations (see instructions) (i)
Excess Distributions
(ii)
Underdistributions
Pre-2018
(iii)
Distributable
Amount for 2018
1 Distributable amount for 2018 from Section C, line
6
 
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2018:
a From 2013.......  
b From 2014.......  
c From 2015.......  
d From 2016.......  
e From 2017.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2018 distributable amount  
i Carryover from 2013 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2018 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2018 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2018, if any. Subtract lines 3g and 4a from line 2.
If the amount is greater than zero, explain in Part VI.
See instructions.
 
6 Remaining underdistributions for 2018. Subtract
lines 3h and 4b from line 1. If the amount is greater
than zero, explain in Part VI. See instructions.
 
7 Excess distributions carryover to 2019. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2014......  
b Excess from 2015.....  
c Excess from 2016.....  
d Excess from 2017.....  
e Excess from 2018.....  
Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990 or 990-EZ) 2018


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Name of the organization
UNIVERSITY HEALTH SERVICES INC
 
Employer identification number

58-1581103
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution. An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2018)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2
Name of organization
UNIVERSITY HEALTH SERVICES INC
 
Employer identification number
58-1581103
Part I
Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
RESTRICTED
 
 
 
 
  ,    

$ RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
Page 3
Name of organization
UNIVERSITY HEALTH SERVICES INC
 
Employer identification number

58-1581103
Part II
Noncash Property (See instructions). Use duplicate copies of Part II if additional space is needed.
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
Page 4
Name of organization
UNIVERSITY HEALTH SERVICES INC
 
Employer identification number

58-1581103
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet Complete if the organization is described below. SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
UNIVERSITY HEALTH SERVICES INC
 
Employer identification number

58-1581103
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

2
Political campaign activity expenditures (see instructions) ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities (see instructions) ..................................................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 ................................SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 .......................SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................
4a
Was a correction made? ......................................................................................................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b...........SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2018

Schedule C (Form 990 or 990-EZ) 2018
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(b) Affiliated group totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ...............................    
c Total lobbying expenditures (add lines 1a and 1b) ...................................................................    
d Other exempt purpose expenditures ........................................................................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............................................    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
   
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................................................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ...................................................................................................................

4-Year Averaging Period Under section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e))
 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))
 
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2018


Schedule C (Form 990 or 990-EZ) 2018
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
No
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
197,396
j
Total. Add lines 1c through 1i ....................................................................................................
197,396
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) .........................................
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
PART II-B, LINE 1: A PART OF THE VARIOUS ASSOCIATION DUES INCLUDE A PERCENTAGE ALLOCATION FOR EXPENDITURES ON LOBBYING ACTIVITIES. DUES PAID TO THE GEORGIA HOSPITAL ASSOCIATION, THE GEORGIA ALLIANCE OF COMMUNITY HOSPITALS, THE GEORGIA INITIATIVE, THE GEORGIA CHAMBER OF COMMERCE, AND OTHER HEALTH ASSOCIATIONS ALL HAVE A LOBBYING COMPONENT. FOR 2018, THESE FEES AMOUNTED TO $144,327. ADDITIONALLY, OGLETHORPE CONSULTING GROUP WAS CONTRACTED DURING 2018 TO REVIEW AND ADVISE THE HOSPITAL ON LEGISLATIVE ISSUES. DURING 2018, $53,069 WAS PAID TO OGLETHORPE CONSULTING GROUP.
Schedule C (Form 990 or 990EZ) 2018


Additional Data


Software ID:  
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SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
SchDMd Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
UNIVERSITY HEALTH SERVICES INC
 
Employer identification number

58-1581103
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2018

Schedule D (Form 990) 2018
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
(a)Current year (b)Prior year (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance ....          
b Contributions ...          
c Net investment earnings, gains, and losses          
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ...
         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations .................
3a(i)
 
 
(ii) related organizations .................
3a(ii)
 
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment)
(b) Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .....   21,360,215 21,360,215
b Buildings ....   316,917,905 157,452,119 159,465,786
c Leasehold improvements   4,034,729 3,202,219 832,510
d Equipment ....   358,662,848 276,552,014 82,110,834
e Other .....   19,550,553 5,491,214 14,059,339
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 277,828,684
Schedule D (Form 990) 2018

Schedule D (Form 990) 2018
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) Financial derivatives.........    
(2) Closely-held equity interests........    
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes  
ACCRUED COMPENSATION, BENEFITS, & WITHOLDINGS 23,522,692
ACCRUED POSTRETIREMENT BENEFIT COST 32,146,399
ASSET RETIREMENT OBLIGATION 3,318,414
EST THIRD PARTY PAYOR SETTLEMENTS 14,422,520
OTHER CURRENT LIABILITIES 2,642,406
RESERVE FOR SELF INSURED LOSSES 16,851,580
DUE TO AFFILIATES 23,843,660
CAPITALIZED BOND COSTS -1,493,911
ACCRUED PENSION COST 497,042
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 115,750,802
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2018

Schedule D (Form 990) 2018
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1.................. 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a  
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d.................... 2e  
3 Subtract line 2e from line 1................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
PART X, LINE 2: UNIVERSITY HEALTH SERVICES, INC. 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 FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION OR LIABILITY FOR FEDERAL OR STATE INCOME TAXES. THE CORPORATION HAS EVALUATED ITS TAX POSITIONS AND HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF DECEMBER 31, 2018. FISCAL YEARS ENDED ON OR AFTER DECEMBER 31, 2015 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. THERE IS PRESENTLY NO TAXATION IMPOSED BY THE GOVERNMENT OF THE CAYMAN ISLANDS ON INCOME OR PREMIUMS OF WWI. AS A RESULT, NO TAX LIABILITY OR EXPENSE HAS BEEN RECORDED.
Schedule D (Form 990) 2018


Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990.Right pointing arrow large image Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
UNIVERSITY HEALTH SERVICES INC
 
Employer identification number

58-1581103
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of its grants and
other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in region (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region
(f) Total expenditures
for and investments
in region
CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, 1 2 INSURANCE CAPTIVE    
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total ..... 1 2 0
b Total from continuation sheets to Part I ...     0
c Totals (add lines 3a and 3b) 1 2 0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2018
Schedule F (Form 990) 2018
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)
(c) Region (d) Purpose of
grant
(e) Amount of
cash grant
(f) Manner of
cash
disbursement
(g) Amount
of non-cash
assistance
(h) Description
of non-cash
assistance
(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......MediumBullet
 
3 Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 2018
Schedule F (Form 990) 2018Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant
(e) Manner of cash
disbursement
(f) Amount of
non-cash
assistance
(g) Description
of non-cash
assistance
(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2018
Schedule F (Form 990) 2018
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes,"the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .
Schedule F (Form 990) 2018
Schedule F (Form 990) 2018
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).
ReturnReference Explanation
PART 1 - ADDITIONAL SUPPLEMENTAL INFORMATION PLEASE SEE FORM 5471 FILING FOR DETAILS RELATED TO OFFSHORE CAPTIVE INSURANCE.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2018
Additional Data


Software ID:  
Software Version:  



SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
UNIVERSITY HEALTH SERVICES INC
 
Employer identification number

58-1581103
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
    29,614,008 1,705,281 27,908,727 5.230 %
b Medicaid (from Worksheet 3, column a) . . . . .     48,035,631 41,725,487 6,310,144 1.180 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     77,649,639 43,430,768 34,218,871 6.410 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     20,190,894 10,874,503 9,316,391 1.750 %
f Health professions education (from Worksheet 5) . . .     1,198,285 1,070,545 127,740 0.020 %
g Subsidized health services (from Worksheet 6) . . . .            
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     1,312,614   1,312,614 0.250 %
j Total. Other Benefits . .     22,701,793 11,945,048 10,756,745 2.020 %
k Total. Add lines 7d and 7j .     100,351,432 55,375,816 44,975,616 8.430 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and
training for community members
    56,630   56,630 0.010 %
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total     56,630   56,630 0.010 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
26,269,667
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
146,322
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
133,065,625
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
163,363,866
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-30,298,241
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 UNIVERSITY HEALTH SERVICES INC
1350 WALTON WAY
AUGUSTA,GA30901
WWW.UNIVERSITYHEALTH.ORG
121-375
X X   X     X   3 HOME HEALTH AGENCIES  
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
UNIVERSITY HEALTH SERVICES INC
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 16
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 16
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): WWW.UNIVERSITYHEALTH.ORG/ABOUT-US/COMMUNITY-BENEFIT
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
UNIVERSITY HEALTH SERVICES INC
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SCHEDULE O
b
SEE SCHEDULE O
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 6
Part VFacility Information (continued)

Billing and Collections
UNIVERSITY HEALTH SERVICES INC
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
UNIVERSITY HEALTH SERVICES INC
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
UNIVERSITY HEALTH SERVICES INC PART V, SECTION B, LINE 5: PAIGE MILLER, DEVELOPMENT DIRECTOR - HOPE HOUSEREV CHARLES E GOODMAN, PASTOR - TABERNACLE BAPTIST CHURCHLATOYA HARDMAN, DIRECTOR - FAMILY PROMISEJUANITA MCDANIEL, 2-1-1 COORDINATOR - UNITED WAY 2-1-1JONATHAN ADRIANO, DISTRICT PROGRAM MANAGER - GA DEPT OF PUBLIC HEALTH, ECHD IVKELLY BUSHEY, RN, COUNTY NURSE MANAGER - GA DEPT OF PUBLIC HEALTH, RCHDJOY MILLER, EPIDEMIOLOGIST - GA DEPT OF PUBLIC HEALTH , ECHD IVROBERT CAMPBELL, MD, MEDICAL DIRECTOR - CHRIST COMMUNITY HEALTH SERVICESTHOSE WHO WERE INVITED BUT DID NOT ATTEND WERE FROM THE FOLLOWING ORGANIZATIONS: AREA AGENCY ON AGING, AUGUSTA HOUSING & COMMUNITY DEVELOPMENT, AUGUSTA RESCUE MISSION, AUGUSTA PARTNERSHIP FOR CHILDREN, COORDINATED HEALTH SERVICES INC., GARDEN CITY RESCUE MISSION, SAVANNAH RIVER REMEDIATION, GOLDEN HARVEST FOOD BANK, AUGUSTA-RICHMOND COUNTY PUBLIC LIBRARY, MERCY MINISTRIES, WALTON OPTIONS FOR INDEPENDENT LIVING, SAFE HOMES AND SENIOR CITIZEN COUNCIL. REPRESENTATIVES FROM THESE ORGANIZATIONS WERE SENT AN EMAIL WITH THE LIST OF QUESTIONS FROM THE LISTENING SESSION AND INVITED TO PROVIDE FEEDBACK.IN ADDITION ON PAGE 53, UHS REACHED OUT TO 3257 PROVIDERS.WE INVITED PROVIDERS IN OUR COMMUNITY TO, "PLEASE TELL US ABOUT A RESOURCE YOU WISH WAS MORE ACCESSIBLE TO YOUR PATIENTS THAT WOULD HELP THEM ADDRESS THEIR HEALTH NEEDS." THE SURVEY WAS MADE ACCESSIBLE BY AN ONLINE SURVEY VENDOR. WE ACCESSED THE NAME, ADDRESS, AND TYPE OF PROVIDERS IN OUR COMMUNITY THROUGH THE CENTERS FOR MEDICARE AND MEDICAID SERVICES' NATIONAL PLAN AND PROVIDER ENUMERATION SYSTEM (NPPES). WE RESTRICTED THE SURVEY TO PHYSICIANS, MENTAL HEALTH PROVIDERS, AND PHARMACISTS. WE THEN MAILED AN INVITATION (FIGURE 38 ON PG 53) TO 3257 PROVIDERS THAT INCLUDED THE WEB ADDRESS OF THE SURVEY AND THE PROMISE OF A GIFT TO A RANDOMLY SELECTED RESPONDENT.
UNIVERSITY HEALTH SERVICES INC PART V, SECTION B, LINE 6A: N/A
UNIVERSITY HEALTH SERVICES INC PART V, SECTION B, LINE 6B: N/A
UNIVERSITY HEALTH SERVICES INC PART V, SECTION B, LINE 11: SEE PAGE 4 OF IMPLEMENTATION STRATEGY HEART DISEASE & STROKE - EXPAND ADVANCED HEALTH FAILURE PROGRAM WITH OPERATIONAL IMPROVEMENTS AND NEW PROVIDERS: CONTINUE FREE HEART ATTACK AND STROKE CLASSESCANCER - OPEN NODULE CLINIC AND THORACIC SURGERY PROGRAM; CONTINUE CANCER GROUPS ; PHYSICIAN LEAD EDUCATION PRESENTATION & COMMUNITY SCREENINGS ARTHRITIS, OSTEOPOROSIS AND CHRONIC BACK CONDITIONS - EDUCATION ON BACK INJURY PREVENTIONDIABETES - CONTINUE MONTHLY GROUPS AND EDUCATION SESSIONSNUTRITION AND WEIGHT STATUS - CONTINUE EATING WELL WITH KIM PROGRAM ON LOCAL TV AND EMAILACCESS TO HEALTH SERVICES - EXPAND PROMPT AND PRIMARY CARE AREAS; HEALTH U CALENDAR HEALTH LITERACY - HEALTHY U; EDUCATIONAL CLASSES, ETCAREAS THAT UHS WILL NOT FOCUS ON ARE:CHRONIC KIDNEY DISEASE - WHILE UH WILL CONTINUE TO TREAT KIDNEY DISEASE, WE COULD SUPPORT THIS AREA BETTER BY PLACING OUR EMPHASIS ON DIABETES, OBESITY, AND EDUCATION.RESPIRATORY DISEASE - UH WILL EMPHASIS EDUCATION; HOWEVER, THERE ARE OTHER PROVIDERS TO OFFER ASSISTANCE SUCH AS KOHL'S CARES AS WELL AS CHILDREN'S HOSPITAL OF GEORGIAMENTAL HEALTH - OTHER PROVIDERS HAVE MORE EXPERTISE IN THIS AREA; SUCH AS, AU'S PSYCHIATRY, SERENITY BEHAVIORAL HEALTH, LIGHTHOUSE CARE CENTER, AIKEN-BARNWELL MENTAL HEALTH CENTER, ETC.
UNIVERSITY HEALTH SERVICES INC PART V, SECTION B, LINE 13B: ALSO USES ASSET TEST, REGARDLESS OF INCOME, TO DETERMINE ELIGIBILITY FOR FREE AND DISCOUNTED CARE. IN ADDITION THE HOSPITAL TAKES INTO CONSIDERATION BANKRUPCY AND FINANCIAL STANDING WHEN OFFERING DISCOUNTS ON PATIENT LIABILITY.USE ELECTRONIC ELIGIBILITY SYSTEM TO DETERMINE INDIGENT CARE.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?  
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
PART I, LINE 3C: IN ADDITION TO THE FPG, HOSPITAL MAY ALSO USE ASSET TEST, REGARDLESS OF INCOME, TO DETERMINE ELIGIBILITY FOR FREE AND DISCOUNTED CARE FOR THOSE INDIVIDUALS THAT DO NOT QUALIFY UNDER THE ELECTRONIC ELIGIBILITY SYSTEM OR THOSE WHO HAVE INSURANCE BUT HOSPITAL BILL IS CATASTROPHIC. IN ADDITION THE HOSPITAL TAKES INTO CONSIDERATION BANKRUPCY AND FINANCIAL STANDING WHEN OFFERING DISCOUNTS ON PATIENT LIABILITY.
PART I, LINE 7: EXPLANATION OF COSTING METHODOLOGYUSED COST TO CHARGE RATIO CALCULATED USING WORKSHEET 2 --THE OPTIONAL WORKSHEETS PROVIDED TO ASSIST IN PREPARATION OF SCHEDULE H.
PART II, COMMUNITY BUILDING ACTIVITIES: THE COMMUNITY BUILDING ACTIVITIES REPORTED ARE SUPPORT FOR THE VARIOUS CHAMBERS OF COMMERCE FOR THE COMMUNITIES THAT UH SERVES. IN SUPPORTING THESE ORGANIZATIONS, UH CAN SUPPORT THE DEVELOPMENT OF OUR COMMUNITY BY BRINGING IN NEW INDUSTRIES, AND JOBS, INCREASING THE AVERAGE HOUSEHOLD INCOME, IMPROVING LIVING CONDITIONS, AND IMPACTING OVERALL GENERAL HEALTH.
PART III, LINE 2: FOR RECEIVABLES ASSOCIATED WITH SELFPAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), UHS RECORDS PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. RECOVERIES OF ACCOUNTS PREVIOUSLY WRITTEN OFF ARE RECORDED AS A REDUCTION TO THE PROVISION FOR BAD DEBT EXPENSE WHEN RECEIVED.
PART III, LINE 3: UNIVERSITY PROVIDES ALL UNINSURED PATIENTS A DISCOUNT TO MATCH THE UNWEIGHTED AVERAGE OF DISCOUNT GIVEN TO COMMERCIAL AND MEDICARE PATIENTS . IN ADDITION UH USES ELECTRONIC ELIGIBILITY SYSTEM TO DETERMINE IF PATIENTS COULD QUALITY FOR INDIGENT STATUS AND THEN COMPARES DENIED PATIENTS WITH APPLICATIONS THE STATE DFCS SYSTEM. PLUS THE COLLECTIONS PERSONNEL WHEN CONTACTING PATIENTS WILL SEND PATIENT APPLICATIONS TO COMPLETE FOR A PERSONNAL REVIEW. HOWEVER, EVEN WITH THE ABOVE SOME PATIENTS MAY SLIP THROUGH---- THE ESTIMATED ASSUMES THE SAME % OF BAD DEBT EXPENSE TO TOTAL CHARGES IS THE SAME % OF PATIENTS THAT MAY SLIP THROUGH OUR PROCESSES AND NOT GET CLAIMED AS INDIGENT.BAD DEBT SHOULD BE INCLUDED AS A COMMUNITY BENEFIT SINCE THE SERVICES THAT INCUR BAD DEBT ARE PROVIDED BY THE HOSPITAL TO PROMOTE THE WELL-BEING OF THE COMMUNITY. THESE SERVICES ARE RENDERED IN CONJUNCTION WITH THE HOSPITAL'S CHARITABLE TAX-EXEMPT PURPOSES. THERE IS NO LOCAL SUPPORT FOR UNINSURED PATIENTS; THEREFORE, THE SERVICES PROVIDED BY THE HOSPITAL RELIEVE THE HEALTH CARE BURDENS OF THE LOCAL GOVERNMENTS.
PART III, LINE 4: PAGE 8- 9 OF THE AUDITED FINANCIAL STATEMENTSPATIENT ACCOUNTS RECEIVABLEPATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OFACCOUNTS RECEIVABLE, THE CORPORATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYORSOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS.MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OFTHE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRDPARTY COVERAGE, THE CORPORATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFULACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY.FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTSWITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THECORPORATION RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICHINDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLYRESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES) AND THE AMOUNTS ACTUALLYCOLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FORDOUBTFUL ACCOUNTS. RECOVERIES OF ACCOUNTS PREVIOUSLY WRITTEN OFF ARE RECORDED AS A REDUCTION TO THE PROVISION FORBAD DEBT EXPENSE WHEN RECEIVED.
PART III, LINE 8: EXPLANATION OF SHORTFALL AS COMMUNITY BENEFITTHE SERVICES PROVIDED TO THE MEDICARE BENEFICIARIES ARE TO PROMOTE THE WELL-BEING OF THE COMMUNITY WHICH IS PART OF THE HOSPITAL'S CHARITABLE TAX-EXEMPT PURPOSE. THE MEDICARE DIFFERENCE BETWEEN COST AND MEDICARE REIMBURSEMENT SHOULD BE ALLOWED AS COMMUNITY BENEFIT SINCE PROVIDERS CANNOT NEGOTIATE RATES WITH CENTERS FOR MEDICARE/MEDICAID SERVICES (CMS). CMS REGULATES THAT THE REIMBURSEMENT BE FEDERAL BUDGET NEUTRAL THUS PLACING THE COST OF THE CARING FOR MEDICARE BENEFICIARIES AS A COST TO THE HOSPITALS.
PART III, LINE 9B: PROVISIONS ON COLLECTION PRACTICES FOR QUALIFIED PATIENTSAS OUTSTANDING BALANCES AGE, STATEMENT MESSAGES, COLLECTION LETTERS AND/OR TELEPHONE CALLS MAY BE USED AT APPROPRIATE INTERVALS DETERMINED BY THE PATIENT ACCOUNTING/COLLECTION DEPARTMENT. THE PATIENT ACCOUNTING/COLLECTION DEPARTMENT RECOGNIZES THAT THERE ARE OCCASIONS WHEN A PATIENT IS NOT FINANCIALLY ABLE TO PAY HIS OR HER MEDICAL BILL IN FULL AND/OR THE PATIENT IS EXPERIENCING FINANCIAL HARDSHIP. THE HOSPITAL HAS ESTABLISHED A CATASTROPHIC POLICY WHICH ALLOWS FOR THE COLLECTION DEPARTMENT TO APPLY THE INDIGENT CRITERIA AND WRITE-OFF AS MEDICALLY INDIGENT. AND AT ANY POINT DURING THE COLLECTION PROCESS IF A PATIENT STATES OR PATIENT ACCOUNTING/COLLECTIONS BELIEVES THAT THE PATIENT CANNOT AFFORD TO PAY, THEN AN INDIGENT/CHARITY CARE APPLICATION IS BEGUN BY THE COLLECTION DEPARTMENT WHERE DISCOUNTS MAY BE GIVEN.
PART VI, LINE 2: NEEDS ASSESSMENTIN ADDITION TO THE CHNA PERFORMED IN 2016, UH WORKS WITH ER PERSONNEL TO IDENTIFY NEEDS BASED ON PATIENTS SEEKING HELP THROUGH THE EMERGENCY ROOM. THIS PROCESS STILL SHOWS THAT PATIENTS NEED A MEDICAL HOME, ASTHMA, CHF & DIABETES ASSISTANCE. THE PROGRAMS THAT UH HAS INITIATED AND CONTINUE TO SUPPORT. UH ALSO USED THE HEALTHY PEOPLE 2020 FRAMEWORK TO GUIDE DATA GATHERING FOR LEADING HEALTH INDICATORS.
PART VI, LINE 3: UH HAS THE FOLLOWING INFORMATION AVAILABLE TO PATIENTS AND VISITORS ON THE ELIGIBILITY FOR ASSISTANCE. INFORMATION IS AVAILABLE ON THE UNIVERSITY HOSPITAL WEBSITE, PATIENT/VISITOR INFORMATION BOOKLET, AND UH HAS SIGNAGE AT REGISTRATION AND BILLING AREAS THAT ASK "... HELP WITH YOUR HOSPITAL BILL?" IN ADDITION, WHEN A REGISTERING PATIENT INDICATES THAT HE/SHE CAN NOT AFFORD TO PAY, UH WILL OFFER THE INDIGENT AND CHARITY CARE APPLICATION (ICCP) AND SET UP PATIENT TO SPEAK WITH THE FINANCIAL ASSISTANCE OFFICE (FAO). FAO WILL DIRECT PATIENTS TO A DEPARTMENT OF FAMILY AND CHILDREN (DFCS) CASE MANAGER LOCATED AT THE HOSPITAL TO SEE IF PATIENT QUALIFIES FOR STATE MEDICAID OR THE UH ICCP PROGRAM. THE PATIENT MAY BE DEEMED TO QUALIFY FOR OTHER STATE/FEDERAL ASSISTANCE IN WHICH THE FAO STAFF WILL HELP DIRECT THE PATIENT TO ANOTHER GROUP OPERATED OUT OF THE HOSPITAL, RESOURCE CORPORATION OF AMERICA (RCA), TO ASSIST WITH GETTING THE PATIENT QUALIFIED FOR SSI, ETC.
PART VI, LINE 4: SEE PAGE 6-13 OF THE CHNAUNIVERSITY HEALTH CARE SYSTEM SERVES A DIVERSE COMMUNITY. AIKEN COUNTY HAS MORE RESIDENTS 65 AND OLDER; COLUMBIA COUNTY HAS MORE RESIDENTS BETWEEN 5 AND 17; RICHMOND COUNTY HAS MORE RESIDENTS UNDER 5 YEARS OLD. RICHMOND COUNTY IS VERY DIFFERENT RACIALLY AND ETHNICALLY FROM AIKEN COUNTY AND COLUMBIA COUNTY. WHILE AIKEN AND COLUMBIA COUNTIES HAVE SOME SIMILARITIES IN RACE AND ETHNIC ORIGINS, AIKEN COUNTY HAS FEWER COLLEGE GRADUATES AND HAS MORE POVERTY. RICHMOND COUNTY HAS EVEN FEWER GRADUATES AND AN EVEN HIGHER LEVEL OF POVERTY.RICHMOND COUNTY HAS MORE CHILDREN UNDER 5 YEARS OLD THAN ITS NEIGHBORS AND MORE THAN THE AVERAGE IN GEORGIA, SOUTH CAROLINA, AND THE UNITED STATES. AIKEN COUNTY HAS MORE PERSONS 65 YEARS AND OLDER THAN ALL OTHER GROUPS IN OUR COMPARISON. COLUMBIA COUNTY HAS MORE PERSONS BETWEEN 5 AND 17 YEARS OLD. THIS IS AN ESTIMATE OF THE POPULATION IN 2014.RICHMOND COUNTY HAS FEWER FOREIGN-BORN RESIDENTS AND SPEAKERS OF A LANGUAGE OTHER THAN ENGLISH AT HOME THAN THE REST OF THE NATION, GEORGIA, OR SOUTH CAROLINA IN GENERAL. IT HAS FEWER COLLEGE GRADUATES AND A HIGH DEGREE OF POVERTY. AIKEN COUNTY IS SIMILAR TO RICHMOND COUNTY IN THE PERCENTAGE OF FOREIGN-BORN RESIDENTS AND SPEAKERS OF A LANGUAGE OTHER THAN ENGLISH AT HOME. HOWEVER, IT HAS A HIGHER PERCENTAGE OF COLLEGE GRADUATES AND A LOWER LEVEL OF POVERTY. COLUMBIA COUNTY IS MORE DIVERSE, HAVING A HIGHER PERCENTAGE OF FOREIGN-BORN RESIDENTS AND SPEAKERS OF A LANGUAGE OTHER THAN ENGLISH AT HOME. IT ALSO HAS A HIGHER PERCENTAGE OF COLLEGE GRADUATES AND A LOWER LEVEL OF POVERTY.UNIVERSITY HEALTH CARE SYSTEM SERVES A DIVERSE COMMUNITY. AIKEN COUNTY HAS MORE RESIDENTS 65 AND OLDER; COLUMBIA COUNTY HAS MORE RESIDENTS BETWEEN 5 AND 17; RICHMOND COUNTY HAS MORE RESIDENTS UNDER 5 YEARS OLD. RICHMOND COUNTY IS VERY DIFFERENT RACIALLY AND ETHNICALLY FROM AIKEN COUNTY AND COLUMBIA COUNTY. WHILE AIKEN AND COLUMBIA COUNTIES HAVE SOME SIMILARITIES IN RACE AND ETHNIC ORIGINS, AIKEN COUNTY HAS FEWER COLLEGE GRADUATES AND HAS MORE POVERTY. RICHMOND COUNTY HAS EVEN FEWER GRADUATES AND AN EVEN HIGHER LEVEL OF POVERTY.
PART VI, LINE 5: UH GOVERNING BOARD MEMBERS ARE COMPRISED OF CITZENS WHO RESIDE IN THE UH'S PRIMARY SERVICE AREA AND ARE NEITHER EMPLOYEES NOR CONTRACTORS OF UH. UH BOARD MEMBERS ARE ACTIVE IN THE COMMUNITY AND ARE EAGER TO IMPROVE THE HEALTH AND WELFARE OF THE COMMUNITY. SEVERAL OF UH BOARD MEMBERS WORKED WITH THE LOCAL STATE MEDICAL SCHOOL TO GET INTERNS & RESIDENTS AT THE HOSPITAL SINCE UH IS AMONG SEVERAL COUNTIES THAT HAVE BEEN DEEMED AS A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA). UH EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN OUR COMMUNITY FOR ALL OF THE UH DEPARTMENTS. UH WORKS WITH THE GREATER AUGUSTA HEALTHCARE NETWORK (GAHN) WHICH IS MADE UP OF AREA HOSPITALS AND THE LOCAL MEDICAL COLLEGES SCHOOL OF NURSING AND AREA PRIMARY CARE CLINICS. THIS GROUP ADDRESSES THE PRIMARY AND SPECIALTY CARE NEEDS IN THE COMMUNITY. UH SUPPORTS THE PROJECT ACCESS PROGRAM (PJA) IN RICHMOND AND COLUMBIA COUNTY. PJA IS A PROGRAM WHEREBY THE LOCAL MEDICAL SOCIETY PHYSICIANS AGREE TO TREAT A NUMBER OF INDIGENT COUNTY RESIDENTS WITHOUT PAYMENT. UH PROVIDES ALL OF THE INPATIENT HOSPITALIZATION FOR THE INDIGENT POPULATION THAT IS APPROVED FOR PROJECT ACCESS. THROUGH BOTH OF THESE GROUPS UH IS RESPONSIVE TO SUPPORT THEM IN THEIR NEEDS.UH PROVIDES MANY SCREENINGS IN THE COMMUNITY. ONE SUCH SCREENING IS THE PSA SCREENING THAT IS PERFORMED AT LOWES HOME BUILDING STORES. MANY HAVE RECEIVED THE SCREENING AND RECEIVED POSITIVE RESULTS WHICH WERE CAUGHT AT AN EARLY STAGE. UH'S MOBILE MAMMOGRAPHY UNIT TRAVELS TO AREA PLANTS AND IS AVAILABLE FOR SCREENINGS AT THE JOB SITE DURING LUNCH. THESE ARE ONLY A FEW SCREENING OF THE SCREENINGS THAT UH PROVIDES IN THE COMMUNITY BUT HAVE TREMENDOUS IMPACT WHEN JUST ONE SCREENING IDENTIFIES PROBLEMS THAT CAN BE TREATED AT AN EARLY STAGE 1 CANCER VERSES AT THE LATER STAGES OF CANCER.
PART VI, LINE 7, REPORTS FILED WITH STATES GA
Schedule H (Form 990) 2018
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Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
Name of the organization
UNIVERSITY HEALTH SERVICES INC
 
Employer identification number
58-1581103
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC section
(if applicable)
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
noncash assistance
(h) Purpose of grant
or assistance
(1) NEIGHBORHOOD IMPROVEMENT PROJECT
2467 GOLDEN CAMP ROAD
AUGUSTA,GA30906
31-1491242 501(C)(3) 178,404       CLINIC FINANCIAL SUPPORT
(2) MIRACLE MAKING MINISTRIES
1127 DRUID PARK AVE
AUGUSTA,GA30904
58-2358627 501(C)(3) 39,644       CLINIC FINANCIAL SUPPORT
(3) AMERICAN CANCER SOCIETY
250 WILLIAMS STREET NW
ATLANTA,GA30303
13-1788491 501(C)(3) 5,500       FINANCIAL SUPPORT
(4) HARRISBURG FAMILY HEALTH
309 CRAWFORD AVENUE
AUGUSTA,GA30904
26-4366421 501(C)(3) 10,000       FINANCIAL SUPPORT
(5) COORDINATED HEALTH SERVICES
2110 BROAD STREET
AUGUSTA,GA30904
58-2060572 501(C)(3) 138,754 16,941 COST OF LAB TESTS LAB TESTS CLINIC FINANCIAL SUPPORT
(6) BEULAH GROVE COMMUNITY RESOURCE
1446 LEE BEARD WAY
AUGUSTA,GA30904
58-2159621 501(C)(3) 39,644 18,863 COST EPIC CLINICAL SYSTEM & LAB TESTS CLINIC FINANCIAL SUPPORT
(7) CHRIST COMMUNITY HEALTH SERVICES
519 SCOTTS WAY
AUGUSTA,GA30909
20-5404353 501(C)(3) 506,808 246,247 MEDICARE COST REPORT DONATED FACILITIES CLINIC FINANCIAL SUPPORT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
 
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2018

Schedule I (Form 990) 2018
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients
(c) Amount of
cash grant
(d) Amount of
noncash assistance
(e) Method of valuation (book,
FMV, appraisal, other)
(f) Description of noncash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
PART I, LINE 2: UNIVERSITY HEALTH CARE SYSTEM DOES NOT PROVIDE "GRANTS" TO ASSIST OTHER ORGANIZATIONS, BUT DOES DONATE FUNDS BASED ON THE FOLLOWING POLICY AND PROCEDURES: POLICY: UNIVERSITY HEALTH CARE SYSTEM IS COMMITTED TO THE OVERALL HEALTH AND WELL-BEING OF THE COMMUNITIES IT SERVES AND RECOGNIZES THE NEED TO SUPPORT OTHER NON-PROFIT ORGANIZATIONS WHO SHARE THIS COMMITMENT. CORPORATE CONTRIBUTIONS AND SPONSORSHIPS ARE SOMETIMES AN APPROPRIATE VEHICLE FOR BUILDING PARTNERSHIPS WITH THESE NON-PROFIT ORGANIZATIONS AND MAXIMIZING OUR OVERALL POSITIVE IMPACT ON THE COMMUNITY. PROCEDURE 1.ALL CONTRIBUTION/SPONSORSHIP REQUESTS SHOULD BE SUBMITTED IN WRITING TO THE CORPORATE COMMUNICATIONS DEPARTMENT FOR CONSIDERATION. EVERY EFFORT SHOULD BE MADE TO PROCESS THESE REQUESTS AND NOTIFY THE REQUESTER WITHIN TWO WEEKS OF RECEIVING THE WRITTEN INFORMATION REQUIRED TO EVALUATE THE OPPORTUNITY. 2.IN CONSULTATION WITH THE CEO, THE DIRECTOR OF CORPORATE COMMUNICATIONS WILL PREPARE THE ANNUAL BUDGET FOR CORPORATE CONTRIBUTIONS/SPONSORSHIPS AND PROCESS/MANAGE ACTUAL DISBURSEMENTS DURING THE YEAR. 3.REQUESTS WILL BE EVALUATED BASED ON THE FOLLOWING CRITERIA: A.DOES THE ORGANIZATION, EVENT OR PUBLICATION PROMOTE THE OVERALL HEALTH AND WELL-BEING OF THE COMMUNITIES WE SERVE? SPECIAL CONSIDERATION WILL BE GIVEN TO REQUESTS THAT DIRECTLY IMPACT HEALTH AND WELLNESS EVEN THOUGH SUPPORT MAY BE AVAILABLE FOR ORGANIZATIONS, EVENTS AND/OR PUBLICATIONS THAT HAVE A POSITIVE IMPACT ON THE CSRA BY: "ASSISTING IN ATTRACTING AND RETAINING A VIABLE WORK-FORCE" "ASSISTING IN ATTRACTING AND RETAINING VIABLE BUSINESSES AND EMPLOYERS IN THE CSRA" "PROMOTING THE CONTINUED GROWTH AND ECONOMIC WELL-BEING OF THE COMMUNITY" "ENHANCING THE QUALITY OF LIFE IN THE CSRA" B.DOES THE PROPOSED CONTRIBUTION/SPONSORSHIP PRIMARILY ASSIST PEOPLE LIVING LOCALLY RATHER THAN A NATIONAL EFFORT/INITIATIVE? C.DOES THE REQUESTING ORGANIZATION HAVE AN APPROVED TAX-EXEMPT STATUS? D.WILL THE PROPOSED CONTRIBUTION/SPONSORSHIP ENHANCE THE OVERALL IMAGE/REPUTATION OF UNIVERSITY HEALTH CARE SYSTEM? E.WILL THE PROPOSED CONTRIBUTION/SPONSORSHIP HEIGHTEN AWARENESS OF A SIGNIFICANT HEALTH ISSUE OR DISEASE THAT HAS A NEGATIVE IMPACT ON THE CITIZENS IN THE COMMUNITIES WE SERVE? 4.UNDER NO CIRCUMSTANCES WILL CONTRIBUTIONS BE MADE TO POLITICAL CAMPAIGNS. 5.BECAUSE OF THE LARGE NUMBER OF PUBLIC AND PRIVATE SCHOOLS IN THE CSRA, UNIVERSITY WILL LIMIT FINANCIAL SUPPORT/CONTRIBUTIONS TO THE VARIOUS BOARDS OF EDUCATION RATHER THAN INDIVIDUAL SCHOOLS (ELEMENTARY, MIDDLE, AND HIGH SCHOOLS). 6.BECAUSE OF THE LARGE NUMBER OF CHURCHES IN THE CSRA, UNIVERSITY WILL LIMIT FINANCIAL SUPPORT/CONTRIBUTIONS TO PROGRAMS THAT INCLUDE HEALTH-RELATED SERVICES FOR UNDERSERVED RESIDENTS SUCH AS COMMUNITY CLINICS. 7.EXCEPTION: FINANCIAL SUPPORT AND PARTNERSHIPS WITH AREA COLLEGES AND TECHNICAL SCHOOLS DO NOT FALL UNDER THIS POLICY.
Schedule I (Form 990) 2018



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Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
UNIVERSITY HEALTH SERVICES INC
 
Employer identification number

58-1581103
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ..................
6a
Yes
 
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2018

Schedule J (Form 990) 2018
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation in column (B) reported as deferred on prior Form 990
(i) Base
compensation
(ii) Bonus & incentive
compensation
(iii) Other reportable compensation
1DANIEL H BOONE MD
BOARD MEMBER
(i)

(ii)
0
-------------
181,641
0
-------------
16,500
0
-------------
22,588
0
-------------
5,807
0
-------------
9,945
0
-------------
236,481
0
-------------
0
2JAMES C SHERMAN MD
BOARD MEMBER
(i)

(ii)
120,006
-------------
0
0
-------------
0
366
-------------
0
54,693
-------------
0
0
-------------
0
175,065
-------------
0
0
-------------
0
3DAVID A BELKOSKI
UHS CFO
(i)

(ii)
460,144
-------------
0
115,117
-------------
0
90,495
-------------
0
1,248
-------------
0
14,531
-------------
0
681,535
-------------
0
0
-------------
0
4JAMES R DAVIS
UHS PRESIDENT & CEO
(i)

(ii)
752,167
-------------
0
200,156
-------------
0
27,026
-------------
0
298,718
-------------
0
8,644
-------------
0
1,286,711
-------------
0
0
-------------
0
5MARILYN A BOWCUTT
PRESIDENT OF UNIVERSITY HO
(i)

(ii)
207,819
-------------
0
130,259
-------------
0
113,629
-------------
0
6,053
-------------
0
6,102
-------------
0
463,862
-------------
0
0
-------------
0
6WILLIAM L FARR JR
CMO
(i)

(ii)
399,812
-------------
0
100,742
-------------
0
44,502
-------------
0
9,336
-------------
0
16,335
-------------
0
570,727
-------------
0
0
-------------
0
7EDWARD L BURR
SR. VP LEGAL & REGULATORY
(i)

(ii)
397,173
-------------
0
104,344
-------------
0
44,300
-------------
0
9,343
-------------
0
9,840
-------------
0
565,000
-------------
0
0
-------------
0
8LAURIE OTT SMITH
UHCF-VP HR & COMM SVC
(i)

(ii)
249,598
-------------
0
73,018
-------------
0
51,732
-------------
0
8,208
-------------
0
9,098
-------------
0
391,654
-------------
0
0
-------------
0
9THOMAS E LOWENCAMP
VP - CONTINUING CARE
(i)

(ii)
307,542
-------------
0
64,086
-------------
0
34,673
-------------
0
7,971
-------------
0
18,723
-------------
0
432,995
-------------
0
0
-------------
0
10SHIRLEY K GABRIEL
VP CHIEF INFORMATION OFFIC
(i)

(ii)
294,330
-------------
0
67,710
-------------
0
46,396
-------------
0
4,655
-------------
0
9,224
-------------
0
422,315
-------------
0
0
-------------
0
11TERESA BUSCHBACHER
VP -HVI
(i)

(ii)
218,959
-------------
0
60,392
-------------
0
31,261
-------------
0
4,999
-------------
0
19,845
-------------
0
335,456
-------------
0
0
-------------
0
12SCOTT ANSEDE
VP PROFESSIONAL SERVICES
(i)

(ii)
305,660
-------------
0
74,925
-------------
0
42,514
-------------
0
8,098
-------------
0
14,251
-------------
0
445,448
-------------
0
0
-------------
0
13ELIZABETH R GALLUP
VP CLINICAL OPERATIONS
(i)

(ii)
259,753
-------------
0
71,367
-------------
0
35,306
-------------
0
6,988
-------------
0
16,732
-------------
0
390,146
-------------
0
0
-------------
0
14CLIFFORD B HARGROVE
VP POST ACUTE CARE SERVICES
(i)

(ii)
183,141
-------------
0
18,561
-------------
0
17,484
-------------
0
6,192
-------------
0
10,609
-------------
0
235,987
-------------
0
0
-------------
0
15CHRISTOPHER I WESTBROOK
VP HUMAN RESOURCES
(i)

(ii)
244,673
-------------
0
35,550
-------------
0
45,209
-------------
0
7,778
-------------
0
11,502
-------------
0
344,712
-------------
0
0
-------------
0
16LISA RITCH
VP FINIANCE
(i)

(ii)
189,328
-------------
0
24,939
-------------
0
30,077
-------------
0
5,452
-------------
0
12,393
-------------
0
262,189
-------------
0
0
-------------
0
17ROBERT J KEPSHIRE
ADMINISTRATIVE CNO - MCDUF
(i)

(ii)
172,320
-------------
0
17,499
-------------
0
2,190
-------------
0
5,149
-------------
0
302
-------------
0
197,460
-------------
0
0
-------------
0
18JACKIE KENDINGER
EMPLOYEE
(i)

(ii)
173,715
-------------
0
28,896
-------------
0
635
-------------
0
4,917
-------------
0
0
-------------
0
208,163
-------------
0
0
-------------
0
19DOUGLAS D PUGH II
RN
(i)

(ii)
185,402
-------------
0
598
-------------
0
9,833
-------------
0
3,023
-------------
0
15,793
-------------
0
214,649
-------------
0
0
-------------
0
20VELVETTE L JONES
DIRECTOR UCA
(i)

(ii)
162,414
-------------
0
20,425
-------------
0
4,732
-------------
0
4,168
-------------
0
8,824
-------------
0
200,563
-------------
0
0
-------------
0
21BENJAMIN GUEST
NETWORK DEVELOPMENT
(i)

(ii)
130,313
-------------
0
53,837
-------------
0
2,749
-------------
0
3,738
-------------
0
13,770
-------------
0
204,407
-------------
0
0
-------------
0
Schedule J (Form 990) 2018

Schedule J (Form 990) 2018
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
PART I, LINE 1A SOCIAL CLUB DUES- THE RELATED ORGANIZATION PAYS MEMBERSHIP FEES FOR THE CEO (JAMES DAVIS) TO SAGE VALLEY AND THE AUGUSTA 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, IS INCLUDED IN THE WAGES OF THE CEO.
PART I, LINE 4B JAMES R DAVIS - SERP - $290,468 DAVID A BELKOSKI - ROTH IUL - $58,839 MARILYN A BOWCUTT - CAA BENEFITS - $17,998 WILLIAM L FARR - CAA BENEFITS - $38,076 EDWARD L BURR - CAA REDEMPTION - $37,644 LAURIE OTT SMITH - ROTH IUL - $27,360, SEC. 162 - $2,541 THOMAS E LOWENCAMP - SEC. 162 - $5,946, ROTH IUL - $26,801 SHIRLEY K GABRIEL - ROTH IUL - $29,201, SEC. 162 - $7,036 THERESA BUSCHBACHER - ROTH IUL - $22,801, SEC. 162 - $7,043 SCOTT ANSEDE - ROTH IUL - $31,901, SEC. 162 - $6,626 ELIZABETH R GALLUP - ROTH IUL - $26,250, SEC. 162 - $3,187 CLIFFORD B HARGROVE - ROTH IUL - $14,625, SEC. 162 - $2,279 CHRISTOPHER I WESTBROOK - ROTH IUL - $26,000, SEC. 162 - $7,731 LISA RITCH - ROTH IUL - $15,001, SEC. 162 - $4,584 PLEASE NOTE THAT ALL OF THE BENEFITS LISTED ABOVE ARE INCLUDED IN THE TOTALS REPORTED ON FORM 990, SCHEDULE VII AS REPORTABLE COMPENSATION OR OTHER COMPENSATION AND HAVE BEEN INCLUDED IN THE INDIVIDUALS W-2, WITH THE EXCEPTION OF THE SERP FOR JAMES R DAVIS.
PART I, LINE 6 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 2018 THESE INITIATIVES WERE WEIGHTED AS DISPLAYED IN THE FOLLOWING SCHEDULE: UNIVERSITY HEALTH SERVICES, INC 2018 STRATEGIC INITIATIVES WEIGHT QUALITY 15% ACHIEVE NRC OVERALL RATING OF CARE SCORE 15% ACHIEVE MEDICARE ALL CAUSE 30-DAY READMISSION RATE TO UNIVERSITY GROWTH 10% INCREASE ADMISSIONS FROM AIKEN AND COLUMBIA COUNTIES OVER 2017 LEVELS SAFETY 15% MINIMIZE THE NUMBER OF HOSPITAL ACQUIRED CONDITIONS PER 1000 MEDICARE DISCHARGES AS MEASURED BY MIDAS SYSTEM PEOPLE 15% ACHIEVE RN TURNOVER RATE FOR UHS AFFORDABILITY 25% ACHIEVE OPERATING MARGIN FOR UNIVERSITY HEALTH, INC SERVICE 5% INCREASE THE NUMBER OF ACTIVE MYCHART ACCOUNTS 100% EACH GOAL THAT WAS ACHIEVED REPRESENTED THAT PERCENTAGE OF BONUS PAYOUT OUT OF A POSSIBLE 100% BASED ON A THRESHOLD LEVEL, TARGET LEVEL, OR AN EXCEED LEVEL.
Schedule J (Form 990) 2018
Additional Data


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Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part , line 24a. Provide descriptions,
explanations, and any additional information in Part .
SchKMediumBullet Attach to Form 990.

SchKMediumBulletGo to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
Name of the organization
UNIVERSITY HEALTH SERVICES INC
 
Employer identification number
58-1581103
Part
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A THE RICHMOND COUNTY HOSPITAL AUTHORITY
 
58-6001901 764603BV7 10-25-2016 154,488,348 REFUND BOND CERTIFICATES (SERIES 2009)   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired ..................        
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 154,488,348      
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds .............        
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 1,658,616      
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds .............        
11 Other spent proceeds ............. 152,829,732      
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2016
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? ....   X            
15 Were the bonds issued as part of an advance refunding issue? ..... X              
16 Has the final allocation of proceeds been made? .......... X              
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X              
Part
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X            
2 Are there any lease arrangements that may result in private business use of bond-financed property? ............... X              
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2018

Schedule K (Form 990) 2018
Page 2
Part
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X              
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X              
c Are there any research agreements that may result in private business use of bond-financed property? ............. X              
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X              
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 2.700 %      
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet 0.200 %      
6 Total of lines 4 and 5 ............. 2.900 %      
7 Does the bond issue meet the private security or payment test? ...   X            
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X            
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
  X            
Part
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X            
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? ....... X              
b Exception to rebate? ........   X            
c No rebate due? .........   X            
If "Yes" to line 2c, provide in Part the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? .....   X            
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X            
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
Schedule K (Form 990) 2018

Schedule K (Form 990) 2018
Page 3
Part
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X            
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X            
7 Has the organization established written procedures to monitor the requirements of section 148? ...   X            
Part
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?   X            
Part
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
Schedule K (Form 990) 2018

Additional Data


Software ID:  
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SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
Name of the organization
UNIVERSITY HEALTH SERVICES INC
 
Employer identification number

58-1581103
Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 1 IN JANUARY 1985, THE FULL BOARD APPROVED THE FORMATION OF AN EXECUTIVE BOARD BY PASSING THE FOLLOWING RESOLUTION: BE IT RESOLVED THAT AN EXECUTIVE COMMITTEE OF UNIVERSITY HEALTH SERVICES, INC. BE CREATED TO MEET ON A ROUTINE BASIS, SUCH COMMITTEE BEING COMPOSED OF SEVEN MEMBERS. THE SIZE OF THE COMMITTEE MAY BE CHANGED FROM TIME TO TIME BY THE CHAIRMAN OF THE BOARD BUT MUST ALWAYS CONFORM TO THE BYLAWS. THE TASKS OF THE COMMITTEE SHALL CONSIST OF PLANNING, CAPITAL EXPENDITURE REVIEW, AND FINANCIAL REVIEW OF THE ACTIVITIES OF UNIVERSITY HEALTH SERVICES, INC. THE EXECUTIVE COMMITTEE MAY ACT ON BEHALF OF UNIVERSITY HEALTH SERVICES, INC AND ON BUDGETED CAPITAL REQUESTS; HOWEVER, ALL CAPITAL REQUESTS IN EXCESS OF $500,000 MUST BE ACTED ON BY THE FULL BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION B, LINE 11B A COPY OF FORM 990 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 WEBSITE ON WHICH THE ENTIRE 990 COULD BE VIEWED. THE EMAIL EXPLAINED THAT THE FORM 990 WAS AVAILABLE FOR REVIEW ON THE WEBSITE.
FORM 990, PART VI, SECTION B, LINE 12C THE STEPS IN THE CONFLICT OF INTEREST POLICY ARE OUTLINED BELOW: 1. SENIOR MANAGEMENT (VICE PRESIDENTS AND ABOVE) SHALL COMPLETE A POTENTIAL CONFLICT OF INTEREST QUESTIONNAIRE PERIODICALLY. EACH SYSTEM ORGANIZATION'S CEO, COO, CFO AND WITHIN THEIR DIVISION'S VICE PRESIDENTS MAY REQUIRE ANY EMPLOYEE TO COMPLETE A POTENTIAL CONFLICT OF INTEREST QUESTIONNAIRE. 2.EACH EMPLOYEE IS EXPECTED TO REPORT A POTENTIAL CONFLICT OF INTEREST WHEN IT ARISES. 3. A. AN EMPLOYEE WILL REPORT A POTENTIAL CONFLICT OF INTEREST BY INITIATING A POTENTIAL CONFLICT OF INTEREST DISCLOSURE FORM AND DELIVERING IT TO HIS/HER VICE PRESIDENT. ALL EMPLOYEE POTENTIAL CONFLICTS WILL BE SCREENED BY TWO LEVELS OF SENIOR MANAGEMENT TO IDENTIFY CONFLICT OR DUALITY OF INTEREST SITUATIONS. (A DUALITY OF INTEREST EXISTS WHEN AN INDIVIDUAL HAS PERSONAL OR OUTSIDE INTERESTS THAT CAN BE AFFECTED BY DECISIONS OF THE SYSTEM. SUCH A DUALITY OR EVEN MULTIPLICITY OF INTEREST CAN BE BENEFICIAL TO AND CONSISTENT WITH THE PRIMARY GOALS OF THE INSTITUTIONS. DUALITY OF INTEREST CAN RAISE THE POTENTIAL FOR CONFLICT OF INTEREST WHEN THE PERSONAL INTERESTS OF INDIVIDUALS COME INTO CONFLICT WITH THE INTERESTS OF THE SYSTEM.) B. WHEN A DIVISION VICE PRESIDENT IS NOTIFIED OF A POTENTIAL CONFLICT/DUALITY OF INTEREST, THE VICE PRESIDENT SHALL INVESTIGATE THE SITUATION AND MAKE A REPORT OF HIS OR HER FINDINGS ALONG WITH A RECOMMENDATION TO THE EXECUTIVE VICE PRESIDENT (COO) OR CEO OF THE INVOLVED SYSTEM ORGANIZATION. C. THE EXECUTIVE VICE PRESIDENT OR CEO WHO RECEIVED THE 3.B REPORT SHALL MAKE A DECISION CONCERNING A POTENTIAL CONFLICT OF INTEREST AND ANY RESOLUTION MEASURES TO BE TAKEN. IN THE EVENT THE POTENTIAL CONFLICT INVOLVES A VICE PRESIDENT, THE PRESIDENT OF UNIVERSITY HEALTH SHALL INVESTIGATE THE SITUATION AND MAKE A DECISION CONCERNING A POTENTIAL CONFLICT OF INTEREST AND ANY RESOLUTION MEASURES TO BE TAKEN. THIS INFORMATION SHALL BE COMMUNICATED DIRECTLY TO THE CONCERNED EMPLOYEE. D. THE EMPLOYEE MAY APPEAL THE CONFLICT OF INTEREST DETERMINATION TO THE PRESIDENT OF UNIVERSITY HEALTH. THE PRESIDENT'S DECISION ABOUT A POTENTIAL CONFLICT OF INTEREST AND ANY RESOLUTION MEASURES IS FINAL AND NOT COGNIZABLE UNDER THE EMPLOYEE GRIEVANCE POLICY A-30. E. IN THE EVENT THE POTENTIAL CONFLICT INVOLVES THE CEO OF A SYSTEM ORGANIZATION, THE MATTER SHALL BE REPORTED TO THE CHAIRMAN OF THE INVOLVED SYSTEM ORGANIZATION BOARD, WHO SHALL DETERMINE IF A CONFLICT EXISTS AND WHAT, IF ANY, RESOLUTION MEASURES ARE NECESSARY IN ACCORDANCE WITH THE CORPORATION'S CONFLICT OF INTEREST POLICY. 4. FILING OF FORMS A. CONFLICT OF INTEREST QUESTIONNAIRES OF THOSE WHO ARE REQUIRED BY THIS POLICY TO COMPLETE ONE PERIODICALLY SHALL BE FILED IN THE APPLICABLE CORPORATION'S CEO'S OFFICE AND RETAINED FOR NO LESS THAN SEVEN YEARS. OPTIONAL CONFLICT OF INTEREST QUESTIONNAIRES SHALL BE FILED IN THE OFFICE OF THE VICE PRESIDENT WHO REQUESTED COMPLETION OF THE FORM. B. COMPLETED POTENTIAL CONFLICT OF INTEREST DISCLOSURE FORMS SHALL BE FILED IN THE APPLICABLE CORPORATION'S CEO'S OFFICE FOR THE CEO, COO, AND VICE PRESIDENTS AND FOR ALL OTHERS IN THE APPROPRIATE VICE PRESIDENT'S OFFICE. THE FORMS SHOULD BE RETAINED FOR NO LESS THAN SEVEN YEARS. 5.THE VICE PRESIDENT FOR LEGAL AFFAIRS WILL BE AVAILABLE TO ADVISE ON POTENTIAL CONFLICT OF INTEREST MATTERS. BOARD MEMBERS: BOARD MEMBERS ARE ALSO REQUIRED TO COMPLETE A POTENTIAL CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY. THIS QUESTIONNAIRE ASKS FOR DISCLOSURES RELATED TO ANY FAMILY RELATIONSHIPS OR BUSINESS RELATIONSHIPS WITH OTHER BOARD MEMBERS, OR BUSINESS RELATIONSHIPS WITH THE ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION FOLLOWS THE PROCESS DESCRIBED IN TREASURY REGULATION 53.4958-6(C) FOR ESTABLISHING THE REBUTTABLE PRESUMPTION OF REASONABLENESS IN THE REVIEW, APPROVAL, AND DOCUMENTATION OF ANY OFFICER, KEY MANAGEMENT, AND DIRECTOR COMPENSATION. ANNUALLY, A COMPENSATION COMMITTEE OF THE UNIVERSITY HEALTH SERVICES (UHS) 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 REVIEWS INVOLVE THE ADVICE AND ASSISTANCE OF AN INDEPENDENT COMPENSATION CONSULTING FIRM. MINUTES OF THE COMPENSATION ARE RECORDED. THE COMPENSATION COMMITTEE REPORTS TO THE UHS BOARD EXECUTIVE COMMITTEE.
FORM 990, PART VI, SECTION C, LINE 19 ALL GOVERNING DOCUMENTS, POLICIES, FINANCIAL STATEMENTS, AND INFORMATIONAL RETURNS ARE AVAILABLE UPON REQUEST FROM THE ADMINISTRATION OFFICE.
FORM 990, PART XI, LINE 9: CHANGE IN UNFUNDED PENSION GAINS 5,709,690. OTHER CUMULATIVE EFFECT ON ASSET RETIREMENT OBLIGATIONS 86,093. TRANSFER TO AFFILIATE -30,810,512. PTP INVESTMENT - UBTI NOT ON BOOKS 1,615,298.
FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.
SCHEDULE H, PART V, LINE 16A HTTPS://WWW.UNIVERSITYHEALTH.ORG/PATIENT-VISITOR-INFORMATION/FOR-PATIENT S/BILLING-INFORMATION/INDIGENT-AND-CHARITY-CARE
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2018


Additional Data


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SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
UNIVERSITY HEALTH SERVICES INC
 
Employer identification number

58-1581103
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity

(1) WALTON WAY INDEMNITY SPC
2ND FL GOVERNORS SQ 23 LIME TREE
WEST BAY,GRAND CAYMAN  
CJ
INSURANCE CAPTIVE CJ 662,068 23,678,825 UNIVERSITY HEALTH SERVICES INC
 










Part II
Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1)UNIVERSITY EXTENDED CARE INC
1350 WALTON WAY

AUGUSTA,GA30901
58-1581105
SKILLED NURSING HOMES GA 501(C)(3) 3 UNIVERSITY HEALTH INC
 
 
No
(2)RICHMOND COUNTY HOSPITAL AUTHORITY
1350 WALTON WAY

AUGUSTA,GA30901
58-6001901
LEASED FACILITIES GA 501(C)(3) 3 N/A
 
No
(3)AUGUSTA RESOURCE CENTER ON AGING I
4275 OWENS ROAD

EVANS,GA30809
58-1728812
NON PROFIT LIFE CARE COMMUNITY GA 501(C)(3) 9 UNIVERSITY HEALTH INC
 
 
No
(4)UNIVERSITY HEALTH CARE FOUNDATION
2100 CENTRAL AVENUE SUITE D-1

AUGUSTA,GA30904
58-1343550
PHILANTHROPY GA 501(C)(3) 7 UNIVERSITY HEALTH INC
 
 
No
(5)UNIVERSITY HEALTH INC
1350 WALTON WAY

AUGUSTA,GA30901
58-1581102
CONSOLIDATING PARENT GA 501(C)(3) 9 N/A
 
No
(6)UNIVERSITY MCDUFFIE COUNTY REGIONAL
1350 WALTON WAY

AUGUSTA,GA30901
45-4166209
HOSPITAL GA 501(C)(3) 3 UNIVERSITY HEALTH INC
 
 
No


For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?



(k)
Percentage
ownership


Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) UNIVERSITY HEALTH RESOURCES INC

1350 WALTON WAY
AUGUSTA,GA30901
58-1601372
SVC TO PHYSICIANS GA UNIVERSITY HEALTH INC
 
C         No
(2) UNIVERSITY HOSPITAL AIKEN INC

1350 WALTON WAY
AUGUSTA,GA30901
47-2713774
HOSPITAL SC UNIVERSITY HEALTH INC
 
C         No










Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
 
No
d Loans or loan guarantees to or for related organization(s) ............................
1d
Yes
 
e Loans or loan guarantees by related organization(s) ............................
1e
Yes
 
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved





Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2018

Additional Data


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