EASTERN SHORE RURAL HEALTH SYSTEM INCORPORATED: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
EASTERN SHORE RURAL HEALTH SYSTEM INCORPORATED (EIN 51-0196935)
Tax period
2021-06-01 to 2022-05-31
Filed
2022-09-23
IRS object ID
202212669349300411
Schema version
2021v4.0
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)
Return2022-09-23T09:28:56-04:00ReturnTs
Tax Period End2022-05-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN541896113PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ROBINSON FARMER COX ASSOCIATESBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1530 WESTFIELD RDAddressLine1Txt
CityCHARLOTTESVILLECityNm
State AbbreviationVAStateAbbreviationCd
ZIP229011726ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-06-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN510196935EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1EASTERN SHORE RURAL HEALTHBusinessNameLine1Txt
Business Name Line2SYSTEM INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlEASTBusinessNameControlTxt
Phone7574140400PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line120280 MARKET STREETAddressLine1Txt
CityONANCOCKCityNm
State AbbreviationVAStateAbbreviationCd
ZIP23417ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMATTHEW CLAYPersonNm
Person TitleCHIEF EXECUTIVE OFF.PersonTitleTxt
Phone7574140400PhoneNum
Signature2022-09-13SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstMATTHEWPersonFirstNm
Person LastCLAYPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMICHAEL E LUPTONPreparerPersonNm
PTINP02141280PTIN
Phone4349738314PhoneNum
Preparation2022-09-23PreparationDt
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMATTHEW CLAYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line120280 MARKET STREETAddressLine1Txt
CityONANCOCKCityNm
State AbbreviationVAStateAbbreviationCd
ZIP23417ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$38,285,000GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.ESRH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1976FormationYr
Legal Domicile StateVALegalDomicileStateCd
Activity Or MissionOPERATION OF FEDERALLY SUPPORTED COMMUNITY HEALTH CENTERS.ActivityOrMissionDesc
Voting Members Governing Body16VotingMembersGoverningBodyCnt
Voting Members Independent16VotingMembersIndependentCnt
Total Employee385TotalEmployeeCnt
Total Volunteers36TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$7,892,660PYContributionsGrantsAmt
CY Contributions Grants$12,436,857CYContributionsGrantsAmt
PY Program Service Revenue$23,173,872PYProgramServiceRevenueAmt
CY Program Service Revenue$25,661,663CYProgramServiceRevenueAmt
PY Investment Income$139,147PYInvestmentIncomeAmt
CY Investment Income$19,297CYInvestmentIncomeAmt
PY Other Revenue$57,322PYOtherRevenueAmt
CY Other Revenue$167,183CYOtherRevenueAmt
PY Total Revenue$31,263,001PYTotalRevenueAmt
CY Total Revenue$38,285,000CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$19,265,550PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$20,438,353CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$560,197CYTotalFundraisingExpenseAmt
PY Other Expenses$7,072,680PYOtherExpensesAmt
CY Other Expenses$7,531,235CYOtherExpensesAmt
PY Total Expenses$26,338,230PYTotalExpensesAmt
CY Total Expenses$27,969,588CYTotalExpensesAmt
PY Revenues Less Expenses$4,924,771PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$10,315,412CYRevenuesLessExpensesAmt
Total Assets BOY$43,291,038TotalAssetsBOYAmt
Total Assets EOY$50,328,522TotalAssetsEOYAmt
Total Liabilities BOY$7,250,003TotalLiabilitiesBOYAmt
Total Liabilities EOY$3,972,075TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$36,041,035NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$46,356,447NetAssetsOrFundBalancesEOYAmt
MissionOPERATION OF FEDERALLY SUPPORTED COMMUNITY HEALTH CENTERS.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$23,938,156ExpenseAmt
Revenue$25,661,663RevenueAmt
DescORGANIZATION OPERATES SEVEN FEDERALLY SUPPORTED CENTERS PROVIDING MEDICAL, DENTAL AND BEHAVORIAL HEALTH CARE TO THE APPROXIMATELY 45,000 RESIDENTS OF TWO OF VIRGINIA'S MOST ECONOMICALLY DISADVANTAGED COUNTIES ON THE EASTERN SHORE OF VIRGINIA.Desc
Total Program Service Expenses$23,938,156TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document36IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee385EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members16GoverningBodyVotingMembersCnt
Independent Voting Member16IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMATTHEW CLAYPersonNm
Phone7574140400PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line120280 MARKET STREETAddressLine1Txt
CityONANCOCKCityNm
State AbbreviationVAStateAbbreviationCd
ZIP23417ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (36 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
JEFF HOLLAND
PRESIDENT2.00Yes (X)$0$0$0
BETTY BIBBINS
VICE PRESIDE2.00Yes (X)$0$0$0
ALICE JONES
SECRETARY2.00Yes (X)$0$0$0
BOB KERNS
TREASURER2.00Yes (X)$0$0$0
DENISE BLAND
PAST PRESIDE2.00Yes (X)$0$0$0
LUTHER BYRD
BOARD MEMBER2.00Yes (X)$0$0$0
LISA CUBA
BOARD MEMBER2.00Yes (X)$0$0$0
KEITH COLONNA
BOARD MEMBER2.00Yes (X)$0$0$0
ARTHUR FOURNIER
BOARD MEMBER2.00Yes (X)$0$0$0
GARNETT KELLAM
BOARD MEMBER2.00Yes (X)$0$0$0
SHEILA KERPELMAN
BOARD MEMBER2.00Yes (X)$0$0$0
MARISA SANCHEZ
BOARD MEMBER2.00Yes (X)$0$0$0
JOHN SCHULZ
BOARD MEMBER2.00Yes (X)$0$0$0
JOHN SPARKMAN
BOARD MEMBER2.00Yes (X)$0$0$0
WILLIAM STURGIS
BOARD MEMBER2.00Yes (X)$0$0$0
ANDY COBB
BOARD MEMBER2.00Yes (X)$0$0$0
MATTHEW CLAY
CHIEF EXECUT40.00$195,630$0$0Yes (X)
NANCY STERN
CHIEF EXECUT40.00$34,813$0$0Yes (X)
KANDICE BRUNO
CHIEF FINANC40.00$161,619$0$0Yes (X)
ANNE CRABBE
CHIEF OPERAT40.00$52,601$0$0Yes (X)
TRACY TURMAN
CHIEF OPERAT40.00$77,828$0$0Yes (X)
SCOTT WOLPIN
CHIEF DENTAL40.00$232,621$0$0Yes (X)
THOMAS HOLLANDSWORTH
CHIEF MEDICA40.00$235,299$0$0Yes (X)
JEANNETTE EDWARDS
CHIEF HR OFF40.00$120,022$0$0Yes (X)
KIMBERLY SAVAGE
CHIEF COMPLI40.00$109,964$0$0Yes (X)
MIKE ZODUN
CHIEF INFORM40.00$103,640$0$0Yes (X)
JENNIFER TYLER
CHIEF CLIN I40.00$102,040$0$0Yes (X)
SANDRA HEARN
CHIEF NURSIN40.00$42,461$0$0Yes (X)
JOAN LINGEN
CHIEF MANAGI40.00$219,257$0$0Yes (X)
JESSICA BONNIWELL
DIRECTOR OF40.00$45,586$0$0Yes (X)
JESSE WINGATE
DIR. OF BEHA40.00$126,785$0$0Yes (X)
DAVID HOSHINO
DOCTOR40.00$225,117$0$0Yes (X)
JEANNE ROLL
DOCTOR40.00$222,383$0$0Yes (X)
THOMAS MURRAY
DOCTOR40.00$196,625$0$0Yes (X)
ALBERT HALLS
DOCTOR40.00$194,913$0$0Yes (X)
MACY RUPPRECHT
DOCTOR40.00$192,787$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,891,991TotalReportableCompFromOrgAmt
Indiv Rcvd Greater Than100 K36IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Government Grants$12,044,075GovernmentGrantsAmt
All Other Contributions$392,782AllOtherContributionsAmt
Noncash Contributions$38,898NoncashContributionsAmt
Total Contributions$12,436,857TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE$19,399,758$19,399,758
340B$6,261,905$6,261,905
FieldValueIRS element (for citing)
Total Program Service Revenue$25,661,663TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$19,297TotalRevenueColumnAmt
Exclusion$19,297ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$700RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$700RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$700TotalRevenueColumnAmt
Related Or Exempt Func Income$700RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER REVENUEDesc
Total Revenue Column$166,483TotalRevenueColumnAmt
Related Or Exempt Func Income$166,483RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$166,483OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$38,285,000TotalRevenueColumnAmt
Related Or Exempt Func Income$25,828,846RelatedOrExemptFuncIncomeAmt
Exclusion$19,297ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,919,640TotalAmt
Program Services$915,003ProgramServicesAmt
Management And General$665,855ManagementAndGeneralAmt
Fundraising$338,782FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$14,864,144TotalAmt
Program Services$13,611,720ProgramServicesAmt
Management And General$1,185,145ManagementAndGeneralAmt
Fundraising$67,279FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$480,496TotalAmt
Program Services$415,869ProgramServicesAmt
Management And General$52,989ManagementAndGeneralAmt
Fundraising$11,638FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,980,500TotalAmt
Program Services$1,640,808ProgramServicesAmt
Management And General$289,645ManagementAndGeneralAmt
Fundraising$50,047FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,193,573TotalAmt
Program Services$1,033,038ProgramServicesAmt
Management And General$131,627ManagementAndGeneralAmt
Fundraising$28,908FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$21,040TotalAmt
Management And General$21,040ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$34,470TotalAmt
Management And General$34,470ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$292,955TotalAmt
Program Services$292,955ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$318,770TotalAmt
Management And General$318,770ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$824,215TotalAmt
Program Services$473,133ProgramServicesAmt
Management And General$313,400ManagementAndGeneralAmt
Fundraising$37,682FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$47,706TotalAmt
Program Services$44,985ProgramServicesAmt
Management And General$2,468ManagementAndGeneralAmt
Fundraising$253FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$102,681TotalAmt
Management And General$96,802ManagementAndGeneralAmt
Fundraising$5,879FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$65,009TotalAmt
Program Services$59,158ProgramServicesAmt
Management And General$5,851ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$895,296TotalAmt
Program Services$807,241ProgramServicesAmt
Management And General$79,863ManagementAndGeneralAmt
Fundraising$8,192FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$116,020TotalAmt
Management And General$116,020ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
PHARMACY PROGRAMS$2,430,083$2,430,083
MEDICAL SUPPLIES$1,696,924$1,696,924
TELEPHONE & UTILITIES$344,120$239,128$95,226$9,766
REPAIRS & MAINTENANCE$283,211$264,170$17,270$1,771

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$58,735TotalAmt
Program Services$13,941ProgramServicesAmt
Management And General$44,794ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$27,969,588TotalAmt
Program Services$23,938,156ProgramServicesAmt
Management And General$3,471,235ManagementAndGeneralAmt
Fundraising$560,197FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$17,262,238BOYAmt
EOY$24,376,725EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$36,250BOYAmt
EOY$6,250EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,892,122BOYAmt
EOY$4,113,071EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$13,446BOYAmt
EOY$11,398EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$28,708,396LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$6,893,318LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$22,080,982BOYAmt
EOY$21,815,078EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$6,000BOYAmt
EOY$6,000EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$43,291,038BOYAmt
EOY$50,328,522EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,375,393BOYAmt
EOY$2,524,545EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$4,699,777BOYAmt
EOY$1,300,593EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$174,833BOYAmt
EOY$146,937EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,250,003BOYAmt
EOY$3,972,075EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$35,997,393BOYAmt
EOY$46,316,697EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$43,642BOYAmt
EOY$39,750EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$36,041,035BOYAmt
EOY$46,356,447EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$43,291,038BOYAmt
EOY$50,328,522EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$10,315,412ReconcilationRevenueExpnssAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$6,267,704CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,785,029CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,067,545CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$7,892,660CurrentTaxYearMinus1YearAmt
Current Tax Year$9,102,459CurrentTaxYearAmt
Total$36,115,397TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$18,367,550CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$22,175,631CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$21,273,493CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$23,231,194CurrentTaxYearMinus1YearAmt
Current Tax Year$25,828,846CurrentTaxYearAmt
Total$110,876,714TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$24,635,254CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$27,960,660CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$28,341,038CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$31,123,854CurrentTaxYearMinus1YearAmt
Current Tax Year$34,931,305CurrentTaxYearAmt
Total$146,992,111TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$146,992,111PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$24,046CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$44,997CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$62,818CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$21,782CurrentTaxYearMinus1YearAmt
Current Tax Year$19,297CurrentTaxYearAmt
Total$172,940TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$24,046CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$44,997CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$62,818CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$21,782CurrentTaxYearMinus1YearAmt
Current Tax Year$19,297CurrentTaxYearAmt
Total$172,940TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$24,047CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$21,761CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$24,363CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$56,721CurrentTaxYearMinus1YearAmt
Current Tax Year$166,483CurrentTaxYearAmt
Total$293,375TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$24,683,347CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$28,027,418CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$28,428,219CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$31,202,357CurrentTaxYearMinus1YearAmt
Current Tax Year$35,117,085CurrentTaxYearAmt
Total$147,458,426TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99680PublicSupportCY509Pct
Public Support PY5090.99770PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Investment Income PY0.00000InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferencePART III, LINE 12FormAndLineReferenceDesc
ExplanationOTHER INCOME 293,375ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$989,166OtherCostOrOtherBasisAmt
Book Value$989,166BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$24,859,093OtherCostOrOtherBasisAmt
Depreciation$5,376,698DepreciationAmt
Book Value$19,482,395BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,860,137OtherCostOrOtherBasisAmt
Depreciation$1,516,620DepreciationAmt
Book Value$1,343,517BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$21,815,078TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescOTHER LIABILITIESDesc
Amt$146,937Amt
FieldValueIRS element (for citing)
Total Liability$146,937TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$38,285,000TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal$38,285,000RevenueSubtotalAmt
Total Revenue Per Form990$38,285,000TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$27,969,588TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$27,969,588ExpensesSubtotalAmt
Total Expenses Per Form990$27,969,588TotalExpensesPerForm990Amt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
MATTHEW CLAY
CHIEF EXECUTIVE OFF.$195,630$195,630
KANDICE BRUNO
CHIEF FINANCIAL OFF.$161,619$161,619
SCOTT WOLPIN
CHIEF DENTAL OFFICER$232,621$232,621
THOMAS HOLLANDSWORTH
CHIEF MEDICAL OFF.$235,299$235,299
JOAN LINGEN
CHIEF MANAGING OFF.$219,257$219,257
DAVID HOSHINO
DOCTOR$225,117$225,117
JEANNE ROLL
DOCTOR$222,383$222,383
THOMAS MURRAY
DOCTOR$196,625$196,625
ALBERT HALLS
DOCTOR$194,913$194,913
MACY RUPPRECHT
DOCTOR$192,787$192,787

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTradedGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution2ContributionCnt
Noncash Contributions Rpt F990$38,898NoncashContributionsRptF990Amt
Method Of Determining RevenuesMARKET VALUEMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGiftsInd
Third Parties UsedfalseThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 11BFORM 990 IS REVIEWED BY THE CEO, CFO, AND THE BOARD OF DIRECTORS PRIOR TO FILING.
FORM 990, PAGE 6, PART VI, LINE 12CINITIALLY, BOARD MEMBERS SIGN THE CONFLICT OF INTEREST POLICY AS PART OF ORIENTATION. THE CONFICT OF INTEREST ATTESTATION FORM IS DISTRIBUTED TO ALL BOARD MEMBERS ANNUALLY FOR AN UPDATED SIGNATURE. THE FORMS ARE TRACKED BY THE EXECUTIVE ASSISTANT TO ENSURE 100% OF THE SIGNATURES ARE COLLECTED.
FORM 990, PAGE 6, PART VI, LINE 15ATHE ORGANIZATION INCLUDES AN AVERAGE SALARY INCREASE FOR ALL STAFF IN THE BUDGET SUBMITTED TO THE BOARD OF DIRECTORS FOR APPROVAL ON AN ANNUAL BASIS. THIS BUDGET IS PART OF THE 330 GRANT APPLICATION SUBMITTED TO THE DEPARTMENT OF HEALTH AND HUMAN SERVICES, HEALTH RESOURCES AND SERVICES ADMINISTRATION FOR GRANT FUNDING THAT REPRESENTS 30% OF THE TOTAL BUDGET. GENERALLY, THE GRANT APPLICATION IS SUBMITTED TO THE BOARD AT A SPECIAL CALLED MEETING PRIOR TO THE GRANT DUE DATE AND IS VOTED ON FOR APPROVAL OR AMENDMENTS A WEEK LATER AT THE REGULARLY SCHEDULED MONTHLY BOARD MEETING. THE BUDGET CONTAINS AN AVERAGE INCREASE THAT WILL BE AVAILABLE FOR ALL STAFF, CONTRACTUAL EMPLOYEES, OFFICERS, AND THE CEO. NEXT, IN JUNE OF EACH YEAR, ALL EMPLOYEES, INCLUDING THE CEO, ARE EVALUATED THROUGH A WRITTEN APPRAISAL PROCESS. THE CEO IS EVALUATED BY THE BOARD CHAIR. ALL VALUATIONS REQUIRE A MINIMUM OF TWO INDEPENDENT EVALUATIONS IN ADDITION TO THE SUPERVISOR AND EACH EMPLOYEE SUBMITS A WRITTEN SELF-APPRAISAL. THE EVALUATIONS ARE WRITTEN AND BASED ON THE ESSENTIAL JOB FUNCTIONS. PERFORMANCE OF EACH FUNCTION IS ASSIGNED A NUMERICAL VALUE. THE EVALUATIONS ALSO SET GOALS FOR THE UPCOMING YEAR AND EVALUATE THE LEVEL OF ACHIEVEMENT OF GOALS ESTABLISHED DURING THE PRIOR EVALUATION PERIOD. UPON COMPLETION OF ALL EVALUATIONS, THE BOARD DETERMINES THE PERCENTAGE INCREASE FOR THE CEO BASED ON THE NUMERIC SCORE ACHIEVED, THE ACCOMPLISHMENT OF GOALS ESTABLISHED IN THE PRIOR YEAR, THE FINANCIAL POSITION OF THE ORGANIZATION, THE RANGE APPROVED IN THE BUDGET CYCLE, AND COMPENSATION OF CEOS FROM THE COMMUNITY HEALTH CENTERS LOCATED IN VIRGINIA. THIS INFORMATION IS GATHERED FROM AN ANNUAL COMPENSATION SURVEY GATHERED FROM ALL COMMUNITY HEALTH CENTERS IN THE STATE AND CONDUCTED BY THE VIRGINIA COMMUNITY HEALTHCARE ASSOCIATION.
FORM 990, PAGE 6, PART VI, LINE 15BFOLLOWING THE BUDGET AND EVALUATION PROCESS (DESCRIBED FOR CEO), THE CEO DETERMINES THE PERCENT INCREASES FOR THE OTHER OFFICERS BASED ON THE NUMERIC SCORES OF EVALUATIONS, THE RANGE SET BY THE BOARD DURING THE BUDGET CYCLE, FINANCIAL POSITION OF THE ORGANIZATION, AND PREVAILING COMPENSATION FROM THE SALARY SURVEY. THE CHIEF HUMAN RESOURCE OFFICER AND THE CFO USE THE NUMERIC VALUE OF EACH EMPLOYEE'S EVALUATION TO DETERMINE THE PERCENT INCREASE FROM THE POOL APPROVED BY THE BOARD IN THE BUDGET. THESE PROPOSED RAISES ARE THEN SUBMITTED TO THE CEO FOR FINAL APPROVAL.
FORM 990, PAGE 6, PART VI, LINE 19THE ORGANIZATION PROVIDES ITS GOVERNING DOCUMENTS, POLICIES, AND TAX RETURNS TO THE PUBLIC UPON REQUEST. THE FINANCIAL STATEMENTS ARE MADE AVAILABLE ON THE ORGANIZATION'S WEBSITE.

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