EASTERN SHORE RURAL HEALTH SYSTEM INCORPORATED: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
EASTERN SHORE RURAL HEALTH SYSTEM INCORPORATED (EIN 51-0196935)
Tax period
2016-06-01 to 2017-05-31
Filed
2017-09-27
IRS object ID
201702709349301100
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 ReturnHeader

FieldValueIRS element (for citing)
Return2017-09-27T14:41:04-04:00ReturnTs
Tax Period End2017-05-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN541896113PreparerFirmEIN

Preparer Firm Name PreparerFirmName

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

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1530 WESTFIELD RDAddressLine1Txt
CityCHARLOTTESVILLECityNm
State AbbreviationVAStateAbbreviationCd
ZIP229011726ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-06-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN510196935EIN

Business Name BusinessName

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

US Address USAddress

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

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonNANCY STERNPersonNm
Person TitleCHIEF EXECUTIVE OFF.PersonTitleTxt
Phone7574140400PhoneNum
Signature2017-09-27SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDAVID E FOLEYPreparerPersonNm
PTINP01457488PTIN
Phone4349738314PhoneNum
Preparation2017-09-26PreparationDt

Filing Security Information FilingSecurityInformation

FieldValueIRS element (for citing)
At Submission Creation Device Id5DE83D308AF21EAAC4F44A572013746C71D0E517AtSubmissionCreationDeviceId
At Submission Filing Device Id5DE83D308AF21EAAC4F44A572013746C71D0E517AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerNANCY STERNPrincipalOfficerNm
Gross Receipts$22,938,309GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.ESRH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1976FormationYr
Legal Domicile StateVALegalDomicileStateCd
Activity Or MissionOPERATION OF FEDERALLY SUPPORTED COMMUNITY HEALTH CENTERS.ActivityOrMissionDesc
Voting Members Governing Body16VotingMembersGoverningBodyCnt
Voting Members Independent16VotingMembersIndependentCnt
Total Employee284TotalEmployeeCnt
Total Volunteers105TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$5,019,639PYContributionsGrantsAmt
CY Contributions Grants$5,812,005CYContributionsGrantsAmt
PY Program Service Revenue$15,991,185PYProgramServiceRevenueAmt
CY Program Service Revenue$17,090,337CYProgramServiceRevenueAmt
PY Investment Income$197PYInvestmentIncomeAmt
CY Investment Income$14,168CYInvestmentIncomeAmt
PY Other Revenue$20,583PYOtherRevenueAmt
CY Other Revenue$21,799CYOtherRevenueAmt
PY Total Revenue$21,031,604PYTotalRevenueAmt
CY Total Revenue$22,938,309CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$13,954,380PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$15,176,877CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$456,898CYTotalFundraisingExpenseAmt
PY Other Expenses$5,725,138PYOtherExpensesAmt
CY Other Expenses$5,268,381CYOtherExpensesAmt
PY Total Expenses$19,679,518PYTotalExpensesAmt
CY Total Expenses$20,445,258CYTotalExpensesAmt
PY Revenues Less Expenses$1,352,086PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,493,051CYRevenuesLessExpensesAmt
Total Assets BOY$20,131,385TotalAssetsBOYAmt
Total Assets EOY$22,682,435TotalAssetsEOYAmt
Total Liabilities BOY$3,573,396TotalLiabilitiesBOYAmt
Total Liabilities EOY$3,631,395TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$16,557,989NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$19,051,040NetAssetsOrFundBalancesEOYAmt
MissionOPERATION OF FEDERALLY SUPPORTED COMMUNITY HEALTH CENTERS.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$17,664,046ExpenseAmt
Revenue$17,090,337RevenueAmt
DescORGANIZATION OPERATES FIVE FEDERALLY SUPPORTED COMMUNITY HEALTH CENTERS ON THE EASTERN SHORE OF VIRGINIA. THE SERVICE IS PROVIDED TO APPROXIMATELY 45,000 RESIDENTS IN TWO OF VIRGINIA'S MOST ECONOMICALLY DISADVANTAGED COUNTIES.Desc
Total Program Service Expenses$17,664,046TotalProgramServiceExpensesAmt
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 StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document18IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee284EmployeeCnt
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 Members16GoverningBodyVotingMembersCnt
Independent Voting Member16IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonNANCY STERNPersonNm
Phone7574140400PhoneNum

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (29 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
ARTHUR FOURNIER
BOARD MEMBER2.00Yes (X)$0$0$0
MARTHA WHITE
BOARD MEMBER2.00Yes (X)$0$0$0
SORAYA BUCKNER
BOARD MEMBER2.00Yes (X)$0$0$0
JEFF HOLLAND
BOARD MEMBER2.00Yes (X)$0$0$0
DENISE BLAND
VICE PRESIDE2.00Yes (X)$0$0$0
CARAMINE KELLAM
BOARD MEMBER2.00Yes (X)$0$0$0
BOB MAYES
TREASURER2.00Yes (X)$0$0$0
JOHN SCHULZ
PRESIDENT2.00Yes (X)$0$0$0
GARNETT KELLAM
BOARD MEMBER2.00Yes (X)$0$0$0
WILLIAM STURGIS
BOARD MEMBER2.00Yes (X)$0$0$0
ROBERT KERNS
SECRETARY2.00Yes (X)$0$0$0
SHEILA KERPELMAN
BOARD MEMBER2.00Yes (X)$0$0$0
TOM PACE
BOARD MEMBER2.00Yes (X)$0$0$0
ALICE JONES
BOARD MEMBER2.00Yes (X)$0$0$0
JILL BLEVINS
BOARD MEMBER2.00Yes (X)$0$0$0
LUTHER BYRD
BOARD MEMBER2.00Yes (X)$0$0$0
BLAIR CHICK
CHIEF MEDICA40.00$233,249$0$24,000Yes (X)
SCOTT WOLPIN
CHIEF DENTAL40.00$196,122$0$24,000Yes (X)
NANCY STERN
CHIEF EXECUT40.00$183,322$0$16,321Yes (X)
KANDICE BRUNO
CHIEF FINANC40.00$121,608$0$24,000Yes (X)
ANNE CRABBE
CHIEF OPERAT40.00$98,030$0$10,034Yes (X)
JEANNETTE EDWARDS
CHIEF HR OFF40.00$96,446$0$9,916Yes (X)
KIMBERLY SAVAGE
CHIEF COMPLI40.00$92,080$0$9,444Yes (X)
MIKE ZODUN
CHIEF INFORM40.00$85,927$0$7,975Yes (X)
JEANNE ROLL
DOCTOR40.00$191,124$0$24,000Yes (X)
DAVID HOSHINO
DOCTOR40.00$190,500$0$24,000Yes (X)
THOMAS HOLLANDSWORTH
DOCTOR40.00$187,512$0$18,000Yes (X)
JOAN LINGEN
DOCTOR40.00$173,278$0$24,000Yes (X)
DAVID RIOPEL
DOCTOR40.00$172,792$0$17,325Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,021,990TotalReportableCompFromOrgAmt
Total Other Compensation$233,015TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K24IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Government Grants$5,239,177GovernmentGrantsAmt
All Other Contributions$572,828AllOtherContributionsAmt
Noncash Contributions$29,686NoncashContributionsAmt
Total Contributions$5,812,005TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE$14,127,829$14,127,829
340B$2,648,008$2,648,008
MEANINGFUL USE$314,500$314,500
FieldValueIRS element (for citing)
Total Program Service Revenue$17,090,337TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$14,168TotalRevenueColumnAmt
Exclusion$14,168ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$600RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$600RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$600TotalRevenueColumnAmt
Related Or Exempt Func Income$600RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER REVENUEDesc
Total Revenue Column$21,199TotalRevenueColumnAmt
Related Or Exempt Func Income$21,199RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$21,199OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$22,938,309TotalRevenueColumnAmt
Related Or Exempt Func Income$17,112,136RelatedOrExemptFuncIncomeAmt
Exclusion$14,168ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,371,793TotalAmt
Program Services$486,145ProgramServicesAmt
Management And General$611,734ManagementAndGeneralAmt
Fundraising$273,914FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$11,302,669TotalAmt
Program Services$10,425,771ProgramServicesAmt
Management And General$851,938ManagementAndGeneralAmt
Fundraising$24,960FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$307,828TotalAmt
Program Services$285,277ProgramServicesAmt
Management And General$21,429ManagementAndGeneralAmt
Fundraising$1,122FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,419,396TotalAmt
Program Services$1,315,409ProgramServicesAmt
Management And General$98,811ManagementAndGeneralAmt
Fundraising$5,176FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$775,191TotalAmt
Program Services$718,400ProgramServicesAmt
Management And General$53,964ManagementAndGeneralAmt
Fundraising$2,827FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$26,065TotalAmt
Management And General$26,065ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$22,500TotalAmt
Management And General$22,500ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$397,390TotalAmt
Program Services$349,515ProgramServicesAmt
Fundraising$47,875FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$116,604TotalAmt
Management And General$116,604ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$558,775TotalAmt
Program Services$317,731ProgramServicesAmt
Management And General$156,197ManagementAndGeneralAmt
Fundraising$84,847FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$55,854TotalAmt
Program Services$53,424ProgramServicesAmt
Management And General$2,238ManagementAndGeneralAmt
Fundraising$192FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$145,870TotalAmt
Program Services$7,033ProgramServicesAmt
Management And General$133,323ManagementAndGeneralAmt
Fundraising$5,514FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$91,806TotalAmt
Program Services$91,497ProgramServicesAmt
Management And General$309ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$551,839TotalAmt
Program Services$495,328ProgramServicesAmt
Management And General$52,050ManagementAndGeneralAmt
Fundraising$4,461FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$66,963TotalAmt
Management And General$66,963ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
PHARMACY PROGRAMS$1,348,369$1,348,369
MEDICAL SUPPLIES$1,339,611$1,339,611
TELEPHONE & UTILITIES$287,818$225,955$56,979$4,884
REPAIRS & MAINTENANCE$194,326$180,067$13,133$1,126

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$64,591TotalAmt
Program Services$24,514ProgramServicesAmt
Management And General$40,077ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$20,445,258TotalAmt
Program Services$17,664,046ProgramServicesAmt
Management And General$2,324,314ManagementAndGeneralAmt
Fundraising$456,898FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$4,078,356BOYAmt
EOY$6,306,703EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
EOY$295,049EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,042,848BOYAmt
EOY$2,981,216EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$18,664BOYAmt
EOY$20,982EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$17,776,725LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$4,704,240LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$12,985,517BOYAmt
EOY$13,072,485EOYAmt

Other Assets Total OtherAssetsTotalGrp

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

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$20,131,385BOYAmt
EOY$22,682,435EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,266,857BOYAmt
EOY$1,339,972EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$2,305,632BOYAmt
EOY$2,290,812EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$907BOYAmt
EOY$611EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,573,396BOYAmt
EOY$3,631,395EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$16,556,303BOYAmt
EOY$18,624,999EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,686BOYAmt
EOY$426,041EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$16,557,989BOYAmt
EOY$19,051,040EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$20,131,385BOYAmt
EOY$22,682,435EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$2,493,051ReconcilationRevenueExpnssAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

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

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$7,610,551CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,559,812CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,402,967CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,019,639CurrentTaxYearMinus1YearAmt
Current Tax Year$5,812,005CurrentTaxYearAmt
Total$27,404,974TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$12,532,412CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$13,727,647CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$14,200,132CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$16,011,768CurrentTaxYearMinus1YearAmt
Current Tax Year$17,112,136CurrentTaxYearAmt
Total$73,584,095TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$20,142,963CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$18,287,459CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$18,603,099CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$21,031,407CurrentTaxYearMinus1YearAmt
Current Tax Year$22,924,141CurrentTaxYearAmt
Total$100,989,069TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$100,989,069PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$17,056CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,346CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,034CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,904CurrentTaxYearMinus1YearAmt
Current Tax Year$14,168CurrentTaxYearAmt
Total$48,508TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$17,056CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,346CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,034CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,904CurrentTaxYearMinus1YearAmt
Current Tax Year$14,168CurrentTaxYearAmt
Total$48,508TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$6,914CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$14,407CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,715CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$19,983CurrentTaxYearMinus1YearAmt
Current Tax Year$21,199CurrentTaxYearAmt
Total$68,218TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$20,166,933CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$18,307,212CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$18,613,848CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$21,058,294CurrentTaxYearMinus1YearAmt
Current Tax Year$22,959,508CurrentTaxYearAmt
Total$101,105,795TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99880PublicSupportCY509Pct
Public Support PY5090.99850PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Investment Income PY0.00000InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferencePART III, LINE 12FormAndLineReferenceDesc
ExplanationOTHER INCOME 68,218ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,001,166OtherCostOrOtherBasisAmt
Book Value$1,001,166BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,486,538OtherCostOrOtherBasisAmt
Depreciation$3,577,640DepreciationAmt
Book Value$10,908,898BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,908,499OtherCostOrOtherBasisAmt
Depreciation$1,126,600DepreciationAmt
Book Value$781,899BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$380,522OtherCostOrOtherBasisAmt
Book Value$380,522BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$13,072,485TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescOTHER LIABILITIESDesc
Amt$611Amt
FieldValueIRS element (for citing)
Total Liability$611TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$22,938,309TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal$22,938,309RevenueSubtotalAmt
Total Revenue Per Form990$22,938,309TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$20,445,258TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$20,445,258ExpensesSubtotalAmt
Total Expenses Per Form990$20,445,258TotalExpensesPerForm990Amt

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
BLAIR CHICK
CHIEF MEDICAL OFF.$233,249$24,000$257,249
SCOTT WOLPIN
CHIEF DENTAL OFFICER$196,122$24,000$220,122
NANCY STERN
CHIEF EXECUTIVE OFF.$183,322$16,321$199,643
JEANNE ROLL
DOCTOR$191,124$24,000$215,124
DAVID HOSHINO
DOCTOR$190,500$24,000$214,500
THOMAS HOLLANDSWORTH
DOCTOR$187,512$18,000$205,512
JOAN LINGEN
DOCTOR$173,278$24,000$197,278
DAVID RIOPEL
DOCTOR$172,792$17,325$190,117

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTradedGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution2ContributionCnt
Noncash Contributions Rpt F990$29,686NoncashContributionsRptF990Amt
Method Of Determining RevenuesMARKET VALUEMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGiftsInd
Third Parties UsedfalseThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

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

Comments

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