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MEDICAL STAFF OF ST JOHN & WEST SHORE HOSPITAL: Form 990, tax year 2024

View the entire original 990 at ProPublica ↗

Organization
MEDICAL STAFF OF ST JOHN & WEST SHORE HOSPITAL (EIN 34-1663333)
Tax period
2024-01-01 to 2024-12-31
Filed
2025-05-31
IRS object ID
202501519349300605
Schema version
2024v5.1
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2025-05-31T13:54:56-04:00ReturnTs
Tax Period End2024-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Sauppe Tax Service LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1P O Box 245AddressLine1Txt
CityTrempealeauCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54661ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2024-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN341663333EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Medical Staff of St John Westshore HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% Gregory BloxdorfInCareOfNm
Business Name ControlMEDIBusinessNameControlTxt
Phone4408275536PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line129000 Center Ridge RdAddressLine1Txt
CityWestlakeCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44145ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonGREGORY BLOXDORF MDPersonNm
Person TitlePresidentPersonTitleTxt
Phone4408275536PhoneNum
Signature2025-05-21SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (true)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJANICE SAUPPEPreparerPersonNm
PTINP00014757PTIN
Phone6085342122PhoneNum
Preparation2025-05-31PreparationDt
Self EmployedYes (X)SelfEmployedInd
FieldValueIRS element (for citing)
Tax2024TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerGregory Bloxdorf MDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line110941 Tanager TrailAddressLine1Txt
CityBrecksvilleCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44141ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$420,411GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website AddressN/AWebsiteAddressTxt
Type Of Organization AssocYes (X)TypeOfOrganizationAssocInd
Formation1981FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or MissionContinuing Medical Education to keep doctors up to date on medical issuesActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers53TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$155,635PYContributionsGrantsAmt
CY Contributions Grants$207,158CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$17,417PYInvestmentIncomeAmt
CY Investment Income$37,569CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$173,052PYTotalRevenueAmt
CY Total Revenue$244,727CYTotalRevenueAmt
PY Grants And Similar Paid$1,485PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$943CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$12,790PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$5,262CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$118,000PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$116,000CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$52,905PYOtherExpensesAmt
CY Other Expenses$39,423CYOtherExpensesAmt
PY Total Expenses$185,180PYTotalExpensesAmt
CY Total Expenses$161,628CYTotalExpensesAmt
PY Revenues Less Expenses-$12,128PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$83,099CYRevenuesLessExpensesAmt
Total Assets BOY$633,815TotalAssetsBOYAmt
Total Assets EOY$716,715TotalAssetsEOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$633,815NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$716,715NetAssetsOrFundBalancesEOYAmt
MissionContinuing Medical Education to keep doctors up to date on medical issuesMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$16,417ExpenseAmt
DescOngoing medical training and conferencing for hospital medical staffDesc
Total Program Service Expenses$16,417TotalProgramServiceExpensesAmt
Described In Section501c3falseDescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document12IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyfalseConflictOfInterestPolicyInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonGregory Bloxdorf MDPersonNm
Phone4408275536PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line110941 Tanager TrailAddressLine1Txt
CityBrecksvilleCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44141ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Gregory Bloxdorf
President10.000.00Yes (X)Yes (X)$50,000$0$0
Stephen Evans Jr
Dept Chair5.000.00Yes (X)$12,000$0$0
Mehrun Elyaderani
Dept Chair5.000.00Yes (X)$12,000$0$0
Richard Chang
Dept Chair5.000.00Yes (X)$11,000$0$0
Atul Hulyalkar
Dept Chair5.000.00Yes (X)$11,000$0$0
Michelle Belardo
Dept Chair5.000.00Yes (X)$6,000$0$0
Andrew Filiatraut
SecretaryTreasurer5.000.00Yes (X)Yes (X)$6,000$0$0
Christopher Reese
Vice President5.000.00Yes (X)Yes (X)$6,000$0$0
John Coletta
Dept Chair5.000.00$1,000$0$0Yes (X)
Hazem Nouraldin
Dept Chair5.000.00$1,000$0$0Yes (X)
Robert Stern
Immediate Past President10.000.00Yes (X)Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$116,000TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Membership Dues$154,075MembershipDuesAmt
Related Organizations$53,083RelatedOrganizationsAmt
Total Contributions$207,158TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$29,787TotalRevenueColumnAmt
Related Or Exempt Func Income$29,787RelatedOrExemptFuncIncomeAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$183,466SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$175,684SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$7,782SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,782TotalRevenueColumnAmt
Related Or Exempt Func Income$7,782RelatedOrExemptFuncIncomeAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$244,727TotalRevenueColumnAmt
Related Or Exempt Func Income$37,569RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$943TotalAmt
Program Services$943ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$5,262TotalAmt
Program Services$5,262ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$116,000TotalAmt
Management And General$116,000ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$19,500TotalAmt
Management And General$19,500ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$625TotalAmt
Management And General$625ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$6,499TotalAmt
Management And General$6,499ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,532TotalAmt
Management And General$1,532ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$10,212TotalAmt
Program Services$10,212ProgramServicesAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescGiftsDesc
Total$1,055TotalAmt
Management And General$1,055ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$161,628TotalAmt
Program Services$16,417ProgramServicesAmt
Management And General$145,211ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$16,201BOYAmt
EOY$92,345EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$617,614BOYAmt
EOY$624,370EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$633,815BOYAmt
EOY$716,715EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow FASB117Yes (X)OrgDoesNotFollowFASB117Ind

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$633,815BOYAmt
EOY$716,715EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$633,815BOYAmt
EOY$716,715EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$633,815BOYAmt
EOY$716,715EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$83,099ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$199NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedfalseFSAuditedInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule J IRS990ScheduleJ

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
John Coletta MD
Dept Chair$1,000$1,000
Hazem Nouraldin MD
Dept Chair$1,000$1,000

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Officer directors etc family relationship Part VI line 2Officers, trustees, etc. may consult and work together on patient care but there is no family or direct business relationships
Member election for additional members Part VI line 7aAll officers and department chairs are elected by the general membership by paper ballot
Governing body decisions Part VI line 7bAll governing decisions are voted upon by the membership and must have a majority approval to pass.
Form 990 governing body review Part VI line 11A complete copy of the 990 is available for review by all members of the governing body before the return is filed.
Governing documents etc available to public Part VI line 19These documents are available upon request
General explanation attachmentMonitoring of donations - receipts are kept and all disbursements approved in advance for any donations made.