EASTERN SHORE RURAL HEALTH SYSTEM INCORPORATED: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
EASTERN SHORE RURAL HEALTH SYSTEM INCORPORATED (EIN 51-0196935)
Tax period
2015-06-01 to 2016-05-31
Filed
2016-09-28
IRS object ID
201622729349300922
Schema version
2015v2.1
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)
Return2016-09-28T13:57:26-05:00ReturnTs
Tax Period End2016-05-31TaxPeriodEndDt

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 Begin2015-06-01TaxPeriodBeginDt

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
Signature2016-09-23SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDAVID E FOLEYPreparerPersonNm
PTINP01457488PTIN
Phone4349738314PhoneNum
Preparation2016-09-28PreparationDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerNANCY STERNPrincipalOfficerNm
Gross Receipts$21,043,421GrossReceiptsAmt
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 Body15VotingMembersGoverningBodyCnt
Voting Members Independent15VotingMembersIndependentCnt
Total Employee255TotalEmployeeCnt
Total Volunteers10TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$4,402,967PYContributionsGrantsAmt
CY Contributions Grants$5,019,639CYContributionsGrantsAmt
PY Program Service Revenue$14,190,867PYProgramServiceRevenueAmt
CY Program Service Revenue$15,991,185CYProgramServiceRevenueAmt
PY Investment Income-$38,838PYInvestmentIncomeAmt
CY Investment Income$197CYInvestmentIncomeAmt
PY Other Revenue$9,265PYOtherRevenueAmt
CY Other Revenue$20,583CYOtherRevenueAmt
PY Total Revenue$18,564,261PYTotalRevenueAmt
CY Total Revenue$21,031,604CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$12,655,644PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$13,954,380CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$275,787CYTotalFundraisingExpenseAmt
PY Other Expenses$5,561,258PYOtherExpensesAmt
CY Other Expenses$5,725,138CYOtherExpensesAmt
PY Total Expenses$18,216,902PYTotalExpensesAmt
CY Total Expenses$19,679,518CYTotalExpensesAmt
PY Revenues Less Expenses$347,359PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,352,086CYRevenuesLessExpensesAmt
Total Assets BOY$18,489,846TotalAssetsBOYAmt
Total Assets EOY$20,131,385TotalAssetsEOYAmt
Total Liabilities BOY$3,283,943TotalLiabilitiesBOYAmt
Total Liabilities EOY$3,573,396TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$15,205,903NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$16,557,989NetAssetsOrFundBalancesEOYAmt
MissionOPERATION OF FEDERALLY SUPPORTED COMMUNITY HEALTH CENTERS.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$17,228,262ExpenseAmt
Revenue$15,991,185RevenueAmt
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$17,228,262TotalProgramServiceExpensesAmt
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 ContrifalseDeductibleNonCashContriInd
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 Document23IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee255EmployeeCnt
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 Member15IndependentVotingMemberCnt
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 (28 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
SECRETARY2.00Yes (X)$0$0$0
SORAYA BUCKNER
BOARD MEMBER2.00Yes (X)$0$0$0
JEFF HOLLAND
BOARD MEMBER2.00Yes (X)$0$0$0
DENISE BLAND
PRESIDENT2.00Yes (X)$0$0$0
CARAMINE KELLAM
BOARD MEMBER2.00Yes (X)$0$0$0
BOB MAYES
TREASURER2.00Yes (X)$0$0$0
JOHN SCHULZ
VICE PRESIDE2.00Yes (X)$0$0$0
GARNETT KELLAM
BOARD MEMBER2.00Yes (X)$0$0$0
WILLIAM STURGIS
BOARD MEMBER2.00Yes (X)$0$0$0
ROBERT KERNS
BOARD MEMBER2.00Yes (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
BONNIE JONES
BOARD MEMBER2.00Yes (X)$0$0$0
BLAIR CHICK
CHIEF MEDICA40.00$227,487$0$24,000Yes (X)
SCOTT WOLPIN
CHIEF DENTAL40.00$189,837$0$24,000Yes (X)
NANCY STERN
CHIEF EXECUT40.00$174,913$0$14,004Yes (X)
KANDICE BRUNO
CHIEF FINANC40.00$115,364$0$22,634Yes (X)
ANNE CRABBE
CHIEF OPERAT40.00$94,002$0$9,623Yes (X)
JEANNETTE EDWARDS
CHIEF HR OFF40.00$92,219$0$9,468Yes (X)
KIMBERLY SAVAGE
CHIEF COMPLI40.00$88,246$0$9,195Yes (X)
MIKE ZODUN
CHIEF INFORM40.00$82,601$0$7,666Yes (X)
THOMAS HOLLANDSWORTH
DOCTOR40.00$189,406$0$18,000Yes (X)
JEANNE ROLL
DOCTOR40.00$186,847$0$24,000Yes (X)
DAVID HOSHINO
DOCTOR40.00$185,520$0$18,625Yes (X)
JOAN LINGEN
DOCTOR40.00$172,245$0$24,000Yes (X)
DAVID RIOPEL
DOCTOR40.00$172,225$0$17,188Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,970,912TotalReportableCompFromOrgAmt
Total Other Compensation$222,403TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K20IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Government Grants$4,885,896GovernmentGrantsAmt
All Other Contributions$133,743AllOtherContributionsAmt
Total Contributions$5,019,639TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE$12,958,419$12,958,419
340B$2,714,016$2,714,016
MEANINGFUL USE$318,750$318,750
FieldValueIRS element (for citing)
Total Program Service Revenue$15,991,185TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,904TotalRevenueColumnAmt
Exclusion$6,904ExclusionAmt

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

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$5,110OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$11,817OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$6,707OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$6,707TotalRevenueColumnAmt
Related Or Exempt Func Income-$6,707RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER REVENUEDesc
Total Revenue Column$19,983TotalRevenueColumnAmt
Related Or Exempt Func Income$19,983RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$19,983OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$21,031,604TotalRevenueColumnAmt
Related Or Exempt Func Income$16,005,061RelatedOrExemptFuncIncomeAmt
Exclusion$6,904ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,326,085TotalAmt
Program Services$472,152ProgramServicesAmt
Management And General$665,592ManagementAndGeneralAmt
Fundraising$188,341FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$10,311,373TotalAmt
Program Services$9,537,057ProgramServicesAmt
Management And General$759,008ManagementAndGeneralAmt
Fundraising$15,308FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$269,563TotalAmt
Program Services$250,798ProgramServicesAmt
Management And General$18,083ManagementAndGeneralAmt
Fundraising$682FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,336,305TotalAmt
Program Services$1,243,284ProgramServicesAmt
Management And General$89,642ManagementAndGeneralAmt
Fundraising$3,379FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$711,054TotalAmt
Program Services$661,557ProgramServicesAmt
Management And General$47,699ManagementAndGeneralAmt
Fundraising$1,798FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$21,529TotalAmt
Management And General$21,529ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$23,500TotalAmt
Management And General$23,500ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$324,572TotalAmt
Program Services$282,060ProgramServicesAmt
Fundraising$42,512FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$128,894TotalAmt
Program Services$58,243ProgramServicesAmt
Management And General$70,651ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$437,918TotalAmt
Program Services$293,371ProgramServicesAmt
Management And General$134,428ManagementAndGeneralAmt
Fundraising$10,119FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$53,532TotalAmt
Program Services$50,993ProgramServicesAmt
Management And General$2,378ManagementAndGeneralAmt
Fundraising$161FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$139,903TotalAmt
Program Services$7,685ProgramServicesAmt
Management And General$126,941ManagementAndGeneralAmt
Fundraising$5,277FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$92,964TotalAmt
Program Services$92,964ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$552,181TotalAmt
Program Services$493,951ProgramServicesAmt
Management And General$54,545ManagementAndGeneralAmt
Fundraising$3,685FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$55,189TotalAmt
Management And General$55,189ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
PHARMACY PROGRAMS$2,167,063$2,167,063
MEDICAL SUPPLIES$1,201,547$1,201,547
TELEPHONE & UTILITIES$288,107$228,116$56,194$3,797
REPAIRS & MAINTENANCE$186,754$175,250$10,776$728

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$51,485TotalAmt
Program Services$12,171ProgramServicesAmt
Management And General$39,314ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$19,679,518TotalAmt
Program Services$17,228,262ProgramServicesAmt
Management And General$2,175,469ManagementAndGeneralAmt
Fundraising$275,787FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,842,102BOYAmt
EOY$4,078,356EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,645,608BOYAmt
EOY$3,042,848EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$33,652BOYAmt
EOY$18,664EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$17,137,917LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$4,152,400LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$12,962,484BOYAmt
EOY$12,985,517EOYAmt

Other Assets Total OtherAssetsTotalGrp

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

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$18,489,846BOYAmt
EOY$20,131,385EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$943,362BOYAmt
EOY$1,266,857EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$2,339,568BOYAmt
EOY$2,305,632EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,013BOYAmt
EOY$907EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,283,943BOYAmt
EOY$3,573,396EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$15,205,890BOYAmt
EOY$16,556,303EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$13BOYAmt
EOY$1,686EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$15,205,903BOYAmt
EOY$16,557,989EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$18,489,846BOYAmt
EOY$20,131,385EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,352,086ReconcilationRevenueExpnssAmt
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$4,304,592CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$7,610,551CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,559,812CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,402,967CurrentTaxYearMinus1YearAmt
Current Tax Year$5,019,639CurrentTaxYearAmt
Total$25,897,561TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$11,114,742CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$12,532,412CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$13,727,647CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$14,200,132CurrentTaxYearMinus1YearAmt
Current Tax Year$16,011,768CurrentTaxYearAmt
Total$67,586,701TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$15,419,334CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$20,142,963CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$18,287,459CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$18,603,099CurrentTaxYearMinus1YearAmt
Current Tax Year$21,031,407CurrentTaxYearAmt
Total$93,484,262TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$93,484,262PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$18,177CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$17,056CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,346CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,034CurrentTaxYearMinus1YearAmt
Current Tax Year$6,904CurrentTaxYearAmt
Total$52,517TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$18,177CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$17,056CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,346CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,034CurrentTaxYearMinus1YearAmt
Current Tax Year$6,904CurrentTaxYearAmt
Total$52,517TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$43,396CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$6,914CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$14,407CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,715CurrentTaxYearMinus1YearAmt
Current Tax Year$19,983CurrentTaxYearAmt
Total$90,415TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$15,480,907CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$20,166,933CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$18,307,212CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$18,613,848CurrentTaxYearMinus1YearAmt
Current Tax Year$21,058,294CurrentTaxYearAmt
Total$93,627,194TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99850PublicSupportCY509Pct
Public Support PY5090.99770PublicSupportPY509Pct
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 90,415ExplanationTxt

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$14,480,538OtherCostOrOtherBasisAmt
Depreciation$3,154,415DepreciationAmt
Book Value$11,326,123BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,570,893OtherCostOrOtherBasisAmt
Depreciation$997,985DepreciationAmt
Book Value$572,908BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$85,320OtherCostOrOtherBasisAmt
Book Value$85,320BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$12,985,517TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescOTHER LIABILITIESDesc
Amt$907Amt
FieldValueIRS element (for citing)
Total Liability$907TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$21,031,604TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal$21,031,604RevenueSubtotalAmt
Total Revenue Per Form990$21,031,604TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$19,679,518TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$19,679,518ExpensesSubtotalAmt
Total Expenses Per Form990$19,679,518TotalExpensesPerForm990Amt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
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.$227,487$24,000$251,487
SCOTT WOLPIN
CHIEF DENTAL OFFICER$189,837$24,000$213,837
NANCY STERN
CHIEF EXECUTIVE OFF.$174,913$14,004$188,917
THOMAS HOLLANDSWORTH
DOCTOR$189,406$18,000$207,406
JEANNE ROLL
DOCTOR$186,847$24,000$210,847
DAVID HOSHINO
DOCTOR$185,520$18,625$204,145
JOAN LINGEN
DOCTOR$172,245$24,000$196,245
DAVID RIOPEL
DOCTOR$172,225$17,188$189,413

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.

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