ROANOKE VALLEY HEALTH SERVICES INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- ROANOKE VALLEY HEALTH SERVICES INC (EIN 56-1925492)
- Tax period
- 2022-10-01 to 2023-09-30
- Filed
- 2024-07-09
- IRS object ID
- 202401919349300735
- Schema version
- 2022v5.0
- 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) |
|---|---|---|
| Return | 2024-07-09T12:44:04-05:00 | ReturnTs |
| Tax Period End | 2023-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BDO USA | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 421 Fayetteville Street Suite 300 | AddressLine1Txt |
| City | Raleigh | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27601 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 561925492 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Roanoke Valley Health Services Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % JENNIFER WORSLEY | InCareOfNm |
| Business Name Control | ROAN | BusinessNameControlTxt |
| Phone | 2525358130 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 SMITH CHURCH ROAD | AddressLine1Txt |
| City | ROANOKE RAPIDS | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27870 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANDREW K ZUKOWSKI | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 2525358130 | PhoneNum |
| Signature | 2024-06-20 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | ANDREW K | PersonFirstNm |
| Person Last | ZUKOWSKI | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SANDRA L FEINSMITH | PreparerPersonNm |
| PTIN | P01064157 | PTIN |
| Phone | 9192781936 | PhoneNum |
| Preparation | 2024-06-20 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ECU Health Roanoke Valley Health | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ANDREW K ZUKOWSKI | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 SMITH CHURCH ROAD | AddressLine1Txt |
| City | ROANOKE RAPIDS | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27870 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $3,016,394 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ECUHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1994 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE THE HEALTH AND WELL-BEING OF EASTERN NORTH CAROLINA. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $64,953 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,231,535 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $2,900,133 | CYProgramServiceRevenueAmt |
| PY Investment Income | $298 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,688 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$15,874 | PYOtherRevenueAmt |
| CY Other Revenue | $49,620 | CYOtherRevenueAmt |
| PY Total Revenue | $3,215,959 | PYTotalRevenueAmt |
| CY Total Revenue | $3,016,394 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $2,810,398 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,970,358 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,028,902 | PYOtherExpensesAmt |
| CY Other Expenses | $1,309,010 | CYOtherExpensesAmt |
| PY Total Expenses | $4,839,300 | PYTotalExpensesAmt |
| CY Total Expenses | $4,279,368 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,623,341 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,262,974 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,573,841 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,418,612 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $945,639 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,167,681 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,628,202 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,250,931 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO IMPROVE THE HEALTH AND WELL-BEING OF EASTERN NORTH CAROLINA. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $4,104,448 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $2,900,133 | RevenueAmt |
| Desc | ECU HEALTH PROFESSIONALS PROVIDED EVALUATIONS, CLINICAL CARE MANAGEMENT AND MEDICALLY NECESSARY PROCEDURES. | Desc |
| Total Program Service Expenses | $4,104,448 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NC | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JENNIFER WORSLEY | PersonNm |
| Phone | 2528472254 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2100 STANTONSBURG ROAD | AddressLine1Txt |
| City | GREENVILLE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27834 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| MICHAEL WALDRUM | ||||||||
| CEO | 2.0 | 52.0 | Yes (X) | $0 | $986,095 | $792,121 | ||
| DAVID HUGHES | ||||||||
| CFO | 2.0 | 48.0 | Yes (X) | $0 | $607,253 | $465,113 | Yes (X) | |
| WILLIAM FLOYD | ||||||||
| BOARD MEMBER | 2.0 | 44.0 | $0 | $640,470 | $242,062 | Yes (X) | ||
| JAY BRILEY | ||||||||
| BOARD MEMBER | 2.0 | 46.0 | $0 | $395,814 | $185,320 | Yes (X) | ||
| DANIEL DRAKE | ||||||||
| BOARD MEMBER | 2.0 | 44.0 | $0 | $345,393 | $215,675 | Yes (X) | ||
| KENNETH ROBERT | ||||||||
| BOARD MEMBER | 2.0 | 40.0 | $0 | $286,086 | $52,165 | Yes (X) | ||
| ANTHONY BARTHOLOMEW | ||||||||
| BOARD MEMBER | 2.0 | 40.0 | $0 | $268,575 | $57,563 | Yes (X) | ||
| FNU SABA MUSHTAQ | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $269,434 | $0 | $173 | Yes (X) | ||
| SARAH MASSEY | ||||||||
| NURSE PRACTITIONER | 40.0 | 0.0 | $162,605 | $0 | $68,431 | Yes (X) | ||
| BRANDON CARLISLE | ||||||||
| PHYSICIAN ASSISTANT | 40.0 | 0.0 | $163,262 | $0 | $28,644 | Yes (X) | ||
| ROBERT A KEETER | ||||||||
| NURSE PRACTITIONER | 40.0 | 0.0 | $128,297 | $0 | $58,133 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $723,598 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,529,686 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $2,165,400 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 4 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $64,953 | GovernmentGrantsAmt |
| Total Contributions | $64,953 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 621610 | BusinessCd |
| Total Revenue Column | $2,900,133 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,900,133 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $2,900,133 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,688 | TotalRevenueColumnAmt |
| Exclusion | $1,688 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $49,620 | TotalRevenueColumnAmt |
| Exclusion | $49,620 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $49,620 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,016,394 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,900,133 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $51,308 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,680,098 | TotalAmt |
| Program Services | $2,569,332 | ProgramServicesAmt |
| Management And General | $110,766 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,675 | TotalAmt |
| Program Services | $85,969 | ProgramServicesAmt |
| Management And General | $3,706 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,190 | TotalAmt |
| Program Services | $24,149 | ProgramServicesAmt |
| Management And General | $1,041 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $175,395 | TotalAmt |
| Program Services | $168,146 | ProgramServicesAmt |
| Management And General | $7,249 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $543,104 | TotalAmt |
| Program Services | $520,658 | ProgramServicesAmt |
| Management And General | $22,446 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,533 | TotalAmt |
| Program Services | $14,891 | ProgramServicesAmt |
| Management And General | $642 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $460 | TotalAmt |
| Program Services | $441 | ProgramServicesAmt |
| Management And General | $19 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,491 | TotalAmt |
| Program Services | $18,685 | ProgramServicesAmt |
| Management And General | $806 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $200,343 | TotalAmt |
| Program Services | $192,063 | ProgramServicesAmt |
| Management And General | $8,280 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,489 | TotalAmt |
| Program Services | $1,618 | ProgramServicesAmt |
| Management And General | $871 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,454 | TotalAmt |
| Program Services | $21,526 | ProgramServicesAmt |
| Management And General | $928 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $322,839 | $309,496 | $13,343 |
| BAD DEBT | $172,668 | $172,668 | |
| OTHER EXPENSE | $9,629 | $4,806 | $4,823 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,279,368 | TotalAmt |
| Program Services | $4,104,448 | ProgramServicesAmt |
| Management And General | $174,920 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,846,040 | BOYAmt |
| EOY | $3,342,886 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $275,910 | BOYAmt |
| EOY | $382,193 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,189 | BOYAmt |
| EOY | $23,576 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$1,427 | BOYAmt |
| EOY | -$1,504 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,166,535 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $804,849 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $384,140 | BOYAmt |
| EOY | $361,686 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,989 | BOYAmt |
| EOY | $309,775 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,573,841 | BOYAmt |
| EOY | $4,418,612 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $945,639 | BOYAmt |
| EOY | $3,167,681 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $945,639 | BOYAmt |
| EOY | $3,167,681 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,628,202 | BOYAmt |
| EOY | $1,250,931 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,628,202 | BOYAmt |
| EOY | $1,250,931 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,573,841 | BOYAmt |
| EOY | $4,418,612 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,262,974 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$1,114,297 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $111,490 | OtherCostOrOtherBasisAmt |
| Book Value | $111,490 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $937,723 | OtherCostOrOtherBasisAmt |
| Depreciation | $688,985 | DepreciationAmt |
| Book Value | $248,738 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $117,322 | OtherCostOrOtherBasisAmt |
| Depreciation | $115,864 | DepreciationAmt |
| Book Value | $1,458 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildingsGrp | |
| Total Book Value Land Buildings | $361,686 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER RECEIVABLES | Desc |
| Book Value | $309,775 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $309,775 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
| Total Liability | $0 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | ROANOKE VALLEY HEALTH SERVICES HAS BEEN DETERMINED TO QUALIFY AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ROANOKE VALLEY HEALTH SERVICES HAS REVIEWED ITS TAX POSITIONS FOR ALL OPEN YEARS AND HAS CONCLUDED THAT NO MATERIAL LIABILITIES EXIST AS OF SEPTEMBER 30, 2023 AND 2022 ROANOKE VALLEY HEALTH SERVICES FILES TAX RETURNS WITH THE U.S. FEDERAL JURISDICTION. WITH FEW EXCEPTIONS, ROANOKE VALLEY HEALTH SERVICES IS NO LONGER SUBJECT TO U.S. FEDERAL EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2020. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MICHAEL WALDRUM | ||||||||||||||
| CEO | $0 | $849,206 | $0 | $121,932 | $0 | $14,957 | $0 | $740,546 | $0 | $51,575 | $0 | $1,778,216 | $0 | $0 |
| KENNETH ROBERT | ||||||||||||||
| BOARD MEMBER | $0 | $286,086 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $52,165 | $0 | $338,251 | $0 | $0 |
| JAY BRILEY | ||||||||||||||
| BOARD MEMBER | $0 | $395,814 | $0 | $0 | $0 | $0 | $0 | $142,532 | $0 | $42,788 | $0 | $581,134 | $0 | $0 |
| DAVID HUGHES | ||||||||||||||
| CFO | $0 | $607,253 | $0 | $0 | $0 | $0 | $0 | $428,227 | $0 | $36,886 | $0 | $1,072,366 | $0 | $0 |
| WILLIAM FLOYD | ||||||||||||||
| BOARD MEMBER | $0 | $640,470 | $0 | $0 | $0 | $0 | $0 | $195,380 | $0 | $46,682 | $0 | $882,532 | $0 | $0 |
| ANTHONY BARTHOLOMEW | ||||||||||||||
| BOARD MEMBER | $0 | $268,575 | $0 | $0 | $0 | $0 | $0 | $27,268 | $0 | $30,295 | $0 | $326,138 | $0 | $0 |
| DANIEL DRAKE | ||||||||||||||
| BOARD MEMBER | $0 | $345,393 | $0 | $0 | $0 | $0 | $0 | $168,993 | $0 | $46,682 | $0 | $561,068 | $0 | $0 |
| FNU SABA MUSHTAQ | ||||||||||||||
| PHYSICIAN | $269,434 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $173 | $0 | $269,607 | $0 | $0 | $0 |
| SARAH MASSEY | ||||||||||||||
| NURSE PRACTITIONER | $162,605 | $0 | $0 | $0 | $0 | $0 | $36,565 | $0 | $31,866 | $0 | $231,036 | $0 | $0 | $0 |
| BRANDON CARLISLE | ||||||||||||||
| PHYSICIAN ASSISTANT | $163,262 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $28,644 | $0 | $191,906 | $0 | $0 | $0 |
| ROBERT A KEETER | ||||||||||||||
| NURSE PRACTITIONER | $128,297 | $0 | $0 | $0 | $0 | $0 | $19,596 | $0 | $38,537 | $0 | $186,430 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PART I, LINE 3: | FormAndLineReferenceDesc |
| Explanation | THE COMPENSATION IS DETERMINED BY THE COMPENSATION AND BENEFITS COMMITTEE OF THE ECU HEALTH BOARD USING COMPARATIVE DATA FROM LIKE ORGANIZATIONS AND INPUT FROM CONSULTANTS. ALL COMPENSATION DISCUSSIONS AND ACTIONS ARE DOCUMENTED AND APPROVED IN THE MINUTES OF THE COMMITTEE. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, ITEM C, DOING BUSINESS AS: | ECU HEALTH ROANOKE VALLEY HEALTH SERVICES. |
| FORM 990, PART VI, SECTION A, LINE 7A: | UNIVERSITY HEALTH SYSTEMS OF EASTERN CAROLINA, INC. (ECU HEALTH) SHALL HAVE THE RESPONSIBILITY TO ELECT OR APPOINT NO MORE THAN 7 INDIVIDUALS TO THE BOARD OF TRUSTEES OF ROANOKE VALLEY HEALTH SERVICES, INC. |
| FORM 990, PART VI, SECTION A, LINE 7B: | THE FOLLOWING RIGHTS ARE RESERVED BY UNIVERSITY HEALTH SYSTEMS OF EASTERN CAROLINA, INC.: A. AMENDING THE ARTICLES OF INCORPORATION OR THE BYLAWS; B. TAKING ANY ACTION THAT WOULD MAKE IT IMPOSSIBLE TO CARRY ON THE ORDINARY BUSINESS OF THE COMPANY; C. SELLING, LEASING OR OTHERWISE DISPOSING OF, OR AGREEING TO SELL, LEASE OR OTHERWISE DISPOSE OF, ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE COMPANY; D. WINDING UP, DISSOLVING, LIQUIDATING, REORGANIZING, OR OTHERWISE TERMINATING THE EXISTENCE OF THE COMPANY; OR E. MERGING OR CONSOLIDATING THE COMPANY WITH OR INTO ANY OTHER ENTITY OR CONVERTING THE COMPANY INTO ANY OTHER TYPE OF ENTITY. |
| FORM 990, PART VI, SECTION B, LINE 11B: | THE BOARD MEMBER IS PROVIDED A COPY OF THE RETURN FOR REVIEW PRIOR TO FILING. THE RETURN IS ALSO REVIEWED BY THE CHIEF FINANCIAL OFFICER, CHIEF GENERAL COUNSEL, AND THE CHIEF AUDIT AND COMPLIANCE OFFICER OF UNIVERSITY HEALTH SYSTEMS OF EASTERN CAROLINA, INC. (D/B/A ECU HEALTH) PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C: | AS DESCRIBED IN THE CONFLICT OF INTEREST POLICY MAINTAINED BY ECU HEALTH, ALL OFFICERS, BOARD MEMBERS AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE A YEARLY COMPREHENSIVE CONFLICT OF INTEREST QUESTIONNAIRE. THESE ARE REVIEWED BY LEGAL COUNSEL AND ANY POTENTIAL OR ACTUAL CONFLICTS ARE BROUGHT TO THE BOARD FOR DISPOSITION. BOARD MEMBERS ARE INSTRUCTED TO REPORT ANY POTENTIAL CONFLICTS ARISING DURING THE YEAR FOR REVIEW. BOARD MEMBERS ARE REQUIRED TO RECUSE THEMSELVES FROM VOTING ON ISSUES IN WHICH THEY ARE DEEMED TO HAVE A CONFLICT. |
| FORM 990, PART VI, SECTION B, LINE 15: | THE COMPENSATION IS DETERMINED BY THE COMPENSATION AND BENEFITS COMMITTEE OF THE ECU HEALTH BOARD USING COMPARATIVE DATA FROM LIKE ORGANIZATIONS AND INPUT FROM CONSULTANTS. ALL COMPENSATION DISCUSSIONS AND ACTIONS ARE DOCUMENTED AND APPROVED IN THE MINUTES OF THE COMMITTEE. |
| FORM 990, PART VI, SECTION C, LINE 19: | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN IRC SECTION 6104(D). |
| FORM 990, PART XI, LINE 9: | OTHER CHANGES IN NET ASSETS: NET ASSET TRANSFER ($1,114,297) |
| FORM 990, PART XII, LINE 2C: | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (15 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| PITT COUNTY MEMORIAL HOSPITAL INC | ||||||||||
| 2100 STANTONSBURG RD | GREENVILLE | NC | 27835 | 560585243 | HOSPITAL | NC | 501(C)(3) | LINE 3 | ECU HEALTH | false |
| EAST CAROLINA HEALTH INC | ||||||||||
| 2100 STANTONSBURG RD | GREENVILLE | NC | 27835 | 562003393 | HOSPITAL | NC | 501(C)(3) | LINE 3 | ECU HEALTH | false |
| PCMH MANAGEMENT INC | ||||||||||
| 2100 STANTONSBURG RD | GREENVILLE | NC | 27835 | 561690740 | MEDICAL PROPE | NC | 501(C)(2) | N/A | ECU HEALTH | false |
| HEALTHACCESS INC | ||||||||||
| 2100 STANTONSBURG RD | GREENVILLE | NC | 27835 | 561396133 | HEALTHCARE | NC | 501(C)(3) | LINE 12B,II | ECU HEALTH | false |
| VIDANT MEDICAL GROUP LLC | ||||||||||
| 2100 STANTONSBURG RD | GREENVILLE | NC | 27835 | 383740839 | HEALTHCARE | NC | 501(C)(3) | LINE 12C,FI | ECU HEALTH | false |
| THE OUTER BANKS HOSPITAL INC | ||||||||||
| 2100 STANTONSBURG RD | GREENVILLE | NC | 27835 | 562112733 | HOSPITAL | NC | 501(C)(3) | LINE 3 | EC HEALTH | false |
| EAST CAROLINA HEALTH - BERTIE | ||||||||||
| 2100 STANTONSBURG RD | GREENVILLE | NC | 27835 | 562072002 | HOSPITAL | NC | 501(C)(3) | LINE 3 | ECU HEALTH | false |
| EAST CAROLINA HEALTH - CHOWAN | ||||||||||
| 2100 STANTONSBURG RD | GREENVILLE | NC | 27835 | 562101090 | HOSPITAL | NC | 501(C)(3) | LINE 3 | ECU HEALTH | false |
| EAST CAROLINA HEALTH - HERITAGE | ||||||||||
| 2100 STANTONSBURG RD | GREENVILLE | NC | 27835 | 562093700 | HOSPITAL | NC | 501(C)(3) | LINE 3 | ECU HEALTH | false |
| EAST CAROLINA HEALTH - BEAUFORT | ||||||||||
| 2100 STANTONSBURG RD | GREENVILLE | NC | 27835 | 452436270 | HOSPITAL | NC | 501(C)(3) | LINE 3 | ECU HEALTH | false |
| DUPLIN GENERAL HOSPITAL | ||||||||||
| 2100 STANTONSBURG RD | GREENVILLE | NC | 27835 | 566011594 | HOSPITAL | NC | 501(C)(3) | LINE 3 | ECU HEALTH | false |
| HALIFAX REGIONAL MEDICAL CENTER | ||||||||||
| 2100 STANTONSBURG RD | GREENVILLE | NC | 27835 | 560989789 | HOSPITAL | NC | 501(C)(3) | LINE 3 | ECU HEALTH | false |
| ACCESS EAST | ||||||||||
| 2410 STANTONSBURG RD STANTON SQUA | GREENVILLE | NC | 27834 | 561949493 | HEALTHCARE | NC | 501(C)(3) | LINE 10 | ECU HEALTH | false |
| UNIV HEALTH SYSTEMS OF EASTERN CAROLINA | ||||||||||
| 2100 STANTONSBURG RD | GREENVILLE | NC | 27835 | 562141073 | HEALTHCARE | NC | 501(C)(3) | 12C-III FI | NA | false |
| EAST CAROLINA HEALTH INC | ||||||||||
| 2100 STANTONSBURG ROAD | GREENVILLE | NC | 27835 | 911997979 | HOSPITAL | NC | 501(C)(3) | LINE 3 | ECU HEALTH | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PART II, IDENTIFICATION OF RELATED TAX-EXEMPT ORGANIZATIONS: | FormAndLineReferenceDesc |
| Explanation | Full Name, EIN, and Address of Related Organizations: Name: PITT COUNTY MEMORIAL HOSPITAL, INC. D/B/A ECU HEALTH MEDICAL CENTER EIN: 56-0585243 Address: 2100 STANTONSBURG ROAD, GREENVILLE, NC 27835 Name: EAST CAROLINA HEALTH, INC. D/B/A ECU HEALTH COMMUNITY HOSPITALS EIN: 56-2003393 Address: 2100 STANTONSBURG ROAD, GREENVILLE, NC 27835 Name: PCMH Management, Inc. D/B/A ECU Health Properties EIN: 56-1690740 Address: 2100 STANTONSBURG ROAD, GREENVILLE, NC 27835 Name: VIDANT MEDICAL GROUP, LLC. D/B/A ECU HEALTH PHYSICIANS EIN: 38-3740839 Address: 2100 STANTONSBURG ROAD, GREENVILLE, NC 27835 Name: THE OUTER BANKS HOSPITAL, INC. D/B/A OUTER BANKS HEALTH EIN: 56-2112733 Address: 2100 STANTONSBURG ROAD, GREENVILLE, NC 27835 Name: EAST CAROLINA HEALTH-BERTIE D/B/A ECU HEALTH BERTIE HOSPITAL EIN: 56-2072002 Address: 2100 STANTONSBURG ROAD, GREENVILLE, NC 27835 Name: EAST CAROLINA HEALTH-CHOWAN D/B/A ECU HEALTH CHOWAN HOSPITAL EIN: 56-2101090 Address: 2100 STANTONSBURG ROAD, GREENVILLE, NC 27835 Name: EAST CAROLINA HEALTH-HERITAGE D/B/A ECU HEALTH EDGECOMBE HOSPITAL EIN: 56-2093700 Address: 2100 STANTONSBURG ROAD, GREENVILLE, NC 27835 Name: EAST CAROLINA HEALTH-BEAUFORT D/B/A ECU HEALTH BEAUFORT HOSPITAL EIN: 45-2436270 Address: 2100 STANTONSBURG ROAD, GREENVILLE, NC 27835 Name: DUPLIN GENERAL HOSPITAL D/B/A ECU HEALTH DUPLIN HOSPITAL EIN: 56-6011594 Address: 2100 STANTONSBURG ROAD, GREENVILLE, NC 27835 Name: HALIFAX REGIONAL MEDICAL CENTER, INC. D/B/A ECU HEALTH NORTH HOSPITAL EIN: 56-0989789 Address: 2100 STANTONSBURG ROAD, GREENVILLE, NC 27835 Name: UNIVERSITY HEALTH SYSTEMS OF EASTERN CAROLINA D/B/A ECU HEALTH EIN: 56-2141073 Address: 2100 STANTONSBURG ROAD, GREENVILLE, NC 27835 Name: EAST CAROLINA HEALTH, INC. D/B/A ECU HEALTH COMMUNITY HOSPITALS GROUP EIN: 91-1997979 ADDRESS: 2100 STANTONSBURG ROAD, GREENVILLE, NC 27835 | ExplanationTxt |