SHORE HEALTH SERVICES INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- SHORE HEALTH SERVICES INC (EIN 54-0560500)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2019-01-25
- IRS object ID
- 201920259349300837
- Schema version
- 2017v2.3
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-01-25T15:41:00-06:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5 TIMES SQUARE | AddressLine1Txt |
| City | NEW YORK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10036 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 540560500 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHORE HEALTH SERVICES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % VP OF FINANCE RHA INC | InCareOfNm |
| Business Name Control | SHOR | BusinessNameControlTxt |
| Phone | 7578757838 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 608 Denbigh Blvd Suite Ste 800 | AddressLine1Txt |
| City | Newport News | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 236084487 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | W WILLIAM AUSTIN JR | PersonNm |
| Person Title | SR VP & CFO | PersonTitleTxt |
| Phone | 7578757838 | PhoneNum |
| Signature | 2019-01-24 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Laura Kielczewski | PreparerPersonNm |
| PTIN | P00740769 | PTIN |
| Phone | 2127733000 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 164.57.159.254 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 31499120190255000004 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2019-01-25 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 582F47EFACDD6166E52205D1FBFEA2601660FA18 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | D7645E384763AEB8339B885771554B833BC3ADBE | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | William Downey | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 608 Denbigh Blvd | AddressLine1Txt |
| City | Newport News | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 236084487 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $69,252,003 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.riversideonline.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1928 | FormationYr |
| Legal Domicile State | VA | LegalDomicileStateCd |
| Activity Or Mission | Healthcare Services | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 485 | TotalEmployeeCnt |
| Total Volunteers | 17 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $5,000 | PYContributionsGrantsAmt |
| CY Contributions Grants | $31,905 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $64,964,449 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $66,269,634 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$6,640 | PYInvestmentIncomeAmt |
| CY Investment Income | $299,452 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,021,861 | PYOtherRevenueAmt |
| CY Other Revenue | $2,386,251 | CYOtherRevenueAmt |
| PY Total Revenue | $66,984,670 | PYTotalRevenueAmt |
| CY Total Revenue | $68,987,242 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $226 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $224 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $23,837,879 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $26,635,575 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $45,229,601 | PYOtherExpensesAmt |
| CY Other Expenses | $47,200,293 | CYOtherExpensesAmt |
| PY Total Expenses | $69,067,706 | PYTotalExpensesAmt |
| CY Total Expenses | $73,836,092 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$2,083,036 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$4,848,850 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $89,076,712 | TotalAssetsBOYAmt |
| Total Assets EOY | $95,640,732 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $78,670,176 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $90,082,888 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $10,406,536 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,557,844 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO CARE FOR OTHERS AS WE WOULD CARE FOR THOSE WE LOVE - TO ENHANCE THEIR WELL-BEING AND IMPROVE THEIR HEALTH. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $66,090,755 | ExpenseAmt |
| Grant | $224 | GrantAmt |
| Revenue | $66,269,634 | RevenueAmt |
| Desc | GENERAL HOSPITAL SERVICES PROVIDED TO THE COMMUNITY. THE NUMBER OF PERSONS BENEFITED IN 2017 WAS 126,998 AND THE TOTAL QUANTIFIABLE COMMUNITY BENEFITS WERE 18,809,650. | Desc |
| Total Program Service Expenses | $66,090,755 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 57 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 485 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | VP OF FINANCE RHA INC | PersonNm |
| Phone | 7578757838 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 608 DENBIGH BLVD 800 | AddressLine1Txt |
| City | NEWPORT NEWS | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23608 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| ANN WILLIAMS | ||||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $6,835 | $0 | ||||
| CATHY RIOPEL | ||||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| CLYDE DAVIS | ||||||||||
| CHAIRMAN | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| DAVID PARKER | ||||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| JEFFREY HOLLAND | ||||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| JOHN PETERMAN | ||||||||||
| VP/ADMINISTRATOR | 40.0 | 0.0 | Yes (X) | $0 | $307,380 | $36,577 | Yes (X) | |||
| JOHN WEBB | ||||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| LINDA THOMAS-GLOVER | ||||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| LLOYD KELLAM | ||||||||||
| BOARD MEMBER | 1.0 | 39.0 | Yes (X) | $0 | $535,227 | $44,429 | ||||
| RICHARD HUBBARD | ||||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| ROBERT CROCKETT | ||||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| ROBERT LALOR | ||||||||||
| VICE CHAIRMAN | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| ROBERT LEATHERBURY | ||||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| THURMAN RENNER | ||||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| WALTER AUSTIN | ||||||||||
| SR VP, CFO & TREASURER | 1.0 | 39.0 | $0 | $596,660 | $30,649 | Yes (X) | ||||
| WILLIAM DOWNEY | ||||||||||
| PRESIDENT,CEO RHS | 1.0 | 39.0 | $0 | $1,308,513 | $53,959 | Yes (X) | ||||
| DAVID JONES | ||||||||||
| SERVICE LINE CHIEF | 1.0 | 39.0 | $0 | $285,464 | $52,272 | Yes (X) | ||||
| JOHN PATTERSON | ||||||||||
| PHARMACIST | 40.0 | 0.0 | $160,045 | $0 | $18,349 | Yes (X) | ||||
| JOSEPH JAMES SUNDAR | ||||||||||
| THERAPIST PHYSICAL HHA | 40.0 | 0.0 | $109,704 | $0 | $29,659 | Yes (X) | ||||
| LYNETTE PATTERSON | ||||||||||
| PHARMACIST | 40.0 | 0.0 | $144,147 | $0 | $16,409 | Yes (X) | ||||
| PATRICIA BRADY | ||||||||||
| PHARMACIST | 40.0 | 0.0 | $133,227 | $0 | $30,297 | Yes (X) | ||||
| SCOTT MILLIKEN | ||||||||||
| THERAPIST PHYSICAL HHA | 40.0 | 0.0 | $107,707 | $0 | $34,623 | Yes (X) | ||||
| WADE BROUGHAM | ||||||||||
| EVP | 0.0 | 40.0 | $0 | $1,614,434 | $27,837 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $654,830 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,654,513 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $375,060 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 33 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (true) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | FISHER SCIENTIFIC COMPANY LLC | PersonNm |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 404705 | AddressLine1Txt |
| City | ATLANTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 303844705 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | Professional Service | ServicesDesc |
| Compensation | $170,622 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $31,905 | AllOtherContributionsAmt |
| Total Contributions | $31,905 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| PATIENT REVENUE | 622110 | $66,299,008 | $66,299,008 | $0 |
| MEANINGFUL USE INCENTIVE PAYMENTS | 622110 | -$29,374 | -$29,374 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $66,269,634 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,682 | TotalRevenueColumnAmt |
| Exclusion | $5,682 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $423,827 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $106,113 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $317,714 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $317,714 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $317,714 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $452,418 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $158,648 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $293,770 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $293,770 | TotalRevenueColumnAmt |
| Exclusion | $293,770 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| CAFETERIA REVENUE | 900099 | $211,944 | $0 | $211,944 |
| PHARMACY SALES | 900099 | $740,854 | $0 | $740,854 |
| RENT/VACANCIES | 900099 | $281,299 | $0 | $281,299 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $834,440 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $834,440 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,068,537 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $68,987,242 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $66,269,634 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,685,703 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $224 | TotalAmt |
| Program Services | $224 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,699,361 | TotalAmt |
| Program Services | $20,083,380 | ProgramServicesAmt |
| Management And General | $1,615,981 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,183,131 | TotalAmt |
| Program Services | $1,183,131 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,293,910 | TotalAmt |
| Program Services | $2,293,910 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,459,173 | TotalAmt |
| Program Services | $1,369,692 | ProgramServicesAmt |
| Management And General | $89,481 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$953,522 | TotalAmt |
| Program Services | $1,442,796 | ProgramServicesAmt |
| Management And General | -$2,396,318 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,000 | TotalAmt |
| Management And General | $2,000 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $345,956 | TotalAmt |
| Management And General | $345,956 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,777,846 | TotalAmt |
| Program Services | $2,111,286 | ProgramServicesAmt |
| Management And General | $666,560 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $441,833 | TotalAmt |
| Program Services | $19,372 | ProgramServicesAmt |
| Management And General | $422,461 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,422,525 | TotalAmt |
| Program Services | $1,753,018 | ProgramServicesAmt |
| Management And General | $669,507 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,862,393 | TotalAmt |
| Program Services | $67,545 | ProgramServicesAmt |
| Management And General | $1,794,848 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,203,251 | TotalAmt |
| Program Services | $1,583,200 | ProgramServicesAmt |
| Management And General | $620,051 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $312,865 | TotalAmt |
| Program Services | $204,918 | ProgramServicesAmt |
| Management And General | $107,947 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $158 | TotalAmt |
| Management And General | $158 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,867,979 | TotalAmt |
| Program Services | $9,312,119 | ProgramServicesAmt |
| Management And General | -$444,140 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $358,080 | TotalAmt |
| Management And General | $358,080 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PROFESSIONAL SERVICES | $11,307,156 | $7,476,277 | $3,830,879 |
| BAD DEBT EXPENSE | $7,008,255 | $7,008,255 | |
| TAXES | $1,971 | $3,583 | -$1,612 |
| MEDICAL SUPPLIES | $10,076,095 | $10,012,597 | $63,498 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $165,452 | TotalAmt |
| Program Services | $165,452 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,836,092 | TotalAmt |
| Program Services | $66,090,755 | ProgramServicesAmt |
| Management And General | $7,745,337 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$72,901 | BOYAmt |
| EOY | $140,499 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,605 | BOYAmt |
| EOY | $27,613 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,960,651 | BOYAmt |
| EOY | $10,598,852 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $862,401 | BOYAmt |
| EOY | $873,815 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $856,416 | BOYAmt |
| EOY | $184,648 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $138,185,993 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $54,784,316 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $80,442,540 | BOYAmt |
| EOY | $83,401,677 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $413,628 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $89,076,712 | BOYAmt |
| EOY | $95,640,732 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,370,304 | BOYAmt |
| EOY | $3,332,696 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$116,505 | BOYAmt |
| EOY | -$145,151 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,416,377 | BOYAmt |
| EOY | $86,895,343 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $78,670,176 | BOYAmt |
| EOY | $90,082,888 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,596,613 | BOYAmt |
| EOY | $4,747,921 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $809,923 | BOYAmt |
| EOY | $809,923 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,406,536 | BOYAmt |
| EOY | $5,557,844 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $89,076,712 | BOYAmt |
| EOY | $95,640,732 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$4,848,692 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,230,828 | OtherCostOrOtherBasisAmt |
| Book Value | $2,230,828 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $76,898,056 | OtherCostOrOtherBasisAmt |
| Depreciation | $25,159,426 | DepreciationAmt |
| Book Value | $51,738,630 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $44,994,449 | OtherCostOrOtherBasisAmt |
| Depreciation | $27,827,618 | DepreciationAmt |
| Book Value | $17,166,831 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,062,660 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,797,272 | DepreciationAmt |
| Book Value | $12,265,388 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $83,401,677 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| ASSET RETIREMENT OBLIGATION | $908,798 |
| INTERCOMPANY CONSOLIDATION | $85,986,545 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $86,895,343 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule D - Part VI 1E | FormAndLineReferenceDesc |
| Explanation | Other includes the cost, accumulated depreciation and book value of Land Improvements. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,217,423 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,217,423 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06310 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,828,834 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,219,729 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,609,105 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03900 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,046,257 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,219,729 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,826,528 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10210 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $544 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $544 | NetCommunityBenefitExpnsAmt |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $66,629 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $66,629 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,450 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $10,450 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $77,623 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $77,623 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,123,880 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,219,729 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,904,151 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10330 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $7,008,255 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $25,206,376 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $30,103,620 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$4,897,244 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Riverside Shore Memorial Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 20480 Market Street | AddressLine1Txt |
| City | Onancock | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23417 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | http://www.riversideonline.com/shore/ | WebsiteAddressTxt |
| State License | H 1901 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Riverside Shore Memorial Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Part V, Sec. C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Part V, Sec. C | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400. | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | See Part V, Sec. C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Part V, Sec. C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See Part V, Sec. C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part V Section C | FormAndLineReferenceDesc |
| Explanation | Line 5. In the 2016 CHNA process, Riverside Shore Memorial Hospital worked to conduct a CHNA for the Eastern Shore region of Virginia. RSMH utilized the consulting group Community Health Solutions to conduct a survey of community stakeholders. The RSMH survey was sent to 239 individuals across the area, of which 65 (27%) responded. After the initial surveys were distributed, Riverside reached out through emails, letters and personal phone calls to encourage individuals to take the survey and help provide feedback and guidance in this process. Surveys were sent to individuals who represented the broad community (such as local government, school and business leaders), seniors (such as the Eastern Shore Agency on Aging), minority populations (such as faith community leaders and migrant worker groups), uninsured populations (such as local free clinics), people with behavioral health and substance abuse challenges (such as the Community Services Boards), low income populations (safety net organizations including food banks and area social services departments) and individuals with expertise in public health (including the area Health Department as well as the first responders in the various localities). A full list of the organizations can be found on page 68 of the CHNA. In addition to the initial survey work, a smaller group was assembled to review the CHNA and survey results for the Eastern Shore. This group met multiple times and prioritized the needs to be addressed and provided guidance to Riverside on how to best create an implementation plan that would be meaningful to the community. This smaller group included individuals from local governments, local physician groups, public health department, the Community Services Board and local non-profit groups. The administrator of RSMH also participated in this group. Line 7a. riversideonline.com/about_riverside/community-health-needs.cfm Line 7d. In addition to having the CHNA and Implementation Strategy on the website and available by request the facility, Riverside has made an effort to share the document with regional leaders, including mailing copies to local government officials and representatives as well as sharing with local groups such as the Chamber of Commerce, Rotary groups and other local organizations. Line 10a. riversideonline.com/about_riverside/community-health-needs.cfm Line 11. Through the CHNA process Riverside identified many significant needs in the community. Through meetings with community leaders, Riverside determined to focus its efforts on addressing five main areas of issues: 1) Mental Health 2) Healthy Lifestyle / Obesity; 3) Cancer; 4) Diabetes and 5) Awareness of Services. As noted in more detail in the Implementation Plan, these areas will be addressed through a variety of ways. However, the community advisory group noted that there were many services currently available in the community addressing these issues that individuals were not aware of. They encouraged Riverside to focus its efforts on developing a non-internet based (due to the lack of available high speed internet in the rural location) way of increasing awareness of services specifically recommending a phone based service. Not every need identified through the CHNA process could be addressed as a priority area due to the limitation of resources, the size of the issue and the capacity of existing organizations to impact the problem. Therefore, the following identified issues were not identified as priorities for the 2016 CHNA / Implementation Plan cycle: Chronic Respiratory Conditions, Stroke, Reproductive Health, Infant Mortality and Aging Services. That said, many of these issues are already being addressed through existing Riverside programs, and Riverside will continue to evaluate the possibility of expanding if needs arise. Additionally, some issues that were listed in the survey as potential issues did not rise to the top of the quantitative analysis or qualitative survey process and will also not be addressed as priority issues. These include: Environmental Health, Drowning and Water Safety, Autism, HIV / AIDS, Dental / Oral Care, Neurological Problems, Arthritis, Hunger, Chronic Pain, Renal Disease, Orthopedic Problems, Sexually Transmitted Diseases, Violence, Physical Disabilities and Bullying. Again, some of these areas are already being addressed by existing Riverside Services. Line 16a. riversideonline.com/patients_guests/financial-assistance.cfm Line 16b. riversideonline.com/patients_guests/financial-assistance.cfm Line 16c. riversideonline.com/patients_guests/financial-assistance.cfm | ExplanationTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| Shore MOB | ||||
| 20486 Market Street | Onancock | VA | 23417 | Physcian Offices |
| Shore Healthcare at Home | ||||
| 25379 Lanksford Highway | Onley | VA | 23418 | Home Health Agency |
| Shore Med Center at Metompkin | ||||
| 17385 Lankford Highway | Parksley | VA | 23421 | Diagnostic Center |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part VI | FormAndLineReferenceDesc |
| Explanation | Line 1: Part I Line 3c: Free care uses 200% and discounted care uses 400% of the FPG. Line 1: Part I Line 7, column F: Bad debt expense removed from total expense in line 7, column F is $7,008,255. Line 1: Part I Line 7A: The cost to charge ratio calculated on worksheet 2 was used for the charity expense calculation. Line 1: Part I Line 7B: Medicaid cost and net revenue are directly from the Medicaid cost report. Line 1: Part I Line 7E: Community health improvement is actual cost accumulated by the individuals participating in the activities. Line 1: Part III Line 2: Bad debt is the amount remaining on a patient's account after cash payments, third party payer contractual adjustments and hospital discounts have been taken. Before the amount is written off to bad debt the account is sent to a collection agency which returns the account when they have exhausted all possible effort. Upon return the account balance is written off to bad debt. Line 1: Part III Line 3: Patients eligible under the financial assistance policy were provided 100% discount and therefore were not included in bad debt expense. Line 1: Part III Line 4: Footnote 4 of the Audited Financial Statements states: Patient accounts receivable are reduced by an allowance for uncollectible accounts. In evaluating the collectibility of accounts receivable, the System analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for uncollectible accounts and provision for bad debts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for uncollectible accounts. For receivables associated with services provided to patients who have third-party coverage, the System analyzes contractually due amounts and provides an allowance for uncollectible accounts and a provision for bad debts, if necessary. For receivables associated with self-pay patients (which include both patients without insurance and patients with deductible and co-payment balances due for which third-party coverage exists for part of the bill), the System records a provision for bad debts in the period of service on the basis of its past experience. The difference between standard rates (or discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for uncollectible accounts. Line 1: Part III Line 8: The organization uses CMS cost reporting guidelines and methodology to determine allowable Medicare costs. The shortfall from Medicare should be recognized as a community benefit, since the patients are provided services at a loss for the facility. The Health System is assuring that these essential emergency and acute care services are provided for the population's health. Line 1: Part III Line 9b: Patients eligible under the written Financial Assistance Policy were provided 100% discount and were therefore excluded from debt collection processes. Line 2. Riverside has embraced the Community Health Needs Assessment process as the way to best assess the health care needs of the communities it serves. To supplement this data, Riverside also utilizes resources such as the Virginia Atlas of Community Health, demographic data, as well as observing utilization and diagnoses trends across the Riverside service areas and nationally. Finally, Riverside works closely with other community leaders to identify and respond to local needs. Having community-based, volunteer boards also allows for continuous feedback from individuals living and working in the service area. Line 3: Riverside makes available the Financial Assistance Policy and plain language summary to patients and answers questions patients have about it via our call center. Riverside also screens patients for Medicare, Medicaid and commercial insurances. We will also assist in filling out Medicaid applications and submit retro-authorizations when applicable to assist patients in getting their bill paid or adjusted. Line 4. Virginia's Eastern Shore consists of the southernmost part of the Delmarva Peninsula, and is bordered to the north by Maryland, to the east by the Atlantic Ocean, and to the south and east by the Chesapeake Bay. It is connected to the Hampton Roads region of Virginia by the 23-mile Chesapeake Bay Bridge Tunnel. The 70-mile stretch of land that makes up the Eastern Shore of Virginia is spread across two counties, Accomack to the north and Northampton to the south. The Eastern Shore area is home to approximately 45,000 people. Approximately two thirds of the population located in northern Accomack County while one third in Northampton County. The region is defined by the water, both for the major tourism industry as well as by the watermen who work in the aquaculture industry. Agriculture also plays a key role, with poultry farming and processing employing many people in the area. NASA has a continued presence at the Wallops Island flight facility. Despite multiple industries, the Eastern Shore Region lags in economic development and prosperity compared to the rest of Virginia. Riverside Shore Memorial Hospital is the only hospital on Virginia's Eastern Shore. The closest competition is in Salisbury, Maryland to the north or in Virginia Beach across the Bay Bridge Tunnel to the south. Demographically, the region is approximately two thirds Caucasian and one third African American. There is also a growing migrant community in the region which helps serve the agricultural industry, and the Hispanic community is the fastest growing segment in the region. Per capita income is approximately $23,000. U.S. Census Bureau reports indicate that more than 19 percent of the adult (25+) population have not graduated from high school. Due to the rural nature of the region and its historical isolation, the Eastern Shore lags behind the rest of Virginia in areas of infrastructure development, with limited cell phone service and internet access as significant issues. The Eastern Shore is seeing the aging of the Baby Boomer generation like the rest of Virginia and the country. Individuals age 65+ make up more than 21 percent of the population. The entire region is designated as a Medically Underserved Area. Line 5. In 1916 Riverside was founded by the community in order to serve the community. In the 100 years since then, Riverside has taken pride in caring for each community it serves. While people initially think of Riverside caring for patients one at a time in one of the many hospitals or physician offices, Riverside works to promote the health of its communities in many ways. This passion for meeting the individual needs of its communities is driven by the community-based boards of directors. Riverside Shore Memorial Hospital has a community based board of directors that reports up through the Riverside Health System Board of Directors. This community-based leadership is important, Riverside Shore Memorial Hospital provides critical services to individual patients, but also serves as key community resources in responding to a regional disaster. This has been demonstrated in Riverside's emergency department responding to small communities hit by a tornado as RSMH did in 2014 when the Cherrystone Campground in Northampton County was hit by a tornado. The importance of a local emergency department open 24/7 is crucial for the communities it serves. Additionally, RSMH is the only place on the Virginia's Eastern Shore that offers Labor & Delivery services. If not for RSMH, women would have to go north to Maryland (which does not accept Virginia Medicaid, which is the predominant payor in the region for OB) or travel across the 23 mile bridge-tunnel to Norfolk. However, in severe storms or high winds this bridge tunnel is closed. As a part of the commitment to community, Riverside believes in continual investment in the education of future health care professionals. This belief has been demonstrated since year one, when the School of Nursing opened alongside the original Riverside Hospital. Both have evolved to keep up with local needs, and now the Riverside College of Health Careers trains LPNs, RNs, nursing assistants, physical therapy assistants, surgical technologists and radiologic technologists. Additionally, Riverside has a Medical Residency program that not only trains future physicians but also cares for at risk patient populations through their clinic. In addition to these Riverside programs, hundreds of students in other area programs rotate through Riverside facilities as they complete their journeys to become nurses, doctors, nurse practitioners, physician assistants, pharmacists and other health care professionals. Finally, Riverside also works with local first responders to assist with training for EMTs, police and fire in responding to certain situations. RSMH continues to work with local students in the hea | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAVID JONES | ||||||||||||||
| SERVICE LINE CHIEF | $0 | $122,933 | $0 | $20,151 | $0 | $142,380 | $0 | $26,812 | $0 | $25,460 | $0 | $337,736 | $0 | $0 |
| JOHN PATTERSON | ||||||||||||||
| PHARMACIST | $159,268 | $0 | $0 | $0 | $777 | $0 | $10,440 | $0 | $7,909 | $0 | $178,394 | $0 | $0 | $0 |
| JOHN PETERMAN | ||||||||||||||
| VP/ADMINISTRATOR | $0 | $222,118 | $0 | $34,294 | $0 | $50,968 | $0 | $28,444 | $0 | $8,133 | $0 | $343,957 | $0 | $0 |
| LLOYD KELLAM | ||||||||||||||
| BOARD MEMBER | $0 | $339,032 | $0 | $145,448 | $0 | $50,747 | $0 | $26,812 | $0 | $17,617 | $0 | $579,656 | $0 | $0 |
| LYNETTE PATTERSON | ||||||||||||||
| PHARMACIST | $143,370 | $0 | $0 | $0 | $777 | $0 | $9,362 | $0 | $7,047 | $0 | $160,556 | $0 | $0 | $0 |
| PATRICIA BRADY | ||||||||||||||
| PHARMACIST | $132,165 | $0 | $0 | $0 | $1,062 | $0 | $9,079 | $0 | $21,218 | $0 | $163,524 | $0 | $0 | $0 |
| WALTER AUSTIN | ||||||||||||||
| SR VP, CFO & TREASURER | $0 | $455,949 | $0 | $65,903 | $0 | $74,808 | $0 | $12,150 | $0 | $18,499 | $0 | $627,309 | $0 | $0 |
| WILLIAM DOWNEY | ||||||||||||||
| PRESIDENT,CEO RHS | $0 | $896,511 | $0 | $206,400 | $0 | $205,602 | $0 | $32,212 | $0 | $21,747 | $0 | $1,362,472 | $0 | $0 |
| WADE BROUGHAM | ||||||||||||||
| EVP | $158,297 | $0 | $102,664 | $0 | $1,353,473 | $0 | $22,762 | $0 | $5,075 | $0 | $1,642,271 | $0 | $0 | |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 3 | The compensation committee of the parent corporation, Riverside Healthcare Association, Inc. reviews and approves the compensation for top management using independent consultants and surveys. |
| Schedule J, Part I, Line 4b | John Peterman $ 26,709 Walter Austin $ 54,919 William Downey $ 180,600 Wade Broughman $ 88,975 Total $ 351,203 Riverside has established this SERP to provide retirement benefits to certain executive employees to supplement the retirement benefits to be received from Riverside and Social Security. Although the employee is fully vested in these funds, he/she will not have the right to withdraw these funds until the later of the employee reaching age 62 or separation from service with Riverside. |
| Schedule J, Part I, Line 4A | SEVERANCE PAYMENT WADE BROUGHMAN $1,140,709 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Thurman Charles Renner JR | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | SEE PART V | RelationshipDescriptionTxt |
| Transaction | $15,806 | TransactionAmt |
| Transaction | SEE PART V | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | THURMAN CHARLES RENNER, JR | FormAndLineReferenceDesc |
| Explanation | SCHEDULE L, Part IV THURMAN CHARLES RENNER'S FAMILY MEMBER IS EMPLOYED BY RIVERSIDE SHORE MEMORIAL HOSPITAL. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, Line 6, 7a, & 7b | Riverside Healthcare Association Inc. is the sole corporate member of Shore Health Services Inc. Riverside Healthcare Association Inc. has certain rights such as approval of members of the governing body, mergers, and amendments of organizing documents. |
| Form 990, Part VI, Section B, Line 11b | On behalf of the organization's governing body, the Riverside Healthcare Association, Inc. board of directors salary and pension committee reviews key data from the Form 990. The 990 return was reviewed by an independent accounting firm. |
| Form 990, Part VI, Section B, Line 12c | All Board Members, Officers, Directors and Key Employees complete an annual Conflict of Interest questionnaire. A report of potential Conflicts of Interest is reviewed by the Compliance Officer. Further concern, as reflected in the Conflict of Interest, Financial Disclosure, and Compliance Certification Questionnaire, is reviewed by the Riverside Health System President to determine if additional follow-up is necessary. If a conflict presents, Board Members are required by the By-Laws, to disclose the conflict to the full Board and recuse themselves from voting on a case by case basis. |
| Form 990, Part VI, Section C, Line 19 | The organization makes its governing documents, conflict of interest policy, and financial statements available to the general public upon written request. |
| Tax Relief for Victims of Hurricane Florence in Virginia | The Organization was impacted by the declared major disaster in Virginia caused by Hurricane Florence. The IRS issued a tax relief notice for victims of Hurricane Florence in Virginia. Newport News was one of the counties mentioned as qualifying for tax relief. Specifically, the notice provides tax relief to extend the filing deadline to January 31, 2019 for impacted organizations. The Organization's books and records and all financial information to prepare this Form 990 are located within the Newport News disaster area and were impacted by the major disaster. As a result, the Organization is filing the Form 990 by the extended January 31, 2019 deadline. The Organization is hereby requesting the waiving of any late filing penalties per the notice. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (23 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Ctr for Excellence in Aging & Geriatric | ||||||||||
| 608 Denbigh Blvd Suite 800 | Newport News | VA | 23608 | 061644517 | Research | VA | 501(C)(3) | 7 | RivRetSvc | Yes (true) |
| Charlottesville Area Retirement Svcs Inc | ||||||||||
| 608 Denbigh Blvd Suite 800 | Newport News | VA | 23608 | 454854018 | Pt Services | VA | 501(C)(3) | 10 | RivRetSvc | Yes (true) |
| Doctors' Hospital of Williamsburg | ||||||||||
| 608 Denbigh Blvd Suite 800 | Newport News | VA | 23608 | 271540267 | Hospital | VA | 501(C)(3) | 3 | RivHCAssc | Yes (true) |
| Francis N Sanders Nursing Home Inc | ||||||||||
| 608 Denbigh Blvd Suite 800 | Newport News | VA | 23608 | 540683174 | Nursing Care | VA | 501(C)(3) | 10 | RivHCAssc | Yes (true) |
| Newport News General & Nonsectarian Hosp | ||||||||||
| 608 Denbigh Blvd Suite 800 | Newport News | VA | 23608 | 540505934 | Holding Comp | VA | 501(c)(2) | NA | RivHCAssc | Yes (true) |
| Patrick Henry Hospital Incorporated | ||||||||||
| 608 Denbigh Blvd Suite 800 | Newport News | VA | 23608 | 540610803 | Nursing Care | VA | 501(C)(3) | 3 | RivHCAssc | Yes (true) |
| Patriots Colony Inc | ||||||||||
| 608 Denbigh Blvd Suite 800 | Newport News | VA | 23608 | 541680163 | Ret Community | VA | 501(C)(3) | 10 | RivHCAssc | Yes (true) |
| Rehabilitation Institute of VA Inc | ||||||||||
| 608 Denbigh Blvd Suite 800 | Newport News | VA | 23608 | 521432269 | Hospital | VA | 501(c)(3) | 3 | RivHCAssc | Yes (true) |
| Riverside Convalescent Centers Inc | ||||||||||
| 608 Denbigh Blvd Suite 800 | Newport News | VA | 23608 | 521276323 | Nursing Care | VA | 501(c)(3) | 3 | RivHCAssc | Yes (true) |
| Riverside Health System Foundation | ||||||||||
| 608 Denbigh Blvd Suite 800 | Newport News | VA | 23608 | 541994013 | Foundation | VA | 501(c)(3) | 7 | RivHCAssc | Yes (true) |
| Riverside Healthcare Association Inc | ||||||||||
| 608 Denbigh Blvd Suite 800 | Newport News | VA | 23608 | 521241835 | Financing | VA | 501(c)(3) | 10 | NA | false |
| Riverside Healthcare Foundation Inc | ||||||||||
| 608 Denbigh Blvd Suite 800 | Newport News | VA | 23608 | 521241989 | Foundation | VA | 501(c)(3) | 12c | RivHCAssc | Yes (true) |
| Riverside Healthcare Services Inc | ||||||||||
| 608 Denbigh Blvd Suite 800 | Newport News | VA | 23608 | 521241839 | Management | VA | 501(c)(3) | 12c | RivHCAssc | Yes (true) |
| Riverside Hospital Inc | ||||||||||
| 608 Denbigh Blvd Suite 800 | Newport News | VA | 23608 | 521245746 | Hospital | VA | 501(c)(3) | 3 | RivHCAssc | Yes (true) |
| Riverside Management Services Inc | ||||||||||
| 608 Denbigh Blvd Suite 800 | Newport News | VA | 23608 | 521241840 | Management | VA | 501(c)(3) | 12c | RivHCAssc | |
| Riverside Middle Peninsula Hospital Inc | ||||||||||
| 608 Denbigh Blvd Suite 800 | Newport News | VA | 23608 | 521241836 | Hospital | VA | 501(c)(3) | 3 | RivHCAssc | Yes (true) |
| Riverside Physician Services Inc | ||||||||||
| 608 Denbigh Blvd Suite 800 | Newport News | VA | 23608 | 541519724 | Pt Services | VA | 501(c)(3) | 12c | RivHCAssc | Yes (true) |
| Riverside Retirement Services Inc | ||||||||||
| 608 Denbigh Blvd Suite 800 | Newport News | VA | 23608 | 541348674 | RET COMMUNITY | VA | 501(c)(3) | 10 | RivHCAssc | Yes (true) |
| Riverside Tappahannock Hospital Inc | ||||||||||
| 608 Denbigh Blvd Ste 800 | Newport News | VA | 23608 | 541489410 | Hospital | VA | 501(C)(3) | 3 | RivHCAssc | Yes (true) |
| Riverside Wellness & Fitness Centers Inc | ||||||||||
| 608 Denbigh Blvd Ste 800 | Newport News | VA | 23608 | 541318861 | Fitness | VA | 501(C)(3) | 10 | RivHCAssc | Yes (true) |
| Sanders Common LTD | ||||||||||
| 608 Denbigh Blvd Ste 800 | Newport News | VA | 23608 | 524233030 | Nursing Care | VA | 501(C)(3) | 12c | RivHCAssc | Yes (true) |
| Shore Life Care Inc | ||||||||||
| 608 Denbigh Blvd Suite 800 | Newport News | VA | 23608 | 541876370 | Nursing Care | VA | 501(C)(3) | 10 | ShoreHSvc | Yes (true) |
| Tilden and Virginia Davis Support | ||||||||||
| 608 Denbigh Blvd Ste 800 | Newport News | VA | 23608 | 541527703 | Foundation | VA | 501(C)(3) | 12c | RivRetSvc | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|
| AtHomePtr | |||||||
| 608 Denbigh Blvd Ste 800 | Newport News | VA | 23608 | 472999121 | Management | VA | NA |
| Coastal Virginia Rehabilitation LLC | |||||||
| 608 Denbigh Blvd | Newport News | VA | 23608 | 821270202 | Pt Services | VA | NA |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Peninsula Hospital Services | |||||||||||||
| 608 Denbigh Blvd Ste 800 | Newport News | VA | 23608 | 540991295 | Laundry | VA | NA | COOP | false | ||||
| Riverside Medical Equipment Center Inc | |||||||||||||
| 608 Denbigh Blvd Suite 800 | Newport News | VA | 23608 | 541325596 | Billing | VA | NA | C Corp | false | ||||
| RHS Medinsur LTD | |||||||||||||
| Insurance | NA | C CORP | false | Craig Applin House 8 Wesley Street | Hamilton | BD | BD | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Comments