BRIDGINGLIFE INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- BRIDGINGLIFE INC (EIN 52-1565870)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2018-05-14
- IRS object ID
- 201821349349305132
- Schema version
- 2016v3.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-05-14T13:16:30-05:00 | ReturnTs |
| Tax Period End | 2017-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 205991824 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SC&H Tax & Advisory Services LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 910 Ridgebrook Road | AddressLine1Txt |
| City | Sparks | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 21152 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 521565870 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Carroll Hospice Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CARR | BusinessNameControlTxt |
| Phone | 4108716695 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 292 Stoner Ave | AddressLine1Txt |
| City | Westminster | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 21157 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Kevin Kelbly | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 4108716695 | PhoneNum |
| Signature | 2018-05-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Lori S Burghauser | PreparerPersonNm |
| PTIN | P00370694 | PTIN |
| Phone | 4104031500 | PhoneNum |
| Preparation | 2018-05-09 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 50.206.141.66 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-05-09 | IPDt |
| IP Tm | 20:27:45 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | D598169B7B70477E3779F4FD99F3BFF6A447919F | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Regina Bodnar | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 292 Stoner Ave | AddressLine1Txt |
| City | Westminster | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 21157 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $9,276,934 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.Carrollhospice.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1988 | FormationYr |
| Legal Domicile State | MD | LegalDomicileStateCd |
| Activity Or Mission | CARROLL HOSPICE, AN AFFILIATE OF CARROLL HOSPITAL CENTER, IS DEDICATED TO IMPROVING THE QUALITY OF LIFE FOR PATIENTS NEEDING END-OF-LIFE HOSPICE CARE. OUR COMPREHENSIVE AND COMPASSIONATE CARE IS CENTERED AROUND A HOLISTIC PHILOSOPHY OF TREATMENT THAT ADDRESSES THE PATIENTS PHYSICAL, EMOTIONAL AND SPIRITUAL WELL-BEING, ALLOWING THEM TO LIVE AS FULLY AND COMFORTABLY AS POSSIBLE IN THEIR FINAL DAYS. OUR SERVICES INCLUDE A FULL SPECTRUM OF CARE: PAIN MANAGEMENT AND SYMPTOM CONTROL, COORDINATION OF HOME AND INPATIENT SERVICES, AN INTERDISCIPLINARY TEAM INCLUDING PHYSICIANS, NURSES, SOCIAL WORKERS, CLERGY, PHARMACISTS, HOSPICE VOLUNTEERS, HOME HEALTH AIDES, AND BEREAVEMENT CARE FOR FAMILY MEMBERS FOR UP TO 13 MONTHS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 90 | TotalEmployeeCnt |
| Total Volunteers | 210 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $832,006 | PYContributionsGrantsAmt |
| CY Contributions Grants | $966,672 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $6,179,852 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $8,257,292 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,011 | PYInvestmentIncomeAmt |
| CY Investment Income | $5,444 | CYInvestmentIncomeAmt |
| PY Other Revenue | $33,127 | PYOtherRevenueAmt |
| CY Other Revenue | $34,252 | CYOtherRevenueAmt |
| PY Total Revenue | $7,046,996 | PYTotalRevenueAmt |
| CY Total Revenue | $9,263,660 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,312,207 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,153,812 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $202,310 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,850,572 | PYOtherExpensesAmt |
| CY Other Expenses | $2,632,602 | CYOtherExpensesAmt |
| PY Total Expenses | $6,162,779 | PYTotalExpensesAmt |
| CY Total Expenses | $7,786,414 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $884,217 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,477,246 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $11,259,499 | TotalAssetsBOYAmt |
| Total Assets EOY | $13,003,829 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $81,298 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $178,891 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $11,178,201 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $12,824,938 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | CARROLL HOSPICE, AN AFFILIATE OF CARROLL HOSPITAL CENTER, IS DEDICATED TO IMPROVING THE QUALITY OF LIFE FOR PATIENTS NEEDING END-OF-LIFE HOSPICE CARE. OUR COMPREHENSIVE AND COMPASSIONATE CARE IS CENTERED AROUND A HOLISTIC PHILOSOPHY OF TREATMENT THAT ADDRESSES THE PATIENTS PHYSICAL, EMOTIONAL AND SPIRITUAL WELL-BEING, ALLOWING THEM TO LIVE AS FULLY AND COMFORTABLY AS POSSIBLE IN THEIR FINAL DAYS. OUR SERVICES INCLUDE A FULL SPECTRUM OF CARE: PAIN MANAGEMENT AND SYMPTOM CONTROL, COORDINATION OF HOME AND INPATIENT SERVICES, AN INTERDISCIPLINARY TEAM INCLUDING PHYSICIANS, NURSES, SOCIAL WORKERS, CLERGY, PHARMACISTS, HOSPICE VOLUNTEERS, HOME HEALTH AIDES, AND BEREAVEMENT CARE FOR FAMILY MEMBERS FOR UP TO 13 MONTHS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $5,087,498 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $6,777,686 | RevenueAmt |
| Desc | home hospice carroll hospice provides hospice care in the patients home, nursing home or assisted living facility. Number of patients serviced in fy2017 - 833. days of care provided in fy2017 - 42,395. programs provided - general inpatient hospice care, residential. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,465,045 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $1,480,765 | RevenueAmt |
| Desc | inpatient hospice (dove house) patients in the dove house receive care 24 hours a day from an expert medical team dedicated to helping them live as comfortable and supported as possible. Number of patients served in fy2017 - 496. days of care provided fy2017 - 2,145. programs provided - hospice education to nursing facilities, general hospice patient care, palliative care. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,746 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | bereavement services carroll hospice bereavement program helps families to better understand and cope with their grief, while respecting their unique grieving style. Served 1,298 family members in fy2017. served 3,864 community members in various bv support groups in fy2017. programs provided - pathways, bv luncheon, widow support, widower support, gried speaker at hospice, rememberance service, pet loss support, healing hearts day camp. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $6,554,289 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 43 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 90 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MD | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Amy Engle | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4108717114 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 Memorial Avenue | AddressLine1Txt |
| City | Westminster | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 21157 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| R Wayne Barnes CLU CLTC | |||||||
| Chair | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Delegate Susan Krebs | |||||||
| Vice Chair | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Denise Whitecotton | |||||||
| Secretary | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| James R Andersen Esq | |||||||
| Board Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Regina Bodnar | |||||||
| Board Member/Executive Director | 40.00 | 0.00 | Yes (X) | Yes (X) | $204,465 | $0 | $25,712 |
| Ann M Bollinger | |||||||
| Board Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Janet Buchanan DD | |||||||
| Board Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Mary Darrell | |||||||
| Board Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Shirlyn Evans-Ford | |||||||
| Board Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Ellen Finnerty-Myers | |||||||
| Board Member | 1.00 | 40.00 | Yes (X) | $0 | $370,851 | $24,307 | |
| Thomas Dale Fletcher Jr | |||||||
| Board Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Laura Gillen | |||||||
| Board Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Gary M Merry | |||||||
| Board Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| John W Middleton MD | |||||||
| Board Member | 1.00 | 0.00 | Yes (X) | $0 | $38,457 | $56 | |
| James Miller PD | |||||||
| Board Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Todd Mitchell | |||||||
| Board Member | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Kevin Kelbly | |||||||
| Treasurer/CFO | 1.00 | 40.00 | Yes (X) | $0 | $467,892 | $73,491 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $204,465 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $877,200 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $123,566 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| LONGVIEW NURSING HOME | |||||
| 3332 MAIN STReet | Manchester | MD | 21102 | Pass through Room & Board | $288,989 |
| Beverly Enterprises - Maryland Inc | |||||
| 1000 Fianna Way | Fort Smith | AR | 729192256 | Pass through Room & Board | $116,870 |
| Pleasant View Nursing Home of MT Airy | |||||
| 4101 Old National Park | Mt Airy | MD | 21771 | Pass through Room & Board | $104,637 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $153,760 | FundraisingAmt |
| Related Organizations | $292,282 | RelatedOrganizationsAmt |
| All Other Contributions | $520,630 | AllOtherContributionsAmt |
| Noncash Contributions | $26,207 | NoncashContributionsAmt |
| Total Contributions | $966,672 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Medicare/Medicaid | 623000 | $7,592,583 | $7,592,583 |
| Private | 623000 | $480,586 | $480,586 |
| Program Service Rental | 623000 | $92,745 | $92,745 |
| Physician Service | 623000 | $91,378 | $91,378 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $8,257,292 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,444 | TotalRevenueColumnAmt |
| Exclusion | $5,444 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $46,367 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $153,760 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $13,274 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $33,093 | TotalRevenueColumnAmt |
| Exclusion | $33,093 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Medical Records Copy | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $1,159 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,159 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,159 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,263,660 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,258,451 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $38,537 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $209,773 | TotalAmt |
| Program Services | $209,773 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,081,738 | TotalAmt |
| Program Services | $3,916,436 | ProgramServicesAmt |
| Fundraising | $165,302 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $862,301 | TotalAmt |
| Program Services | $856,089 | ProgramServicesAmt |
| Fundraising | $6,212 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,391,927 | TotalAmt |
| Program Services | $691,505 | ProgramServicesAmt |
| Management And General | $699,472 | ManagementAndGeneralAmt |
| Fundraising | $950 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,816 | TotalAmt |
| Management And General | $28,816 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,262 | TotalAmt |
| Management And General | $19,400 | ManagementAndGeneralAmt |
| Fundraising | $1,862 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,745 | TotalAmt |
| Management And General | $2,745 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $146,028 | TotalAmt |
| Management And General | $146,028 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $131,293 | TotalAmt |
| Program Services | $120,958 | ProgramServicesAmt |
| Management And General | $7,975 | ManagementAndGeneralAmt |
| Fundraising | $2,360 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,361 | TotalAmt |
| Management And General | $8,361 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $170,102 | TotalAmt |
| Program Services | $102,061 | ProgramServicesAmt |
| Management And General | $68,041 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,000 | TotalAmt |
| Management And General | $30,000 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Medical Supplies | $664,691 | $657,467 | $7,128 | $96 |
| Fundraising Expenses | $25,528 | $25,528 | ||
| Training and Education | $11,849 | $11,849 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,786,414 | TotalAmt |
| Program Services | $6,554,289 | ProgramServicesAmt |
| Management And General | $1,029,815 | ManagementAndGeneralAmt |
| Fundraising | $202,310 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,357,841 | BOYAmt |
| EOY | $6,333,125 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,850 | BOYAmt |
| EOY | $80,905 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $869,200 | BOYAmt |
| EOY | $1,034,009 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,835 | BOYAmt |
| EOY | $19,956 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $6,101,172 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,992,946 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,261,572 | BOYAmt |
| EOY | $4,108,226 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $719,201 | BOYAmt |
| EOY | $1,427,608 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,259,499 | BOYAmt |
| EOY | $13,003,829 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,051 | BOYAmt |
| EOY | $117,970 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,247 | BOYAmt |
| EOY | $60,921 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $81,298 | BOYAmt |
| EOY | $178,891 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,861,109 | BOYAmt |
| EOY | $11,338,355 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,317,092 | BOYAmt |
| EOY | $1,486,583 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,178,201 | BOYAmt |
| EOY | $12,824,938 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,259,499 | BOYAmt |
| EOY | $13,003,829 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,477,246 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $169,491 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | 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 (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $840,714 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $844,031 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,315,636 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $832,006 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $966,672 | CurrentTaxYearAmt |
| Total | $4,799,059 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $840,714 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $844,031 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,315,636 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $832,006 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $966,672 | CurrentTaxYearAmt |
| Total | $4,799,059 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $1,255,777 | SubstantialContributorsTotAmt |
| Public Support Total170 | $3,543,282 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $653 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,011 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,444 | CurrentTaxYearAmt |
| Total | $8,108 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $53,275 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $53,577 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $49,715 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $45,935 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $46,367 | CurrentTaxYearAmt |
| Total | $248,869 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $5,056,036 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $29,762,990 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.70080 | PublicSupportCY170Pct |
| Public Support PY170 | 0.78090 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule A, Part II, Line 10, Explanation of Other Income: | FormAndLineReferenceDesc |
| Explanation | Fundraising Gross Income | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,604,613 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,544,852 | DepreciationAmt |
| Book Value | $4,059,761 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $25,879 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,547 | DepreciationAmt |
| Book Value | $20,332 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $470,680 | OtherCostOrOtherBasisAmt |
| Depreciation | $442,547 | DepreciationAmt |
| Book Value | $28,133 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,108,226 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Assets limited as to use | Desc |
| Book Value | $1,427,608 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,427,608 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Due to Carroll affiliates | Desc |
| Amt | $60,921 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $60,921 | TotalLiabilityAmt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Taste of Carroll | Event1Nm |
| Gross Receipts Event1 | $183,212 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $144,615 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $38,597 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $485 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $3,570 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $762 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $100 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $6,709 | OtherDirectExpensesEvent1Amt |
| Event2 | Season to Remember | Event2Nm |
| Gross Receipts Event2 | $16,915 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $9,145 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $7,770 | GrossRevenueEvent2Amt |
| Other Direct Expenses Event2 | $1,649 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $200,127 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $153,760 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $46,367 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $485 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $3,570 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $762 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $100 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $8,358 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $13,275 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $33,092 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Regina Bodnar | ||||||||||||||
| Board Member/Executive Director | $182,061 | $0 | $20,358 | $0 | $2,046 | $0 | $925 | $0 | $24,787 | $0 | $230,177 | $0 | $0 | $0 |
| Ellen Finnerty-Myers | ||||||||||||||
| Board Member | $0 | $238,202 | $0 | $120,064 | $0 | $12,585 | $0 | $18,150 | $0 | $6,157 | $0 | $395,158 | $0 | $0 |
| Kevin Kelbly | ||||||||||||||
| Treasurer/CFO | $0 | $346,545 | $0 | $116,445 | $0 | $4,902 | $0 | $49,436 | $0 | $24,055 | $0 | $541,383 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 4 | During the year the following director participated in an LifeBridge Sponsored Supplemental Nonqualified Retirement Plan: Kevin Kelbly $39,200 |
| Part 1, Line 3 | CARROLL HOSPITAL CENTER COMPENSATES THE EXECUTIVE OF THE ORGANIZATION AND THE ORGANIZATION RELIES ON CARROLL HOSPITAL CENTER TO UTILIZE THE FOLLOWING METHODS IN ESTABLISHING COMPENSATION: COMPENSATION COMMITTEE, WRITTEN EMPLOYMENT CONTRACT, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, FORM 990 OF OTHER ORGANIZATIONS, APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. |
| Compensation Provided by Related Organizations | MRS. FINNERTY-MYERS RECeiVED COMPENSATION AS CHIEF DEVELOPMENT OFFICER OF CARROLL HOSPITAL CENTER, INC., NOT AS A DIRECTOR. Dr. Middleton RECeiVED COMPENSATION AS A PHYSICIAN OF LIFEBRIDGE HEALTH, INC., NOT AS A DIRECTOR. |
Schedule M IRS990ScheduleM
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | Silent Auction Item Donations | Desc |
| Contribution | 43 | ContributionCnt |
| Noncash Contributions Rpt F990 | $26,207 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | CARROLL HOSPITAL CENTER, INC., A 501(C)(3) CORPORATION, IS THE SOLE MEMBER OF CARROLL HOSPICE, INC. |
| Form 990, Part VI, Section A, line 7a | THE SOLE MEMBER OF THE CORPORATION HAS THE RIGHT TO ELECT AND REMOVE TRUSTEES OF THE CORPORATION. THE SOLE MEMBER MAY REMOVE ANY ELECTED TRUSTEE AT ANY TIME, WITH OR WITHOUT CAUSE. EX OFFICIO TRUSTEES SHALL BE DEEMED TO BE REMOVED AS OF THE TIME THEY CEASE TO HOLD THE OFFICE ON WHICH THEIR EX OFFICIO STATUS IS BASED. A VACANCY IN AN EX OFFICIO POSITION SHALL BE FILLED BY THE INDIVIDUAL APPOINTED TO THE UNDERLYING OFFICE. |
| Form 990, Part VI, Section A, line 7b | THE SOLE MEMBER OF THE CORPORATION HAS THE RIGHT TO ELECT AND REMOVE TRUSTEES OF THE CORPORATION, THE RIGHT TO APPROVE AMENDMENTS TO THE BYLAWS, AND SUCH OTHER RIGHTS AS MAY BE CONFERRED BY LAW ON THE MEMBERS OF A NON-STOCK CORPORATION ORGANIZED UNDER THE LAWS OF THE STATE OF MARYLAND. |
| Form 990, Part VI, Section B, line 11b | THE ORGANIZATION'S FORM 990 IS REVIEWED IN DETAIL BETWEEN THE PREPARER, AN OUTSIDE ACCOUNTING FIRM, AND THE FINANCE DEPARTMENT OF CARROLL HOSPITAL CENTER and lifebridge health. PRIOR TO FILING THE ORGANIZATION'S FORM 990, THE ORGANIZATION PROVIDES A COPY OF THE FORM 990 TO EACH MEMBER OF THE ORGANIZATION'S BOARD OF DIRECTORS FOR THEIR REVIEW. QUESTIONS, COMMENTS AND FEEDBACK IS THEN INCORPORATED INTO THE FILED FORM 990. |
| Form 990, Part VI, Section B, line 12c | THE CONFLICT OF INTEREST POLICY APPLIES TO CARROLL HOSPITAL CENTER AND ITS DIRECT AND INDIRECT SUBSIDIARIES. REVIEW OF DISCLOSURE STATEMENTS/REPORT TO THE BOARD: THE CHIEF EXECUTIVE OFFICER OF THE HOSPITAL ORGANIZATION, THE GOVERNANCE COMMITTEE AND THE CORPORATE COMPLIANCE OFFICER SHALL REVIEW THE MATTERS DISCLOSED IN THE DISCLOSURE STATEMENTS AND SHALL SUBMIT TO THE HOSPITAL ORGANIZATION'S BOARD OF DIRECTORS AN ANNUAL SUMMARY OR SPREADSHEET OF THE DISCLOSURES AND THEIR RECOMMENDATION FOR THE RESOLUTION OF ANY CONFLICTS DISCLOSED. IN FORMULATING RECOMMENDATIONS, THE CHIEF EXECUTIVE OFFICER SHALL CONSULT WITH APPROPRIATE OFFICERS OF THE HOSPITAL ORGANIZATION AND COUNSEL AS NECESSARY. THE BOARD OF DIRECTORS OF THE HOSPITAL ORGANIZATION, ACTING IN THE BEST INTERESTS OF THE HOSPITAL ORGANIZATION, SHALL HAVE SOLE DISCRETION TO MAKE ALL FINAL DECISIONS REGARDING CONFLICTS OF INTEREST, OTHER THAN THOSE REGARDING GIFTS TO HOSPITAL ORGANIZATION EMPLOYEES WHICH SHALL BE RESOLVED BY THE APPROPRIATE SUPERVISORY EXECUTIVE. HOWEVER, NO PERSON SHALL BE INVOLVED IN CONSIDERING THE EXISTENCE OF AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST, IN THE MANAGEMENT AND OVERSIGHT OF A CONFLICT RELATIONSHIP, OR IN DETERMINATION OF DISCIPLINE FOR VIOLATIONS OF THIS POLICY, IF THAT PERSON IS A PARTY OR POTENTIAL PARTY TO THAT CONFLICT. ALL FINAL DECISIONS REGARDING CONFLICTS OF INTEREST SHALL BE REFLECTED IN A REVISED ANNUAL SUMMARY OR SPREADSHEET OF CONFLICT DISCLOSURES WHICH WILL BE SHARED WITH EACH DIRECTOR. THE CHAIR AND VICE-CHAIR OF THE BOARD, AND ALL BOARD COMMITTEE CHAIRS, SHALL HAVE THIS REVISED SUMMARY OR SPREADSHEET AVAILABLE AT THE TIME OF ALL BOARD AND BOARD COMMITTEE MEETINGS IN CASE A MATTER INVOLVING A POTENTIAL CONFLICT ARISES. CONFLICT OF INTEREST RECUSAL PROCEDURE FOR BOARD MEETINGS: WHENEVER A HOSPITAL ORGANIZATIONS' BOARD OR BOARD COMMITTEE IS TO CONSIDER A TRANSACTION OR AN ARRANGEMENT WITH ANOTHER ORGANIZATION, ENTITY OR INDIVIDUAL IN WHICH OR WITH WHOM A PERSON COVERED BY THIS POLICY HAS A RELATIONSHIP CREATING AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST, THE FOLLOWING PROCEDURES SHALL BE EMPLOYED: A. THE INTERESTED PERSON MUST FULLY DISCLOSE THE ACTUAL OR POTENTIAL CONFLICT OF INTEREST TO THE BOARD; B. THE INTERESTED PERSON SHOULD BE ASKED TO LEAVE THE MEETING DURING DISCUSSION OF THE POTENTIAL CONFLICT AND ANY RELATED VOTES, BUT THE INTERESTED PERSON MAY MAKE A STATEMENT OR ANSWER ANY QUESTIONS ON THE MATTER BEFORE DEPARTING THE MEETING; C. IF APPROPRIATE, THE BOARD OR BOARD COMMITTEE MAY APPOINT A NON-INTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT; D. TO CONSIDER THE PROPOSED TRANSACTION OR ARRANGEMENT, THE BOARD MUST: 1. FIND, BY A MAJORITY VOTE OF DIRECTORS THEN IN OFFICE, NOT COUNTING THE INTERESTED PERSON, THAT THE PROPOSED TRANSACTION OR ARRANGEMENT IS IN THE HOSPITAL ORGANIZATION'S BEST INTEREST AND FOR THE HOSPITAL ORGANIZATION'S OWN BENEFIT, IT IS FAIR AND REASONABLE, AND THAT AFTER REASONABLE INVESTIGATION, THE HOSPITAL ORGANIZATION CANNOT OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT USING REASONABLE EFFORTS; AND 2. VOTE ON THE TRANSACTION OR ARRANGEMENT, APPROVAL REQUIRING A MAJORITY VOTE OF DIRECTORS THEN IN OFFICE, NOT COUNTING THE INTERESTED PERSON. E. THE MINUTES SHOULD INCLUDE: (1) THE NAME OF THE PERSON DISCLOSING THE CONFLICT OF INTEREST AND A DESCRIPTION OF THE CONFLICT; (2) THE BOARD'S DETERMINATION OF WHETHER THERE IS A CONFLICT; (3) THE NAMES AND VOTES OF PERSONS PRESENT FOR THE DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT; AND (4) THE CONTENT OF THOSE DISCUSSIONS INCLUDING THE BOARD'S DETERMINATION OF WHETHER OR NOT THE TRANSACTION OR ARRANGEMENT IS IN THE HOSPITAL ORGANIZATION'S BEST INTEREST, FAIR AND REASONABLE, AND THE BEST REASONABLY AVAILABLE ALTERNATIVE. ONGOING DUTY TO DISCLOSE ONE'S OWN OR OTHERS' CONFLICTS OF INTEREST: AS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST CAN ARISE AT ANY TIME, ANY ACTUAL OR POTENTIAL CONFLICT MUST BE DISCLOSED PROMPTLY IN WRITING BY USE OF A SUPPLEMENTAL DISCLOSURE STATEMENT, AS SOON AS ITS EXISTENCE IS OR SHOULD BE KNOWN. IF A PERSON IS IN DOUBT ABOUT A SITUATION, THE PERSON SHOULD CONSULT WITH THE CHIEF EXECUTIVE OFFICER, BOARD CHAIRMAN OR THE HOSPITAL ORGANIZATION'S COMPLIANCE OFFICER. PERSONS SHOULD ERR ON THE SIDE OF DISCLOSURE SO THAT A CONFLICT OF INTEREST ASSESSMENT CAN BE MADE. THE POTENTIAL CONFLICT WILL BE REFERRED TO THE GOVERNANCE COMMITTEE FOR REVIEW AND A RESPONSE WILL BE PROVIDED WITHIN 14 DAYS. NONCOMPLIANCE WITH THE POLICY: THE ORGANIZATION'S BOARD OF DIRECTORS RETAINS BROAD POWER AND SOLE DISCRETION UNDER THIS POLICY TO: (1) DETERMINE THE EXISTENCE OF ACTUAL OR POTENTIAL CONFLICTS OF INTEREST; (2) SUBJECT CONFLICT OF INTEREST RELATIONSHIPS TO APPROPRIATE OVERSIGHT, MANAGEMENT, CONDITIONS, RESTRICTIONS AND PROHIBITIONS; AND (3) IMPOSE APPROPRIATE SANCTIONS. A BREACH OF THIS POLICY CAN BECOME GROUNDS FOR DISCIPLINE, UP TO AND INCLUDING REMOVAL FROM OFFICE OR, FOR MANAGEMENT PERSONNEL, TERMINATION OF EMPLOYMENT. IT MAY ALSO RESULT IN CESSATION OF BUSINESS WITH A VENDOR AND IN LIABILITY FOR DAMAGES. GROUNDS FOR DISCIPLINE INCLUDE, BUT ARE NOT LIMITED TO: A. WILLFUL FAILURE TO SIGN AND RETURN THE CONFLICT OF INTEREST DISCLOSURE STATEMENT IN ACCORD WITH THIS POLICY; B. A MATERIAL MISSTATEMENT OR OMISSION IN THE DISCLOSURE STATEMENT; C. WILLFUL FAILURE TO DISCLOSE AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST AT ANY TIME IN ACCORD WITH THE REQUIREMENTS OF THIS POLICY; D. WILLFUL PARTICIPATION IN A VOTE OR DECISION INVOLVING A TRANSACTION WHICH RAISES AN UNDISCLOSED CONFLICT OF INTEREST; OR E. WILLFUL DISCLOSURE OR USE OF CONFIDENTIAL INFORMATION REGARDING THE AFFAIRS, BUSINESS OR PLANS OF A HOSPITAL ORGANIZATION FOR ANY PURPOSE OTHER THAN IN FURTHERANCE OF THE AFFAIRS AND BEST INTERESTS OF THE HOSPITAL ORGANIZATION. |
| Form 990, Part VI, Section B, line 15 | THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF LIFEBRIDGE HEALTH, WHICH IS COMPRISED OF INDEPENDENT BOARD MEMBERS DETERMINED TO BE FREE OF ANY CONFLICT OF INTEREST, IS CHARGED WITH DETERMINING EXECUTIVE COMPENSATION AND ESTABLISHING PERFORMANCE CRITERIA ACCORDING TO AN APPROVED COMPENSATION PHILOSOPHY. THE COMMITTEE WORKS WITH AN INDEPENDENT EXECTUVE COMPENSATION CONSULTING AND ADVISORY FIRM THAT PROVIDES MARKET SURVEY DATA CONCERNING COMPENSATION AND BENEFIT LEVELS FOR FUNCTIONALLY COMPARABLE HEATLHCARE EXECUTIVES IN SIMILAR HEALTH SYSTEMS AND HOSPITALS ACROSS THE REGION AND NATION BASED ON SEVERAL FACTORS INCLUDING SIZE, REVENUES, HOSPITAL TYPE AND COMPLEXITY. THE COMMITTEE REVIEWS AND APPROVES THE COMPENSATION OF THE SENIOR EXECUTIVES AND ENSURES THAT ALL FORMS OF EXECUTIVE COMPENSATION ARE REASONABLE, APPROPRIATE AND CONSISTENT WITH ITS ESTABLISHED COMPENSATION PHILOSOPHY. CARROLL HOSPITAL CENTER HAS A WRITTEN POLICY REGARDING THE REVIEW OF PHYSICIAN COMPENSATION TO ENSURE THE PAYMENTS BETWEEN THE HOSPITAL AND THE PHYSICIAN ARE BOTH COMMERCIALLY REASONABLE AND NOT GREATER THAN FAIR MARKET VALUE FOR THE SERVICES RENDERED. THE POLICY APPLIES TO CARROLL HOSPITAL CENTER AND EACH OF ITS SUBSIDIARIES/AFFILIATES. PURSUANT TO THE POLICY, CARROLL HOSPITAL CENTER, IN ORDER TO ENSURE THE PAYMENTS TO PHYSICIANS ARE COMMERCIALLY REASONABLE AND CONSISTENT WITH FAIR MARKET VALUE, UNDERTAKES A NUMBER OF REVIEW ACTIVITIES, INCLUDING REVIEWING COMPENSATION INFORMATION FROM COMPENSATION SURVEY AND RELIABLE DATA SUCH AS RECENT EARNINGS AND THIRD PARTY VALUATIONS. |
| Form 990, Part VI, Section C, line 19 | THIS ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND AUDITED FINANCIALS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| Form 990, Part IX, line 11g | Purchased Services: Program service expenses 251,023. Management and general expenses 314,472. Fundraising expenses 950. Total expenses 566,445. Hospice Administrative Fee: Program service expenses 0. Management and general expenses 385,000. Fundraising expenses 0. Total expenses 385,000. DME Rental Fees: Program service expenses 440,482. Management and general expenses 0. Fundraising expenses 0. Total expenses 440,482. |
| Form 990, Part XI, line 9: | Transfer from Affiliate 169,491. |
| Part XII, Line 2C | This process has not changed from the prior year. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (13 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 | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Carroll Hospital Center Inc | |||||||||||
| 200 Memorial Avenue | Westminster | MD | 21157 | 521452024 | Hospital | MD | 501(c)3 | Line 3 | Carroll County Health Services Corporation | 0 | |
| Carroll Hospital Center Foundation Inc | |||||||||||
| 200 Memorial Avenue | Westminster | MD | 21157 | 521115038 | Foundation | MD | 501(c)3 | Line 12a, I | Carroll Hospital Center Inc | 0 | |
| Carroll County Health Services Inc | |||||||||||
| 200 Memorial Avenue | Westminster | MD | 21157 | 520691413 | Health Service | MD | 501(c)3 | Line 12b, II | LifeBridge Health Inc | 0 | |
| Partnership for a Healthier Carroll County | |||||||||||
| 535 Old Westminster Pike Suite 102 | Westminster | MD | 21157 | 522156892 | Health Service | MD | 501(c)3 | Line 7 | Carroll Hospital Center Inc | 0 | |
| LifeBridge Health Inc | |||||||||||
| 2401 West Belvedere Avenue | Baltimore | MD | 21215 | 521402373 | To Support the charitable mission of its subsidaries | MD | 501(c)3 | Line 12c, III-FI | 0 | N/A | |
| Levindale Hebrew Geriatric Center and Hospital | |||||||||||
| 2434 West Belvedere Avenue | Baltimore | MD | 21215 | 520607913 | Geriatric Hospital Dedicated to Providing Service to the Aged | MD | 501(c)3 | Line 3 | LifeBridge Health Inc | 0 | |
| Sinai Hospital of Baltimore Inc | |||||||||||
| 2401 West Belvedere Avenue | Baltimore | MD | 21215 | 520486540 | Provide Medical Care, Educate Students, Perform Medical Research | MD | 501(c)3 | Line 3 | LifeBridge Health Inc | 0 | |
| Courtland Gardens Nursing and Rehabilitation Center | |||||||||||
| 2343 West Belvedere Avenue | Baltimore | MD | 21215 | 520607907 | Skilled Nursing Care for the Elderly and Disabled | MD | 501(c)3 | Line 10 | LifeBridge Health Inc | 0 | |
| Northwest Hospital Center Inc | |||||||||||
| 5401 Old Court Road | Randallstown | MD | 21133 | 521372665 | A Hospital Aspiring to Improve the wellbeing of the Community it Serves | MD | 501(c)3 | Line 3 | LifeBridge Health Inc | 0 | |
| Children's Hospital of Baltimore City | |||||||||||
| 2401 West Belvedere Avenue | Baltimore | MD | 21215 | 520591592 | Charity Support for Sinai Hospital of Baltimore, Inc. | MD | 501(c)3 | Line 12b, II | LifeBridge Health Inc | 0 | |
| Children's Hospital at Sinai Foundation | |||||||||||
| 2401 West Belvedere Avenue | Baltimore | MD | 21215 | 522167587 | Charity Support for Sinai Hospital of Baltimore, Inc. | MD | 501(c)3 | Line 12b, II | LifeBridge Health Inc | 0 | |
| The Baltimore Jewish Eldercare Foundation | |||||||||||
| 2401 West Belvedere Avenue | Baltimore | MD | 21215 | 522337669 | Charity Support for Levindale Hebrew Geriatric Center Hospital | MD | 501(c)3 | Line 12b, II | LifeBridge Health Inc | 0 | |
| The Baltimore Jewish Health Foundation Inc | |||||||||||
| 2401 West Belvedere Avenue | Baltimore | MD | 21215 | 522111541 | Charity Support for Sinai Hospital of Baltimore, Inc. | MD | 501(c)3 | Line 12b, II | LifeBridge Health Inc | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (22 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| LifeBridge NeuroSciences LLC (Formally Orthopedic Specialists LLC) | |||||||
| 2401 West Belvedere Avenue | Baltimore | MD | 21215 | 450719598 | Medical Services | MD | N/A |
| LifeBridge Gynecology of Pikesville LLC | |||||||
| 2401 West Belvedere Avenue | Baltimore | MD | 21215 | 462949092 | Medical Services | MD | N/A |
| LifeBridge Medical Associates LLC | |||||||
| 2401 West Belvedere Avenue | Baltimore | MD | 21215 | 462941505 | Medical Services | MD | N/A |
| LifeBridge Community Pediatrics LLC | |||||||
| 2401 West Belvedere Avenue | Baltimore | MD | 21215 | 462842468 | Medical Services | MD | N/A |
| LifeBridge Community Pulmonology LLC | |||||||
| 2401 West Belvedere Avenue | Baltimore | MD | 21215 | 461401312 | Medical Services | MD | N/A |
| LifeBridge Community Gastroenterology LLC | |||||||
| 2401 West Belvedere Avenue | Baltimore | MD | 21215 | 462863298 | Medical Services | MD | N/A |
| LifeBridge Cardiology Parkville LLC | |||||||
| 2401 West Belvedere Avenue | Baltimore | MD | 21215 | 463742313 | Medical Services | MD | N/A |
| Homecare Marlyand LLC | |||||||
| 8028 Ritchie Highway Suite 210B | Pasadena | MD | 21122 | 261378175 | Medical Services | MD | N/A |
| LifeBridge Rehabilitation Services LLC | |||||||
| 2401 West Belvedere Avenue | baltimore | MD | 21215 | 811504380 | medical Services | MD | N/A |
| Cardiovascular Associates of Maryland LLC | |||||||
| 2401 West Belvedere Avenue | Baltimore | MD | 21215 | 462935110 | Medical Services | MD | N/A |
| Carroll Occupational Health LLC | |||||||
| 7001 Corporate Center Court | Westminster | MD | 21157 | 202769332 | Occupational | MD | N/A |
| Carroll County Radiology LLC | |||||||
| 7253 Ambassador Road | Baltimore | MD | 21244 | 522190849 | Radiology | MD | N/A |
| LifeBridge Primary Care of Eldersburg LLC | |||||||
| 2401 West Belvedere Avenue | Baltimore | MD | 21215 | 383897702 | Medical Services | MD | N/A |
| LifeBridge Primary Care of North Carroll LLC | |||||||
| 2401 West Belvedere Avenue | Baltimore | MD | 21215 | 800883321 | Medical Services | MD | N/A |
| Ellicott City ASC Management LLC | |||||||
| 2401 West Belvedere Avenue | Baltimore | MD | 21215 | 522331663 | Medical Services | MD | N/A |
| SurgiCenter of Baltimore LLC | |||||||
| 2401 West Belvedere Avenue | Baltimore | MD | 21215 | 521658841 | Medical Services | MD | N/A |
| Mount Airy Med-Services LLC 46-5632176 200 Memorial Avenue Westminster Mary | |||||||
| 200 Memorial Avenue | Westminster | MD | 21157 | 465632176 | Medical Services | MD | N/A |
| Springwell Partners LLC | |||||||
| 2200 Pine Hill Farms Lane | Hunt Valley | MD | 21030 | 271971171 | Assisted Living | MD | N/A |
| LifeBridge Suburban Physician Group II LLC | |||||||
| 5401 Old Court Road | Randallstown | MD | 21133 | 814209029 | Medical Services | MD | N/A |
| LifeBridge Lab Management LLC | |||||||
| 2401 West Belvedere Avenue | Baltimore | MD | 21215 | 821113874 | Laboratory Services | MD | N/A |
| LifeBridge Metropolitan Physician Group II LLC | |||||||
| 2401 West Belvedere Avenue | Baltimore | MD | 21215 | 814223537 | Medical Services | MD | N/A |
| LifeBridge Multi-Specialty LLC | |||||||
| 41 Magna Way Suite 100 | Westminster | MD | 21157 | 463753120 | Medical Services | MD | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (11 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | Province Or StateForeignAddress/ProvinceOrStateNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Carroll County Med Services Inc | ||||||||||||||
| 200 Memorial Avenue | Westminster | MD | 21157 | 521891102 | Medical Service | MD | N/A | C | 0 | |||||
| LifeBridge Investments Inc | ||||||||||||||
| 2401 West Belvedere Avenue | Baltimore | MD | 21215 | 521483166 | Investments | MD | N/A | C | 0 | |||||
| Healthstar Medical Services Inc | ||||||||||||||
| 2401 West Belvedere Avenue | Baltimore | MD | 21215 | 521829098 | Healthcare | MD | N/A | C | 0 | |||||
| Practice Dynamics Inc | ||||||||||||||
| 124 Business Center Drive | Reisterstown | MD | 21136 | 521960319 | Management | MD | N/A | C | 0 | |||||
| LifeBridge Insurance Company Ltd | ||||||||||||||
| 980415396 | Insurance | N/A | C | 0 | PO Box 1109 | Grand Cayman | CJ | KY1-1102 | CJ | |||||
| LifeBridge Community Physicians Inc | ||||||||||||||
| 2401 West Belvedere Avenue | Baltimore | MD | 21215 | 800719005 | Healthcare | MD | N/A | C | 0 | |||||
| Carroll Billing Services Inc | ||||||||||||||
| 200 Memorial Avenue | Westminster | MD | 21157 | 300026598 | Healthcare Services | MD | N/A | C | 0 | |||||
| Carroll County General Hospital South Carroll Medical Center Condominium | ||||||||||||||
| 200 Memorial Avenue | westminster | MD | 21157 | Real Estate | MD | N/A | C | 0 | ||||||
| Med-Services Holdings Inc | ||||||||||||||
| 200 Memorial Avenue | Westminster | MD | 21157 | Medical Service | MD | N/A | C | 0 | ||||||
| Carroll Health Group LLC | ||||||||||||||
| 200 Memorial Avenue | Westminster | MD | 21157 | 271956453 | Healthcare | MD | N/A | C | 0 | |||||
| Carroll Urgent Care LLC | ||||||||||||||
| 200 Memorial Avenue | Westminster | MD | 21157 | 465739154 | Healthcare | MD | N/A | C | 0 | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Carroll Care Pharmacies LLC | ||
| M | $580,644 | FMV |
| Carroll Hospital Center Inc | ||
| P | $5,858,723 | FMV |
| Carroll Hospital Center Inc | ||
| M | $75,000 | FMV |
| Carroll Hospital Center Foundation Inc | ||
| C | $52,282 | FMV |
| Carroll Hospital Center Inc | ||
| C | $240,000 | FMV |
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