STANLY MEDICAL SERVICES INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
STANLY MEDICAL SERVICES INC (EIN 56-1892763)
Tax period
2010-10-01 to 2011-09-30
Filed
2012-08-15
IRS object ID
201232289349303908
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

FieldValueIRS element (for citing)
Timestamp2012-08-15T15:51:19-05:00Timestamp
Tax Period End Date2011-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1101 N TRYON STREET SUITE 1000AddressLine1
CityCHARLOTTECity
StateNCState
ZIP Code28246ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN561892763EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1STANLY MEDICAL SERVICES INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSTANNameControl
Phone7049820636Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1320 YADKIN STREETAddressLine1
CityALBEMARLECity
StateNCState
ZIP Code28801ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameNYKOLA SAMILOName
TitleOFFICERTitle
Phone7049820636Phone
Date Signed2012-08-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameGREGORY W JOHNSName
Phone7049985200Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonBRAD MARINONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1320 YADKIN STREETAddressLine1
CityALBEMARLECity
StateNCState
ZIP Code28801ZIPCode
FieldValueIRS element (for citing)
Gross Receipts15239717GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.STANLYMEDICALSERVICES.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1994YearFormation
State Legal DomicileNCStateLegalDomicile
Activity Or Mission DescriptionTO PROMOTE, IMPROVE, AND ENHANCE THE HEALTH AND WELFARE OF COMMUNITIES IN OR OUTSIDE OF THIS STATE.ActivityOrMissionDescription
Nbr Voting Members Governing Body5NbrVotingMembersGoverningBody
Nbr Independent Voting Members2NbrIndependentVotingMembers
Total Nbr Employees153TotalNbrEmployees
Total Nbr Volunteers2TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year20384ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year13609817ProgramServiceRevenuePriorYear
Program Service Revenue CY15239717ProgramServiceRevenueCY
Investment Income Prior Year0InvestmentIncomePriorYear
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Prior Year3144OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year13633345TotalRevenuePriorYear
Total Revenue Current Year15239717TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year11835273SalariesEtcPriorYear
Salaries Etc Current Year13075748SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year4410882OtherExpensePriorYear
Other Expenses Current Year5046222OtherExpensesCurrentYear
Total Expenses Prior Year16246155TotalExpensesPriorYear
Total Expenses Current Year18121970TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-2612810RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-2882253RevenuesLessExpensesCY
Total Assets BOY3952765TotalAssetsBOY
Total Assets EOY3897837TotalAssetsEOY
Total Liabilities BOY2601820TotalLiabilitiesBOY
Total Liabilities EOY2757259TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1350945NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1140578NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission Description1) TO PROMOTE, IMPROVE, AND ENHANCE THE HEALTH AND WELFARE OF COMMUNITIES IN OR OUTSIDE OF THIS STATE THROUGH THE SUPPORT OF OR INVOLVEMENT IN THE RECRUITMENT, FORMATION, DEVELOPMENT, MANAGEMENT, EQUIPPING, AND MAINTENANCE OF HEALTHCARE SERVICES PROVIDED IN AFFILIATION WITH THE HEALTH CARE SYSTEM OF WHICH STANLY REGIONAL MEDICAL CENTER, INC., A NORTH CAROLINA NONPROFIT CORPORATION EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE CODE, IS AN AFFILIATE AND OTHER HEALTH CARE PROVIDERS LOCATED IN AND AROUND ALBEMARLE, STANLY COUNTY, NORTH CAROLINA (A MEDICALLY UNDERSERVED AREA). 2) TO PROVIDE FUNDS, PROPERTY, OR OTHER BENEFITS FOR THE BENEFIT OF OTHER MEDICALLY UNDERSERVED AREAS IN OR OUTSIDE OF THIS STATE. 3) TO PROMOTE AND CARRY ON EDUCATIONAL ACTIVITIES RELATED TO THE CARE OF THE SICK, INJURED, OR RELATED TO THE PROMOTION OF HEALTH. 4) TO PROMOTE OR CARRY OUT SUCH OTHER ACTIVITIES AS MAY BE DEEMED ADVISABLE FOR THE BETTERMENT OF THE GENERAL HEALTH OF THE COMMUNITIES SERVED.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense16297008Expense
Revenue14615442Revenue
DescriptionHEALTH SERVICESPROVIDED HEALTHCARE IN A PROVIDER'S OFFICE SETTING. SERVICES INCLUDED GENERAL PATIENT SERVICES, LABORATORY SERVICES, AND X-RAY SERVICES.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense478332Expense
Revenue624275Revenue
DescriptionCENTRAL LABDescription
FieldValueIRS element (for citing)
Total Program Service Expense16775340TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109617NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees153NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members5NbrVotingGoverningBodyMembers
Number Independent Voting Members2NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1PENNY PATRICKBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7049844643TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1301 YADKIN STREETAddressLine1
CityALBEMARLECity
StateNCState
ZIP Code28001ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (11 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
AL TAYLOR
BOARD MEMBER1.00XX031707642607
AMY BOGER
BOARD MEMBER1.00X000
DR YOLANDA JOHNSON
BOARD MEMBER1.00X230336010278
NYKOLA SAMILO
BOARD MEMBER1.00XX021407132636
KRISTI JACKSON
BOARD MEMBER1.00X000
BRAD MARINO
VP40.00X016508310388
ERIC JOHN MALLICO
PHYSICIAN40.0059701208598X
JOHN DAVID HILL
PHYSICIAN40.00479759011658X
JOSEPH ZUCKER
PHYSICIAN40.00439196011495X
TIMOTHY SEAN HALL
PHYSICIAN40.00398378011330X
EDWARD WILLIAMS
PHYSICIAN40.0034926605278X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2493947TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs696230TotalReportableCompFrmRltdOrgs
Total Other Compensation144268TotalOtherCompensation
Number Individuals GT100 K29NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
WINDSTREAM
PO BOX 9001908LOUISVILLEKY402901908PHONE/FAX/INTERNET SERVICES169491
LABORATORY CORP OF AMERICA HOLDINGS
PO BOX 12140BURLINGTONNC272162140LAB SERVICES124936
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT REVENUEDescription
Business Code621300BusinessCode
Total Revenue Column15115634TotalRevenueColumn
Related Or Exempt Function Income15115634RelatedOrExemptFunctionIncome

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column124083TotalRevenueColumn
Related Or Exempt Function Income124083RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue15239717TotalProgramServiceRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column15239717TotalRevenueColumn
Related Or Exempt Function Income15239717RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1095726Total
Program Services246224ProgramServices
Management And General849502ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total9763009Total
Program Services9763009ProgramServices

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total231349Total
Program Services231349ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1408926Total
Program Services1295488ProgramServices
Management And General113438ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total576738Total
Program Services519144ProgramServices
Management And General57594ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total19055Total
Management And General19055ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total65172Total
Management And General65172ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total351809Total
Program Services336728ProgramServices
Management And General15081ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total9851Total
Program Services9189ProgramServices
Management And General662ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total317988Total
Program Services317988ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1627035Total
Program Services1484646ProgramServices
Management And General142389ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total23728Total
Program Services8854ProgramServices
Management And General14874ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total50Total
Program Services50ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total179245Total
Program Services138633ProgramServices
Management And General40612ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total68414Total
Program Services61377ProgramServices
Management And General7037ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES977188977188
BAD DEBT EXPENSE975050975050
MAINTENANCE/REPAIRS29950028728812212
CLEANING/LAUNDRY1321371231359002

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total18121970Total
Program Services16775340ProgramServices
Management And General1346630ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1160802BOY
EOY1184709EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1979812BOY
EOY1909210EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY106873BOY
EOY92160EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis3375614LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec2708880LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY637408BOY
EOY666734EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY67870BOY
EOY45024EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY3952765BOY
EOY3897837EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1687598BOY
EOY1821149EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY914222BOY
EOY936110EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY2601820BOY
EOY2757259EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1350945BOY
EOY1140578EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1350945BOY
EOY1140578EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3952765BOY
EOY3897837EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-2882253ReconcilationRevenueExpenses
Reconcilation Other Changes2671886ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years33145CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years71189CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years19143CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year20382CurrentTaxYearMinus1Year
Total143859Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years9268830CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11420767CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years13121277CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year13609817CurrentTaxYearMinus1Year
Current Tax Year15239717CurrentTaxYear
Total62660408Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years9301975CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11491956CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years13140420CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year13630199CurrentTaxYearMinus1Year
Current Tax Year15239717CurrentTaxYear
Total62804267Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50962804267PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5024CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2342CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years364CurrentTaxYearMinus2Years
Total7730Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5024CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2342CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years364CurrentTaxYearMinus2Years
Total7730Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years3390CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3144CurrentTaxYearMinus1Year
Total6534Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years9306999CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11494298CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years13144174CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year13633343CurrentTaxYearMinus1Year
Current Tax Year15239717CurrentTaxYear
Total62818531Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99980PublicSupportPercentage509
Prior Year Support Percentage0.99970PriorYearSupportPercentage
Investment Income Percentage0.00010InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00020PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis18285OtherCostOrOtherBasis
Depreciation9898Depreciation
Book Value8387BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis3335829OtherCostOrOtherBasis
Depreciation2685363Depreciation
Book Value650466BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis21500OtherCostOrOtherBasis
Depreciation13619Depreciation
Book Value7881BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings666734TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
PENSION LIABILITY$933,241
ADVANCES FROM AFFILIATES$2,869
FieldValueIRS element (for citing)
Total Of Amounts936110TotalOfAmounts
Total Revenue15239717TotalRevenue
Total Expenses18121970TotalExpenses
Excess Or Deficit For Year-2882253ExcessOrDeficitForYear
Other$2,671,886OtherAmount
Total Adjustments2671886TotalAdjustments
Excess Or Deficit Per FS-210367ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt17911603TotRevenueEtcAuditedFinclStmt
Other Revenues2671886OtherRevenues
Revenue Not Rptd F9902671886RevenueNotRptdF990
Revenue Subtotal15239717RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99015239717TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt18121970TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal18121970ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99018121970TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE FILING ORGANIZATION IS A NON PROFIT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM INCOME TAX ON REVENUE EARNED FROM ITS TAX-EXEMPT STATUS. THE FILING ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE FILING ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUSES NOR IS IT AWARE OF ANY OF ITS ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. THE TAX RETURNS FOR THE YEARS 2007 TO 2010 ARE OPEN TO EXAMINATION BY FEDERAL, LOCAL, AND STATE AUTHORITIES. THE FILING ORGANIZATION HAS ADOPTED THE INCOME TAX STANDARD ISSUED BY FINANCIAL ACCOUNTING STANDARDS BOARD IN LIGHT OF ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL AND STATE INCOME TAXES. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS IN ACCORDANCE WITH THE INCOME TAX STANDARD. THIS STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED.
PART XII, LINE 2D - OTHER ADJUSTMENTS:UNRECOGNIZED PENSION EXPENSE -192,074. TRANSFERS TO AFFILIATES 2,863,960.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
AL TAYLOR
0239370059819017887020258022349035968300
DR YOLANDA JOHNSON
177486036350016500000102780240614000
NYKOLA SAMILO
018295302873802380014960017676024670700
BRAD MARINO
01548890001019400010388017547100
ERIC JOHN MALLICO
460570011994201650000085980605610000
JOHN DAVID HILL
46325900016500000116580491417000
JOSEPH ZUCKER
41455802638022000000114950450691000
TIMOTHY SEAN HALL
329507052371016500000113300409708000
EDWARD WILLIAMS
3327660001650000052780354544000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 3THREE EMPLOYEES (CEO, COO, CFO) ARE EMPLOYED BY THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY D/B/A CAROLINAS HEALTHCARE SYSTEM ("CHS") AND LEASED TO THE ORGANIZATION THROUGH A MANAGEMENT AGREEMENT. AS SUCH, THEIR COMPENSATION INFORMATION IS NOT REQUIRED ON PART VII.
FORM 990, PART VI, SECTION B, LINE 11THE CFO AND CONTROLLER WILL REVIEW THE DRAFT, COPIES WILL BE EMAILED TO THE BOARD MEMBERS, AND THE DRAFT WILL BE REVIEWED AT THE BOARD MEETING.
THE BYLAWS ADDRESS WHAT CONSTITUTES CONFLICTS OF INTEREST, THE RESPONSIBILITY OF DISCLOSURE OF EACH MEMBER, HOW CONFLICTS (AND POTENTIAL CONFLICTS) ARE ADDRESSED, AND EACH MEMBER OF THE BOARD OF DIRECTORS FILES A CONFLICT OF INTEREST STATEMENT ANNUALLY WHICH IS REVIEWED BY THE BOARD CHAIR AND IS MAINTAINED BY THE CORPORATE SECRETARY. MEMBERS WITH POTENTIAL CONFLICTS ARE ASKED TO EXCUSE THEMSELVES FROM VOTING ON MATTERS THAT ARE OF POTENTIAL CONFLICT.FORM 990, PART VI, SECTION B, LINE 12C
COMPENSATION OF TOP EXECUTIVES AND TOP MANAGEMENT AND OTHER OFFICERS AND KEY EMPLOYEES IS DETERMINED THROUGH AN INDEPENDENT CONSULTANT'S REVIEW OF MARKET COMPARISON STUDIES. THIS PROCESS WAS LAST PERFORMED IN 2008.FORM 990, PART VI, SECTION B, LINE 15
THESE DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.FORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:UNRECOGNIZED PENSION EXPENSE -192,074. TRANSFERS FROM AFFILIATES 2,863,960. TOTAL TO FORM 990, PART XI, LINE 5: 2,671,886.FORM 990, PART XI, LINE 5:
THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE ORGANIZATION HAS NOT CHANGED ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX YEAR.FORM 990, PART XII, LINE 2C:
OFFICERS LISTED ON PART VII WORK AN AVERAGE OF 40 HOURS PER WEEK. THEIR TIME IS SHARED BETWEEN THE FILING ORGANIZATION AND THE RELATED ENTITIES LISTED ON SCHEDULE R.FORM 990, PART VII, DESCRIPTION OF HOURS FOR RELATED ORGANIZATIONS:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
STANLY REGIONAL MEDICAL CENTER FOUNDATION INC
301 YADKIN STREETALBEMARLENC28001561698181CHARITYNC501(C)(3)170(B)(1)(A)(VI)N/A0
STANLY REGIONAL MEDICAL CENTER INC
301 YADKIN STREETALBEMARLENC28001560556760HOSPITALNC501(C)(3)170(B)(1)(A)(III)N/A0
STANLY MANOR INC
625 BETHANY ROADALBEMARLENC28001561623092LONG-TERM HEALTHCARENC501(C)(3)509(A)(2)N/A0
STANLEX INC
907 NORTH SECOND STREETALBEMARLENC28001561532751HEALTHCARENC501(C)(3)509(A)(3)N/A0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
STANLY REGIONAL MEDICAL CENTER INC
R717000CASH VALUE
STANLY REGIONAL MEDICAL CENTER INC
J626451MARKET VALUE
STANLY REGIONAL MEDICAL CENTER INC
P1520509EXPENSES

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