MEDICAL STAFF OF ST JOHN & WEST SHORE HOSPITAL: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- MEDICAL STAFF OF ST JOHN & WEST SHORE HOSPITAL (EIN 34-1663333)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-05-13
- IRS object ID
- 201941339349302694
- Schema version
- 2018v3.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-05-13T11:00:04-04:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Sauppe Tax Service LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O Box 245 | AddressLine1Txt |
| City | Trempealeau | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54661 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 341663333 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Medical Staff of St John Westshore Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MEDI | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 29000 Center Ridge Rd | AddressLine1Txt |
| City | Westlake | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44145 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Robert Stern MD | PersonNm |
| Person Title | President | PersonTitleTxt |
| Phone | 4408275536 | PhoneNum |
| Signature | 2019-05-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Janice Sauppe | PreparerPersonNm |
| PTIN | P00014757 | PTIN |
| Phone | 6085342122 | PhoneNum |
| Preparation | 2019-05-13 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 208.157.177.246 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-05-13 | IPDt |
| IP Tm | 11:01:27 | IPTm |
| Federal Original Submission Id | 3450262019133c4njw5y | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2019-05-13 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 82BC287C1A18061EA0CEC8D102BE6C3BB08AAE76 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 82BC287C1A18061EA0CEC8D102BE6C3BB08AAE76 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $418,845 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Assoc | Yes (X) | TypeOfOrganizationAssocInd |
| Formation | 1981 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | Continuing Medical Education to keep doctors up to date on medical issues | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 147 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $172,476 | PYContributionsGrantsAmt |
| CY Contributions Grants | $167,105 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $22,569 | PYInvestmentIncomeAmt |
| CY Investment Income | $32,811 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $195,045 | PYTotalRevenueAmt |
| CY Total Revenue | $199,916 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $10,452 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $8,047 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $19,097 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $21,892 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $122,833 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $134,000 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $42,728 | PYOtherExpensesAmt |
| CY Other Expenses | $43,058 | CYOtherExpensesAmt |
| PY Total Expenses | $195,110 | PYTotalExpensesAmt |
| CY Total Expenses | $206,997 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$65 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$7,081 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $728,066 | TotalAssetsBOYAmt |
| Total Assets EOY | $657,115 | TotalAssetsEOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $728,066 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $657,115 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Continuing Medical Education to keep doctors up to date on medical issues | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $58,883 | ExpenseAmt |
| Desc | Ongoing medical training and conferencing for hospital medical staff | Desc |
| Total Program Service Expenses | $58,883 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | false | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | false | 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 | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | 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 | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| 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 With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| 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 | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 15 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| 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 |
| 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 | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | 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 | false | ConflictOfInterestPolicyInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Robert Stern MD | PersonNm |
| Phone | 4408275536 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 29000 Center Ridge Rd | AddressLine1Txt |
| City | Westlake | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44145 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| Robert Stern | |||||||
| President | 10.00 | 0.00 | Yes (X) | Yes (X) | $50,000 | $0 | $0 |
| Gregory Bloxdorf | |||||||
| Vice President | 5.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| James H Myers | |||||||
| Dept Chair | 5.00 | 0.00 | Yes (X) | $1,000 | $0 | $0 | |
| Jeffrey Christian | |||||||
| Dept Chair | 5.00 | 0.00 | Yes (X) | $1,000 | $0 | $0 | |
| Matthew Kacir | |||||||
| Dept Chair | 5.00 | 0.00 | Yes (X) | $1,000 | $0 | $0 | |
| Adnan Mournay | |||||||
| Immediate Past President | 5.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Mehrun Elyaderani | |||||||
| Dept Chair | 5.00 | 0.00 | Yes (X) | $1,000 | $0 | $0 | |
| Atul Hulyalkar | |||||||
| Dept Chair | 5.00 | 0.00 | Yes (X) | $1,000 | $0 | $0 | |
| John Coletta | |||||||
| Dept Chair | 5.00 | 0.00 | Yes (X) | $11,000 | $0 | $0 | |
| Richard Below | |||||||
| Dept Chair | 5.00 | 0.00 | Yes (X) | $12,000 | $0 | $0 | |
| Aparna Reddy | |||||||
| Dept Chair | 5.00 | 0.00 | Yes (X) | $6,000 | $0 | $0 | |
| Hazem Nouraldin | |||||||
| Dept Chair | 5.00 | 0.00 | Yes (X) | $5,000 | $0 | $0 | |
| Irwin Mandell | |||||||
| Dept Chair | 5.00 | 0.00 | Yes (X) | $11,000 | $0 | $0 | |
| Michelle Belardo | |||||||
| Dept Chair | 5.00 | 0.00 | Yes (X) | $11,000 | $0 | $0 | |
| Stephen Evans | |||||||
| Dept Chair | 5.00 | 0.00 | Yes (X) | $12,000 | $0 | $0 | |
| Melanie Stempowski | |||||||
| Dept Chair | 5.00 | 0.00 | Yes (X) | $11,000 | $0 | $0 | |
| Jeffrey Roberts | |||||||
| Secretary Treasurer | 5.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $134,000 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Membership Dues | $94,522 | MembershipDuesAmt |
| Related Organizations | $72,583 | RelatedOrganizationsAmt |
| Total Contributions | $167,105 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,557 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $19,557 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $232,183 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $218,929 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $13,254 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,254 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,254 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $199,916 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $32,811 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,047 | TotalAmt |
| Program Services | $8,047 | ProgramServicesAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,892 | TotalAmt |
| Program Services | $21,892 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $134,000 | TotalAmt |
| Management And General | $134,000 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $535 | TotalAmt |
| Management And General | $535 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,305 | TotalAmt |
| Management And General | $5,305 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $308 | TotalAmt |
| Management And General | $308 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,944 | TotalAmt |
| Program Services | $28,944 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Gifts | Desc |
| Total | $7,966 | TotalAmt |
| Management And General | $7,966 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $206,997 | TotalAmt |
| Program Services | $58,883 | ProgramServicesAmt |
| Management And General | $148,114 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $155,613 | BOYAmt |
| EOY | $82,819 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $502,849 | BOYAmt |
| EOY | $474,682 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $69,604 | BOYAmt |
| EOY | $99,614 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $728,066 | BOYAmt |
| EOY | $657,115 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $728,066 | BOYAmt |
| EOY | $657,115 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $728,066 | BOYAmt |
| EOY | $657,115 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $728,066 | BOYAmt |
| EOY | $657,115 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$7,081 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$63,870 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Ally Bank CD | $24,698 |
| Investors Bank CD | $24,959 |
| Stifel Bank and Trust CD | $24,989 |
| UBS Bank CD | $24,968 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $99,614 | TotalBookValueOtherAssetsAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (13 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Recipient EINRecipientEIN |
|---|---|---|---|---|---|---|
| American Heart Association | ||||||
| 1375 East Ninth St Ste 600 | Cleveland | OH | 44114 | 501c3 | $750 | |
| Ohio Physicians Health Program | ||||||
| 5900 Roche Dr Ste 440 | Columbus | OH | 43229 | 501c3 | $500 | 341817218 |
| United Way | ||||||
| 1331 Euclid Ave | Cleveland | OH | 44115 | 501c3 | $599 | 346516654 |
| The Wilderness Society | ||||||
| 1615 M Street NW | Washington | DC | 20036 | 501c3 | $100 | |
| Monastery of the Poor Clares | ||||||
| 3501 Rocky River Dr | Cleveland | OH | 44111 | 501c3 | $200 | 260701762 |
| St John Medical Center Emerg Presci | ||||||
| 29000 Center Ridge Rd | Westlake | OH | 44145 | 501c3 | $348 | |
| Westshore Osteopathic Foundation | ||||||
| 29101 Health Campus Dr Ste 150 | Westlake | OH | 44145 | 501c3 | $2,500 | 341207772 |
| Alzheimers Association | ||||||
| P O Box 96011 | Washington | DC | 20090 | 501c3 | $500 | |
| Open Hands of the Caring Penn Found | ||||||
| 27059 Center Ridge Rd | Westlake | OH | 44145 | $1,500 | ||
| Cleveland Animal Protective League | ||||||
| 1729 Willey Ave | Cleveland | OH | 44113 | $50 | ||
| Doctors Without Borders | ||||||
| P O Box 5023 | Hagerstown | MD | 21741 | 501c3 | $250 | |
| St Kizito Foundation | ||||||
| 41295 North Ridge Dr | Elyria | OH | 44035 | 501c3 | $250 | |
| University Hospitals | ||||||
| P O Box 94554 | Cleveland | OH | 44101 | $500 | ||
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Officer directors etc family relationship Part VI line 2 | Officers, 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 7a | All officers and department chairs are elected by the general membership by paper ballot |
| Governing body decisions Part VI line 7b | All governing decisions are voted upon by the membership and must have a majority approval to pass. |
| Form 990 governing body review Part VI line 11 | A 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 19 | These documents are available upon request |
| General explanation attachment | Monitoring of donations - receipts are kept and all disbursements approved in advance for any donations made. |