OHIOHEALTH CORPORATION: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- OHIOHEALTH CORPORATION (EIN 31-1045101)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-14
- IRS object ID
- 201421349349306922
- Schema version
- 2012v2.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-14T16:04:50-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381357951 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 65 EAST STATE ST STE 600 | AddressLine1 |
| City | COLUMBUS | City |
| State | OH | State |
| ZIP Code | 43215 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 311045101 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | APPALACHIAN COMMUNITY VISITING NURSE | BusinessNameLine1 |
| Business Name Line2 | ASSOCIATION HOSPICE AND HEALTH SERVICES | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | APPA | NameControl |
| Phone | 7405935551 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 30 HERROLD AVENUE | AddressLine1 |
| City | ATHENS | City |
| State | OH | State |
| ZIP Code | 457012326 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KEN DICKEN | Name |
| Title | CFO | Title |
| Phone | 7405935551 | Phone |
| Date Signed | 2014-05-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BERNIE OSTROWSKI | Name |
| PTIN | P00366367 | PTIN |
| Phone | 6148493000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | GREG LONG | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 30 HERROLD AVENUE | AddressLine1 |
| City | ATHENS | City |
| State | OH | State |
| ZIP Code | 457012326 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 3602544 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.ACVNA.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1982 | YearFormation |
| State Legal Domicile | OH | StateLegalDomicile |
| Activity Or Mission Description | WE ARE DEDICATED TO PROVIDING COST EFFECTIVE, HIGH QUALITY HOME HEALTH SERVICES TO THE PEOPLE IN OUR APPALACHIAN COMMUNITY. WE PROVIDE SERVICES TO MEDICAID CLIENTS THROUGH OHIO HOME CARE PROGRAMS AS WELL AS FOR CLIENTS WITH WORKERS' COMPENSATION, VETERAN'S ADMINISTRATION, MEDICARE AND OTHER PAYOR SOURCES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 3 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 2 | NbrIndependentVotingMembers |
| Total Nbr Employees | 104 | TotalNbrEmployees |
| Total Nbr Volunteers | 48 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 99056 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 85108 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 3674576 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 3515715 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 2694 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1721 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 3776326 | TotalRevenuePriorYear |
| Total Revenue Current Year | 3602544 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 2684106 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 2632504 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 5053 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1231929 | OtherExpensePriorYear |
| Other Expenses Current Year | 1214931 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 3916035 | TotalExpensesPriorYear |
| Total Expenses Current Year | 3847435 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -139709 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -244891 | RevenuesLessExpensesCY |
| Total Assets BOY | 950851 | TotalAssetsBOY |
| Total Assets EOY | 958141 | TotalAssetsEOY |
| Total Liabilities BOY | 462839 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 649648 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 488012 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 308493 | NetAssetsOrFundBalancesEOY |
| Mission Description | WE ARE SOUTHEASTERN OHIO'S PRIMARY SOURCE FOR QUALITY HOME CARE, STRIVING TO IDENTIFY AND FULFILL THE HEALTHCARE NEEDS OF OUR APPALACHIAN COMMUNITY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 3450657 | Expense |
| Grants | 0 | Grants |
| Revenue | 3515715 | Revenue |
| Description | THE ORGANIZATION PROVIDES CARE TO HOME BOUND, INDIGENT, AND TERMINALLY-ILL PATIENTS IN THE COMMUNITY. THE ORGANIZATION PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. TO ACCOMPLISH ITS CHARITABLE PURPOSE, THE ORGANIZATION PROVIDED 8,011 DAYS OF HOSPICE CARE, 30,184 HOURS OF HEALTH SERVICES AND 12,385 HOME HEALTH VISITS. | Description |
| Total Program Service Expense | 3450657 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 9 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 104 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 3 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 2 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | OH | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KEN DICKEN | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7405929298 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 55 HOSPITAL DRIVE | AddressLine1 |
| City | ATHENS | City |
| State | OH | State |
| ZIP Code | 45701 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (14 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| JAN HODSON | ||||||||
| TRUSTEE | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| SUSAN CYRAN | ||||||||
| TRUSTEE | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| RON STRICKMAKER | ||||||||
| TRUSTEE | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| DAVID STROH | ||||||||
| CHAIR | 1.00 | 0.00 | X | 0 | 0 | 0 | X | |
| MICHAEL TURNER | ||||||||
| VICE CHAIR | 1.00 | 0.00 | X | 0 | 0 | 0 | X | |
| KATHY TARANTELLI | ||||||||
| TRUSTEE | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| RUTH ANN ALTHAUS | ||||||||
| SECRETARY | 1.00 | 0.00 | X | 0 | 0 | 0 | X | |
| DOREEN IRETON | ||||||||
| TRUSTEE | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| SANDRA SHIREY | ||||||||
| TRUSTEE | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| RAY STEPHENS | ||||||||
| TREASURER | 1.00 | 0.00 | X | 0 | 0 | 0 | X | |
| CANDY KEMMERER | ||||||||
| TRUSTEE | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| GREG LONG | ||||||||
| PRESIDENT/CEO | 40.00 | 0.00 | X | 0 | 0 | 0 | X | |
| TERRI MCKINLEY | ||||||||
| INTERIM DIRECTOR | 40.00 | 0.00 | 55355 | 0 | 0 | X | ||
| THOMAS CAMPBELL | ||||||||
| PHYSICAL THERAPIST | 40.00 | 0.00 | 160156 | 0 | 0 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 215511 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 1 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| All Other Contributions | 85108 | AllOtherContributions |
| Total Contributions | 85108 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT SERVICES | Description |
| Business Code | 621610 | BusinessCode |
| Total Revenue Column | 3515715 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3515715 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 3515715 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1721 | TotalRevenueColumn |
| Exclusion | $1,721 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3602544 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3515715 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $1,721 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 64802 | Total |
| Program Services | 57512 | ProgramServices |
| Management And General | 7290 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2163427 | Total |
| Program Services | 1920042 | ProgramServices |
| Management And General | 243385 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40291 | Total |
| Program Services | 35859 | ProgramServices |
| Management And General | 4432 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 202312 | Total |
| Program Services | 179552 | ProgramServices |
| Management And General | 22760 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 161672 | Total |
| Program Services | 143484 | ProgramServices |
| Management And General | 18188 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3122 | Total |
| Management And General | 3122 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 113781 | Total |
| Program Services | 100980 | ProgramServices |
| Management And General | 12801 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11978 | Total |
| Program Services | 10630 | ProgramServices |
| Management And General | 1348 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 363642 | Total |
| Program Services | 322732 | ProgramServices |
| Management And General | 40910 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7454 | Total |
| Program Services | 6616 | ProgramServices |
| Management And General | 838 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 87315 | Total |
| Program Services | 77492 | ProgramServices |
| Management And General | 9823 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 198947 | Total |
| Program Services | 176566 | ProgramServices |
| Management And General | 22381 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2693 | Total |
| Program Services | 2390 | ProgramServices |
| Management And General | 303 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1702 | Total |
| Program Services | 1511 | ProgramServices |
| Management And General | 191 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28132 | Total |
| Program Services | 24967 | ProgramServices |
| Management And General | 3165 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| HOSPICE ROOM & BOARD | 318674 | 318674 | ||
| EMERGENCY RESPONSE SYST | 64469 | 64469 | ||
| TRAINING & CONT. EDUC./ | 5506 | 4956 | 550 | |
| FUNDRAISING MAILING | 5053 | 5053 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2463 | Total |
| Program Services | 2225 | ProgramServices |
| Management And General | 238 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3847435 | Total |
| Program Services | 3450657 | ProgramServices |
| Management And General | 391725 | ManagementAndGeneral |
| Fundraising | 5053 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35094 | BOY |
| EOY | 141587 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 712760 | BOY |
| EOY | 561379 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11521 | BOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29853 | BOY |
| EOY | 34406 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 834548 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 831991 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4258 | BOY |
| EOY | 2557 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 157365 | BOY |
| EOY | 187382 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 30830 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 950851 | BOY |
| EOY | 958141 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 362839 | BOY |
| EOY | 414648 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 100000 | BOY |
| EOY | 235000 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 462839 | BOY |
| EOY | 649648 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 331052 | BOY |
| EOY | 122372 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 156960 | BOY |
| EOY | 186121 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 488012 | BOY |
| EOY | 308493 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 950851 | BOY |
| EOY | 958141 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -244891 | ReconcilationRevenueExpenses |
| Reconcilation Prior Adjustment | -2 | ReconcilationPriorAdjustment |
| Reconcilation Other Changes | 65374 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 153022 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 230286 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 133112 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 99056 | CurrentTaxYearMinus1Year |
| Current Tax Year | 85108 | CurrentTaxYear |
| Total | 700584 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3540437 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 3901744 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 3758424 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3747453 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3515715 | CurrentTaxYear |
| Total | 18463773 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3693459 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 4132030 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 3891536 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3846509 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3600823 | CurrentTaxYear |
| Total | 19164357 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | 231042 | CurrentTaxYear |
| Total | 231042 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | 231042 | CurrentTaxYear |
| Total | 231042 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 18933315 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2425 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2100 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2286 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2694 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1721 | CurrentTaxYear |
| Total | 11226 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2425 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2100 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2286 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2694 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1721 | CurrentTaxYear |
| Total | 11226 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3695884 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 4134130 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 3893822 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3849203 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3602544 | CurrentTaxYear |
| Total | 19175583 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.98740 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.99940 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00060 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00060 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 159228 | BeginningOfYearBalance |
| Contributions | 30017 | Contributions |
| End Of Year Balance | 189245 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2261 | BeginningOfYearBalance |
| Contributions | 156967 | Contributions |
| End Of Year Balance | 159228 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2259 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 2 | InvestmentEarningsOrLosses |
| End Of Year Balance | 2261 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2257 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 2 | InvestmentEarningsOrLosses |
| End Of Year Balance | 2259 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2251 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 6 | InvestmentEarningsOrLosses |
| End Of Year Balance | 2257 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Endowment EOY Balance | 1.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 1 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 834548 | OtherCostOrOtherBasis |
| Depreciation | 831991 | Depreciation |
| Book Value | 2557 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 2557 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (2 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| BOARD DESIGNATED INVESTMENTS | 79030 | C |
| TEMPORARILY RESTRICTED GRANTS | 108352 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 187382 | TotalOfBookValueSecurities |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | SHELTERING ARMS HOSPITAL FOUNDATION LOAN PAYABLE | Description |
| Amount | $235,000 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 235000 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | THE ENDOWMENTS ARE INTENDED FOR THE SUPPORT OF THE ORGANIZATION'S HEALTHCARE ACTIVITIES. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X, LINE 2: | ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY IF THE HOSPITAL HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE HOSPITAL AND HAS CONCLUDED THAT AS OF JUNE 30, 2013, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO JUNE 30, 2009. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | THOMAS CAMPBELL | NamePerson |
| Title | PHYSICAL THERAPIST | Title |
| Base Compensation Filing Org | 160156 | BaseCompensationFilingOrg |
| Comp Based On Related Orgs | 0 | CompBasedOnRelatedOrgs |
| Bonus Filing Org | 0 | BonusFilingOrg |
| Bonus Related Orgs | 0 | BonusRelatedOrgs |
| Other Compensation Filing Org | 0 | OtherCompensationFilingOrg |
| Other Compensation Related Orgs | 0 | OtherCompensationRelatedOrgs |
| Deferred Comp Filing Org | 0 | DeferredCompFilingOrg |
| Deferred Comp Related Orgs | 0 | DeferredCompRelatedOrgs |
| Nontaxable Benefits Filing Org | 0 | NontaxableBenefitsFilingOrg |
| Nontaxable Benefits Related Orgs | 0 | NontaxableBenefitsRelatedOrgs |
| Total Compensation Filing Org | 160156 | TotalCompensationFilingOrg |
| Total Compensation Related Orgs | 0 | TotalCompensationRelatedOrgs |
| Comp Report Prior990 Filing Org | 0 | CompReportPrior990FilingOrg |
| Comp Report Prior990 Related Orgs | 0 | CompReportPrior990RelatedOrgs |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART I, LINE 3 | ReturnReference |
| Explanation | THE CEO IS COMPENSATED THROUGH AN UNRELATED MANAGEMENT COMPANY, OHIOHEALTH HOSPITAL MANAGEMENT SERVICES, LLC. THE CONTRACT WITH THE MANAGEMENT COMPANY IS REVIEWED AND APPROVED BY THE BOARD. THE COMPENSATION FOR THE CEO IS REVIEWED AND APPROVED BY THE MANAGEMENT COMPANY. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | THE ORGANIZATION ENTERED INTO A MANAGEMENT AGREEMENT WITH HOMEREACH, AN OHIO NOT-FOR-PROFIT CORPORATION, EFFECTIVE NOVEMBER 6, 2012 AND EXPIRING SEPTEMBER 30, 2014. HOMEREACH IS A WHOLLY OWNED SUBSIDIARY OF OHIOHEALTH CORPORATION, AN OHIO NONPROFIT CORPORATION THAT IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3). THE MANAGEMENT AGREEMENT REQUIRES THE MANAGEMENT COMPANY TO PERFORM MANAGEMENT SERVICES AND OVERSIGHT OF DAILY OPERATIONS,IT AND SUPPORT SERVICES, BILLING AND COLLECTION SERVICES, AND COMPLIANCE WITH LAWS AND REGULATIONS. | |
| FORM 990, PART VI, SECTION A, LINE 6 | SHELTERING ARMS HOSPITAL FOUNDATION, INC. D/B/A O'BLENESS MEMORIAL HOSPITAL IS THE SOLE MEMBER OF THE ORGANIZATION. | |
| FORM 990, PART VI, SECTION A, LINE 7A | THE SOLE MEMBER HAS THE RIGHT TO ELECT OR APPOINT MEMBERS OF THE GOVERNING BODY. | |
| FORM 990, PART VI, SECTION A, LINE 7B | GOVERNANCE DECISIONS OF THE ORGANIZATION, SUCH AS APPROVAL OF THE ELECTION OR REMOVAL OF MEMBERS OF THE GOVERNING BODY AND DECISIONS TO DISSOLVE, ARE RESERVED FOR THE SOLE MEMBER. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 WILL NOT BE REVIEWED BY THE BOARD. THE FORM IS REVIEWED BY AN OFFICER OF THE ORGANIZATION BEFORE FILING. | |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUAL CONFLICTS OF INTEREST SURVEYS (OR QUESTIONNAIRES) ARE COMPLETED AND SIGNED BY BOARD MEMBERS. CONFLICTS THAT ARISE THROUGHOUT THE YEAR ARE TO BE DISCLOSED TO THE BOARD AND NECESSARY ACTION WILL BE DETERMINED BY THE BOARD. POSSIBLE RESOLUTION COULD INCLUDE RESTRICTIONS ON VOTING AND PARTICIPATION OF ORGANIZATION BUSINESS BEFORE THE BOARD. | |
| FORM 990, PART VI, SECTION B, LINE 15A | COMPENSATION FOR THE DIRECTOR IS REVIEWED BY AN EVALUATION COMMITTEE APPOINTED BY THE BOARD AND IS NEGOTIATED DURING THIS REVIEW. THIS EVALUATION IS PERFORMED ANNUALLY. THE LAST EVALUATION WAS IN 2013. THERE ARE NO OTHER OFFICERS OR KEY EMPLOYEES THAT ARE COMPENSATED BY THE ORGANIZATION. | |
| FORM 990, PART VI, SECTION C, LINE 19 | IF REQUESTS ARE MADE FROM THE PUBLIC TO VIEW THE ORGANIZATION'S GOVERNING DOCUMENTS, THE ORGANIZATION COMPLIES WITH THE IRS PUBLIC INSPECTION REQUIREMENTS FOR FORM 990, FORM 990-T, FORM 1023, GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS. REQUESTS FROM THE PUBLIC FOR ANY OTHER DOCUMENTS MUST BE IN WRITING AND LEGAL COUNSEL ENSURES COMPLIANCE AS REQUIRED. | |
| FORM 990, PART XI, LINE 9: | NET ASSETS RELEASED FROM RESTRICTION 36,213. TEMPORARILY RESTRICTED NET ASSETS RECLASS FROM OPERATING CASH ACCOUNT 29,161. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART XII, LINE 2C | THE AUDIT IS OVERSEEN BY A COMMITTEE OF THE SHELTERING ARMS HOSPITAL FOUNDATION AND THIS HAS NOT CHANGED SINCE THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHELTERING ARMS HOSPITAL FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 55 HOSPITAL DRIVE | AddressLine1 |
| City | ATHENS | City |
| State | OH | State |
| ZIP Code | 45701 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 314446959 | EIN |
| Primary Activities | PATIENT CARE | PrimaryActivities |
| Legal Domicile State | OH | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | HOSPITAL | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Controlled Org | 0 | ControlledOrg |
Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|
| ATHENS SURGERY CENTER LTD | |||||||
| 75 HOSPITAL DRIVE | ATHENS | OH | 45701 | 550840856 | OUTPATIENT SURGERY | OH | N/A |
| O'BLENESS MEMORIAL PAIN MANAGEMENT CLINIC LLC | |||||||
| 55 HOSPITAL DRIVE | ATHENS | OH | 45701 | 454587317 | PAIN CLINIC | OH | N/A |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ATHENS MEDICAL LABORATORY ASSOCIATES INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 265 WEST UNION STREET SUITE B | AddressLine1 |
| City | ATHENS | City |
| State | OH | State |
| ZIP Code | 45701 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 311381808 | EIN |
| Primary Activity | MEDICAL LABORATORY | PrimaryActivity |
| Legal Domicile State | OH | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | S | TypeOfEntity |
| Controlled Org | 0 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| SHELTERING ARMS HOSPITAL FOUNDATION | ||
| J | 67200 | LEASE AGREEMENT |
| SHELTERING ARMS HOSPITAL FOUNDATION | ||
| E | 235000 | LOAN AGREEMENT |
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