EASTERN SHORE RURAL HEALTH SYSTEM INCORPORATED: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
EASTERN SHORE RURAL HEALTH SYSTEM INCORPORATED (EIN 51-0196935)
Tax period
2014-06-01 to 2015-05-31
Filed
2015-09-24
IRS object ID
201502679349300705
Schema version
2014v5.0
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)
Return2015-09-24T07:58:58-05:00ReturnTs
Tax Period End2015-05-31TaxPeriodEndDt

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 Begin2014-06-01TaxPeriodBeginDt

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 OFFICERPersonTitleTxt
Phone7574140400PhoneNum
Signature2015-09-21SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDAVID E FOLEYPreparerPersonNm
PTINP01457488PTIN
Phone4349738314PhoneNum
Preparation2015-09-24PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerNANCY STERNPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line120280 MARKET STREETAddressLine1Txt
CityONANCOCKCityNm
State AbbreviationVAStateAbbreviationCd
ZIP23417ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$18,658,133GrossReceiptsAmt
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 Employee248TotalEmployeeCnt
Total Volunteers10TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$4,559,812PYContributionsGrantsAmt
CY Contributions Grants$4,402,967CYContributionsGrantsAmt
PY Program Service Revenue$13,707,380PYProgramServiceRevenueAmt
CY Program Service Revenue$14,190,867CYProgramServiceRevenueAmt
PY Investment Income-$139,180PYInvestmentIncomeAmt
CY Investment Income-$38,838CYInvestmentIncomeAmt
PY Other Revenue$20,267PYOtherRevenueAmt
CY Other Revenue$9,265CYOtherRevenueAmt
PY Total Revenue$18,148,279PYTotalRevenueAmt
CY Total Revenue$18,564,261CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$11,845,222PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$12,655,644CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$246,554CYTotalFundraisingExpenseAmt
PY Other Expenses$5,053,798PYOtherExpensesAmt
CY Other Expenses$5,561,258CYOtherExpensesAmt
PY Total Expenses$16,899,020PYTotalExpensesAmt
CY Total Expenses$18,216,902CYTotalExpensesAmt
PY Revenues Less Expenses$1,249,259PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$347,359CYRevenuesLessExpensesAmt
Total Assets BOY$18,092,533TotalAssetsBOYAmt
Total Assets EOY$18,489,846TotalAssetsEOYAmt
Total Liabilities BOY$3,233,989TotalLiabilitiesBOYAmt
Total Liabilities EOY$3,283,943TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$14,858,544NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$15,205,903NetAssetsOrFundBalancesEOYAmt
MissionOPERATION OF FEDERALLY SUPPORTED COMMUNITY HEALTH CENTERS.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$15,910,241ExpenseAmt
Revenue$14,190,867RevenueAmt
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$15,910,241TotalProgramServiceExpensesAmt
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
Employee248EmployeeCnt
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
Form1098 C FiledYes (true)Form1098CFiledInd
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
HARRY DEITCH
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
PRESIDENT2.00Yes (X)$0$0$0
DELORES THOMPSON
BOARD MEMBER2.00Yes (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
BLAIR CHICK
CHIEF MEDICA40.00$216,543$0$22,620Yes (X)
SCOTT WOLPIN
CHIEF DENTAL40.00$181,121$0$23,000Yes (X)
NANCY STERN
CHIEF EXECUT40.00$169,408$0$13,531Yes (X)
KANDICE BRUNO
CHIEF FINANC40.00$109,687$0$18,682Yes (X)
ANNE CRABBE
CHIEF OPERAT40.00$93,049$0$9,303Yes (X)
JEANNETTE EDWARDS
CHIEF HR OFF40.00$89,193$0$9,020Yes (X)
KIMBERLY SAVAGE
CHIEF COMPLI40.00$88,288$0$7,809Yes (X)
MIKE ZODUN
CHIEF INFORM40.00$78,961$0$7,257Yes (X)
DAVID HOSHINO
DOCTOR40.00$180,534$0$17,984Yes (X)
JEANNE ROLL
DOCTOR40.00$175,808$0$23,000Yes (X)
THOMAS HOLLANDSWORTH
DOCTOR40.00$174,933$0$17,500Yes (X)
DAVID RIOPEL
DOCTOR40.00$159,438$0$16,009Yes (X)
EDWARD GRIGGS
DENTIST40.00$159,132$0$23,000Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,876,095TotalReportableCompFromOrgAmt
Total Other Compensation$208,715TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K28IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Government Grants$4,344,747GovernmentGrantsAmt
All Other Contributions$58,220AllOtherContributionsAmt
Total Contributions$4,402,967TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE$11,172,894$11,172,894
340B$2,932,973$2,932,973
MEANINGFUL USE$85,000$85,000
FieldValueIRS element (for citing)
Total Program Service Revenue$14,190,867TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,034TotalRevenueColumnAmt
Exclusion$5,034ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$3,550RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$3,550RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,550TotalRevenueColumnAmt
Related Or Exempt Func Income$3,550RelatedOrExemptFuncIncomeAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$50,000OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$93,872OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$43,872OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$43,872TotalRevenueColumnAmt
Related Or Exempt Func Income-$43,872RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER REVENUEDesc
Total Revenue Column$5,715TotalRevenueColumnAmt
Related Or Exempt Func Income$5,715RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$5,715OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$18,564,261TotalRevenueColumnAmt
Related Or Exempt Func Income$14,156,260RelatedOrExemptFuncIncomeAmt
Exclusion$5,034ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,262,512TotalAmt
Program Services$448,587ProgramServicesAmt
Management And General$634,198ManagementAndGeneralAmt
Fundraising$179,727FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$9,434,115TotalAmt
Program Services$8,670,821ProgramServicesAmt
Management And General$756,634ManagementAndGeneralAmt
Fundraising$6,660FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$235,480TotalAmt
Program Services$217,384ProgramServicesAmt
Management And General$17,691ManagementAndGeneralAmt
Fundraising$405FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,071,873TotalAmt
Program Services$989,502ProgramServicesAmt
Management And General$80,529ManagementAndGeneralAmt
Fundraising$1,842FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$651,664TotalAmt
Program Services$601,585ProgramServicesAmt
Management And General$48,959ManagementAndGeneralAmt
Fundraising$1,120FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$28,764TotalAmt
Management And General$28,764ManagementAndGeneralAmt

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$399,645TotalAmt
Program Services$360,181ProgramServicesAmt
Fundraising$39,464FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$131,280TotalAmt
Program Services$66,138ProgramServicesAmt
Management And General$65,142ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$421,960TotalAmt
Program Services$314,900ProgramServicesAmt
Management And General$100,049ManagementAndGeneralAmt
Fundraising$7,011FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$52,700TotalAmt
Program Services$52,700ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$116,054TotalAmt
Program Services$25,328ProgramServicesAmt
Management And General$86,724ManagementAndGeneralAmt
Fundraising$4,002FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$94,303TotalAmt
Program Services$90,531ProgramServicesAmt
Management And General$3,772ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$534,177TotalAmt
Program Services$471,707ProgramServicesAmt
Management And General$59,422ManagementAndGeneralAmt
Fundraising$3,048FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$52,727TotalAmt
Management And General$52,727ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
PHARMACY PROGRAMS$1,801,031$1,801,031
MEDICAL SUPPLIES$1,359,799$1,359,799
TELEPHONE & UTILITIES$301,159$246,769$51,736$2,654
REPAIRS & MAINTENANCE$194,998$182,271$12,106$621

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$50,161TotalAmt
Program Services$11,007ProgramServicesAmt
Management And General$39,154ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$18,216,902TotalAmt
Program Services$15,910,241ProgramServicesAmt
Management And General$2,060,107ManagementAndGeneralAmt
Fundraising$246,554FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,507,416BOYAmt
EOY$2,842,102EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,339,015BOYAmt
EOY$2,645,608EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$18,090BOYAmt
EOY$33,652EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$16,643,682LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$3,681,198LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$13,222,012BOYAmt
EOY$12,962,484EOYAmt

Other Assets Total OtherAssetsTotalGrp

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

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$18,092,533BOYAmt
EOY$18,489,846EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$861,022BOYAmt
EOY$943,362EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$2,372,164BOYAmt
EOY$2,339,568EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$803BOYAmt
EOY$1,013EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,233,989BOYAmt
EOY$3,283,943EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$14,819,799BOYAmt
EOY$15,205,890EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$38,745BOYAmt
EOY$13EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$14,858,544BOYAmt
EOY$15,205,903EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$18,092,533BOYAmt
EOY$18,489,846EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$347,359ReconcilationRevenueExpnssAmt
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$4,842,593CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,304,592CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,610,551CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,559,812CurrentTaxYearMinus1YearAmt
Current Tax Year$4,402,967CurrentTaxYearAmt
Total$25,720,515TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,685,373CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,114,742CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$12,532,412CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$13,727,647CurrentTaxYearMinus1YearAmt
Current Tax Year$14,200,132CurrentTaxYearAmt
Total$60,260,306TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,527,966CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$15,419,334CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$20,142,963CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$18,287,459CurrentTaxYearMinus1YearAmt
Current Tax Year$18,603,099CurrentTaxYearAmt
Total$85,980,821TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$85,980,821PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$22,305CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$18,177CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$17,056CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,346CurrentTaxYearMinus1YearAmt
Current Tax Year$5,034CurrentTaxYearAmt
Total$67,918TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$22,305CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$18,177CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$17,056CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,346CurrentTaxYearMinus1YearAmt
Current Tax Year$5,034CurrentTaxYearAmt
Total$67,918TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$58,989CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$43,396CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$6,914CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$14,407CurrentTaxYearMinus1YearAmt
Current Tax Year$5,715CurrentTaxYearAmt
Total$129,421TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,609,260CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$15,480,907CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$20,166,933CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$18,307,212CurrentTaxYearMinus1YearAmt
Current Tax Year$18,613,848CurrentTaxYearAmt
Total$86,178,160TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99770PublicSupportCY509Pct
Public Support PY5090.99650PublicSupportPY509Pct
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 129,421ExplanationTxt

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$741,480OtherCostOrOtherBasisAmt
Book Value$741,480BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,350,473OtherCostOrOtherBasisAmt
Depreciation$2,721,394DepreciationAmt
Book Value$11,629,079BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,551,729OtherCostOrOtherBasisAmt
Depreciation$959,804DepreciationAmt
Book Value$591,925BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$12,962,484TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescOTHER LIABILITIESDesc
Amt$1,013Amt
FieldValueIRS element (for citing)
Total Liability$1,013TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$18,564,261TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal$18,564,261RevenueSubtotalAmt
Total Revenue Per Form990$18,564,261TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$18,216,902TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$18,216,902ExpensesSubtotalAmt
Total Expenses Per Form990$18,216,902TotalExpensesPerForm990Amt

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.$216,543$22,620$239,163
SCOTT WOLPIN
CHIEF DENTAL OFFICER$181,121$23,000$204,121
NANCY STERN
CHIEF EXECUTIVE OFF.$169,408$13,531$182,939
DAVID HOSHINO
DOCTOR$180,534$17,984$198,518
JEANNE ROLL
DOCTOR$175,808$23,000$198,808
THOMAS HOLLANDSWORTH
DOCTOR$174,933$17,500$192,433
DAVID RIOPEL
DOCTOR$159,438$16,009$175,447
EDWARD GRIGGS
DENTIST$159,132$23,000$182,132

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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