UNIVERSITY SURGICAL ASSOCIATES INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- UNIVERSITY SURGICAL ASSOCIATES INC (EIN 05-0389803)
- Tax period
- 2016-10-01 to 2017-09-30
- Filed
- 2018-02-13
- IRS object ID
- 201830449349301453
- Schema version
- 2016v3.0
- 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 | 2018-02-13T13:20:54-06:00 | ReturnTs |
| Tax Period End | 2017-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 050353162 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PICCERELLI GILSTEIN & CO LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 144 WESTMINSTER STREET | AddressLine1Txt |
| City | PROVIDENCE | CityNm |
| State Abbreviation | RI | StateAbbreviationCd |
| ZIP | 029032282 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 050389803 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNIVERSITY SURGICAL ASSOCIATES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | UNIV | BusinessNameControlTxt |
| Phone | 4014539623 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 16149 | AddressLine1Txt |
| City | RUMFORD | CityNm |
| State Abbreviation | RI | StateAbbreviationCd |
| ZIP | 02916 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | WILLIAM CIOFFI MD | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 4014446290 | PhoneNum |
| Signature | 2018-02-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SHARON KENNEDY | PreparerPersonNm |
| PTIN | P00218909 | PTIN |
| Phone | 4018310200 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | WILLIAM CIOFFI MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 16149 | AddressLine1Txt |
| City | RUMFORD | CityNm |
| State Abbreviation | RI | StateAbbreviationCd |
| ZIP | 02916 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $53,108,976 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.USASURG.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1980 | FormationYr |
| Legal Domicile State | RI | LegalDomicileStateCd |
| Activity Or Mission | UNIVERSITY SURGICAL ASSOCIATES, INC. IS A NONPROFIT CORPORATION FOUNDED TO PROVIDE DIAGNOSIS AND TREATMENT OF DISORDERS FOR PATIENTS OF RHODE ISLAND HOSPITAL AND OTHERS REQUIRING SURGERY; TO CONDUCT RESEARCH IN THE FIELD OF SURGERY AND TO TEACH PHYSICIANS, MEDICAL STUDENTS AND OTHER HEALTH CARE PERSONNEL IN THE FIELD OF SURGERY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 236 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $148,845 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$29,784 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,525 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $36,737,503 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $35,873,920 | CYProgramServiceRevenueAmt |
| PY Investment Income | $450,902 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,168,360 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$13,762 | PYOtherRevenueAmt |
| CY Other Revenue | -$69,550 | CYOtherRevenueAmt |
| PY Total Revenue | $37,174,643 | PYTotalRevenueAmt |
| CY Total Revenue | $37,974,255 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $76,210 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $52,310 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $31,315,592 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $31,898,752 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $132,728 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,227,918 | PYOtherExpensesAmt |
| CY Other Expenses | $5,546,969 | CYOtherExpensesAmt |
| PY Total Expenses | $37,619,720 | PYTotalExpensesAmt |
| CY Total Expenses | $37,498,031 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$445,077 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $476,224 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $33,344,928 | TotalAssetsBOYAmt |
| Total Assets EOY | $33,658,311 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $8,160,309 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $8,003,428 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $25,184,619 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $25,654,883 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | UNIVERSITY SURGICAL ASSOCIATES, INC. IS A NONPROFIT CORPORATION FOUNDED TO PROVIDE DIAGNOSIS AND TREATMENT OF DISORDERS FOR PATIENTS OF RHODE ISLAND HOSPITAL AND OTHERS REQUIRING SURGERY; TO CONDUCT RESEARCH IN THE FIELD OF SURGERY AND TO TEACH PHYSICIANS, MEDICAL STUDENTS AND OTHER HEALTH CARE PERSONNEL IN THE FIELD OF SURGERY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $32,362,776 | ExpenseAmt |
| Grant | $52,310 | GrantAmt |
| Revenue | $35,684,549 | RevenueAmt |
| Desc | PROVIDES DIAGNOSIS AND TREATMENT OF DISORDERS AND SURGERY FOR PATIENTS AS WELL AS RESEARCH IN SURGERY AND RELATED FIELDS AND PROVIDES INSTRUCTION IN SURGERY AND RELATED FIELDS. | Desc |
| Total Program Service Expenses | $32,362,776 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | 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 | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | 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 | Yes (1) | 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 | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | 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 | 43 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 236 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| 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 |
| Form8899 Filedind | 0 | Form8899Filedind |
| Form1098 C Filed | 0 | Form1098CFiledInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | 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 | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | RI | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMY HICKEY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4014539623 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 75 NEWMAN AVE PO BOX 16149 | AddressLine1Txt |
| City | RUMFORD | CityNm |
| State Abbreviation | RI | StateAbbreviationCd |
| ZIP | 02916 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| CIOFFI MD WILLIAM | ||||||||
| PRESIDENT | 40.00 | Yes (X) | Yes (X) | $501,892 | $0 | $59,966 | ||
| MIGLIORI MD STEPHEN | ||||||||
| VICE PRESIDENT | 40.00 | Yes (X) | Yes (X) | $409,601 | $0 | $64,232 | ||
| KURKCHUBASCHE MD ARLET | ||||||||
| TREASURER/SECRETARY | 40.00 | Yes (X) | Yes (X) | $353,607 | $0 | $54,639 | ||
| ADAMS MD CHARLES | ||||||||
| TRUSTEE | 40.00 | Yes (X) | $489,837 | $0 | $64,270 | |||
| HARRINGTON MD DAVID | ||||||||
| TRUSTEE | 40.00 | Yes (X) | $428,070 | $0 | $60,283 | |||
| NG MD THOMAS | ||||||||
| TRUSTEE | 40.00 | Yes (X) | $463,595 | $0 | $60,023 | |||
| ROYE MD G DEAN | ||||||||
| TRUSTEE | 40.00 | Yes (X) | $386,375 | $0 | $60,584 | |||
| SLAIBY MD JEFFREY | ||||||||
| TRUSTEE | 40.00 | Yes (X) | $400,975 | $0 | $64,157 | |||
| GRAY MD BRADFORD | ||||||||
| PHYSICIAN | 40.00 | $400,206 | $0 | $62,583 | Yes (X) | |||
| LUKS MD FRANCOIS | ||||||||
| PHYSICIAN | 40.00 | $370,415 | $0 | $61,016 | Yes (X) | |||
| MAZZAGLIA MD PETER | ||||||||
| PHYSICIAN | 40.00 | $430,887 | $0 | $53,540 | Yes (X) | |||
| MORRISSEY MD PAUL | ||||||||
| PHYSICIAN | 40.00 | $403,190 | $0 | $60,742 | Yes (X) | |||
| VALENTE MD JAMES | ||||||||
| PHYSICIAN | 40.00 | $386,117 | $0 | $48,568 | Yes (X) | |||
| MARCACCIO MD EDWARD | ||||||||
| PHYSICIAN/FORMER TRUSTEE | 40.00 | $527,254 | $0 | $31,582 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $5,952,021 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $806,185 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 72 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NEW ENGLAND MEDICAL BILLNG INC | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 75 NEWMAN AVE SUITE 100 | AddressLine1Txt |
| City | RUMFORD | CityNm |
| State Abbreviation | RI | StateAbbreviationCd |
| ZIP | 02916 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | MEDICAL BILLING SERVICES | ServicesDesc |
| Compensation | $1,166,803 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $1,525 | AllOtherContributionsAmt |
| Total Contributions | $1,525 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| PATIENT FEES | 621110 | $18,922,454 | $18,922,454 | |
| CONTRACT REVENUE - RI HOSPITAL | 621110 | $7,325,467 | $7,325,467 | |
| OTHER INCOME - SURGERY | 621110 | $4,546,970 | $4,546,970 | |
| CONTRACTUAL REVENUE - MIRIAM HOSP | 621110 | $3,043,038 | $3,043,038 | |
| OTHER CONTRACT REVENUE | 621110 | $885,977 | $705,977 | $180,000 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,150,014 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,140,643 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $9,371 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $35,873,920 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $839,036 | TotalRevenueColumnAmt |
| Exclusion | $839,036 | ExclusionAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $29,024 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$29,024 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$29,024 | TotalRevenueColumnAmt |
| Exclusion | -$29,024 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $16,178,258 | SecuritiesAmt |
| Other | $256,763 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $14,975,003 | SecuritiesAmt |
| Other | $130,694 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,203,255 | SecuritiesAmt |
| Other | $126,069 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,329,324 | TotalRevenueColumnAmt |
| Exclusion | $1,329,324 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INCOME FROM INVESTMENT IN PASSTHR | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | -$40,526 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | -$40,526 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | -$40,526 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $37,974,255 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $35,684,549 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $148,845 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,139,336 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,310 | TotalAmt |
| Program Services | $52,310 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,845,988 | TotalAmt |
| Program Services | $3,269,090 | ProgramServicesAmt |
| Management And General | $548,053 | ManagementAndGeneralAmt |
| Fundraising | $28,845 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,858,570 | TotalAmt |
| Program Services | $19,036,843 | ProgramServicesAmt |
| Management And General | $2,744,130 | ManagementAndGeneralAmt |
| Fundraising | $77,597 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,539,906 | TotalAmt |
| Program Services | $2,158,920 | ProgramServicesAmt |
| Management And General | $371,588 | ManagementAndGeneralAmt |
| Fundraising | $9,398 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,338,217 | TotalAmt |
| Program Services | $1,987,485 | ProgramServicesAmt |
| Management And General | $342,081 | ManagementAndGeneralAmt |
| Fundraising | $8,651 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,316,071 | TotalAmt |
| Program Services | $1,118,661 | ProgramServicesAmt |
| Management And General | $192,541 | ManagementAndGeneralAmt |
| Fundraising | $4,869 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $171,009 | TotalAmt |
| Management And General | $171,009 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,889 | TotalAmt |
| Management And General | $50,889 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $133,607 | TotalAmt |
| Program Services | $133,607 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,484 | TotalAmt |
| Program Services | $83,484 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,100,791 | TotalAmt |
| Program Services | $1,021,937 | ProgramServicesAmt |
| Management And General | $78,854 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,068,127 | TotalAmt |
| Program Services | $1,705,292 | ProgramServicesAmt |
| Management And General | $362,835 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,886 | TotalAmt |
| Program Services | $36,886 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,235 | TotalAmt |
| Program Services | $5,235 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $193,299 | TotalAmt |
| Program Services | $187,782 | ProgramServicesAmt |
| Management And General | $5,517 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $963,958 | TotalAmt |
| Program Services | $827,130 | ProgramServicesAmt |
| Management And General | $133,460 | ManagementAndGeneralAmt |
| Fundraising | $3,368 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| OUTSIDE SERVICES | $605,894 | $605,894 | |
| DUES AND SUBSCRIPTIONS | $78,479 | $76,909 | $1,570 |
| LICENSES AND PERMITS | $32,967 | $32,967 | |
| MISCELLANEOUS | $22,344 | $22,344 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,498,031 | TotalAmt |
| Program Services | $32,362,776 | ProgramServicesAmt |
| Management And General | $5,002,527 | ManagementAndGeneralAmt |
| Fundraising | $132,728 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,631,687 | BOYAmt |
| EOY | $2,741,594 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,402,278 | BOYAmt |
| EOY | $598,090 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $157,080 | BOYAmt |
| EOY | $63,618 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,138,349 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,694,382 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $573,967 | BOYAmt |
| EOY | $443,967 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,094,052 | BOYAmt |
| EOY | $21,470,387 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,500,788 | BOYAmt |
| EOY | $7,280,515 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,017 | BOYAmt |
| EOY | $66,414 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,953,059 | BOYAmt |
| EOY | $993,726 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,344,928 | BOYAmt |
| EOY | $33,658,311 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,433 | BOYAmt |
| EOY | $49,027 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $154,035 | BOYAmt |
| EOY | $86,185 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,968,841 | BOYAmt |
| EOY | $7,868,216 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,160,309 | BOYAmt |
| EOY | $8,003,428 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,624,690 | BOYAmt |
| EOY | $2,824,689 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,325,986 | BOYAmt |
| EOY | $22,580,286 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $233,943 | BOYAmt |
| EOY | $249,908 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,184,619 | BOYAmt |
| EOY | $25,654,883 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,344,928 | BOYAmt |
| EOY | $33,658,311 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $476,224 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$5,960 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Other | Yes (X) | MethodOfAccountingOtherInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type3 Func Int | Yes (X) | SupportingOrgType3FuncIntInd |
| IRS Written Determination | Yes (X) | IRSWrittenDeterminationInd |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RHODE ISLAND HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 050258954 | EIN |
| Organization Type | 3 | OrganizationTypeCd |
| Governing Document Listed | Yes (1) | GoverningDocumentListedInd |
| Support | $0 | SupportAmt |
| Other Support | $0 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (1) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Form990 Sch A Type3 Sprt Org All Form990SchAType3SprtOrgAllGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timely Provided Documents | 0 | TimelyProvidedDocumentsInd |
| Officers Close Relationship | Yes (1) | OfficersCloseRelationshipInd |
| Supported Org Voice Investment | 0 | SupportedOrgVoiceInvestmentInd |
Form990 Sch A Type3 Func Int Form990SchAType3FuncIntGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Test | Yes (X) | ActivitiesTestInd |
| Activities Further Exempt Prps | 0 | ActivitiesFurtherExemptPrpsInd |
| Activities Engaged Org Invlmnt | 0 | ActivitiesEngagedOrgInvlmntInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $233,943 | BeginningYearBalanceAmt |
| Contributions | $452 | ContributionsAmt |
| Investment Earnings Or Losses | $18,482 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $2,969 | OtherExpendituresAmt |
| End Year Balance | $249,908 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $233,747 | BeginningYearBalanceAmt |
| Contributions | $106 | ContributionsAmt |
| Investment Earnings Or Losses | $5,073 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $4,983 | OtherExpendituresAmt |
| End Year Balance | $233,943 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $211,979 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $25,028 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $2,524 | OtherExpendituresAmt |
| Administrative Expenses | $736 | AdministrativeExpensesAmt |
| End Year Balance | $233,747 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $192,112 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $22,023 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,918 | OtherExpendituresAmt |
| Administrative Expenses | $238 | AdministrativeExpensesAmt |
| End Year Balance | $211,979 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $175,293 | BeginningYearBalanceAmt |
| Contributions | $249 | ContributionsAmt |
| Investment Earnings Or Losses | $18,320 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,750 | OtherExpendituresAmt |
| End Year Balance | $192,112 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $282,626 | OtherCostOrOtherBasisAmt |
| Depreciation | $211,470 | DepreciationAmt |
| Book Value | $71,156 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,855,723 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,482,912 | DepreciationAmt |
| Book Value | $372,811 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $443,967 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVESTMENTS - MUTUAL FUNDS | Desc |
| Book Value | $7,280,515 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $7,280,515 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DEFERRED COMPENSATION | $7,280,515 |
| DUE TO OTHER FUNDS | $587,701 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $7,868,216 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $38,007,270 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $38,975 | OtherRevenueAmt |
| Revenue Not Reported | $38,975 | RevenueNotReportedAmt |
| Revenue Subtotal | $37,968,295 | RevenueSubtotalAmt |
| Other Revenues Not Included | $5,960 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $5,960 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $37,974,255 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $37,537,006 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $38,975 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $38,975 | ExpensesNotReportedAmt |
| Expenses Subtotal | $37,498,031 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $37,498,031 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | W.R. THOMPSON LECTURESHIP ENDOWMENT IS USED TO ACCOUNT FOR FUNDS SET ASIDE TO ESTABLISH THE WR THOMPSON LECTURESHIP IN ESOPHAGASTRIC SURGERY. THE INTEREST EARNED ON THE CORPUS MAY BE USED FOR AN ANNUAL LECTURESHIP. THE PRINCIPAL MAY NOT BE INVADED; AS A RESULT, THIS FUND IS CONSIDERED AN ENDOWMENT FUND. DR. SHOAIB SHEIKH SURGICAL ENDOWMENT WAS ESTABLISHED TO FUND THE DR. SHOAIB SHEIKH SURGICAL AWARD. THE INTEREST EARNED ON THE CORPUS MAY BE USED FOR AN ANNUAL AWARD TO A RESIDENT INCLUDING A MONETARY SUM AND FUNDING OF EXPENSES TO GO ON A ONE OR TWO WEEK INTERNATIONAL BURN TRIP WITH THE SURGICAL FACULTY, AT THE DISCRETION OF THE PRESIDENT OF USA. THE PRINCIPAL MAY NOT BE INVADED; AS A RESULT, THIS FUND IS CONSIDERED AN ENDOWMENT FUND. |
| PART X, LINE 2: | USA INTERNALLY MONITORS ITS TAX POSITIONS TO DETERMINE WHETHER ANY ARE UNCERTAIN. A TAX POSITION IS TAKEN IF IT IS DETERMINED THAT THE POSITION WILL "MORE-LIKELY-THAN-NOT" BE SUSTAINED UPON EXAMINATION BY A TAXING AUTHORITY. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY USA AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2017, THERE WERE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE THE RECOGNITION OF A LIABILITY OR ASSET OR DISCLOSURE IN THE FINANCIAL STATEMENTS. USA IS NOT CURRENTLY SUBJECT TO AUDITS FOR ANY TAX PERIODS. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | RENTAL LOSS 29,024. LOSS ON SALE OF ASSETS 9,951. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | ADJUSTMENT FOR NON-DEDUCTIBLE EXPENSES FROM PASSTHROUGH ENTITY 5,960. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL LOSS 29,024. LOSS ON SALE OF ASSETS 9,951. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| AMERICAN CANCER SOCIETY | |||||||
| 931 JEFFERSON BLVD STE 3004 | WARWICK | RI | 02886 | 131788491 | 501 (C) 3 | $5,000 | MAKING STRIDES AGAINST BREAST CANCER WALK |
| RI HOSPITAL FOUNDATION | |||||||
| BOX H | PROVIDENCE | RI | 02901 | 050258954 | 501 (C) 3 | $20,000 | $5,000 - PURSUIT OF EXCELLENCE DINNER (2016)$5,000 - PURSUIT OF EXCELLENCE DINNER (2017)$5,000 - HASBRO CHILDREN'S BALL$5,000 - HASBRO CHILDREN'S HOSPITAL GOLF INVITATIONAL |
| THE TOMORROW FUND | |||||||
| RIH DEVELOPMENT OFFICE PO BOX H | PROVIDENCE | RI | 02901 | 050450569 | 501 (C) 3 | $10,000 | $5,000 - FANTASY BALL-BRONZE (2016)$5,000 - FANTASY BALL-BRONZE (2017) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 3 | Total501c3OrgCnt |
| Total Other Org | 3 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | OUR ORGANIZATION IS FREQUENTLY APPROACHED BY OTHER 501(C)3 ORGANIZATIONS FOR SUPPORT OF VARIOUS PROGRAMS WHICH ARE IN LINE WITH OUR MISSION. WE MAINTAIN A FILE OF SUCH SOLICITATIONS ALONG WITH THE ACKNOWLEDGEMENTS OF THEIR RECEIPT OF OUR CONTRIBUTIONS AS WELL AS THEIR CANCELLED CHECKS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| 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 (14 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CIOFFI MD WILLIAM | ||||||||||||||
| PRESIDENT | $493,126 | $0 | $0 | $0 | $8,766 | $0 | $38,506 | $0 | $21,460 | $0 | $561,858 | $0 | $0 | $0 |
| MIGLIORI MD STEPHEN | ||||||||||||||
| VICE PRESIDENT | $405,628 | $0 | $0 | $0 | $3,973 | $0 | $40,613 | $0 | $23,619 | $0 | $473,833 | $0 | $0 | $0 |
| KURKCHUBASCHE MD ARLET | ||||||||||||||
| TREASURER/SECRETARY | $349,109 | $0 | $0 | $0 | $4,498 | $0 | $40,968 | $0 | $13,671 | $0 | $408,246 | $0 | $0 | $0 |
| ADAMS MD CHARLES | ||||||||||||||
| TRUSTEE | $486,878 | $0 | $0 | $0 | $2,959 | $0 | $42,310 | $0 | $21,960 | $0 | $554,107 | $0 | $0 | $0 |
| HARRINGTON MD DAVID | ||||||||||||||
| TRUSTEE | $415,753 | $0 | $0 | $0 | $12,317 | $0 | $40,823 | $0 | $19,460 | $0 | $488,353 | $0 | $0 | $0 |
| NG MD THOMAS | ||||||||||||||
| TRUSTEE | $461,128 | $0 | $0 | $0 | $2,467 | $0 | $40,563 | $0 | $19,460 | $0 | $523,618 | $0 | $0 | $0 |
| ROYE MD G DEAN | ||||||||||||||
| TRUSTEE | $383,508 | $0 | $0 | $0 | $2,867 | $0 | $41,124 | $0 | $19,460 | $0 | $446,959 | $0 | $0 | $0 |
| SLAIBY MD JEFFREY | ||||||||||||||
| TRUSTEE | $395,628 | $0 | $0 | $0 | $5,347 | $0 | $40,623 | $0 | $23,534 | $0 | $465,132 | $0 | $0 | $0 |
| GRAY MD BRADFORD | ||||||||||||||
| PHYSICIAN | $395,628 | $0 | $0 | $0 | $4,578 | $0 | $40,623 | $0 | $21,960 | $0 | $462,789 | $0 | $0 | $0 |
| LUKS MD FRANCOIS | ||||||||||||||
| PHYSICIAN | $365,628 | $0 | $0 | $0 | $4,787 | $0 | $41,556 | $0 | $19,460 | $0 | $431,431 | $0 | $0 | $0 |
| MAZZAGLIA MD PETER | ||||||||||||||
| PHYSICIAN | $427,859 | $0 | $0 | $0 | $3,028 | $0 | $43,825 | $0 | $9,715 | $0 | $484,427 | $0 | $0 | $0 |
| MORRISSEY MD PAUL | ||||||||||||||
| PHYSICIAN | $398,128 | $0 | $0 | $0 | $5,062 | $0 | $40,623 | $0 | $20,119 | $0 | $463,932 | $0 | $0 | $0 |
| VALENTE MD JAMES | ||||||||||||||
| PHYSICIAN | $379,532 | $0 | $0 | $0 | $6,585 | $0 | $40,641 | $0 | $7,927 | $0 | $434,685 | $0 | $0 | $0 |
| MARCACCIO MD EDWARD | ||||||||||||||
| PHYSICIAN/FORMER TRUSTEE | $522,594 | $0 | $0 | $0 | $4,660 | $0 | $16,218 | $0 | $15,364 | $0 | $558,836 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| NEW ENGLAND MEDICAL BILLING | |||
| THE PRESIDENT OF THE FOUNDATION, WILLIAM CIOFFI, MD, SITS ON THE BOARD. | $1,179,269 | BILLING FEES: THE FOUNDATION OWNS 40.54% OF NEW ENGLAND MEDICAL BILLING (NEMB). NEMB IS AN INDEPENDENT CONTRACTOR OF THE FOUNDATION. | 0 |
| THERESA A GRAVES MD | |||
| EMPLOYEE IS MARRIED TO DR. WILLIAM CIOFFI, PRESIDENT OF UNIVERSITY SURGICAL | $354,772 | COMPENSATION: THERESA A GRAVES, MD IS EMPLOYED BY UNIVERSITY SURGICAL ASSOCIATES, INC. | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 4 | THE FOLLOWING CHANGES WERE MADE TO THE ORGANIZATION'S BYLAWS, EFFECTIVE JULY 1, 2017: ARTICLE II, SECTION 2.1 - THERE ARE TWO CLASSES OF MEMBERS, CLASS A MEMBERS AND A CLASS B MEMBER. ARTICLE II, SECTION 2.2 - CLASS A MEMBERS MUST MEET THE CRITERIA FOR ADMISSION AND BE APPROVED FOR MEMBERSHIP BY THE VOTING MEMBERS OF THE CORPORATION. ARTICLE II, SECTION 2.5 - THE SOLE CLASS B MEMBERS OF THE CORPORATION SHALL BE BROWN PHYSICIANS, INC WITH SUCH POWERS DESCRIBED IN ARTICLE III. ARTICLE III- RESERVED POWERS OF THE CLASS B MEMBER. THESE POWERS INCLUDE THE RIGHT TO APPROVE: 1. THE ADDITION OF ANY NEW MEMBER OF THE CORPORATION THAT IS NOT AN INDIVIDUAL PHYSICIAN EMPLOYED BY THE CORPORATION, 2. THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION, 3. MERGER OR CONSOLIDATION OF THE CORPORATION, 4. AMENDMENT OF THESE BYLAWS OR OF THE ARTICLES OF INCORPORATION OF THE CORPORATION, 5. THE CORPORATION'S DECISION TO SELF-INSURE FOR MALPRACTICE EXPOSURE, 6. THE EXECUTION OF ANY ACADEMIC AFFILIATION AGREEMENT OTHER THAN WITH BROWN UNIVERSITY ACTING, 7. INCURRENCE OF DEBT BY THE CORPORATION FOR BORROWED MONEY FROM COMMERCIAL LENDER (NOT INCLUDING TRADE PAYABLES AND SIMILAR OBLIGATIONS) ABOVE A THRESHOLD SET BY THE MEMBER FROM TIME TO TIME, 8. UPON COMMENCEMENT OF JOINT BUDGETING AS DESCRIBED IN THE FORMATION AND SUPPORT AGREEMENT BETWEEN THE CORPORATION, THE CLASS B MEMBER, BROWN, AND THE OTHER CONSTITUENT FOUNDATIONS EACH CAPITAL AND OPERATION BUDGET OF THE CORPORATION, AND 9. SIGNIFICANT CHANGES IN THE METHODOLOGY OF THE CORPORATION FOR DETERMINING PHYSICIAN COMPENSATION THAT ARE NOT CONSISTENT WITH THE FORMATION AND SUPPORT AGREEMENT. ARTICLE V, SECTION 5.2 - THE BOARD OF TRUSTEES SHALL NOW BE COMPOSED OF NOT MORE THAN 9 INDIVIDUALS. THIS REMOVES THE REQUIREMENT OF ONE TRUSTEE THAT REPRESENTED THE DEAN OF BROWN AND THE OTHER TRUSTEE BEING THE PRESIDENT OF RHODE ISLAND HOSPITAL. ARTICLE V, SECTION 5.2.3 - THE ELECTED TRUSTEES MUST ALWAYS CONSTITUTE 51 PERCENT OR MORE OF THE TRUSTEES WHO POSITIONS HAVE BEEN FILLED. THE BYLAWS NO LONGER INCLUDE SECTION 2.3.5 (RIMG DESIGNATED MEMBER), SECTION 2.3.6 (APPROVAL RIGHTS OF RIMG DESIGNATED MEMBER), SECTION 2.3.7 (METHOD OF EXERCISE OF RIMG DESIGNATED MEMBER RIGHTS), AND SECTION 2.3.8 (AUTOMATIC REPEAL) RELATED TO RIMG. |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 IS REVIEWED BY THE PRESIDENT OF THE BOARD AND PRESENTED TO THE TRUSTEES FOR THEIR REVIEW. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS DISTRIBUTED ANNUALLY AND DISCUSSED WITH THE PRESIDENT, MEMBERS OF THE BOARD OF TRUSTEES AND SENIOR MANAGEMENT. THE DOCUMENTATION INCLUDES A DETAILED EXPLANATION OF THE POLICY AND THE ACTIONS TO BE TAKEN IF A CONFLICT SHOULD ARISE. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION MAINTAINS SALARY RANGES FOR ALL EMPLOYEES WHICH IS UPDATED AND APPROVED BY THE BOARD OF TRUSTEES ANNUALLY. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE FORM 990 OF THE ORGANIZATION IS MADE AVAILABLE UPON REQUEST AND TO THE PUBLIC ON GUIDESTAR.ORG. THE CONFLICT OF INTEREST POLICY WILL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | ADJUSTMENT FOR NON-DEDUCTIBLE EXPENSES FROM PASSTHROUGH ENTITY -5,960. |
| FORM 990, PART XII, LINE 2C: | COMMITTEE'S OVERSIGHT OF AUDIT AND SELECTION OF INDEPENDENT ACCOUNTANT PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | USA PAWTUCKET PROPERTIES LLC (DISREGARDED ENTITY) | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 15 HAZEL STREET | AddressLine1Txt |
| City | PAWTUCKET | CityNm |
| State Abbreviation | RI | StateAbbreviationCd |
| ZIP | 02860 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 261855890 | EIN |
| Primary Activities | RENTAL PROPERTY | PrimaryActivitiesTxt |
| Legal Domicile State | RI | LegalDomicileStateCd |
| Total Income | $0 | TotalIncomeAmt |
| End Of Year Assets | $0 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNIVERSITY SURGICAL ASSOCIATES INC | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RHODE ISLAND HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 593 EDDY STREET | AddressLine1Txt |
| City | PROVIDENCE | CityNm |
| State Abbreviation | RI | StateAbbreviationCd |
| ZIP | 02903 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 050258954 | EIN |
| Primary Activities | HOSPITAL COMMITTED TO ITS MISSION OF DELIVERING HEALTH WITH CARE | PrimaryActivitiesTxt |
| Legal Domicile State | RI | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 3 | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
| 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 | 0 | 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 | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | 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 |