2020-07-29T16:05:56-05:00 2019-09-30 410746749 CLIFTONLARSONALLEN LLP 227 WEST TRADE STREET SUITE 800 CHARLOTTE NC 28202 990 2018-10-01 261694368 ONSLOW RADIATION ONCOLOGY LLC ATTN DANIEL WALLER MANAGER ONSL 9105774703 241 NEW RIVER DRIVE JACKSONVILLE NC 28540 DANIEL WALLER CHIEF FINANCIAL OFFICER 9105774703 2020-07-27 1 JOHN NORMAN P01506766 7049985200 2020-07-27 67.137.57.251 2020-07-27 13:05:08 ED P D73DD419434AD86791BAD4D174710EE2F5735302 AF8A95852F2B61CB8A9D2632419903EA5923B1AC 2018 2020-09-23 17:36:50Z CARL BIBER 241 NEW RIVER DRIVE JACKSONVILLE NC 28540 1960975 0 X WWW.ONSLOW.ORG X LLC 2006 NC 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. 2 2 0 0 0 0 648053 250000 1978068 1710755 495 220 0 0 2626616 1960975 0 0 0 0 543247 476090 0 0 0 1993995 1750384 2537242 2226474 89374 -265499 4891687 4340497 2974838 2689147 1916849 1651350 X 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. 0 0 2226474 1710755 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. 2226474 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 2 2 0 0 0 0 1 1 1 1 1 0 0 1 1 1 0 1 1 0 0 0 X VALERIE RUSSELL 9105772734 241 NEW RIVER DRIVE JACKSONVILLE NC 28540 X ONSLOW MEMORIAL HOSPITAL INSTITUTIONAL TRUSTEE 1.00 X 0 0 0 PITT COUNTY MEMORIAL HOSPITAL INSTITUTIONAL TRUSTEE 1.00 X 0 0 0 THOMAS JENKINS MANAGER (OMH) 1.00 X 0 0 0 ROY SMITH 10118 TO 123018 MANAGER (OMH) 1.00 X 0 0 0 DANIEL THOMAS WALLER MANAGER (OMH) 1.00 X 0 0 0 PHYLLIS DEANTONIO MANAGER (PCMH) 1.00 X 0 0 0 DAVID HUGHES MANAGER (PCMH) 1.00 X 0 0 0 TODD HICKEY MANAGER (PCMH) 1.00 X 0 0 0 CARL BIBER 92319 TO 93019 MANAGER (OMH) 1.00 X 0 0 0 0 0 0 0 0 0 0 VIDANT MEDICAL GROUP PO BOX 6028 GREENVILLE NC 27835 PHYSICIAN SERVICES 779419 ONSLOW MEMORIAL HOSPITAL 317 WESTERN BOULEVARD JACKSONVILLE NC 28546 MEDICAL SERVICES 616248 SIEMENS MEDICAL SOLUTIONS PO BOX 120001 DEPT 0733 DALLAS TX 75312 MAINTENANCE CONTRACT 301840 NEWCO CANCER SERVICES LLC PO BOX 6028 GREENVILLE NC 27835 PHYSICIAN SERVICES 197677 REVENUE CYCLE BILLING SERVICES INC PO BOX 659831-MSC224 SAN ANTONIO TX 78265 BILLING SERVICES 110664 5 250000 250000 NET OUTPATIENT REVENUE 621400 1710755 1710755 1710755 220 220 1960975 1710755 0 220 X 366336 366336 83206 83206 26548 26548 18000 18000 63585 63585 908546 908546 1776 1776 10282 10282 7760 7760 102344 102344 207533 207533 38492 38492 MAINTENANCE CONTRACT 367004 367004 SUPPLIES 24102 24102 EQUIPMENT RENTAL 835 835 DUES 125 125 2226474 2226474 0 0 333485 94670 213315 141945 50941 8834 6431239 2336191 4293946 4095048 4891687 4340497 116275 99593 2817511 2541399 41052 48155 2974838 2689147 X 1916849 1651350 1916849 1651350 4891687 4340497 -265499 0 X 1 X 0 0 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5045729 1131610 3914119 1385510 1204581 180929 4095048 RELATED PARTY PAYABLE 48155 48155 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.