VIDANT MEDICAL GROUP LLC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- VIDANT MEDICAL GROUP LLC (EIN 38-3740839)
- Tax period
- 2010-10-01 to 2011-09-30
- Filed
- 2012-04-04
- IRS object ID
- 201220959349300707
- Schema version
- 2010v3.4
- 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 | 2012-04-04T09:02:50-05:00 | Timestamp |
| Tax Period End Date | 2011-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 N TRYON STREET SUITE 1000 | AddressLine1 |
| City | CHARLOTTE | City |
| State | NC | State |
| ZIP Code | 28246 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 383740839 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UHS PHYSICIANS LLC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | UHSP | 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 | 2012-04-04 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | GREGORY W JOHNS | Name |
| Phone | 7049985200 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | 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 | 34426837 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.UHSEAST.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 | 302 | 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 | 19217070 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 34419109 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 4515 | InvestmentIncomePriorYear |
| Investment Income Current Year | 7728 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 19221585 | TotalRevenuePriorYear |
| Total Revenue Current Year | 34426837 | 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 | 24452570 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 39106218 | 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 | 10642729 | OtherExpensePriorYear |
| Other Expenses Current Year | 20529830 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 35095299 | TotalExpensesPriorYear |
| Total Expenses Current Year | 59636048 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -15873714 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -25209211 | RevenuesLessExpensesCY |
| Total Assets BOY | 11922478 | TotalAssetsBOY |
| Total Assets EOY | 15458976 | TotalAssetsEOY |
| Total Liabilities BOY | 5197482 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 9148340 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 6724996 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 6310636 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | TO PROVIDE MEDICAL SERVICES IN EASTERN NORTH CAROLINA TO SUPPORT THE CHARITABLE HEALTH CARE MISSION OF PITT COUNTY MEMORIAL HOSPITAL ("PCMH"), UNIVERSITY HEALTH SYSTEMS OF EASTERN CAROLINA ("UHSEC") AND OTHER TAX-EXEMPT ENTITIES IN THE REGION. MEDICAL SERVICES INCLUDE THE PROFESSIONAL SERVICES OF ADVANCED LEVEL PRACTITIONERS ("ALPS") AND PHYSICIANS WHO PERFORM EVALUATIONS, CLINICAL CARE MANAGEMENT AND MEDICALLY NECESSARY PROCEDURES FOR OUTPATIENTS AND INPATIENTS. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 55325735 | Expense |
| Revenue | 34419109 | Revenue |
| Description | UHS PHYSICIANS PROFESSIONALS PROVIDED EVALUATIONS, CLINICAL CARE MANGAGEMENT AND MEDICALLY NECESSARY PROCEDURES FOR 292,248 ENCOUNTERS DURING THE YEAR. | Description |
| Total Program Service Expense | 55325735 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| 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 | 0 | 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 |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| 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 |
| Number Of Employees | 302 | 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 | 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 | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Own Website | X | OwnWebsite |
| 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 (6 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| TRAVIS DOUGLASS | |||||||
| MANAGER | 40.00 | X | X | 0 | 239156 | 47317 | |
| MICHAEL LAM | |||||||
| PHYSICIAN | 40.00 | 440989 | 0 | 189 | X | ||
| GHIATH ALMASRI | |||||||
| PHYSICIAN | 40.00 | 460558 | 0 | 14889 | X | ||
| EDOUARD MISSE | |||||||
| PHYSICIAN | 40.00 | 447300 | 0 | 6314 | X | ||
| JON DUBOSE | |||||||
| PHYSICIAN | 40.00 | 417669 | 0 | 6193 | X | ||
| MARK GIBBONS | |||||||
| PHYSICIAN | 40.00 | 351385 | 0 | 167 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2117901 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 239156 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 75069 | TotalOtherCompensation |
| Number Individuals GT100 K | 105 | 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 | 2455610 |
| EASTERN EMERGENCY PHYSICIANS INC | |||||
| 3102 STAR HILL FARM RD | GREENVILLE | NC | 27834 | PHYSICIAN SERVICES | 2039041 |
| MAG MUTUAL INS CO | |||||
| PO BOX 52979 | ATLANTA | GA | 303550979 | PROF LIABILITY INSURANCE | 513247 |
| TRIANGLE ANESTHESIA ASSOC PLLC | |||||
| 3650 ROGERS ROAD STE 295 | WAKE FOREST | NC | 27587 | ANESTHESIA SERVICES | 316680 |
| MARY HELEN JOHNSON MD | |||||
| 1073 WOODSIDE PLACE | ASHEBORO | NC | 27205 | PHYSICIAN SERVICES | 247065 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 18 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT REVENUE | Description |
| Business Code | 621110 | BusinessCode |
| Total Revenue Column | 24095227 | TotalRevenueColumn |
| Related Or Exempt Function Income | 24095227 | RelatedOrExemptFunctionIncome |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 10323882 | TotalRevenueColumn |
| Related Or Exempt Function Income | 10323882 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 34419109 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7728 | TotalRevenueColumn |
| Exclusion | $7,728 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 34426837 | TotalRevenueColumn |
| Related Or Exempt Function Income | 34419109 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $7,728 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 35247711 | Total |
| Program Services | 33086900 | ProgramServices |
| Management And General | 2160811 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 274997 | Total |
| Program Services | 258139 | ProgramServices |
| Management And General | 16858 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1718082 | Total |
| Program Services | 1612757 | ProgramServices |
| Management And General | 105325 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1865428 | Total |
| Program Services | 1751071 | ProgramServices |
| Management And General | 114357 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 112640 | Total |
| Program Services | 93491 | ProgramServices |
| Management And General | 19149 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16631160 | Total |
| Program Services | 15735048 | ProgramServices |
| Management And General | 896112 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22266 | Total |
| Program Services | 22266 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1357040 | Total |
| Program Services | 1126343 | ProgramServices |
| Management And General | 230697 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 251377 | Total |
| Program Services | 208643 | ProgramServices |
| Management And General | 42734 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 710259 | Total |
| Program Services | 589350 | ProgramServices |
| Management And General | 120909 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 138368 | Total |
| Program Services | 89939 | ProgramServices |
| Management And General | 48429 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1991 | Total |
| Program Services | 1653 | ProgramServices |
| Management And General | 338 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 430066 | Total |
| Program Services | 356955 | ProgramServices |
| Management And General | 73111 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 832069 | Total |
| Program Services | 374431 | ProgramServices |
| Management And General | 457638 | ManagementAndGeneral |
Other Expenses OtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MEMBERSHIP DUES | Description |
| Total | 22437 | Total |
| Program Services | 2019 | ProgramServices |
| Management And General | 20418 | ManagementAndGeneral |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20157 | Total |
| Program Services | 16730 | ProgramServices |
| Management And General | 3427 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 59636048 | Total |
| Program Services | 55325735 | ProgramServices |
| Management And General | 4310313 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2411983 | BOY |
| EOY | 2468589 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6317918 | BOY |
| EOY | 6224479 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 112534 | BOY |
| EOY | 167742 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 532978 | BOY |
| EOY | 683374 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 3423744 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 579425 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 943859 | BOY |
| EOY | 2844319 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2282 | BOY |
| EOY | 27984 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1600924 | BOY |
| EOY | 3042489 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11922478 | BOY |
| EOY | 15458976 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5197482 | BOY |
| EOY | 9148340 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5197482 | BOY |
| EOY | 9148340 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6724996 | BOY |
| EOY | 6310636 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6724996 | BOY |
| EOY | 6310636 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11922478 | BOY |
| EOY | 15458976 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -25209211 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 24791851 | 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 |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Written IRS Determination | X | WrittenIRSDetermination |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNIVERSITY HEALTH SYSTEM OF EASTERN CAROLINA INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 562141073 | EIN |
| Type Of Organization | 03 | TypeOfOrganization |
| Listed In Governing Doc | 1 | ListedInGoverningDoc |
| Supported Organization Notified | 1 | SupportedOrganizationNotified |
| Organized In US | 1 | OrganizedInUS |
| Amount | $0 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 0 | SumOfAmounts |
Schedule D IRS990ScheduleD
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1075680 | OtherCostOrOtherBasis |
| Depreciation | 15202 | Depreciation |
| Book Value | 1060478 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 58559 | OtherCostOrOtherBasis |
| Book Value | 58559 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2289505 | OtherCostOrOtherBasis |
| Depreciation | 564223 | Depreciation |
| Book Value | 1725282 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | 0 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 2844319 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER RECEIVABLES | Description |
| Book Value | 3042489 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 3042489 | TotalBookValueOtherAssets |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X: | ReturnReference |
| Explanation | UHS PHYSICIANS, LLC IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| 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 (6 entries)
| 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 | |||||||||||||
| 0 | 236837 | 0 | 2319 | 0 | 0 | 0 | 44856 | 0 | 2461 | 0 | 286473 | 0 | 0 |
| MICHAEL LAM | |||||||||||||
| 416001 | 0 | 0 | 0 | 24988 | 0 | 0 | 0 | 189 | 0 | 441178 | 0 | 0 | 0 |
| GHIATH ALMASRI | |||||||||||||
| 460558 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 14889 | 0 | 475447 | 0 | 0 | 0 |
| EDOUARD MISSE | |||||||||||||
| 447300 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 6314 | 0 | 453614 | 0 | 0 | 0 |
| JON DUBOSE | |||||||||||||
| 417669 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 6193 | 0 | 423862 | 0 | 0 | 0 |
| MARK GIBBONS | |||||||||||||
| 351385 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 167 | 0 | 351552 | 0 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE MANAGER APPOINTED BY THE SOLE MEMBER OF THE ORGANIZATION IS PROVIDED A COPY OF THE RETURN FOR REVIEW PRIOR TO FILING. THE RETURN IS ALSO PROVIDED TO THE CHIEF FINANCIAL OFFICER, CHIEF GENERAL COUNSEL AND THE CHIEF AUDIT AND COMPLIANCE OFFICER OF UNIVERSITY HEALTH SYSTEMS OF EASTERN CAROLINA, INC. PRIOR TO FILING. | |
| THE MANAGER WAS REQUIRED TO COMPLETE A COMPREHENSIVE CONFLICT OF INTEREST QUESTIONNAIRE IN HIS ROLE AS VP OF THE SOLE OWNER. THIS WAS REVIEWED BY LEGAL COUNSEL AND ANY POTENTIAL OR ACTUAL CONFLICTS ARE BROUGHT TO THE BOARD OF THE PARENT FOR DISPOSITION. BOARD MEMBERS ARE REQUIRED TO EXCUSE THEMSELVES FROM VOTING ON ISSUES IN WHICH THEY ARE DEEMED TO HAVE A CONFLICT. | FORM 990, PART VI, SECTION B, LINE 12C | |
| THE MANAGER'S COMPENSATION IS DETERMINED BY UNIVERSITY HEALTH SYSTEMS OF EASTERN CAROLINA, INC. ("UHSEC"), A RELATED TAX-EXEMPT ENTITY. UHSEC'S PROCESS IS AS FOLLOWS: COMPENSATION IS DETERMINED BY THE UHSEC BOARD USING COMPARATIVE DATA FROM LIKE ORGANIZATIONS AND INPUT FROM CONSULTANTS. THIS PROCESS IS PERFORMED EVERY THREE YEARS, THE LAST YEAR BEING 2010. IT IS EXPECTED TO BE PERFORMED AGAIN IN 2013. | FORM 990, PART VI, SECTION B, LINE 15 | |
| THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. | FORM 990, PART VI, SECTION C, LINE 19 | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | CAPITAL CONTRIBUTIONS AND TRANSFERS WITH AFFILIATES, NET 24,791,851. TOTAL TO FORM 990, PART XI, LINE 5: 24,791,851. | FORM 990, PART XI, LINE 5: |
| NO CHANGES FOR APPROVING AUDITED FINANCIAL STATEMENTS OR SELECTION OF INDEPENDENT ACCOUNTANTS HAVE OCCURRED FROM THE PRIOR YEAR. | FORM 990, PART XII, LINE 2C: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (9 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| UNIVERSITY HEALTH SYSTEMS OF EASTERN NORTH CAROLINA INC | ||||||||||
| 2100 STANTONSBURG ROAD | GREENVILLE | NC | 27835 | 562141073 | HEALTHCARE | NC | 501(C)(3) | LINE 11C, III-FI | N/A | 0 |
| PITT COUNTY MEMORIAL HOSPITAL INC | ||||||||||
| 2100 STANTONSBURG ROAD | GREENVILLE | NC | 27835 | 560585243 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | N/A | 0 |
| EAST CAROLINA HEALTH-CHOWAN INC | ||||||||||
| 2100 STANTONSBURG ROAD | GREENVILLE | NC | 27835 | 562101090 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | N/A | 0 |
| EAST CAROLINA HEALTH-BERTIE | ||||||||||
| 2100 STANTONSBURG ROAD | GREENVILLE | NC | 27835 | 562072002 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | N/A | 0 |
| EAST CAROLINA HEALTH | ||||||||||
| 2100 STANTONSBURG ROAD | GREENVILLE | NC | 27835 | 562003393 | HEALTHCARE | NC | 501(C)(3) | 509(A)(3) | N/A | 0 |
| EAST CAROLINA HEALTH-HERITAGE INC | ||||||||||
| 2100 STANTONSBURG ROAD | GREENVILLE | NC | 27835 | 562093700 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | N/A | 0 |
| EAST CAROLINA HEALTH-BEAUFORT INC | ||||||||||
| 2100 STANTONSBURG ROAD | GREENVILLE | NC | 27835 | 452436270 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | N/A | 0 |
| DUPLIN GENERAL HOSPITAL INC | ||||||||||
| 2100 STANTONSBURG ROAD | GREENVILLE | NC | 27835 | 566011594 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | N/A | 0 |
| THE OUTER BANKS HOSPITAL INC | ||||||||||
| 2100 STANTONSBURG ROAD | GREENVILLE | NC | 27835 | 562112733 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | N/A | 0 |
| 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 |
| 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 | 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 | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (14 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| EAST CAROLINA HEALTH-BEAUFORT | ||
| B | 78952 | ACTUAL CASH PAYMENT |
| EAST CAROLINA HEALTH-CHOWAN | ||
| J | 74480 | ACTUAL CASH PAYMENT |
| EAST CAROLINA HEALTH-CHOWAN | ||
| K | 74848 | ACTUAL CASH PAYMENT |
| EAST CAROLINA HEALTH-HERITAGE | ||
| K | 64000 | ACTUAL CASH PAYMENT |
| EAST CAROLINA HEALTH-RCH | ||
| J | 20007 | ACTUAL CASH PAYMENT |
| EAST CAROLINA HEALTH-RCH | ||
| K | 124043 | ACTUAL CASH PAYMENT |
| PITT COUNTY MEMORIAL HOSPITAL INC | ||
| N | 2109844 | ACTUAL CASH PAYMENT |
| UNIVERSITY HEALTH SYSTEMS OF EASTERN CAROLINA INC | ||
| C | 24406527 | ACTUAL CASH PAYMENT |
| UNIVERSITY HEALTH SYSTEMS OF EASTERN CAROLINA INC | ||
| L | 1332022 | ACTUAL CASH PAYMENT |
| UNIVERSITY HEALTH SYSTEMS OF EASTERN CAROLINA INC | ||
| N | 250595 | ACTUAL CASH PAYMENT |
| THE OUTER BANKS HOSPITAL INC | ||
| K | 113040 | ACTUAL CASH PAYMENT |
| DUPLIN GENERAL INC | ||
| J | 18000 | ACTUAL CASH PAYMENT |
| DUPLIN GENERAL INC | ||
| O | 50604 | ACTUAL CASH PAYMENT |
| DUPLIN GENERAL INC | ||
| P | 117333 | ACTUAL CASH PAYMENT |
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