Tri-County Care Systems Inc: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- Tri-County Care Systems Inc (EIN 34-1552205)
- Tax period
- 2014-01-01 to 2014-12-31
- Filed
- 2016-11-15
- IRS object ID
- 201603219349300620
- Schema version
- 2014v6.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-15T00:00:00-06:00 | ReturnTs |
| Tax Period End | 2014-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 351178661 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Blue & Co LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8800 Lyra Drive Suite 450 | AddressLine1Txt |
| City | Columbus | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43240 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 341552205 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Tri-County Care Systems Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | TRI- | BusinessNameControlTxt |
| Phone | 3303857200 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 425 W 5TH Street | AddressLine1Txt |
| City | East Liverpool | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43920 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Tarun Ghosh | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 3303857200 | PhoneNum |
| Signature | 2016-11-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Nancy Kirchner | PreparerPersonNm |
| PTIN | P00386751 | PTIN |
| Phone | 6148852583 | PhoneNum |
| Preparation | 2016-11-10 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | River Valley Health Partners | BusinessNameLine1Txt |
| Business Name Line2 | East Liverpool Professionals | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Tarun Ghosh | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 425 W 5TH Street | AddressLine1Txt |
| City | East Liverpool | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43920 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,713,726 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1986 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | TRI COUNTY CARE SYSTEMS INC. DBA RIVER VALLEY HEALTH PARTNERS IS A PARENT HOLDING COMPANY FOR THE NON-PROFIT COMPANIES OF EAST LIVERPOOL CITY HOSPITAL, OHIO VALLEY HOME HEALTH SERVICES, AND EAST LIVERPOOL PROFESSIONALS. OHIO VALLEY HOME HEALTH SERVICES ALSO MAINTAINS CONTROL OVER A FOR-PROFIT COMPANY CALLED AMERICAN COMMUNITY SERVICES AND A NON-PROFIT COMPANY CALLED OHIO VALLEY HOME CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 4 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $2,462,705 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $4,669,946 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $480,152 | PYOtherRevenueAmt |
| CY Other Revenue | $43,780 | CYOtherRevenueAmt |
| PY Total Revenue | $2,942,857 | PYTotalRevenueAmt |
| CY Total Revenue | $4,713,726 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,264,958 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,418,077 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,953,847 | PYOtherExpensesAmt |
| CY Other Expenses | $3,553,665 | CYOtherExpensesAmt |
| PY Total Expenses | $5,218,805 | PYTotalExpensesAmt |
| CY Total Expenses | $7,971,742 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$2,275,948 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$3,258,016 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,071,409 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,442,167 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $10,508 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,114,393 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,060,901 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,327,774 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TRI-COUNTY CARE SYSTEMS, INC. IS A PARENT HOLDING COMPANY FOR THE NON-PROFIT COMPANIES OF EAST LIVERPOOL CITY HOSPITAL, OHIO VALLEY HOME HEALTH SERVICES AND EAST LIVERPOOL PROFESSIONALS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $5,685,835 | ExpenseAmt |
| Revenue | $4,713,726 | RevenueAmt |
| Desc | THE NUMBERS PROVIDED ARE FOR river valley physicians WHICH IS A DISREGARDED ENTITY OF TRI-COUNTY CARE SYSTEMS INC. they PROVIDE NEEDED PHYSICIAN SERVICES TO THE COMMUNITY WITHOUT DISCRIMination. | Desc |
| Total Program Service Expenses | $5,685,835 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (1) | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| DAF Excess Business Holdings | 0 | DAFExcessBusinessHoldingsInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OH | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANTHONY M PUORRO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3303862633 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 425 W FIFTH STREET | AddressLine1Txt |
| City | EAST LIVERPOOL | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43920 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| KENNETH COCHRAN | |||||||||
| CEO | 40.00 | Yes (X) | Yes (X) | $0 | $332,717 | $0 | |||
| JD GAURON | |||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| MARK MANGANO | |||||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| ROB O'HARA | |||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| TERRENCE E ZIPFEL | |||||||||
| PHYSICIAN | 40.00 | Yes (X) | $0 | $416,827 | $4,648 | ||||
| PAMELA SMITH | |||||||||
| ADMINISTRATOR | 1.00 | Yes (X) | $0 | $0 | $0 | 40.00 | |||
| BETH WEIR | |||||||||
| DIRECTOR | 40.00 | Yes (X) | $0 | $81,467 | $10,470 | ||||
| DR AGGARWAL | |||||||||
| PHYSICIAN | 40.00 | $0 | $374,500 | $0 | Yes (X) | ||||
| DR TORRES | |||||||||
| PHYSICIAN | 40.00 | $0 | $324,815 | $4,008 | Yes (X) | ||||
| DR R PARULKAR | |||||||||
| PHYSICIAN | 40.00 | $0 | $293,125 | $36,462 | Yes (X) | ||||
| DR WRIGHT | |||||||||
| PHYSICIAN | 40.00 | $0 | $272,256 | $39,988 | Yes (X) | ||||
| KYLE JOHNSON | |||||||||
| FORMER CFO | 1.00 | $0 | $205,058 | $20,272 | 40.00 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,300,765 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $115,848 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Weatherby Locums | |||||
| 6451 North Federal Highway | Fort Lauderdale | FL | 33308 | Locums for Ortho | $604,892 |
| Comprehensive Surgical Group | |||||
| 3292 Stones Throw Ave | Poland | OH | 44514 | Locums for Surgery | $515,225 |
| Quasitive Ventures | |||||
| 19800 Macarther Blvd | Irvine | CA | 92612 | Locums for Gastroentorology | $409,689 |
| Renaissance | |||||
| 4295 Cromwell Road | Chattanooga | TN | 37421 | Billing Company | $250,154 |
| Eclinicalwebb LLC | |||||
| 425 W 5th Street | East Liverpool | OH | 43920 | EMR System | $180,071 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 623990 | $4,667,820 | $4,667,820 |
| BAD DEBT RECOVERY | 900099 | $2,126 | $2,126 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $4,669,946 | TotalProgramServiceRevenueAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | EHR | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $43,780 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $43,780 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $43,780 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,713,726 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,713,726 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,788,291 | TotalAmt |
| Program Services | $3,409,462 | ProgramServicesAmt |
| Management And General | $378,829 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,254 | TotalAmt |
| Program Services | $25,429 | ProgramServicesAmt |
| Management And General | $2,825 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $601,532 | TotalAmt |
| Program Services | $601,532 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,076,214 | TotalAmt |
| Program Services | $851,248 | ProgramServicesAmt |
| Management And General | $1,224,966 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $228,770 | TotalAmt |
| Management And General | $228,770 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $339,934 | TotalAmt |
| Program Services | $244,752 | ProgramServicesAmt |
| Management And General | $95,182 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,000 | TotalAmt |
| Management And General | $78,000 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $232,751 | TotalAmt |
| Program Services | $221,113 | ProgramServicesAmt |
| Management And General | $11,638 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $332,299 | $332,299 | |
| OTHER MISCELLANEOUS | $263,507 | $263,507 | |
| PROPERTY TAXES | $2,190 | $2,190 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,971,742 | TotalAmt |
| Program Services | $5,685,835 | ProgramServicesAmt |
| Management And General | $2,285,907 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $316 | BOYAmt |
| EOY | $316 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $126,572 | BOYAmt |
| EOY | $5,075 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $188,456 | BOYAmt |
| EOY | $972,999 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,000 | BOYAmt |
| EOY | $75,000 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $91,591 | BOYAmt |
| EOY | $126,654 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,328,837 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $434,619 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $582,976 | BOYAmt |
| EOY | $894,218 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $58,725 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,498 | BOYAmt |
| EOY | $309,180 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,071,409 | BOYAmt |
| EOY | $2,442,167 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,508 | BOYAmt |
| EOY | $1,108,182 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $6,211 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,508 | BOYAmt |
| EOY | $1,114,393 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,060,901 | BOYAmt |
| EOY | $1,327,774 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,060,901 | BOYAmt |
| EOY | $1,327,774 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,071,409 | BOYAmt |
| EOY | $2,442,167 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$3,258,016 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $3,524,889 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type3 Func Int | Yes (X) | SupportingOrgType3FuncIntInd |
| Supported Organizations | 2 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp (2 entries)
| EINEIN | Organization TypeOrganizationTypeCd | Governing Document ListedGoverningDocumentListedInd | SupportSupportAmt | Other SupportOtherSupportAmt |
|---|---|---|---|---|
| City Hospital Association | ||||
| 340714583 | 3 | Yes (1) | $0 | $0 |
| Ohio Valley Home Health Services | ||||
| 341014198 | 9 | Yes (1) | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 2 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (1) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Form990 Sch A Type3 Sprt Org All Form990SchAType3SprtOrgAllGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timely Provided Documents | 0 | TimelyProvidedDocumentsInd |
| Officers Close Relationship | Yes (1) | OfficersCloseRelationshipInd |
| Supported Org Voice Investment | 0 | SupportedOrgVoiceInvestmentInd |
Form990 Sch A Type3 Func Int Form990SchAType3FuncIntGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Test | Yes (X) | ActivitiesTestInd |
| Activities Further Exempt Prps | Yes (1) | ActivitiesFurtherExemptPrpsInd |
| Activities Engaged Org Invlmnt | Yes (1) | ActivitiesEngagedOrgInvlmntInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part VI Line 2a | Tri-County Care Systems/RVP is the medical group associated with East Liverpool City Hospital. They currently employ the physicians and mid-levels that provide coverage to the primary care and specialty clinics supporting the hospital's patient population. |
| Part VI Line 2b | ALL THE PHYSICIANS AND MID-LEVELS ARE MEMBERS OF THE HOSPITAL'S MEDICAL STAFF AND UTILIZES THE HOSPITAL'S LAB AND IMAGING AS WELL AS OPERATING ROOMS FOR THEIR PATIENTS. |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,328,837 | OtherCostOrOtherBasisAmt |
| Depreciation | $434,619 | DepreciationAmt |
| Book Value | $894,218 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $894,218 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Other Receivables | Desc |
| Book Value | $309,180 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $309,180 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Line of Credit | $24 |
| Accrued Liabilities | $6,187 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $6,211 | TotalLiabilityAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KENNETH COCHRAN | ||||||||||||||
| CEO | $0 | $332,717 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $332,717 | $0 | $0 |
| TERRENCE E ZIPFEL | ||||||||||||||
| PHYSICIAN | $0 | $416,827 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $4,648 | $0 | $421,475 | $0 | $0 |
| DR AGGARWAL | ||||||||||||||
| PHYSICIAN | $0 | $374,500 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $374,500 | $0 | $0 |
| DR TORRES | ||||||||||||||
| PHYSICIAN | $0 | $324,333 | $0 | $0 | $0 | $482 | $0 | $0 | $0 | $4,008 | $0 | $328,823 | $0 | $0 |
| DR R PARULKAR | ||||||||||||||
| PHYSICIAN | $0 | $293,125 | $0 | $0 | $0 | $0 | $0 | $36,462 | $0 | $0 | $0 | $329,587 | $0 | $0 |
| DR WRIGHT | ||||||||||||||
| PHYSICIAN | $0 | $272,256 | $0 | $0 | $0 | $0 | $0 | $36,461 | $0 | $3,527 | $0 | $312,244 | $0 | $0 |
| KYLE JOHNSON | ||||||||||||||
| FORMER CFO | $0 | $205,058 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $205,058 | $0 | $0 |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Dr Terrence Zipfel | PersonNm |
| Loan Purpose | Transitional Loan | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $75,000 | OriginalPrincipalAmt |
| Balance Due | $75,000 | BalanceDueAmt |
| Default | 0 | DefaultInd |
| Board Or Committee Approval | Yes (1) | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (1) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $75,000 | TotalBalanceDueAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 3 | AMERICAN COMMUNITY SERVICES, INC. PROVIDES ADMINISTRATIVE MANAGEMENT AND CLERICAL SERVICES. |
| Form 990, Part VI, Section B, line 11 | A copy is provided to the finance committee of the board for review prior to filing. |
| Form 990, Part VI, Section B, line 12c | HOSPITAL TRUSTEES AND ADMINISTRATORS, MEDICAL STAFF MEMBERS AND AUXILIARY MEMBERS SERVING AS TRUSTEES WILL ANNUALLY COMPLETE AND SUBMIT THE BOARD OF TRUSTEES DISCLOSURE OF POTENTIAL CONFLICT OF INTEREST. THE AFOREMENTIONED PARTIES WILL ACT IN ACCORD WITH THE BOARD'S BYLAW GOVERNING CONFLICT OF INTEREST. HOSPITAL ADMINISTRATORS AND MANAGEMENT EMPLOYEES WHO ARE MADE AWARE, EITHER DIRECTLY OR INDIRECTLY, OR ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST, WILL IMMEDIATELY REPORT IT TO THEIR SUPERIOR. THE AFOREMENTIONED PARTIES WILL THEREAFTER ACT IN ACCORD WITH THE GUIDANCE PROVIDED BY THE SUPERIOR OR HOSPITAL ADMINISTRATION. |
| Form 990, Part VI, Section C, line 19 | ALL ITEMS ARE MADE AVAILABLE UPON REQUEST. |
| Form 990, Part IX, line 11g | PURCHASED SERVICES: Program service expenses 851,248. Management and general expenses 1,224,966. Fundraising expenses 0. Total expenses 2,076,214. |
| Form 990, Part XI, line 9: | Advance From Afilliate (East Liverpool City Hospital) 3,524,889. |
| Form 990, Part XII, line 2b | Tri-County Care Systems as an entity was not audited. However, their only activity, a wholly owned LLC, East Liverpool Professionals, was audited. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EAST LIVERPOOL PROFESSIONALS LLC DBA RIVER VALLEY PHYSICIANS | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 425 W Fifth Street | AddressLine1Txt |
| City | East Liverpool | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43920 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 203986815 | EIN |
| Primary Activities | Employ Physicians | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | River Valley Health Partners | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Ohio Valley Home Health Services | ||||||||||
| 15679 St Rte 170 | East Liverpool | OH | 43920 | 341014198 | HOME HEALTH AGENCY | OH | 501(c)(3) | Line 9 | River Valley Health Partners | 0 |
| East Liverpool City Hospital | ||||||||||
| 425 W Fifth Street | East Liverpool | OH | 43920 | 340714583 | ACUTE CARE HOSPITAL | OH | 501(c)(3) | Line 3 | River Valley Health Partners | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| American Community Services | |||||||||
| 422 W 6th Street | East Liverpool | OH | 43920 | 341522019 | ADMINISTRATIVE & BILLING SERVICES | OH | Ohio Valley Home Health Services | C | 0 |
| Monroe Health Corporation | |||||||||
| 422 W 6th Street | East Liverpool | OH | 43920 | 341562035 | PHYSICIAN SERVICES | OH | ACS | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
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