Appalachian Emergency Physicians

“Changes to the bylaws were made to increase the number of maximum directors from 5 to 9.”

“Aep's tax preparer reviewed the form 990 with aep's board members prior to filing the return with the irs. Board members received a copy of the form 990 prior to the review.”

“Explanation: every covered person as defined by the conflict of interest policy adopted by the board of directors shall be subject to that policy. As part of said policy, every covered person shall complete a conflict of interest disclosure statement in accordance with the requirement of the conflict of interest policy.”

“Explanation: aep has entered into professional service contracts with physicians to assist aep in providing emergency service coverage to hospitals. These agreements may include fixed rates and bonuses based on productivity or achieving quality,patient satisfaction scores or other quality metrics. The methodology or amount of the bonus is fixed and set in advance within each contract. Bonus formulas are based upon reached pre- determined and objectively verifiable performance metrics. In addition to addressing excess benefit, private inurement and private benefit concerns, aep's compensation arrangements are structured in a manner to comply with applicable fraud and abuse laws that apply to health care providers. Aep has negotiated each of its compensation arrangements at arm's length. The agreements include commercially reasonable terms and conditions with a compensation arrangement that is consistent with fair market value for the services rendered. The terms and conditions of such arrangements have been, are and will continue to be set through good faith negotiations among the relevant parties in an effort to be consistent with similar arrangements for other health care providers providing similar services in similar specialties within southwestern virginia and northeastern tennessee. National physician compensation survey data (e.g. Mgma physician compensation survey) and other objective comparable data has been and will continue to be used as the basis for setting physician compensation arrangements. Aep also utilizes the services of nationally-recognized valuation firms to evaluate certain proposed compensation arrangements to ensure that they are consistent with fair market value and are commercially reasonable. In addition to compensation received for provision of physician services, an addendum was added to the current president's written contract as an indpendent contractor that describes his duties and responsibilities as president as well as his compensation for the additional responsibilities as president. The addendum was approved by aep's board and the compensation was deemed reasonable by an outside and independent valuation firm.”

“Explanation: director moody receives compensation from aep as an independent contractor for his provision of physician services to hospitals serviced by aep. He and director/president puhr are the only two directors/officers paid by aep.”

“Explanation: the conflict of interest policy, in addition to other governing policies, is available upon request. All corporate policies and corporate financial statements are also available upon request. Form 990, part vii, section a - compensation of directors and officers explanation: aep does not compensate its officers and directors except as follows: president/director puhr and director moody are paid by aep for physician services they provide to hospitals. In addition, puhr receives additional compensation, as approved by the board, for his services to the organization as president.”

“Appalachian emergency physicians is organized and operated for charitable purposes, which include the provision of emergency physician services to acute care hospital facilities in southwest virginia and northeast tennessee.”

“Appalachian emergency physicians helps to fulfill a need in southwest virginia and northeast tennessee for acute care facilities that have encountered problems in securing comprehensive physician coverage within the field of emergency medicine. Aep will ensure that patients are treated for medically necessary conditions regardless of race, religion, ethnicity or ability to pay, in a manner consistent with the patient financial assistance program applicable for each respective hospital where aep provides emergency services. In recognizing that not all individuals possess the ability to purchase essential medical services, aep will not pursue collection of amounts determined to qualify for patient financial assistance. The financial assistance policy for each respective hospital facility serviced by aep has been adopted by the aep board with respect to services at the respective facility. Aep is organized and operated as an emergency physician development service. Specifically, aep will (i) recruit and contract with a stable base of physicians and mid-level providers (e.g. Nurse practitioners and physician assistants) to support the level of emergency medical care required for msha acute care hospital facilities; (ii) create a vehicle for future collaboration between msha hospitals and their medical staffs; and (iii) stabilize the provision of emergency care through existing physician practices in southwest virginia and northeast tennessee. Aep provides emergency medicine professional coverage by contract for the following hospitals: johnson city medical center (tn) franklin woods community hospital (tn) niswonger children's hospital (tn) indian path medical center (tn) sycamore shoals hospital (tn) johnson county community hospital (tn) unicoi county memorial hospital (tn) norton community hospital (va) dickenson community hospital (va) russell county medical center (va), and smyth county community hospital (va) each of these hospital facilities is either wholly or partially owned by mountain states health alliance (msha). Msha is a nonprofit health system based in johnson city, tn. Msha is tax-exempt under irc section 501(c)(3). While some msha representatives are on aep's governing board, msha and its affiliates do not control aep's board or the manner in which aep is operated, managed, or governed. Medical services are provided to individuals presenting to the emergency department of one of the aforementioned hospital facilities and are based upon emergency medical need. Aep follows the patient financial assistance policies and procedures adopted by each of the aforementioned hospital facilities for the treatment of patients without regard to the ability to pay. As such services are made available to the general public, aep may incidentally provide emergency services to officers, directors, employees and independent contractors. However, such individuals would not be treated differently than other patients and such services would only be made available in the normal course of aep's business operations.”

“Physician fees 22,469,038 0 0 management & billing services 4,365,977 0 0 consulting 0 7,548 0”