ONSLOW RADIATION ONCOLOGY LLC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- ONSLOW RADIATION ONCOLOGY LLC (EIN 26-1694368)
- Tax period
- 2018-10-01 to 2019-09-30
- Filed
- 2020-07-29
- IRS object ID
- 202042119349301269
- Schema version
- 2018v3.2
- 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 | 2020-07-29T16:05:56-05:00 | ReturnTs |
| Tax Period End | 2019-09-30 | 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 | 2018-10-01 | 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 | DANIEL WALLER | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 9105774703 | PhoneNum |
| Signature | 2020-07-27 | 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 | 2020-07-27 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 67.137.57.251 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-07-27 | IPDt |
| IP Tm | 13:05:08 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | D73DD419434AD86791BAD4D174710EE2F5735302 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | AF8A95852F2B61CB8A9D2632419903EA5923B1AC | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-09-23 17:36:50Z | 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 | $1,960,975 | 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 | 2 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 2 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $648,053 | PYContributionsGrantsAmt |
| CY Contributions Grants | $250,000 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,978,068 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,710,755 | CYProgramServiceRevenueAmt |
| PY Investment Income | $495 | PYInvestmentIncomeAmt |
| CY Investment Income | $220 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $2,626,616 | PYTotalRevenueAmt |
| CY Total Revenue | $1,960,975 | 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 | $543,247 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $476,090 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,993,995 | PYOtherExpensesAmt |
| CY Other Expenses | $1,750,384 | CYOtherExpensesAmt |
| PY Total Expenses | $2,537,242 | PYTotalExpensesAmt |
| CY Total Expenses | $2,226,474 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $89,374 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$265,499 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,891,687 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,340,497 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,974,838 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,689,147 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,916,849 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,651,350 | 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 | 0 | SignificantChangeInd |
| Expense | $2,226,474 | ExpenseAmt |
| Revenue | $1,710,755 | 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 | $2,226,474 | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| 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 | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 | 0 | 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 With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| 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 | 0 | 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 | 2 | 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 | 2 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 2 | 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 | VALERIE RUSSELL | 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Institutional TrusteeInstitutionalTrusteeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| ONSLOW MEMORIAL HOSPITAL | ||||||
| INSTITUTIONAL TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |
| PITT COUNTY MEMORIAL HOSPITAL | ||||||
| INSTITUTIONAL TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |
| THOMAS JENKINS | ||||||
| MANAGER (OMH) | 1.00 | $0 | $0 | $0 | Yes (X) | |
| ROY SMITH 10118 TO 123018 | ||||||
| MANAGER (OMH) | 1.00 | $0 | $0 | $0 | Yes (X) | |
| DANIEL THOMAS WALLER | ||||||
| MANAGER (OMH) | 1.00 | $0 | $0 | $0 | Yes (X) | |
| PHYLLIS DEANTONIO | ||||||
| MANAGER (PCMH) | 1.00 | $0 | $0 | $0 | Yes (X) | |
| DAVID HUGHES | ||||||
| MANAGER (PCMH) | 1.00 | $0 | $0 | $0 | Yes (X) | |
| TODD HICKEY | ||||||
| MANAGER (PCMH) | 1.00 | $0 | $0 | $0 | Yes (X) | |
| CARL BIBER 92319 TO 93019 | ||||||
| MANAGER (OMH) | 1.00 | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 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 | $779,419 |
| ONSLOW MEMORIAL HOSPITAL | |||||
| 317 WESTERN BOULEVARD | JACKSONVILLE | NC | 28546 | MEDICAL SERVICES | $616,248 |
| SIEMENS MEDICAL SOLUTIONS | |||||
| PO BOX 120001 DEPT 0733 | DALLAS | TX | 75312 | MAINTENANCE CONTRACT | $301,840 |
| NEWCO CANCER SERVICES LLC | |||||
| PO BOX 6028 | GREENVILLE | NC | 27835 | PHYSICIAN SERVICES | $197,677 |
| REVENUE CYCLE BILLING SERVICES INC | |||||
| PO BOX 659831-MSC224 | SAN ANTONIO | TX | 78265 | BILLING SERVICES | $110,664 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $250,000 | RelatedOrganizationsAmt |
| Total Contributions | $250,000 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET OUTPATIENT REVENUE | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $1,710,755 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,710,755 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,710,755 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $220 | TotalRevenueColumnAmt |
| Exclusion | $220 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,960,975 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,710,755 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $220 | 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 | $366,336 | TotalAmt |
| Program Services | $366,336 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,206 | TotalAmt |
| Program Services | $83,206 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,548 | TotalAmt |
| Program Services | $26,548 | 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 | $63,585 | TotalAmt |
| Program Services | $63,585 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $908,546 | TotalAmt |
| Program Services | $908,546 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,776 | TotalAmt |
| Program Services | $1,776 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,282 | TotalAmt |
| Program Services | $10,282 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,760 | TotalAmt |
| Program Services | $7,760 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $102,344 | TotalAmt |
| Program Services | $102,344 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $207,533 | TotalAmt |
| Program Services | $207,533 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,492 | TotalAmt |
| Program Services | $38,492 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| MAINTENANCE CONTRACT | $367,004 | $367,004 |
| SUPPLIES | $24,102 | $24,102 |
| EQUIPMENT RENTAL | $835 | $835 |
| DUES | $125 | $125 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,226,474 | TotalAmt |
| Program Services | $2,226,474 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $333,485 | BOYAmt |
| EOY | $94,670 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $213,315 | BOYAmt |
| EOY | $141,945 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,941 | BOYAmt |
| EOY | $8,834 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $6,431,239 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,336,191 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,293,946 | BOYAmt |
| EOY | $4,095,048 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,891,687 | BOYAmt |
| EOY | $4,340,497 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $116,275 | BOYAmt |
| EOY | $99,593 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,817,511 | BOYAmt |
| EOY | $2,541,399 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,052 | BOYAmt |
| EOY | $48,155 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,974,838 | BOYAmt |
| EOY | $2,689,147 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,916,849 | BOYAmt |
| EOY | $1,651,350 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,916,849 | BOYAmt |
| EOY | $1,651,350 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,891,687 | BOYAmt |
| EOY | $4,340,497 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$265,499 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | Yes (1) | AccountantCompileOrReviewInd |
Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FS Audited | 0 | FSAuditedInd |
| 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 | $1,131,610 | DepreciationAmt |
| Book Value | $3,914,119 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,385,510 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,204,581 | DepreciationAmt |
| Book Value | $180,929 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,095,048 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RELATED PARTY PAYABLE | Desc |
| Amt | $48,155 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $48,155 | TotalLiabilityAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION IS AN LLC AND HAS TWO MEMBERS/OWNERS THAT ARE HOSPITALS. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE BOARD OF TRUSTEES OF EACH MEMBER/HOSPITAL SELECTS ONE (1) INDIVIDUAL TO REPRESENT THAT MEMBER/HOSPITAL IN ALL MATTERS AND TO VOTE THE HOSPITAL'S MEMBERSHIP INTEREST. THE BOARD OF TRUSTEES OF EACH MEMBER/HOSPITAL MAY ALSO SELECT AN ALTERNATE TO SERVE IN THE REPRESENTATIVE'S PLACE IF FOR ANY REASON THE REPRESENTATIVE 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 TWO MEMBERS/OWNERS. EACH MEMBER/OWNER ELECTS 3 INDIVIDUALS (MANAGERS) TO MANAGE THE ORGANIZATION'S 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 ELECTED 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 390,101. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 390,101. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 518,445. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 518,445. |