SMHA HEALTHCARE INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
SMHA HEALTHCARE INC (EIN 58-2460001)
Tax period
2022-01-01 to 2022-12-31
Filed
2023-07-19
IRS object ID
202312009349300801
Schema version
2022v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2023-07-19T07:30:24-05:00ReturnTs
Tax Period End2022-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN440160260PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1FORVIS LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1500 RIDGEFIELD COURTAddressLine1Txt
CityASHEVILLECityNm
State AbbreviationNCStateAbbreviationCd
ZIP28806ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN582460001EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SMHA HEALTHCARE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSMHABusinessNameControlTxt
Phone3219723585PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1425 W NEW ENGLAND AVE STE 300AddressLine1Txt
CityWINTER PARKCityNm
State AbbreviationFLStateAbbreviationCd
ZIP32789ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonNEIL LURIAPersonNm
Person TitleCHIEF WIND-DOWN OFFICERPersonTitleTxt
Phone3219723585PhoneNum
Signature2023-06-07SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstNEILPersonFirstNm
Person LastLURIAPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (1)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAMY BIBBYPreparerPersonNm
PTINP00445891PTIN
Phone8282542254PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerNEIL LURIAPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1425 W NEW ENGLAND AVE STE 300AddressLine1Txt
CityWINTER PARKCityNm
State AbbreviationFLStateAbbreviationCd
ZIP32789ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$20,637GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1997FormationYr
Legal Domicile StateGALegalDomicileStateCd
Activity Or MissionTHE ORGANIZATION SUPPORTS THE EXCLUDED ASSETS AND LIABILITIES ASSOCIATED WITH THE ASSET PURCHASE TRANSACTION AND THE WIND DOWN OF SUCH ACTIVITIES.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$576,222PYProgramServiceRevenueAmt
CY Program Service Revenue$250CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$1,389,401PYOtherRevenueAmt
CY Other Revenue$20,387CYOtherRevenueAmt
PY Total Revenue$1,965,623PYTotalRevenueAmt
CY Total Revenue$20,637CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,131,054PYOtherExpensesAmt
CY Other Expenses$2,835,280CYOtherExpensesAmt
PY Total Expenses$2,131,054PYTotalExpensesAmt
CY Total Expenses$2,835,280CYTotalExpensesAmt
PY Revenues Less Expenses-$165,431PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$2,814,643CYRevenuesLessExpensesAmt
Total Assets BOY$23,371,773TotalAssetsBOYAmt
Total Assets EOY$20,395,823TotalAssetsEOYAmt
Total Liabilities BOY$3,305,697TotalLiabilitiesBOYAmt
Total Liabilities EOY$12,408,964TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$20,066,076NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$7,986,859NetAssetsOrFundBalancesEOYAmt
MissionTHE ORGANIZATION SUPPORTS THE EXCLUDED ASSETS AND LIABILITIES ASSOCIATED WITH THE ASSET PURCHASE TRANSACTION AND THE WIND DOWN OF SUCH ACTIVITIES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$1,591,629ExpenseAmt
Revenue$250RevenueAmt
DescTO PROVIDE ADMINISTRATIVE SUPPORT BY ENGAGING IN SUCH OTHER ACTIVITIES THAT BENEFIT, PERFORM THE FUNCTIONS OF, OR CARRY OUT THE PURPOSES OF SMHA HEALTH, INC.JANUARY 31, 2018 THE ORGANIZATION CLOSED ON THE ASSET PURCHASE AGREEMENT WITH HOSPITAL CORPORATION OF AMERICA (HCA). DISCLOSURES AND ACTIVITIES REPORTED REPRESENT THIS TRANSACTION.THE ORGANIZATION SUPPORTS THE EXCLUDED ASSETS AND LIABILITIES ASSOCIATED WITH THE ASSET PURCHASE TRANSACTION AND THE WIND DOWN OF SUCH ACTIVITIES.Desc
Total Program Service Expenses$1,591,629TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldGAStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KIRA ABRAMOVSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3219723585PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1425 W NEW ENGLAND AVE SUITE 300AddressLine1Txt
CityWINTER PARKCityNm
State AbbreviationFLStateAbbreviationCd
ZIP32789ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
REX TEMPLETON
CHAIRMAN0.250.25Yes (X)Yes (X)$0$0$0
ISRAEL SMALL
DIRECTOR0.250.25Yes (X)$0$0$0
CHARLES MCMILLIAN
DIRECTOR0.250.25Yes (X)$0$0$0
CURTIS LEWIS III
DIRECTOR0.250.25Yes (X)$0$0$0
SUSAN WILLETTS
DIRECTOR0.250.25Yes (X)$0$0$0
FRANK ROSSITER MD
DIRECTOR0.250.25Yes (X)$0$0$0
ARTHUR DANA
DIRECTOR0.250.25Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENTS RECEIPTSDesc
Business621400BusinessCd
Total Revenue Column$250TotalRevenueColumnAmt
Related Or Exempt Func Income$250RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$250TotalProgramServiceRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS INCOMEDesc
Business900099BusinessCd
Total Revenue Column$20,387TotalRevenueColumnAmt
Exclusion$20,387ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$20,387OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$20,637TotalRevenueColumnAmt
Related Or Exempt Func Income$250RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$20,387ExclusionAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$360,000TotalAmt
Program Services$360,000ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$1,122,935TotalAmt
Program Services$1,122,935ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$103,158TotalAmt
Management And General$103,158ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$62,584TotalAmt
Program Services$62,584ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$10,857TotalAmt
Management And General$10,857ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,055,563TotalAmt
Management And General$1,055,563ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$13,975TotalAmt
Management And General$13,975ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$60,098TotalAmt
Management And General$60,098ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
NET PATIENT RECEIPTS /$29,990$29,990
PRE-CLOSE INVOICES$16,120$16,120

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$2,835,280TotalAmt
Program Services$1,591,629ProgramServicesAmt
Management And General$1,243,651ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$15,818,796BOYAmt
EOY$14,167,399EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,674,545BOYAmt
EOY$2,971,257EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$3,878,432BOYAmt
EOY$3,257,167EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$23,371,773BOYAmt
EOY$20,395,823EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$711,300BOYAmt
EOY$351,642EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,594,397BOYAmt
EOY$12,057,322EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,305,697BOYAmt
EOY$12,408,964EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$20,066,076BOYAmt
EOY$7,986,859EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$20,066,076BOYAmt
EOY$7,986,859EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$23,371,773BOYAmt
EOY$20,395,823EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$2,814,643ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$9,264,574OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS Audited0FSAuditedInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type2Yes (X)SupportingOrgType2Ind
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1SMHA HEALTHCARE CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN311126469EIN
Organization Type3OrganizationTypeCd
Governing Document ListedYes (1)GoverningDocumentListedInd
Support$0SupportAmt
Other Support$1,591,629OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$0SupportSumAmt
Other Support Sum$1,591,629OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (1)ListedByNameGoverningDocInd
Suprt Org No IRS Determination0SuprtOrgNoIRSDeterminationInd
Supported Org Section C4560SupportedOrgSectionC456Ind
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org0OrganizationChangeSuprtOrgInd
Support Non Supported Org0SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd
FieldValueIRS element (for citing)
Majority Dir Trst Supported OrgYes (1)MajorityDirTrstSupportedOrgInd

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
ASSETS FOR DISPOSITION$3,017,409
FUNDS HELD AT STERLING SEACREST$239,758
FieldValueIRS element (for citing)
Total Book Value Other Assets$3,257,167TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
PATIENT/INSURANCE REFUND LIABILITY$2,057,322
ESTIMATED PHYSICIAN SETTLEMENT$10,000,000
FieldValueIRS element (for citing)
Total Liability$12,057,322TotalLiabilityAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE TAX RETURN IS PREPARED BY AN UNRELATED, INDEPENDENT ACCOUNTING FIRM AND THEN SUBMITTED TO MANAGEMENT FOR REVIEW BEFORE BEING FILED.
FORM 990, PART VI, SECTION B, LINE 12CBOARD MEMBERS ARE REQUIRED TO UPDATE AND SUBMIT A NEW CONFLICT OF INTEREST STATEMENT ANNUALLY. THE CHAIRMAN OF THE BOARD SHALL BECOME FAMILIAR WITH THE STATEMENTS OF THE BOARD MEMBERS IN ORDER TO GUIDE THEIR CONDUCT SHOULD A CONFLICT ARISE AT SUCH TIMES AS ANY MATTER COMES BEFORE THE BOARD THAT MAY POTENTIALLY RESULT IN A CONFLICT OF INTEREST. THE AFFECTED BOARD MEMBER SHALL MAKE KNOWN THE POTENTIAL CONFLICT, WHETHER OR NOT DISCLOSED IN A WRITTEN STATEMENT. THE AFFECTED BOARD MEMBER MAY MAKE A PRESENTATION TO THE BOARD, BUT AFTER SUCH PRESENTATION, HE OR SHE MUST LEAVE THE MEETING DURING THE DISCUSSION OF AND THE VOTE ON THE TRANSACTION OR ARRANGEMENT CONSIDERED TO BE A CONFLICT OF INTEREST.
FORM 990, PART VI, SECTION C, LINE 18THE FORM 990 IS MADE AVAILABLE UPON REQUESTION. IN ADDITION, THE FORM 990 IS AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG.
FORM 990, PART VI, SECTION C, LINE 19THE GOVERNING DOCUMENTS OF THE ORGANIZATION ARE HELD AS PUBLIC RECORDS OF THE STATE OF GEORGIA SECRETARY OF STATE OFFICE. AS SUCH, THESE DOCUMENTS ARE OPEN TO THE PUBLIC. THE CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC AS THIS IS NOT A REQUIREMENT.
FORM 990, PART XI, LINE 9:RECON OF INS REFUND LIABILITY TO ACTUAL 476,918. NET EQUITY TRANSFERS TO AFFILIATES -10,034,999. RECON OF COST REPORT RECOVERIES TO ACTUAL 293,507.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
SMHA CARDIOVASCULAR LLC
425 W NEW ENGLAND AVE STE 300WINTER PARKFL32789473916622PROVISION OF MEDICAL SERVICES (DISSOLVED 8/21)GA$0$0MEMORIAL HEALTH INC
SMHA PHYSICIANS LLC
425 W NEW ENGLAND AVE STE 300WINTER PARKFL32789INACTIVE (DISSOLVED 8/21)GA$0$0MEMORIAL HEALTH INC

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1SMHA HEALTHCARE CENTER INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1425 W NEW ENGLAND AVE STE 300AddressLine1Txt
CityWINTER PARKCityNm
State AbbreviationFLStateAbbreviationCd
ZIP32789ZIPCd
FieldValueIRS element (for citing)
EIN311126469EIN
Primary ActivitiesHEALTH CARE PROVIDERPrimaryActivitiesTxt
Legal Domicile StateGALegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 3PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1SMHA HEALTHCARE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled OrganizationYes (1)ControlledOrganizationInd

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerInd
GODLEY STATION MEDICAL PROPERTIES LLC
4600 WATERS AVE SUITE 100SAVANNAHGA31404HEALTH CAREGAN/A00
ENCOMPASS HEALTH REHABILITATION HOSPITAL OF SAVANNAH
9001 LIBERTY PARKWAYBIRMINGHAMAL35242HEALTH CAREALN/A00

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtOwnershipOwnershipPctControlled OrganizationControlledOrganizationInd
SMHA HEALTHCARE PARTNERS INC
425 W NEW ENGLAND AVE STE 300WINTER PARKFL32789581707311MANAGED CARE (DISSOLVED 8/21)FLSMHA HEALTH SERVICES GROUP INCC1.00000Yes (1)
SMHA ANESTHETISTS GROUP INC
425 W NEW ENGLAND AVE STE 300WINTER PARKFL32789431985441MEDICAL SERVICES (DISSOLVED 8/21)FLSMHA HEALTH SERVICES GROUP INCC1.00000Yes (1)
SMHA VENTURES INC
425 W NEW ENGLAND AVE STE 300WINTER PARKFL32789582162071PHYSICIANS PRACTICEFLSMHA HEALTH SERVICES GROUP INCC1.00000Yes (1)
SMHA HEALTH SERVICES GROUP INC
425 W NEW ENGLAND AVE STE 300WINTER PARKFL32789581611969MEDICAL SERVICES/ CONSOLIDATING ENTITYFLSMHA HEALTH INCC1.00000Yes (1)
SMHA PROPERTIES INC
425 W NEW ENGLAND AVE STE 300WINTER PARKFL32789582537941REAL ESTATE HOLDING (DISSOLVED 8/21)FLSMHA HEALTH SERVICES GROUP INCC1.00000Yes (1)
SMHA CORPORATE SERVICES INC
425 W NEW ENGLAND AVE STE 300WINTER PARKFL32789900963434CORPORATE SERVICES (DISSOLVED 8/21)FLSMHA HEALTH SERVICES GROUP INCC1.00000Yes (1)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.