EASTERN SHORE RURAL HEALTH SYSTEM INCORPORATED: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
EASTERN SHORE RURAL HEALTH SYSTEM INCORPORATED (EIN 51-0196935)
Tax period
2013-06-01 to 2014-05-31
Filed
2014-10-10
IRS object ID
201442839349300009
Schema version
2013v3.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2014-10-10T07:49:41-05:00ReturnTs
Tax Period End2014-05-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN541896113PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ROBINSON FARMER COX ASSOCIATESBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1530 WESTFIELD RDAddressLine1
CityCHARLOTTESVILLECity
StateVAState
ZIP Code229011726ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-06-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN510196935EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1EASTERN SHORE RURAL HEALTHBusinessNameLine1
Business Name Line2SYSTEM INCBusinessNameLine2
FieldValueIRS element (for citing)
Business Name ControlEASTBusinessNameControlTxt
Phone7574140400PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line120280 MARKET STREETAddressLine1
CityONANCOCKCity
StateVAState
ZIP Code23417ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonNANCY STERNPersonNm
Person TitleCHIEF EXECUTIVE OFFICERPersonTitleTxt
Phone7574140400PhoneNum
Signature2014-09-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDAVID E FOLEYPreparerPersonNm
PTINP01457488PTIN
Phone4349738314PhoneNum
Preparation2014-10-10PreparationDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerNANCY STERNPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line120280 MARKET STREETAddressLine1
CityONANCOCKCity
StateVAState
ZIP Code23417ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$18,337,805GrossReceiptsAmt
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 Body12VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee241TotalEmployeeCnt
Total Volunteers25TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$7,610,551PYContributionsGrantsAmt
CY Contributions Grants$4,559,812CYContributionsGrantsAmt
PY Program Service Revenue$12,532,412PYProgramServiceRevenueAmt
CY Program Service Revenue$13,707,380CYProgramServiceRevenueAmt
PY Investment Income$5,896PYInvestmentIncomeAmt
CY Investment Income-$139,180CYInvestmentIncomeAmt
PY Other Revenue$18,074PYOtherRevenueAmt
CY Other Revenue$20,267CYOtherRevenueAmt
PY Total Revenue$20,166,933PYTotalRevenueAmt
CY Total Revenue$18,148,279CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$11,100,761PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$11,845,222CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$212,373CYTotalFundraisingExpenseAmt
PY Other Expenses$4,382,763PYOtherExpensesAmt
CY Other Expenses$5,053,798CYOtherExpensesAmt
PY Total Expenses$15,483,524PYTotalExpensesAmt
CY Total Expenses$16,899,020CYTotalExpensesAmt
PY Revenues Less Expenses$4,683,409PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,249,259CYRevenuesLessExpensesAmt
Total Assets BOY$17,332,945TotalAssetsBOYAmt
Total Assets EOY$18,092,533TotalAssetsEOYAmt
Total Liabilities BOY$3,723,660TotalLiabilitiesBOYAmt
Total Liabilities EOY$3,233,989TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$13,609,285NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$14,858,544NetAssetsOrFundBalancesEOYAmt
MissionOPERATION OF FEDERALLY SUPPORTED COMMUNITY HEALTH CENTERS.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$14,730,064ExpenseAmt
Revenue$13,707,380RevenueAmt
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$14,730,064TotalProgramServiceExpensesAmt
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 Document25IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee241EmployeeCnt
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 Members12GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
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 STREETAddressLine1
CityONANCOCKCity
StateVAState
ZIP Code23417ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (25 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
BOARD MEMBER2.00Yes (X)$0$0$0
HARRY DEITCH
BOARD MEMBER2.00Yes (X)$0$0$0
SORAYA BUCKNER
BOARD MEMBER2.00Yes (X)$0$0$0
SHEILA KERPELMAN
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
SECRETARY2.00Yes (X)$0$0$0
BOB MAYES
BOARD MEMBER2.00Yes (X)$0$0$0
JOHN SCHULZ
VICE PRESIDE2.00Yes (X)$0$0$0
PETE DUER
BOARD MEMBER2.00Yes (X)$0$0$0
WILLIAM STURGIS
BOARD MEMBER2.00Yes (X)$0$0$0
BLAIR CHICK
MEDICAL DIRE40.00$213,385$0$22,500Yes (X)
NANCY STERN
CHIEF EXECUT40.00$158,187$0$12,650Yes (X)
KANDICE BRUNO
CHIEF FINANC40.00$105,754$0$15,843Yes (X)
ANNE CRABBE
CHIEF OPERAT40.00$90,464$0$9,044Yes (X)
JEANNETTE EDWARDS
DIRECTOR OF40.00$87,621$0$8,774Yes (X)
KIMBERLY SAVAGE
CHIEF COMPLI40.00$86,054$0$5,200Yes (X)
MIKE ZODUN
CHIEF INFORM40.00$76,498$0$6,409Yes (X)
SCOTT WOLPIN
DENTAL DIREC40.00$37,765$0$5,660Yes (X)
DAVID HOSHINO
DOCTOR40.00$174,459$0$17,383Yes (X)
THOMAS HOLLANDSWORTH
DOCTOR40.00$172,176$0$17,500Yes (X)
JEANNE ROLL
DOCTOR40.00$170,182$0$12,000Yes (X)
DAVID RIOPEL
DOCTOR40.00$156,970$0$15,683Yes (X)
EDWARD GRIGGS
DENTIST40.00$155,055$0$23,000Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,684,570TotalReportableCompFromOrgAmt
Total Other Compensation$171,646TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K8IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Government Grants$4,471,238GovernmentGrantsAmt
All Other Contributions$88,574AllOtherContributionsAmt
Total Contributions$4,559,812TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE$10,744,944$10,744,944
340B$2,800,936$2,800,936
MEANINGFUL USE$161,500$161,500
FieldValueIRS element (for citing)
Total Program Service Revenue$13,707,380TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,346TotalRevenueColumnAmt
Exclusion$5,346ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$5,860RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$5,860RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,860TotalRevenueColumnAmt
Related Or Exempt Func Income$5,860RelatedOrExemptFuncIncomeAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$45,000SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$189,526SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$144,526SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$144,526TotalRevenueColumnAmt
Related Or Exempt Func Income-$144,526RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER REVENUEDesc
Total Revenue Column$14,407TotalRevenueColumnAmt
Related Or Exempt Func Income$14,407RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$14,407OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$18,148,279TotalRevenueColumnAmt
Related Or Exempt Func Income$13,583,121RelatedOrExemptFuncIncomeAmt
Exclusion$5,346ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$992,011TotalAmt
Program Services$252,303ProgramServicesAmt
Management And General$590,299ManagementAndGeneralAmt
Fundraising$149,409FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$9,216,537TotalAmt
Program Services$8,455,050ProgramServicesAmt
Management And General$756,552ManagementAndGeneralAmt
Fundraising$4,935FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$183,678TotalAmt
Program Services$168,795ProgramServicesAmt
Management And General$14,535ManagementAndGeneralAmt
Fundraising$348FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$828,416TotalAmt
Program Services$761,292ProgramServicesAmt
Management And General$65,556ManagementAndGeneralAmt
Fundraising$1,568FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$624,580TotalAmt
Program Services$573,972ProgramServicesAmt
Management And General$49,426ManagementAndGeneralAmt
Fundraising$1,182FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$28,793TotalAmt
Management And General$28,793ManagementAndGeneralAmt

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$372,373TotalAmt
Program Services$331,034ProgramServicesAmt
Fundraising$41,339FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$103,639TotalAmt
Program Services$47,450ProgramServicesAmt
Management And General$56,189ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$437,495TotalAmt
Program Services$325,673ProgramServicesAmt
Management And General$106,718ManagementAndGeneralAmt
Fundraising$5,104FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$45,194TotalAmt
Program Services$45,194ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$99,055TotalAmt
Program Services$18,690ProgramServicesAmt
Management And General$76,816ManagementAndGeneralAmt
Fundraising$3,549FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$95,697TotalAmt
Program Services$92,256ProgramServicesAmt
Management And General$3,441ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$537,718TotalAmt
Program Services$493,969ProgramServicesAmt
Management And General$41,462ManagementAndGeneralAmt
Fundraising$2,287FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$49,646TotalAmt
Management And General$49,646ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
PHARMACY PROGRAMS$1,645,699$1,645,699
MEDICAL SUPPLIES$1,115,066$1,115,066
TELEPHONE & UTILITIES$253,263$215,289$36,357$1,617
REPAIRS & MAINTENANCE$195,481$171,165$23,281$1,035

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$52,179TotalAmt
Program Services$17,167ProgramServicesAmt
Management And General$35,012ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$16,899,020TotalAmt
Program Services$14,730,064ProgramServicesAmt
Management And General$1,956,583ManagementAndGeneralAmt
Fundraising$212,373FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,998,666BOYAmt
EOY$2,507,416EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,952,573BOYAmt
EOY$2,339,015EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$15,650BOYAmt
EOY$18,090EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$16,568,097LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$3,346,085LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$13,359,056BOYAmt
EOY$13,222,012EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$7,000BOYAmt
EOY$6,000EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$17,332,945BOYAmt
EOY$18,092,533EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,316,104BOYAmt
EOY$861,022EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$2,403,367BOYAmt
EOY$2,372,164EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,189BOYAmt
EOY$803EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,723,660BOYAmt
EOY$3,233,989EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$13,609,285BOYAmt
EOY$14,819,799EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$13,609,285BOYAmt
EOY$14,858,544EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$17,332,945BOYAmt
EOY$18,092,533EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,249,259ReconcilationRevenueExpnssAmt
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$5,330,230CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,842,593CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,304,592CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$7,610,551CurrentTaxYearMinus1YearAmt
Current Tax Year$4,559,812CurrentTaxYearAmt
Total$26,647,778TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,152,733CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$8,685,373CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$11,114,742CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$12,532,412CurrentTaxYearMinus1YearAmt
Current Tax Year$13,727,647CurrentTaxYearAmt
Total$54,212,907TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,482,963CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$13,527,966CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$15,419,334CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$20,142,963CurrentTaxYearMinus1YearAmt
Current Tax Year$18,287,459CurrentTaxYearAmt
Total$80,860,685TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$80,860,685PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$17,711CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$22,305CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$18,177CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$17,056CurrentTaxYearMinus1YearAmt
Current Tax Year$5,346CurrentTaxYearAmt
Total$80,595TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$17,711CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$22,305CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$18,177CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$17,056CurrentTaxYearMinus1YearAmt
Current Tax Year$5,346CurrentTaxYearAmt
Total$80,595TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$82,653CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$58,989CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$43,396CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,914CurrentTaxYearMinus1YearAmt
Current Tax Year$14,407CurrentTaxYearAmt
Total$206,359TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,583,327CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$13,609,260CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$15,480,907CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$20,166,933CurrentTaxYearMinus1YearAmt
Current Tax Year$18,307,212CurrentTaxYearAmt
Total$81,147,639TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99650PublicSupportCY509Pct
Public Support PY5090.99530PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part IV Form990ScheduleAPartIVGrp

FieldValueIRS element (for citing)
Form And Line ReferencePART II, LINE 12FormAndLineReferenceDesc
ExplanationOTHER INCOME 206,359ExplanationTxt

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$760,380OtherCostOrOtherBasisAmt
Book Value$760,380BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,340,018OtherCostOrOtherBasisAmt
Depreciation$2,414,018DepreciationAmt
Book Value$11,926,000BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,467,699OtherCostOrOtherBasisAmt
Depreciation$932,067DepreciationAmt
Book Value$535,632BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$13,222,012TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescOTHER LIABILITIESDesc
Amt$803Amt
FieldValueIRS element (for citing)
Total Liability$803TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$18,148,279TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal$18,148,279RevenueSubtotalAmt
Total Revenue Per Form990$18,148,279TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$16,899,020TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$16,899,020ExpensesSubtotalAmt
Total Expenses Per Form990$16,899,020TotalExpensesPerForm990Amt

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 (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
BLAIR CHICK
MEDICAL DIRECTOR$213,385$22,500$235,885
NANCY STERN
CHIEF EXECUTIVE OFF.$158,187$12,650$170,837
DAVID HOSHINO
DOCTOR$174,459$17,383$191,842
THOMAS HOLLANDSWORTH
DOCTOR$172,176$17,500$189,676
JEANNE ROLL
DOCTOR$170,182$12,000$182,182
DAVID RIOPEL
DOCTOR$156,970$15,683$172,653
EDWARD GRIGGS
DENTIST$155,055$23,000$178,055

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 MEMEBERS 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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