ONSLOW RADIATION ONCOLOGY LLC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- ONSLOW RADIATION ONCOLOGY LLC (EIN 26-1694368)
- Tax period
- 2019-10-01 to 2020-09-30
- Filed
- 2021-08-13
- IRS object ID
- 202122259349300222
- Schema version
- 2019v5.2
- 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 | 2021-08-13T10:16:49-05:00 | ReturnTs |
| Tax Period End | 2020-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 227 WEST TRADE STREET SUITE 800 | AddressLine1Txt |
| City | CHARLOTTE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 261694368 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ONSLOW RADIATION ONCOLOGY LLC | BusinessNameLine1Txt |
| Business Name Line2 | ATTN DANIEL WALLER MANAGER | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ONSL | BusinessNameControlTxt |
| Phone | 9105774703 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 241 NEW RIVER DRIVE | AddressLine1Txt |
| City | JACKSONVILLE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28540 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CARL BIBER | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 9105774703 | PhoneNum |
| Signature | 2021-08-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JOHN NORMAN | PreparerPersonNm |
| PTIN | P01506766 | PTIN |
| Phone | 7049985200 | PhoneNum |
| Preparation | 2021-08-12 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CARL BIBER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 241 NEW RIVER DRIVE | AddressLine1Txt |
| City | JACKSONVILLE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28540 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,220,234 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ONSLOW.ORG | WebsiteAddressTxt |
| Type Of Organization Other | Yes (X) | TypeOfOrganizationOtherInd |
| Other Organization Dsc | LLC | OtherOrganizationDsc |
| Formation | 2006 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE QUALITY AND CONVENIENT CANCER TREATMENT TO THE SURROUNDING COMMUNITY WHILE PROVIDING THE AFOREMENTIONED CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY PURSUANT TO THE ORGANIZATION'S CHARITY CARE POLICY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 1 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 1 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $250,000 | PYContributionsGrantsAmt |
| CY Contributions Grants | $431,998 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,710,755 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,788,073 | CYProgramServiceRevenueAmt |
| PY Investment Income | $220 | PYInvestmentIncomeAmt |
| CY Investment Income | $163 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $1,960,975 | PYTotalRevenueAmt |
| CY Total Revenue | $2,220,234 | 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 | $476,090 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $508,199 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,750,384 | PYOtherExpensesAmt |
| CY Other Expenses | $1,722,951 | CYOtherExpensesAmt |
| PY Total Expenses | $2,226,474 | PYTotalExpensesAmt |
| CY Total Expenses | $2,231,150 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$265,499 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$10,916 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,340,497 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,392,121 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,689,147 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,051,435 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,651,350 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,340,686 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE OTHE PRIMARY MISSION OF ONSLOW RADIATION ONCOLOGY, LLC IS TWO-FOLD. THE FIRST MISSION IS TO ESTABLISH AN ONCOLOGY CENTER IN ONSLOW COUNTY TO ALLEVIATE THE BURDEN OF CANCER PATIENTS IN THE SURROUNDING COMMUNITY TO RECEIVE THEIR CURRENT CANCER TREATMENTS. THE SECOND PURPOSE AND FOCUS IS TO PROVIDE CANCER TREATMENT TO MEMBERS OF THE SURROUNDING AREA WITH THE LEAST AMOUNT OF NEGATIVE IMPACT ON THE PATIENTS AND THEIR FAMILIES. THIS INCLUDES PROVIDING CARE TO PATIENTS IN NEED, REGARDLESS OF THEIR ABILITY TO PAY PURSUANT TO ONSLOW RADIATION ONCOLOGY, LLC'S CHARITY CARE POLICY WITH THE CONSISTENT GOAL OF IMPROVING THE HEALTH IN THE COMMUNITY WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | Yes (1) | SignificantChangeInd |
| Expense | $2,231,150 | ExpenseAmt |
| Revenue | $1,788,073 | RevenueAmt |
| Desc | THE ONCOLOGY CENTER ACCOMPLISHED BOTH GOALS OF 1) PROVIDING CONVENIENT LOCAL CANCER TREATMENT SO THAT PATIENTS DO NOT HAVE TO TRAVEL LONG DISTANCES AND 2) PROVIDING CANCER TREATMENT TO MEMBERS OF THE SURROUNDING AREA WITH THE LEAST AMOUNT OF NEGATIVE IMPACT ON THE PATIENTS AND THEIR FAMILIES. IN DOING SO, THE CENTER PROVIDED CARE TO PATIENTS IN NEED, REGARDLESS OF THEIR ABILITY TO PAY, PURSUANT TO ONSLOW RADIATION ONCOLOGY, LLC'S CHARITY CARE POLICY, AND WITH THE CONSISTENT GOAL OF IMPROVING THE HEALTH IN THE COMMUNITY THE ONCOLOGY CENTER SERVES. | Desc |
| Total Program Service Expenses | $2,231,150 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 1 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 1 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | 0 | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DANIEL WALLER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9105772734 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 241 NEW RIVER DRIVE | AddressLine1Txt |
| City | JACKSONVILLE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28540 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Institutional TrusteeInstitutionalTrusteeInd |
|---|---|---|---|---|---|---|
| DANIEL THOMAS WALLER | ||||||
| MANAGER (OMH) | 1.00 | Yes (X) | $0 | $183,628 | $19,473 | |
| THOMAS JENKINS | ||||||
| MANAGER (OMH) | 1.00 | Yes (X) | $0 | $126,269 | $24,594 | |
| CARL BIBER | ||||||
| MANAGER (OMH) | 1.00 | Yes (X) | $0 | $71,875 | $603 | |
| ONSLOW MEMORIAL HOSPITAL | ||||||
| INSTITUTIONAL TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | |
| PITT COUNTY MEMORIAL HOSPITAL | ||||||
| INSTITUTIONAL TRUSTEE THROUGH 7/31/20 | 1.00 | $0 | $0 | $0 | Yes (X) | |
| PHYLLIS DEANTONIO | ||||||
| MANAGER (PCMH) THROUGH 7/31/20 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DAVID HUGHES | ||||||
| MANAGER (PCMH) THROUGH 7/31/20 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| TODD HICKEY | ||||||
| MANAGER (PCMH) THROUGH 7/31/20 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $381,772 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $44,670 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| VIDANT MEDICAL GROUP | |||||
| PO BOX 6028 | GREENVILLE | NC | 27835 | PHYSICIAN SERVICES | $686,684 |
| SIEMENS MEDICAL SOLUTIONS | |||||
| PO BOX 120001 DEPT 0733 | DALLAS | TX | 75312 | MAINTENANCE CONTRACT | $311,947 |
| ONSLOW MEMORIAL HOSPITAL | |||||
| 317 WESTERN BOULEVARD | JACKSONVILLE | NC | 28546 | MEDICAL SERVICES | $277,752 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $431,998 | RelatedOrganizationsAmt |
| Total Contributions | $431,998 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET OUTPATIENT REVENUE | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $1,788,073 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,788,073 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,788,073 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $163 | TotalRevenueColumnAmt |
| Exclusion | $163 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,220,234 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,788,073 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $163 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $405,372 | TotalAmt |
| Program Services | $405,372 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,951 | TotalAmt |
| Program Services | $75,951 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,876 | TotalAmt |
| Program Services | $26,876 | ProgramServicesAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,000 | TotalAmt |
| Program Services | $18,000 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,104 | TotalAmt |
| Program Services | $40,104 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $934,455 | TotalAmt |
| Program Services | $934,455 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,212 | TotalAmt |
| Program Services | $10,212 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,221 | TotalAmt |
| Program Services | $7,221 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $192 | TotalAmt |
| Program Services | $192 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,554 | TotalAmt |
| Program Services | $89,554 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $210,461 | TotalAmt |
| Program Services | $210,461 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,522 | TotalAmt |
| Program Services | $36,522 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| MAINTENANCE CONTRACT | $361,255 | $361,255 |
| SUPPLIES | $13,973 | $13,973 |
| EQUIPMENT RENTAL | $1,002 | $1,002 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,231,150 | TotalAmt |
| Program Services | $2,231,150 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $94,670 | BOYAmt |
| EOY | $330,334 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $141,945 | BOYAmt |
| EOY | $140,879 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,834 | BOYAmt |
| EOY | $964 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $6,466,274 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,546,652 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,095,048 | BOYAmt |
| EOY | $3,919,622 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $322 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,340,497 | BOYAmt |
| EOY | $4,392,121 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $99,593 | BOYAmt |
| EOY | $171,928 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,541,399 | BOYAmt |
| EOY | $1,879,507 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,155 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,689,147 | BOYAmt |
| EOY | $2,051,435 | 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 | $1,651,350 | BOYAmt |
| EOY | $2,340,686 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,651,350 | BOYAmt |
| EOY | $2,340,686 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,340,497 | BOYAmt |
| EOY | $4,392,121 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$10,916 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $700,252 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | 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 | 0 | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,045,729 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,257,872 | DepreciationAmt |
| Book Value | $3,787,857 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,420,545 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,288,780 | DepreciationAmt |
| Book Value | $131,765 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,919,622 | TotalBookValueLandBuildingsAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DANIEL THOMAS WALLER | ||||||||||||||
| MANAGER (OMH) | $0 | $183,628 | $0 | $0 | $0 | $0 | $0 | $5,357 | $0 | $14,116 | $0 | $203,101 | $0 | $0 |
| THOMAS JENKINS | ||||||||||||||
| MANAGER (OMH) | $0 | $126,269 | $0 | $0 | $0 | $0 | $0 | $4,127 | $0 | $20,467 | $0 | $150,863 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 3 | EFFECTIVE JULY 31, 2020, THE AUTHORITY ENTERED INTO A MEMBERSHIP INTEREST REDEMPTION AGREEMENT AND BILL OF SALE WITH VIDANT, WHEREBY THE HOSPITAL ACQUIRED VIDANT'S 50% INTEREST IN ORO, MAKING THE HOSPITAL THE SOLE MEMBER OF ORO. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION IS AN LLC AND HAS ONLY ONE MEMBER, ONSLOW MEMORIAL HOSPITAL, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE BOARD OF TRUSTEES ARE APPOINTED FROM THE MEMBER HOSPITAL. A TOTAL OF THREE BOARD MEMBERS ARE APPOINTED THAT REPRESENTS THE MEMBER/HOSPITAL IN ALL MATTERS AND TO VOTE THE HOSPITAL'S INTEREST. THE BOARD OF TRUSTEES MAY ALSO SELECT AN ALTERNATE TO SERVE IN THE REPRESENTATIVE'S PLACE IF FOR ANY REASON IS UNABLE TO ATTEND A MEETING OR OTHERWISE FULFILL THEIR DUTIES. |
| FORM 990, PART VI, SECTION A, LINE 7B | CERTAIN ACTIONS REQUIRE MEMBER APPROVAL AS LISTED IN THE ARTICLES OF ORGANIZATION. EXAMPLES OF SUCH ACTIONS ARE: 1) AMENDING THE ARTICLES OF ORGANIZATION, 2) MERGING OR CONSOLIDATING THE "COMPANY" INTO ANOTHER ENTITY, 3) SELLING, ASSIGNING OR TRANSFERRING THE "COMPANY'S" ASSETS, 4) DISSOLVING, LIQUIDATING OR REORGANIZING THE "COMPANY", 5) ADMITTING OTHER MEMBERS TO THE "COMPANY", 6) APPROVING THE ANNUAL BUDGET OR A CALL FOR ADDITIONAL CAPITAL TO BE CONTRIBUTED, 7) APPROVING PURCHASES, CONTRACTS OR ANY BUSINESS DECISIONS REQUIRING EXPENDITURES OF $100,000 OR MORE, OR 8) APPROVING ANY LOAN OR CAPITAL LEASE WHOSE TERM IS OVER 3 YEARS OR WHOSE AMOUNT IS GREATER THAN $50,000. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE ORGANIZATION HAS ONE MEMBER/OWNER. THE MEMBER/OWNER APPOINTS 3 INDIVIDUALS (MANAGERS) TO MANAGER THE ORGANIZATIONS DAY-TO-DAY OPERATIONS. THE MANAGERS IN TURN ELECT A CHAIRMAN. THE CHAIRMAN REVIEWS THE FORM 990. AFTER THE CHAIRMAN COMPLETES THE REVIEW, A COPY IS SUBMITTED TO THE ORGANIZATION'S APPOINTED REPRESENTATIVES. THE FORM 990 IS FILED AFTER THE REPRESENTATIVES HAVE REVIEWED THE FORM AND ALL QUESTIONS OR CORRECTIONS HAVE BEEN ADDRESSED. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN IRC SECTION 6104(D). |
| FORM 990, PART IX, LINE 11G | PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 477,290. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 477,290. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 457,165. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 457,165. |
| FORM 990, PART XI, LINE 9: | ACQUISITION OF NET ASSETS OF AFFILIATE 700,252. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ONSLOW MEMORIAL HOSPITAL | |||||||||||
| 241 NEW RIVER DRIVE | JACKSONVILLE | NC | 28540 | 562014989 | HOSPITAL | NC | 501(C)(3) | LINE 3 | N/A | 0 | |
| ONSLOW AMBULATORY SERVICES | |||||||||||
| 241 NEW RIVER DRIVE | JACKSONVILLE | NC | 28540 | 561880357 | OUTPATIENT MEDICAL SERVICES | NC | 501(C)(3) | LINE 12C, III-FI | 0 | ONSLOW MEMORIAL HOSPITAL | |
| ONSLOW MEMORIAL HOSPITAL FOUNDATION INC | |||||||||||
| 241 NEW RIVER DRIVE | JACKSONVILLE | NC | 28540 | 581943240 | PROMOTE AND SUPPORT ONSLOW MEMORIAL HOSPITAL | NC | 501(C)(3) | LINE 12A, I | 0 | ONSLOW MEMORIAL HOSPITAL | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |