VIDANT MEDICAL GROUP LLC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- VIDANT MEDICAL GROUP LLC (EIN 38-3740839)
- Tax period
- 2012-10-01 to 2013-09-30
- Filed
- 2014-08-08
- IRS object ID
- 201432209349301123
- 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 | 2014-08-08T14:26:33-05:00 | Timestamp |
| Tax Period End Date | 2013-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 420714325 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | McGladrey LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 S Wacker Drive Ste 800 | AddressLine1 |
| City | Chicago | City |
| State | IL | State |
| ZIP Code | 60606 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 383740839 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Vidant Medical Group LLC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | VIDA | NameControl |
| Phone | 2528475129 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2100 Stantonsburg Road | AddressLine1 |
| City | Greenville | City |
| State | NC | State |
| ZIP Code | 27835 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Travis Douglass | Name |
| Title | Manager | Title |
| Phone | 2528475129 | Phone |
| Date Signed | 2014-08-08 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Wayne Harder | Name |
| PTIN | P00294296 | PTIN |
| Phone | 3126343400 | 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 | Travis Douglass | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2100 Stantonsburg Road | AddressLine1 |
| City | Greenville | City |
| State | NC | State |
| ZIP Code | 27835 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 143065647 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.vidanthealth.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2006 | YearFormation |
| State Legal Domicile | NC | StateLegalDomicile |
| Activity Or Mission Description | To provide medical services in Eastern North Carolina. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 1 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 0 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1098 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 96211200 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 143049358 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 9105 | InvestmentIncomePriorYear |
| Investment Income Current Year | 16289 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 96220305 | TotalRevenuePriorYear |
| Total Revenue Current Year | 143065647 | 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 | 80485454 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 106409760 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 40932898 | OtherExpensePriorYear |
| Other Expenses Current Year | 71007268 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 121418352 | TotalExpensesPriorYear |
| Total Expenses Current Year | 177417028 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -25198047 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -34351381 | RevenuesLessExpensesCY |
| Total Assets BOY | 28613736 | TotalAssetsBOY |
| Total Assets EOY | 35217938 | TotalAssetsEOY |
| Total Liabilities BOY | 13939918 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 22634357 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 14673818 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 12583581 | NetAssetsOrFundBalancesEOY |
| Mission Description | To enhance the quality of life for the people and communities we serve, touch and support. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 170567629 | Expense |
| Revenue | 143049358 | Revenue |
| Description | Vidant Health professionals provided evaluations, clinical care management and medically necessary procedures. | Description |
| Total Program Service Expense | 170567629 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | 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 | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | 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 | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1098 | 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 | 1 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 0 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | 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 | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 0 | ConflictOfInterestPolicy |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Chris Townsend | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2528475129 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2100 Stantonsburg Road | AddressLine1 |
| City | Greenville | City |
| State | NC | State |
| ZIP Code | 27835 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (12 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|---|
| Travis Douglass | |||||||||
| Manager | 40.00 | 0.00 | X | X | 0 | 308287 | 67952 | ||
| David Herman MD | |||||||||
| CEO | 2.00 | 50.00 | X | 0 | 1188222 | 89223 | |||
| Roger Robertson | |||||||||
| President, VCOM | 2.00 | 46.00 | X | 0 | 400870 | 90819 | |||
| David Hughes | |||||||||
| Treasurer | 2.00 | 50.00 | X | 0 | 404052 | 139056 | |||
| William Floyd | |||||||||
| Executive Vice President | 2.00 | 40.00 | X | 0 | 314590 | 82893 | |||
| Clyde Brooks | |||||||||
| VP, Medical Affairs | 40.00 | 0.00 | 293201 | 0 | 71037 | X | |||
| Matthew Meyers | |||||||||
| Healthcare Leader - EHR Deployment | 40.00 | 0.00 | 186789 | 0 | 57806 | X | |||
| Randal White | |||||||||
| Physician | 40.00 | 0.00 | 560603 | 0 | 39749 | X | |||
| Jon Dubose | |||||||||
| Physician | 40.00 | 0.00 | 543249 | 0 | 37987 | X | |||
| Edward Birdsong | |||||||||
| Physician | 40.00 | 0.00 | 541268 | 0 | 33843 | X | |||
| Matthew McKenna | |||||||||
| Physician | 40.00 | 0.00 | 549654 | 0 | 31294 | X | |||
| Thomas Ruffolo | |||||||||
| Physician | 40.00 | 0.00 | 518702 | 0 | 45448 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3193466 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 2616021 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 787107 | TotalOtherCompensation |
| Number Individuals GT100 K | 225 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| ECU School of Medicine | |||||
| PO Box 75514 | Charlotte | NC | 282750514 | Physician Services | 4354808 |
| Bunn Medical Associates | |||||
| 606 Ashburton Drive | Greenville | NC | 27858 | Physician Services | 1994207 |
| Eastern Emergency Physicians Inc | |||||
| 3102 Star Hill Farm Road | Greenville | NC | 27834 | Physician Services | 1960952 |
| Eastern Urological Associates | |||||
| 275 Bethesda Drive | Greenville | NC | 27834 | Physician Services | 982292 |
| Greenville Psychiatric Associates PA | |||||
| PO Box 20128 | Greenville | NC | 27858 | Physician Services | 355650 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 23 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Patient Revenue | 621110 | 96411989 | 96411989 |
| Contract Management Fees | 621110 | 46637369 | 46637369 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 143049358 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 16289 | TotalRevenueColumn |
| Exclusion | $16,289 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 143065647 | TotalRevenueColumn |
| Related Or Exempt Function Income | 143049358 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $16,289 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 479990 | Total |
| Program Services | 469603 | ProgramServices |
| Management And General | 10387 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 92582052 | Total |
| Program Services | 90578477 | ProgramServices |
| Management And General | 2003575 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1334010 | Total |
| Program Services | 1305141 | ProgramServices |
| Management And General | 28869 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7099016 | Total |
| Program Services | 6945386 | ProgramServices |
| Management And General | 153630 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4914692 | Total |
| Program Services | 4808333 | ProgramServices |
| Management And General | 106359 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 102208 | Total |
| Program Services | 99996 | ProgramServices |
| Management And General | 2212 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15513 | Total |
| Program Services | 15177 | ProgramServices |
| Management And General | 336 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34058026 | Total |
| Program Services | 33700344 | ProgramServices |
| Management And General | 357682 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 403589 | Total |
| Program Services | 395293 | ProgramServices |
| Management And General | 8296 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10937463 | Total |
| Program Services | 10700765 | ProgramServices |
| Management And General | 236698 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 605661 | Total |
| Program Services | 592554 | ProgramServices |
| Management And General | 13107 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 485508 | Total |
| Program Services | 475001 | ProgramServices |
| Management And General | 10507 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 222322 | Total |
| Program Services | 144509 | ProgramServices |
| Management And General | 77813 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40572 | Total |
| Program Services | 39694 | ProgramServices |
| Management And General | 878 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 125911 | Total |
| Program Services | 11332 | ProgramServices |
| Management And General | 114579 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1545235 | Total |
| Program Services | 1511794 | ProgramServices |
| Management And General | 33441 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6707264 | Total |
| Program Services | 3018269 | ProgramServices |
| Management And General | 3688995 | ManagementAndGeneral |
Other Expenses OtherExpenses (2 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Bad Debt Expense | 15663990 | 15663990 | |
| Books/Subscriptions | 31367 | 30688 | 679 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 62639 | Total |
| Program Services | 61283 | ProgramServices |
| Management And General | 1356 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 177417028 | Total |
| Program Services | 170567629 | ProgramServices |
| Management And General | 6849399 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3895947 | BOY |
| EOY | 3866338 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12356194 | BOY |
| EOY | 16025529 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 442079 | BOY |
| EOY | 768714 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1590492 | BOY |
| EOY | 1272388 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 10821281 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 3125481 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3814242 | BOY |
| EOY | 7695800 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24512 | BOY |
| EOY | 10507 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6490270 | BOY |
| EOY | 5578662 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28613736 | BOY |
| EOY | 35217938 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13807772 | BOY |
| EOY | 17369838 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 132146 | BOY |
| EOY | 5264519 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13939918 | BOY |
| EOY | 22634357 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14673818 | BOY |
| EOY | 12583581 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14673818 | BOY |
| EOY | 12583581 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28613736 | BOY |
| EOY | 35217938 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -34351381 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 32261144 | ReconcilationOtherChanges |
| 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 |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3268920 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 19217070 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 34419109 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 96211200 | CurrentTaxYearMinus1Year |
| Current Tax Year | 127385368 | CurrentTaxYear |
| Total | 280501667 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3268920 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 19217070 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 34419109 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 96211200 | CurrentTaxYearMinus1Year |
| Current Tax Year | 127385368 | CurrentTaxYear |
| Total | 280501667 | 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) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 280501667 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1692 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 4515 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 7728 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 9105 | CurrentTaxYearMinus1Year |
| Current Tax Year | 16287 | CurrentTaxYear |
| Total | 39327 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1692 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 4515 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 7728 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 9105 | CurrentTaxYearMinus1Year |
| Current Tax Year | 16287 | CurrentTaxYear |
| Total | 39327 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3270612 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 19221585 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 34426837 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 96220305 | CurrentTaxYearMinus1Year |
| Current Tax Year | 127401655 | CurrentTaxYear |
| Total | 280540994 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99990 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.99980 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00010 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00020 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule D IRS990ScheduleD
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1147744 | OtherCostOrOtherBasis |
| Depreciation | 177697 | Depreciation |
| Book Value | 970047 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 9673537 | OtherCostOrOtherBasis |
| Depreciation | 2947784 | Depreciation |
| Book Value | 6725753 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 7695800 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (4 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Other Receivables | 2600660 |
| Sales Tax Receivables | 539985 |
| Intercompany Receivables | 1219298 |
| Physician Loan Receivables | 1218719 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 5578662 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Worker Compensation Long Term | $200,519 |
| Self-Insurance Reserve | $5,064,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 5264519 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Description of Uncertain Tax Positions Under FIN 48: | Identifier |
| Return Reference | Part X, Line 2: | ReturnReference |
| Explanation | Vidant Medical Group LLC has been determined to qualify as a tax-exempt organization under Section 501(c)(3) of the Internal Revenue Code. Vidant Medical Group has reviewed its tax positions for all open years and has concluded that no material liabilities exist as of September 30, 2013 and 2012. Vidant Medical Group files tax returns with the US federal and State of North Carolina jurisdictions. With few exceptions, Vidant Medical Group is no longer subject to US federal examinations by tax authorities for years before 2009. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | 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 (12 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Travis Douglass | ||||||||||||||
| Manager | 0 | 266276 | 0 | 42011 | 0 | 0 | 0 | 34133 | 0 | 33819 | 0 | 376239 | 0 | 0 |
| David Herman MD | ||||||||||||||
| CEO | 0 | 907202 | 0 | 185606 | 0 | 95414 | 0 | 72500 | 0 | 16723 | 0 | 1277445 | 0 | 0 |
| Roger Robertson | ||||||||||||||
| President, VCOM | 0 | 362398 | 0 | 36780 | 0 | 1692 | 0 | 70556 | 0 | 20263 | 0 | 491689 | 0 | 0 |
| David Hughes | ||||||||||||||
| Treasurer | 0 | 357502 | 0 | 45500 | 0 | 1050 | 0 | 100966 | 0 | 38090 | 0 | 543108 | 0 | 0 |
| William Floyd | ||||||||||||||
| Executive Vice President | 0 | 294412 | 0 | 19826 | 0 | 352 | 0 | 48652 | 0 | 34241 | 0 | 397483 | 0 | 0 |
| Clyde Brooks | ||||||||||||||
| VP, Medical Affairs | 273357 | 0 | 19844 | 0 | 0 | 0 | 32600 | 0 | 38437 | 0 | 364238 | 0 | 0 | 0 |
| Matthew Meyers | ||||||||||||||
| Healthcare Leader - EHR Deployment | 173289 | 0 | 13500 | 0 | 0 | 0 | 19901 | 0 | 37905 | 0 | 244595 | 0 | 0 | 0 |
| Randal White | ||||||||||||||
| Physician | 560603 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 39749 | 0 | 600352 | 0 | 0 | 0 |
| Jon Dubose | ||||||||||||||
| Physician | 543249 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 37987 | 0 | 581236 | 0 | 0 | 0 |
| Edward Birdsong | ||||||||||||||
| Physician | 541268 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 33843 | 0 | 575111 | 0 | 0 | 0 |
| Matthew McKenna | ||||||||||||||
| Physician | 536134 | 0 | 0 | 0 | 13520 | 0 | 0 | 0 | 31294 | 0 | 580948 | 0 | 0 | 0 |
| Thomas Ruffolo | ||||||||||||||
| Physician | 518702 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 45448 | 0 | 564150 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| Part I, Line 3 | The compensation is determined by the Compensation and Benefits Committee of the VH Board using comparative data from like organizations and input from consultants. This process is performed every two years, the last year being 2012. It will be performed again in fiscal year 2014. All compensation discussions and actions are documented and approved in the minutes of the Committee. |
| Part I, Line 4b | The following individuals participated in a supplemental non-qualified retirement plan during the year. The yearly change of such plan is included in their compensation per Schedule J, Part II, column C: - David Hughes, $55,608 - Roger Robertson, 19,716 - William Floyd, 12,396 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section B, line 11 | The Board Member is provided a copy of the return for review prior to filing. The return is also reviewed by the Chief Financial Officer, Chief General Counsel and the Chief Audit and Compliance Officer of University Health Systems of Eastern Carolina, Inc. (D/B/A Vidant Health) prior to filing. | |
| Form 990, Part VI, Section B, line 12 | As described in the Conflict of Interest policy maintained by VH, all Officers, Board Members and Key Employees are required to complete a yearly comprehensive conflict of interest questionnaire. These are reviewed by legal counsel and any potential or actual conflicts are brought to the Board for disposition. Board Members are instructed to report any potential conflicts arising during the year for review. Board Members are required to recuse themselves from voting on issues in which they are deemed to have a conflict. | |
| The compensation is determined by the Compensation and Benefits Committee of the VH Board using comparative data from like organizations and input from consultants. This process is performed every two years, the last year being 2012. It will be performed again in fiscal year 2014. Compensation of other officers and key employees is also determined by the Compensation and Benefits Committee of the VH Board using comparative data from like organizations and input from consultants. This process is performed every two years, the last year being 2012. It will be performed again in fiscal year 2014. All compensation discussions and actions are documented and approved in the minutes of the Committee. | ||
| Form 990, Part VI, Section C, line 19 | The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. | |
| Form 990, Part IX, line 11g | Intercompany Shared Services: Program service expenses 12,987,857. Management and general expenses 137,848. Fundraising expenses 0. Total expenses 13,125,705. Physician Fees: Program service expenses 14,588,569. Management and general expenses 154,837. Fundraising expenses 0. Total expenses 14,743,406. Other Service Contracts: Program service expenses 6,123,918. Management and general expenses 64,997. Fundraising expenses 0. Total expenses 6,188,915. | Other Fees |
| Form 990, Part XI, line 9: | Contributed Capital 32,261,144. | Changes in Net Assets or Fund Balances: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | University Health Systems of Eastern Carolina (DBA Vidant Health) | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2100 Stantonsburg Road | AddressLine1 |
| City | Greenville | City |
| State | NC | State |
| ZIP Code | 27835 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 562141073 | EIN |
| Primary Activities | Healthcare | PrimaryActivities |
| Legal Domicile State | NC | LegalDomicileState |
| Exempt Code Section | 501(c)(3) | ExemptCodeSection |
| Public Charity Status | Line 11c, III-FI | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| 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 | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | 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 | 1 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (24 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Vidant Medical Center | ||
| B | 7120468 | Actual Cash Payment |
| Vidant Edgecombe Hospital | ||
| B | 2819974 | Actual Cash Payment |
| Vidant Roanoke-Chowan Hospital | ||
| B | 2482952 | Actual Cash Payment |
| Vidant Chowan Hospital | ||
| B | 513181 | Actual Cash Payment |
| Vidant Duplin Hospital | ||
| B | 1620016 | Actual Cash Payment |
| Vidant Beaufort Hospital | ||
| B | 1182561 | Actual Cash Payment |
| Vidant Pungo Hospital | ||
| B | 452669 | Actual Cash Payment |
| Vidant Health | ||
| C | 49000000 | Actual Cash Payment |
| Vidant Chowan Hospital | ||
| J | 275546 | Actual Cash Payment |
| Vidant Duplin Hospital | ||
| J | 120742 | Actual Cash Payment |
| OBH Medical Office Building | ||
| J | 89998 | Actual Cash Payment |
| PCMH Management Inc | ||
| J | 1220273 | Actual Cash Payment |
| Vidant Medical Center | ||
| K | 7141335 | Actual Cash Payment |
| Vidant Edgecombe Hospital | ||
| K | 3440099 | Actual Cash Payment |
| Vidant Roanoke-Chowan Hospital | ||
| K | 2708529 | Actual Cash Payment |
| Vidant Chowan Hospital | ||
| K | 513763 | Actual Cash Payment |
| Vidant Duplin Hospital | ||
| K | 1644508 | Actual Cash Payment |
| The Outer Banks Hospital Inc | ||
| K | 3223303 | Actual Cash Payment |
| Vidant Beaufort Hospital | ||
| K | 1185059 | Actual Cash Payment |
| Vidant Pungo Hospital | ||
| K | 452669 | Actual Cash Payment |
| Vidant Health | ||
| L | 3078801 | Actual Cash Payment |
| Vidant Medical Center | ||
| L | 4832847 | Actual Cash Payment |
| Vidant Health | ||
| N | 388629 | Actual Cash Payment |
| Vidant Health | ||
| O | 179914 | Actual Cash Payment |
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