SHORE HEALTH SERVICES INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
SHORE HEALTH SERVICES INC (EIN 54-0560500)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-11-15
IRS object ID
201713199349312671
Schema version
2016v3.1
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2017-11-15T14:29:27-06:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1800 YARD STREET SUITE 200AddressLine1Txt
CityCOLUMBUSCityNm
State AbbreviationOHStateAbbreviationCd
ZIP43212ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN540560500EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SHORE HEALTH SERVICES INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% VP OF FINANCE RHA INCInCareOfNm
Business Name ControlSHORBusinessNameControlTxt
Phone7578757838PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1608 Denbigh Blvd Suite Ste 800AddressLine1Txt
CityNewport NewsCityNm
State AbbreviationVAStateAbbreviationCd
ZIP236084487ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonW WILLIAM AUSTIN JRPersonNm
Person TitleSR VP & CFOPersonTitleTxt
Phone7578757838PhoneNum
Signature2017-11-14SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDIANE L BEANPreparerPersonNm
PTINP00104972PTIN
Phone6142325678PhoneNum
Preparation2017-11-07PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address164.57.159.254IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id31499120173195000015FederalOriginalSubmissionId
Federal Original Submission Id2017-11-15FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id582F47EFACDD6166E52205D1FBFEA2601660FA18AtSubmissionCreationDeviceId
At Submission Filing Device Id0C6C8F7C1C22E68F83DAB8678A3CDB7085AC22F8AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerWilliam DowneyPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1608 Denbigh BlvdAddressLine1Txt
CityNewport NewsCityNm
State AbbreviationVAStateAbbreviationCd
ZIP236084487ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$67,555,307GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresshttp://www.riversideonline.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1928FormationYr
Legal Domicile StateVALegalDomicileStateCd
Activity Or MissionHealthcare ServicesActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee483TotalEmployeeCnt
Total Volunteers37TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$5,000CYContributionsGrantsAmt
PY Program Service Revenue$59,871,288PYProgramServiceRevenueAmt
CY Program Service Revenue$64,964,449CYProgramServiceRevenueAmt
PY Investment Income-$10,828PYInvestmentIncomeAmt
CY Investment Income-$6,640CYInvestmentIncomeAmt
PY Other Revenue$949,103PYOtherRevenueAmt
CY Other Revenue$2,021,861CYOtherRevenueAmt
PY Total Revenue$60,809,563PYTotalRevenueAmt
CY Total Revenue$66,984,670CYTotalRevenueAmt
PY Grants And Similar Paid$750PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$226CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$22,376,679PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$23,837,879CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$38,407,924PYOtherExpensesAmt
CY Other Expenses$45,170,306CYOtherExpensesAmt
PY Total Expenses$60,785,353PYTotalExpensesAmt
CY Total Expenses$69,008,411CYTotalExpensesAmt
PY Revenues Less Expenses$24,210PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$2,023,741CYRevenuesLessExpensesAmt
Total Assets BOY$51,756,468TotalAssetsBOYAmt
Total Assets EOY$89,076,712TotalAssetsEOYAmt
Total Liabilities BOY$39,326,191TotalLiabilitiesBOYAmt
Total Liabilities EOY$78,670,176TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$12,430,277NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$10,406,536NetAssetsOrFundBalancesEOYAmt
MissionTO CARE FOR OTHERS AS WE WOULD CARE FOR THOSE WE LOVE - TO ENHANCE THEIR WELL-BEING AND IMPROVE THEIR HEALTH.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$44,992,755ExpenseAmt
Grant$226GrantAmt
Revenue$65,011,162RevenueAmt
DescGENERAL HOSPITAL SERVICES PROVIDED TO THE COMMUNITY. THE NUMBER OF PERSONS BENEFITED IN 2016 WAS 113,825 AND THE TOTAL QUANTIFIABLE COMMUNITY BENEFITS WERE 17,566,502.Desc
Total Program Service Expenses$44,992,755TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document43IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee483EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonVP OF FINANCE RHA INCPersonNm
Phone7578757838PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1608 DENBIGH BLVD 800AddressLine1Txt
CityNEWPORT NEWSCityNm
State AbbreviationVAStateAbbreviationCd
ZIP23608ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
JANE BULETTE
BOARD MEMBER1.00.0Yes (X)$0$0$0
ROBERT LALOR
VICE CHAIRMAN1.00.0Yes (X)$0$0$0
CLYDE DAVIS
CHAIRMAN1.00.0Yes (X)$0$0$0Yes (X)
ROBERT CROCKETT
BOARD MEMBER1.00.0Yes (X)$0$0$0
JEFFREY HOLLAND
BOARD MEMBER1.00.0Yes (X)$0$0$0
LLOYD KELLAM L
BOARD MEMBER1.00.0Yes (X)$0$0$0
WADE BROUGHMAN
EXEC VP/COO RHS & SECRETARY1.039.0Yes (X)$0$851,612$35,376Yes (X)
DAVID PARKER
BOARD MEMBER1.00.0Yes (X)$0$0$0
CATHY RIOPEL
BOARD MEMBER1.00.0Yes (X)$0$0$0
THURMAN RENNER
BOARD MEMBER1.00.0Yes (X)$0$0$0
RICHARD HUBBARD
BOARD MEMBER1.00.0Yes (X)$0$0$0
Robert LEATHERBURY
Board member1.00.0Yes (X)$0$0$0
CARAMINE KELLAM
BOARD MEMBER1.00.0Yes (X)$0$0$0
LINDA THOMAS-GLOVER
BOARD MEMBER1.00.0Yes (X)$0$0$0
JOHN PETERMAN
VP/ADMINISTRATOR1.039.0Yes (X)$0$295,027$26,655
WILLIAM DOWNEY
PRESIDENT,CEO RHS1.039.0$0$1,341,551$34,785Yes (X)
WALTER AUSTIN
SR VP,CFO RHS & TREASURER1.039.0$0$593,189$20,496Yes (X)
DAVID JONES
SERVICE LINE CHIEF1.039.0$0$303,576$46,497Yes (X)
JOHN PATTERSON
PHARMACIST37.00.0$141,757$0$15,933Yes (X)
PATRICIA BRADY
PHARMACIST34.00.0$123,459$0$28,676Yes (X)
EILEEN MACDOUGALL
DEPT DIRECTOR38.00.0$129,365$0$4,218Yes (X)
LYNETTE PATTERSON
PHARMACIST34.00.0$127,619$0$14,181Yes (X)
MONA TURNER
DEPT DIRECTOR36.00.0$118,771$0$16,402Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$640,971TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,384,955TotReportableCompRltdOrgAmt
Total Other Compensation$243,219TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K19IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
NONE
FISHER SCIENTIFIC COMPANY LLC
PO BOX 404705ATLANTAGA303844705Professional Service$106,211
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
All Other Contributions$5,000AllOtherContributionsAmt
Total Contributions$5,000TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT REVENUE900099$64,982,798$64,982,798
MEANINGFUL USE INCENTIVE PAYMENTS900099-$18,349-$18,349
FieldValueIRS element (for citing)
Total Program Service Revenue$64,964,449TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,018TotalRevenueColumnAmt
Exclusion$7,018ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$58,733RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$12,020RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$46,713RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$46,713TotalRevenueColumnAmt
Related Or Exempt Func Income$46,713RelatedOrExemptFuncIncomeAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$572,275OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$558,617OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$13,658OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$13,658TotalRevenueColumnAmt
Exclusion-$13,658ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
THRIFT STORE SALES900099$648,259$648,259
CAFETERIA REVENUE900099$216,680$216,680
PHARMACY SALES900099$184,662$184,662

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$925,547TotalRevenueColumnAmt
Exclusion$925,547ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$1,975,148OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$66,984,670TotalRevenueColumnAmt
Related Or Exempt Func Income$65,011,162RelatedOrExemptFuncIncomeAmt
Exclusion$1,968,508ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$226TotalAmt
Program Services$226ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$19,097,206TotalAmt
Program Services$18,247,075ProgramServicesAmt
Management And General$850,131ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,393,666TotalAmt
Management And General$1,393,666ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,963,396TotalAmt
Program Services$1,294,594ProgramServicesAmt
Management And General$668,802ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,383,611TotalAmt
Program Services$1,310,584ProgramServicesAmt
Management And General$73,027ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total-$972,025TotalAmt
Program Services$481,655ProgramServicesAmt
Management And General-$1,453,680ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$5,106TotalAmt
Program Services$5,106ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$360,330TotalAmt
Program Services$224ProgramServicesAmt
Management And General$360,106ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,693,966TotalAmt
Program Services$1,655,597ProgramServicesAmt
Management And General$38,369ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$460,047TotalAmt
Program Services$55,957ProgramServicesAmt
Management And General$404,090ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,433,440TotalAmt
Program Services$2,006,720ProgramServicesAmt
Management And General$426,720ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,713,318TotalAmt
Program Services$121,808ProgramServicesAmt
Management And General$1,591,510ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,765,069TotalAmt
Program Services$919,691ProgramServicesAmt
Management And General$845,378ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$282,222TotalAmt
Program Services$257,847ProgramServicesAmt
Management And General$24,375ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$9,966,796TotalAmt
Program Services$5,801,470ProgramServicesAmt
Management And General$4,165,326ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,745,447TotalAmt
Program Services$1,337,980ProgramServicesAmt
Management And General$3,407,467ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$314,608TotalAmt
Management And General$314,608ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PROFESSIONAL SERVICES$2,821,914$2,672,910$149,004
BAD DEBT EXPENSE$11,232,914$549,108$10,683,806
TAXES$2,625$4,379-$1,754
MEDICAL SUPPLIES$8,344,529$8,269,824$74,705

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$69,008,411TotalAmt
Program Services$44,992,755ProgramServicesAmt
Management And General$24,015,656ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY-$51,239BOYAmt
EOY-$72,901EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$27,627BOYAmt
EOY$27,605EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$6,191,947BOYAmt
EOY$6,960,651EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,003,401BOYAmt
EOY$862,401EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$626,414BOYAmt
EOY$856,416EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$129,553,538LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$49,110,998LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$43,958,318BOYAmt
EOY$80,442,540EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$51,756,468BOYAmt
EOY$89,076,712EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,927,980BOYAmt
EOY$3,370,304EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY-$82,389BOYAmt
EOY-$116,505EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$36,480,600BOYAmt
EOY$75,416,377EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$39,326,191BOYAmt
EOY$78,670,176EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$11,620,354BOYAmt
EOY$9,596,613EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$809,923BOYAmt
EOY$809,923EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$12,430,277BOYAmt
EOY$10,406,536EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$51,756,468BOYAmt
EOY$89,076,712EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$2,023,741ReconcilationRevenueExpnssAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,250,827OtherCostOrOtherBasisAmt
Book Value$2,250,827BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$94,713,485OtherCostOrOtherBasisAmt
Depreciation$18,260,855DepreciationAmt
Book Value$76,452,630BookValueAmt
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$31,734,660OtherCostOrOtherBasisAmt
Depreciation$30,067,114DepreciationAmt
Book Value$1,667,546BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$854,566OtherCostOrOtherBasisAmt
Depreciation$783,029DepreciationAmt
Book Value$71,537BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$80,442,540TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
ASSET RETIREMENT OBLIGATION$882,328
I/C CONSOL$74,534,049
FieldValueIRS element (for citing)
Total Liability$75,416,377TotalLiabilityAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other250.FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CarefalseFPGReferenceDiscountedCareInd
Free Care Medically IndigentfalseFreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served2755PersonsServedCnt
Total Community Benefit Expns$2,011,233TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,011,233NetCommunityBenefitExpnsAmt
Total Expense0.03480TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Persons Served8346PersonsServedCnt
Total Community Benefit Expns$7,447,865TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,147,924DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,299,941NetCommunityBenefitExpnsAmt
Total Expense0.03980TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Activities Or Programs3ActivitiesOrProgramsCnt
Persons Served11101PersonsServedCnt
Total Community Benefit Expns$9,459,098TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,147,924DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,311,174NetCommunityBenefitExpnsAmt
Total Expense0.07460TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$16,875TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$16,875NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$57,626TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$57,626NetCommunityBenefitExpnsAmt
Total Expense0.00100TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,180TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,180NetCommunityBenefitExpnsAmt

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$76,681TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$76,681NetCommunityBenefitExpnsAmt
Total Expense0.00130TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs3ActivitiesOrProgramsCnt
Persons Served11101PersonsServedCnt
Total Community Benefit Expns$9,535,779TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,147,924DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,387,855NetCommunityBenefitExpnsAmt
Total Expense0.07590TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Bad Debt Expense$11,232,914BadDebtExpenseAmt
Reimbursed By Medicare$23,748,983ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$25,694,716CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$1,945,733MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Riverside Shore Memorial HospitalBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line19507 Hospital DriveAddressLine1Txt
CityNassawadoxCityNm
State AbbreviationVAStateAbbreviationCd
ZIP23413ZIPCd
FieldValueIRS element (for citing)
Website Addresshttp://www.riversideonline.com/shore/WebsiteAddressTxt
State LicenseH1901StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Riverside Shore Memorial HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted16CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSee Part V, Sec. COwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt16ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLSee Part V, Sec. CStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care250.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care0.FPGFamilyIncmLmtDscntCarePct
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSee Part V, Sec. CFAPAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSee Part V, Sec. CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Prospective Medicare MedicaidYes (X)ProspectiveMedicareMedicaidInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp

FieldValueIRS element (for citing)
Form And Line ReferencePart V Section CFormAndLineReferenceDesc
ExplanationLine 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 surveyed 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: www.riversideonline.com/about_riverside/community-health-needs.cfm Line 10a: www.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 13h: 1) Scheduled for or have received services at Riverside Acute or Riverside Medical Group. 2) Provide valid Social Security number. 3) Be uninsured. 4) Have low credit (defined as having less than $1000 of available line of credit). 5) Be not likely to pay (defined as a credit score of less than 550). 6) Do not have liquid assets to meet their healthcare financial obligation. 7) Spousal information will be included for services over $10,000. 8) Medicaid Spend Down amounts do not qualify for financial assistance. Line 16a: www.riversideonline.com/patients_guests/financial-assistance.cfm Line 16c: www.riversideonline.com/patients_guests/financial-assistance.cfm Line 16f: Financial Assistance information has always been available without charge when requested but the process was not well known. In FY 2017 steps were taken to standardize the process in all business offices and to publicize the process to business office employees to improve the accessibility of Financial Assistance information. Line 22d: Patients eligible under the Financial Assistance Policy were provided 100% discount and therefore the maximum amount charged to patients once they were determined to be eligible under FAP was $0.00ExplanationTxt
FieldValueIRS element (for citing)
Facility3FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
Shore Healthcare at Home
25379 Lankford HighwayOnleyVA23418Home Health Agency
Shore Cancer Center
10085 Williams F BernartNassawadoxVA23418Infusion Therapy Center
Riverside Diagnostic Center-Metompkin
17385 Lankford HwyParksleyVA234213882Diagnostic Center

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart VIFormAndLineReferenceDesc
ExplanationLine 1: Part I Line 3c: Free care uses 250% of the FPG. Our policies do not include discounted care. Line 1: Part I Line 7, column F: Bad debt expense removed from total expense in line 7, column F is $11,232,914. 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 I Line 7I: Cash and in-kind contributions are the actual dollar value of cash or items given. 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 collectability 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 the 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 amounts. 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: The service area for Riverside Healthcare Association, dba Riverside Health System, covers a wide geographic area, from the Potomac River to south of the James River in southeastern Virginia. Virginias Eastern Shore consists of the southernmost part of the Delmarva Peninsula, and is bordered to the north by Maryland, 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 is located in northern Accomack County and one third in Northampton. 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 Virginias 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. Each hospital has a community-based board of directors. Riverside Medical Group and Riversides Lifelong Health division also have community-based boards. These boards all report up through the Riverside Health System Board of Directors. This community-based leadership is important, as in many of the communities Riverside provides the only hospital either in the area or within at least 30 miles. Similarly, Riverside Behavioral Health Center and Riverside Rehabilitation Institute are the only inpatient psychiatric and rehabilitation facilities on the Virginia Peninsula. And Riverside Regional Medical Center is the only Level 2 trauma center between Richmond and Norfolk. These hospitals provide critical services to individual patients, but also serve as key community resources in responding to a regional disaster. This has been demonstrated in Riversides emergency department responding to small communities hit by a tornado, and in performing drills at Newport News Shipbuilding to prepare mass casualty events. The importance of a local emergency department open 24/7 is crucial for the communities it serves. 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, Riversides medical residency program serves an important role in training future family practice and OB/GYN physicians as well as the transitional residency program. In addition to these Riverside programs, hundreds of students in other area prExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
WILLIAM DOWNEY
PRESIDENT,CEO RHS$0$857,061$0$285,863$0$198,627$0$22,644$0$12,141$0$1,376,336$0$0
DAVID JONES
SERVICE LINE CHIEF$0$121,249$0$30,468$0$151,859$0$22,644$0$23,853$0$350,073$0$0
WADE BROUGHMAN
EXEC VP/COO RHS & SECRETARY$0$564,417$0$143,904$0$143,291$0$21,319$0$14,057$0$886,988$0$0
WALTER AUSTIN
SR VP,CFO RHS & TREASURER$0$434,350$0$88,099$0$70,740$0$6,625$0$13,871$0$613,685$0$0
JOHN PETERMAN
VP/ADMINISTRATOR$0$211,566$0$38,054$0$45,407$0$19,053$0$7,602$0$321,682$0$0
JOHN PATTERSON
PHARMACIST$139,408$0$1,714$0$635$0$8,541$0$7,392$0$157,690$0$0$0
PATRICIA BRADY
PHARMACIST$121,412$0$1,459$0$588$0$7,765$0$20,911$0$152,135$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 3The 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 4bWilliam Downey $173,250 John Peterman $25,437 Wade Broughman $86,384 Walter Austin $50,851 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 O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, Line 6, 7a, & 7bRiverside 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 11bOn 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 12cAll 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 19The organization makes its governing documents, conflict of interest policy, and financial statements available to the general public upon written request.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (23 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndPublic Charity StatusPublicCharityStatusTxt
Ctr for Excellence in Aging & Geriatric
608 Denbigh Blvd Suite 800Newport NewsVA23608061644517ResearchVA501(C)(3)RivHCAsscYes (true)
Charlottesville Area Retirement Svcs Inc
608 Denbigh Blvd Suite 800Newport NewsVA23608454854018Pt ServicesVA501(C)(3)RivRetSvcYes (true)10
Doctors' Hospital of Williamsburg
608 Denbigh Blvd Suite 800Newport NewsVA23608271540267HospitalVA501(C)(3)RivHCAsscYes (true)3
Francis N Sanders Nursing Home Inc
608 Denbigh Blvd Suite 800Newport NewsVA23608540683174Nursing CareVA501(C)(3)RivHCAsscYes (true)10
Newport News General & Nonsectarian Hosp
608 Denbigh Blvd Suite 800Newport NewsVA23608540505934Holding CompVA501(c)(2)RivHCAsscYes (true)NA
Patrick Henry Hospital Incorporated
608 Denbigh Blvd Suite 800Newport NewsVA23608540610803Nursing CareVA501(C)(3)RivHCAsscYes (true)3
Patriots Colony Inc
608 Denbigh Blvd Suite 800Newport NewsVA23608541680163Ret CommunityVA501(C)(3)RivHCAsscYes (true)10
Rehabilitation Institute of VA Inc
608 Denbigh Blvd Suite 800Newport NewsVA23608521432269HospitalVA501(c)(3)RivHCAsscYes (true)3
Riverside Convalescent Centers Inc
608 Denbigh Blvd Suite 800Newport NewsVA23608521276323Nursing CareVA501(c)(3)RivHCAsscYes (true)3
Riverside Health System Foundation
608 Denbigh Blvd Suite 800Newport NewsVA23608541994013FoundationVA501(c)(3)RivHCAsscYes (true)7
Riverside Healthcare Association Inc
608 Denbigh Blvd Suite 800Newport NewsVA23608521241835FinancingVA501(c)(3)NAfalse10
Riverside Healthcare Foundation Inc
608 Denbigh Blvd Suite 800Newport NewsVA23608521241989FoundationVA501(c)(3)RivHCAsscYes (true)12c
Riverside Healthcare Services Inc
608 Denbigh Blvd Suite 800Newport NewsVA23608521241839ManagementVA501(c)(3)RivHCAsscYes (true)12c
Riverside Hospital Inc
608 Denbigh Blvd Suite 800Newport NewsVA23608521245746HospitalVA501(c)(3)RivHCAsscYes (true)3
Riverside Management Services Inc
608 Denbigh Blvd Suite 800Newport NewsVA23608521241840ManagementVA501(c)(3)RivHCAssc12c
Riverside Middle Peninsula Hospital Inc
608 Denbigh Blvd Suite 800Newport NewsVA23608521241836HospitalVA501(c)(3)RivHCAsscYes (true)3
Riverside Physician Services Inc
608 Denbigh Blvd Suite 800Newport NewsVA23608541519724Pt ServicesVA501(c)(3)RivHCAsscYes (true)12c
Riverside Retirement Services Inc
608 Denbigh Blvd Suite 800Newport NewsVA23608541348674RET COMMUNITYVA501(c)(3)RivHCAsscYes (true)10
Riverside Tappahannock Hospital Inc
608 Denbigh Blvd Ste 800Newport NewsVA23608541489410HospitalVA501(C)(3)RivHCAsscYes (true)3
Riverside Wellness & Fitness Centers Inc
608 Denbigh Blvd Ste 800Newport NewsVA23608541318861FitnessVA501(C)(3)RivHCAsscYes (true)10
Sanders Common LTD
608 Denbigh Blvd Ste 800Newport NewsVA23608524233030Nursing CareVA501(C)(3)RivHCAsscYes (true)12c
Shore Life Care Inc
608 Denbigh Blvd Suite 800Newport NewsVA23608541876370Nursing CareVA501(C)(3)ShoreHSvcYes (true)10
Tilden and Virginia Davis Support
608 Denbigh Blvd Ste 800Newport NewsVA23608541527703FoundationVA501(C)(3)RivRetSvcYes (true)12c

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
At Home Partners LLC
608 Denbigh Blvd Ste 800Newport NewsVA23608472999121ManagementVANA
Michumi PLLC
12997 Warwick BlvdNewport NewsVA23608201318732Pt ServicesVANA

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
Peninsula Hospital Services
608 Denbigh Blvd Ste 800Newport NewsVA23608540991295LaundryVANACOOP
Riverside Medical Equipment Center Inc
608 Denbigh Blvd Suite 800Newport NewsVA23608541325596BillingVANAC Corp
RHS Medinsur LTD
InsuranceNAC CORPCraig Applin House 8 Wesley StreetHamiltonBDBD
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

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