DAVA HEALTH INC: Form 990PF, tax year 2024
View the entire original 990 at ProPublica ↗
- Organization
- DAVA HEALTH INC (EIN 87-4039697)
- Tax period
- 2024-01-01 to 2024-12-31
- Filed
- 2025-11-18
- IRS object ID
- 202533229349101213
- Schema version
- 2024v5.0
- 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
- Form 990-PF
- Depreciation Schedule
- Land Etc Schedule2
- Mortgages And Notes Payable Sch
- Other Assets Schedule
- Other Expenses Schedule
- Other Income Schedule2
- Other Increases Schedule
- Other Liabilities Schedule
- Other Professional Fees Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2025-11-18T16:07:42-05:00 | ReturnTs |
| Tax Period End | 2024-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450491842 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLANKENSHIP CPA GROUP PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2672 NORTH MT JULIET RD | AddressLine1Txt |
| City | MT JULIET | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 371228015 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2024-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 874039697 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVA HEALTH INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | DAVA | BusinessNameControlTxt |
| Phone | 6157320564 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 823 TYNE VALLEY COURT | AddressLine1Txt |
| City | NASHVILLE | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37220 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BAPPA MUKHERJI | PersonNm |
| Person Title | CHAIRMAN | PersonTitleTxt |
| Phone | 6157320564 | PhoneNum |
| Signature | 2025-11-17 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | false | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JESSICA FREEMAN CPA | PreparerPersonNm |
| PTIN | P01261457 | PTIN |
| Phone | 6158891153 | PhoneNum |
| Preparation | 2025-11-18 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2024 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| FMV Assets EOY | $58,864,260 | FMVAssetsEOYAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Other Income Rev And Expnss | $75,172,192 | OtherIncomeRevAndExpnssAmt |
| Other Income Adj Net Incm | $75,172,192 | OtherIncomeAdjNetIncmAmt |
| Total Rev And Expnss | $75,172,192 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $0 | TotalNetInvstIncmAmt |
| Total Adj Net Incm | $75,172,192 | TotalAdjNetIncmAmt |
| Oth Empl Slrs Wgs Rev And Expnss | $23,537,710 | OthEmplSlrsWgsRevAndExpnssAmt |
| Oth Empl Slrs Wgs Adj Net Incm | $20,477,808 | OthEmplSlrsWgsAdjNetIncmAmt |
| Oth Empl Slrs Wgs Dsbrs Chrtbl | $3,059,902 | OthEmplSlrsWgsDsbrsChrtblAmt |
| Pension Empl Bnft Rev And Expnss | $4,771,537 | PensionEmplBnftRevAndExpnssAmt |
| Pension Empl Bnft Adj Net Incm | $4,151,237 | PensionEmplBnftAdjNetIncmAmt |
| Pension Empl Bnft Dsbrs Chrtbl | $620,300 | PensionEmplBnftDsbrsChrtblAmt |
| Other Prof Fees Rev And Expnss | $15,974,552 | OtherProfFeesRevAndExpnssAmt |
| Other Prof Fees Adj Net Incm | $13,897,860 | OtherProfFeesAdjNetIncmAmt |
| Other Prof Fees Dsbrs Chrtbl | $2,076,692 | OtherProfFeesDsbrsChrtblAmt |
| Interest Rev And Expnss | $561,217 | InterestRevAndExpnssAmt |
| Interest Adj Net Incm | $561,217 | InterestAdjNetIncmAmt |
| Deprec And Dpltn Rev And Expnss | $2,622,150 | DeprecAndDpltnRevAndExpnssAmt |
| Deprec And Dpltn Adj Net Incm | $2,622,150 | DeprecAndDpltnAdjNetIncmAmt |
| Occupancy Rev And Expnss | $8,673,410 | OccupancyRevAndExpnssAmt |
| Occupancy Adj Net Incm | $8,673,410 | OccupancyAdjNetIncmAmt |
| Other Expenses Rev And Expnss | $30,968,276 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Adj Net Incm | $27,348,142 | OtherExpensesAdjNetIncmAmt |
| Other Expenses Dsbrs Chrtbl | $3,620,134 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $87,108,852 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $0 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Adj Net Incm | $77,731,824 | TotOprExpensesAdjNetIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $9,377,028 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $0 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $0 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $87,108,852 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $0 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Adj Net Incm | $77,731,824 | TotalExpensesAdjNetIncmAmt |
| Total Expenses Dsbrs Chrtbl | $9,377,028 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | -$11,936,660 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash EOY | -$495,018 | CashEOYAmt |
| Cash EOYFMV | -$495,018 | CashEOYFMVAmt |
| Acct Rcvbl | $32,824,894 | AcctRcvblAmt |
| Acct Rcvbl Allwnc Dbtfl Acct | $20,443,092 | AcctRcvblAllwncDbtflAcctAmt |
| Acct Rcvbl BOY | $11,413,207 | AcctRcvblBOYAmt |
| Acct Rcvbl EOY | $12,381,802 | AcctRcvblEOYAmt |
| Acct Rcvbl EOYFMV | $12,381,802 | AcctRcvblEOYFMVAmt |
| Prepaid Expenses BOY | $1,160,349 | PrepaidExpensesBOYAmt |
| Prepaid Expenses EOY | $617,586 | PrepaidExpensesEOYAmt |
| Prepaid Expenses EOYFMV | $617,586 | PrepaidExpensesEOYFMVAmt |
| Land Bldg Equip Cost Or Other Bss | $44,907,437 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,478,295 | LandBldgEquipAccumDeprecAmt |
| Land BOY | $42,707,027 | LandBOYAmt |
| Land EOY | $41,429,142 | LandEOYAmt |
| Land EOYFMV | $41,429,142 | LandEOYFMVAmt |
| Other Assets BOY | $5,948,760 | OtherAssetsBOYAmt |
| Other Assets EOY | $4,930,748 | OtherAssetsEOYAmt |
| Other Assets EOYFMV | $4,930,748 | OtherAssetsEOYFMVAmt |
| Total Assets BOY | $61,229,343 | TotalAssetsBOYAmt |
| Total Assets EOY | $58,864,260 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $58,864,260 | TotalAssetsEOYFMVAmt |
| Accounts Payable BOY | $13,414,496 | AccountsPayableBOYAmt |
| Accounts Payable EOY | $21,559,452 | AccountsPayableEOYAmt |
| Mortgages And Notes Payable BOY | $4,479,359 | MortgagesAndNotesPayableBOYAmt |
| Mortgages And Notes Payable EOY | $8,286,158 | MortgagesAndNotesPayableEOYAmt |
| Other Liabilities BOY | $28,334,649 | OtherLiabilitiesBOYAmt |
| Other Liabilities EOY | $25,934,533 | OtherLiabilitiesEOYAmt |
| Total Liabilities BOY | $46,228,504 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $55,780,143 | TotalLiabilitiesEOYAmt |
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
| Additional Paid In Capital BOY | $18,377,557 | AdditionalPaidInCapitalBOYAmt |
| Additional Paid In Capital EOY | $42,741,440 | AdditionalPaidInCapitalEOYAmt |
| Retained Earning BOY | -$3,376,718 | RetainedEarningBOYAmt |
| Retained Earning EOY | -$39,657,323 | RetainedEarningEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $15,000,839 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $3,084,117 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $61,229,343 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $58,864,260 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $15,000,839 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | -$11,936,660 | ExcessRevenueOverExpensesAmt |
| Other Increases | $19,938 | OtherIncreasesAmt |
| Subtotal | $3,084,117 | SubtotalAmt |
| Tot Net Ast Or Fund Balances EOY | $3,084,117 | TotNetAstOrFundBalancesEOYAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $0 | InvestmentIncomeExciseTaxAmt |
Statements Regarding Acty StatementsRegardingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Legislative Political Acty | false | LegislativePoliticalActyInd |
| More Than100 Spent | false | MoreThan100SpentInd |
| Form1120 POL Filed | false | Form1120POLFiledInd |
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRptInd |
| Changes To Articles Or Bylaws | false | ChangesToArticlesOrBylawsInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Organization Dissolved Etc | false | OrganizationDissolvedEtcInd |
| Section508e Rqr Satisfied | Yes (true) | Section508eRqrSatisfiedInd |
| At Least5000 In Assets | Yes (true) | AtLeast5000InAssetsInd |
| Org Report Or Register State | TN | OrgReportOrRegisterStateCd |
| Form990 PF Filed With Atty Gen | Yes (true) | Form990PFFiledWithAttyGenInd |
| Private Operating Foundation | false | PrivateOperatingFoundationInd |
| New Substantial Contributors | false | NewSubstantialContributorsInd |
| Own Controlled Entity | Yes (true) | OwnControlledEntityInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Comply With Public Insp Rqr | Yes (true) | ComplyWithPublicInspRqrInd |
| Website Address | N/A | WebsiteAddressTxt |
| Individual With Books | BAPPA MUKHERJI | IndividualWithBooksNm |
| Phone | 6153088800 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 823 TYNE VALLEY COURT | AddressLine1Txt |
| City | NASHVILLE | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37220 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Accounts Question | false | ForeignAccountsQuestionInd |
Statements Regarding Acty4720 StatementsRegardingActy4720Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sale Or Exch Disqualified Prsn | false | SaleOrExchDisqualifiedPrsnInd |
| Brrw Or Lend Disqualified Prsn | false | BrrwOrLendDisqualifiedPrsnInd |
| Furn Goods Disqualified Prsn | false | FurnGoodsDisqualifiedPrsnInd |
| Pay Comp Disqualified Prsn | false | PayCompDisqualifiedPrsnInd |
| Transfer Ast Disqualified Prsn | false | TransferAstDisqualifiedPrsnInd |
| Payment To Government Official | false | PaymentToGovernmentOfficialInd |
| Undistributed Income PY | false | UndistributedIncomePYInd |
| Business Holdings | false | BusinessHoldingsInd |
| Jeopardy Investments | false | JeopardyInvestmentsInd |
| Uncorrected PY Jeopardy Invst | false | UncorrectedPYJeopardyInvstInd |
| Influence Legislation | false | InfluenceLegislationInd |
| Influence Election | false | InfluenceElectionInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Noncharitable Purpose | false | NoncharitablePurposeInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp
Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|---|---|---|---|
| BAPPA MUKHERJI | ||||||||
| 823 TYNE VALLEY COURT | NASHVILLE | TN | 37220 | CHAIRMAN | 1.00 | $0 | $0 | $0 |
| BRETT HENLEY | ||||||||
| 823 TYNE VALLEY COURT | NASHVILLE | TN | 37220 | SECRETARY | 1.00 | $0 | $0 | $0 |
| TAMMIE BOYTE | ||||||||
| 823 TYNE VALLEY COURT | NASHVILLE | TN | 37220 | DIRECTOR | 1.00 | $0 | $0 | $0 |
| CLIF TANT JR | ||||||||
| 823 TYNE VALLEY COURT | NASHVILLE | TN | 37220 | DIRECTOR | 1.00 | $0 | $0 | $0 |
| RANA MUKHERJI | ||||||||
| 823 TYNE VALLEY COURT | NASHVILLE | TN | 37220 | DIRECTOR | 1.00 | $0 | $0 | $0 |
| JOE CHESTER | ||||||||
| 823 TYNE VALLEY COURT | NASHVILLE | TN | 37220 | DIRECTOR | 1.00 | $0 | $0 | $0 |
| JOEY VAUGHN | ||||||||
| 823 TYNE VALLEY COURT | NASHVILLE | TN | 37220 | DIRECTOR | 1.00 | $0 | $0 | $0 |
| TRACY RYE | ||||||||
| 823 TYNE VALLEY COURT | NASHVILLE | TN | 37220 | DIRECTOR | 1.00 | $0 | $0 | $0 |
| GARY NESTER | ||||||||
| 823 TYNE VALLEY COURT | NASHVILLE | TN | 37220 | DIRECTOR | 1.00 | $0 | $0 | $0 |
Compensation Highest Paid Empl CompensationHighestPaidEmplGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee BenefitsEmployeeBenefitsAmt |
|---|---|---|---|---|---|---|---|
| ELIAS ISSA | |||||||
| 823 TYNE VALLEY COURT | NASHVILLE | TN | 37220 | PHYSICIAN | 40.00 | $506,975 | $32,342 |
| STEVEN EFIRD | |||||||
| 823 TYNE VALLEY COURT | NASHVILLE | TN | 37220 | PHYSICIAN | 40.00 | $404,987 | $13,876 |
| SHANNON PITMAN | |||||||
| 823 TYNE VALLEY COURT | NASHVILLE | TN | 37220 | PHYSICIAN | 40.00 | $323,691 | $31,205 |
| NEAL TAH | |||||||
| 823 TYNE VALLEY COURT | NASHVILLE | TN | 37220 | PHYSICIAN | 40.00 | $326,966 | $23,964 |
| ROBIN EDWARD | |||||||
| 823 TYNE VALLEY COURT | NASHVILLE | TN | 37220 | PHYSICIAN | 40.00 | $237,915 | $15,166 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Employee Paid Over50k | 159 | OtherEmployeePaidOver50kCnt |
Compensation Of Hghst Pd Cntrct CompensationOfHghstPdCntrctGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Service TypeServiceTypeTxt | CompensationCompensationAmt |
|---|---|---|---|---|---|
| HEALTHTRUST WORKFORCE SOLUTIONS LLC | |||||
| PO BOX 742697 | ATLANTA | GA | 30374 | CONTRACT LABOR | $2,059,332 |
| GA MOUNTAIN EMERGENCY PHYSICIANS | |||||
| 400 GALLERIA PKWY SUITE 1755 | ATLANTA | GA | 30339 | 24/7 ER PHYSICI | $1,635,269 |
| RURAL SURGICAL ASSOCIATES OF LAS VEG | |||||
| 12687 W CEDAR DRIVE SUITE 200 | LAKEWOOD | CO | 80228 | GS/ORTHO CONTRA | $1,446,269 |
| ALIGNED PROVIDERS NEW MEXICO LLC | |||||
| 700 CENTRAL EXPWY SOUTH SUITE 400 | ALLEN | TX | 75013 | ER/HOSPITALISTS | $1,298,444 |
| 360 ANESTHESIA | |||||
| PO BOX 954507 | ST LOUIS | MO | 63195 | ANESTHESIA SERV | $791,261 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contractor Paid Over50k | 46 | ContractorPaidOver50kCnt |
Summary Of Direct Chrtbl Acty SummaryOfDirectChrtblActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description1 | DAVA HEALTH ACQUIRED A DISREGARDED ENTITY, DAVA ALTA VISTA, LLC, IN 2023 AND THE DISREGARDED ENTITY OPERATES ALTA VISTA REGIONAL HOSPITAL THAT CONDUCTS CHARITABLE ACTIVITIES. | Description1Txt |
| Expenses1 | $45,040,701 | Expenses1Amt |
| Description2 | DAVA HEALTH ACQUIRED A DISREGARDED ENTITY, BLUE RIDGE GEORGIA HOLDINGS, LLC, IN 2023 AND THE DISREGARDED ENTITY OPERATES BLUE RIDGE MEDICAL CENTER THAT CONDUCTS CHARITABLE ACTIVITIES. | Description2Txt |
| Expenses2 | $42,068,151 | Expenses2Amt |
Sum Of Program Related Invst SumOfProgramRelatedInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description1 | N/A | Description1Txt |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $0 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $26,033 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $59,359,278 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $59,385,311 | TotalFMVOfUnusedAssetsAmt |
| Adjusted Total FMV Of Unused Ast | $59,385,311 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $890,780 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $58,494,531 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $2,924,727 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Minimum Investment Return | $2,924,727 | MinimumInvestmentReturnAmt |
| Distributable Before Adj | $2,924,727 | DistributableBeforeAdjAmt |
| Distributable Before Ded | $2,924,727 | DistributableBeforeDedAmt |
| Distributable As Adjusted | $2,924,727 | DistributableAsAdjustedAmt |
PF Qualifying Distributions PFQualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $9,377,028 | ExpensesAndContributionsAmt |
| Qualifying Distributions | $9,377,028 | QualifyingDistributionsAmt |
Undistributed Income UndistributedIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Distributable As Adjusted | $2,924,727 | DistributableAsAdjustedAmt |
| Excess Distribution Cyov Yr1 | $2,467,284 | ExcessDistributionCyovYr1Amt |
| Total Excess Distribution Cyov | $2,467,284 | TotalExcessDistributionCyovAmt |
| Qualifying Distributions | $9,377,028 | QualifyingDistributionsAmt |
| Applied To Current Year | $2,924,727 | AppliedToCurrentYearAmt |
| Remaining Distri From Corpus | $6,452,301 | RemainingDistriFromCorpusAmt |
| Total Corpus | $8,919,585 | TotalCorpusAmt |
| Undistributed Income CY | $0 | UndistributedIncomeCYAmt |
| Excess Distri Cyov To Next Yr | $8,919,585 | ExcessDistriCyovToNextYrAmt |
| Excess From Year1 | $2,467,284 | ExcessFromYear1Amt |
| Excess From Current Year | $6,452,301 | ExcessFromCurrentYearAmt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
Other Revenue Described OtherRevenueDescribedGrp (2 entries)
| DescDesc | Related Or Exempt Function IncmRelatedOrExemptFunctionIncmAmt |
|---|---|
| PATIENT REV LESS DISCOUNTS | $71,351,968 |
| OTHER REVENUE | $3,820,224 |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Related Or Exempt Function Incm | $75,172,192 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $75,172,192 | TotalIncomeProducingActyAmt |
Rln Of Acty To Accom Of Exmpt Prps RlnOfActyToAccomOfExmptPrpsGrp
Rln Of Acty To Accom Of Exmpt Prps RlnOfActyToAccomOfExmptPrpsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Line Number | 11A | LineNumberTxt |
| Relationship Statement | HOSPITAL ACTIVITY OF DISREGARDED ENTITIES | RelationshipStatementTxt |
Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trnsfr Of Cash To Nonchrtbl EO | false | TrnsfrOfCashToNonchrtblEOInd |
| Trnsfr Other Asset Nonchrtbl EO | false | TrnsfrOtherAssetNonchrtblEOInd |
| Sales Or Exchanges Of Assets | false | SalesOrExchangesOfAssetsInd |
| Purchase Of Assets Nonchrtbl EO | false | PurchaseOfAssetsNonchrtblEOInd |
| Rental Of Facilities Oth Assets | false | RentalOfFacilitiesOthAssetsInd |
| Reimbursement Arrangements | false | ReimbursementArrangementsInd |
| Loans Or Loan Guarantees | false | LoansOrLoanGuaranteesInd |
| Performance Of Services Etc | false | PerformanceOfServicesEtcInd |
| Sharing Of Facilities Etc | false | SharingOfFacilitiesEtcInd |
| Relationships Nonchrtbl EO | false | RelationshipsNonchrtblEOInd |
Depreciation Schedule DepreciationSchedule
Depreciation Property DepreciationPropertyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Property | DEPRECIATION | PropertyDesc |
| Current Year Expense | $2,622,150 | CurrentYearExpenseAmt |
Land Etc Schedule2 LandEtcSchedule2
Land Etc LandEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category Or Item | COST BASIS | CategoryOrItemTxt |
| Cost Or Other Basis | $44,907,437 | CostOrOtherBasisAmt |
| Accumulated Depreciation | $3,478,295 | AccumulatedDepreciationAmt |
| Book Value | $41,429,142 | BookValueAmt |
| EOYFMV | $41,429,142 | EOYFMVAmt |
Mortgages And Notes Payable Sch MortgagesAndNotesPayableSch
Note Payable NotePayableGrp
Lender Name LenderNameGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NOTE PAYABLE | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Balance Due | $8,286,158 | BalanceDueAmt |
Other Assets Schedule OtherAssetsSchedule
Other Assets Schedule OtherAssetsScheduleGrp (6 entries)
| DescDesc | BOY Book ValueBOYBookValueAmt | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|
| OTHER CURRENT ASSETS | $67,690 | $264,673 | $264,673 |
| ROU ASSETS | $3,558,304 | $2,999,000 | $2,999,000 |
| DEPOSITS | $5,260 | ||
| DEFERRED EXPENSES | $131,053 | $831 | $831 |
| INTERCOMPANY ACCOUNTS | $107,758 | ||
| SUPPLY INVENTORY | $2,078,695 | $1,666,244 | $1,666,244 |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (8 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Adjusted Net IncomeAdjustedNetIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| EXPENSES | |||
| REPAIRS & MAINTENANCE | $2,051,050 | $2,051,050 | |
| MARKETING | $30,550 | $30,550 | |
| MEDICAL SPEC FEES | $9,003,007 | $7,832,616 | $1,170,391 |
| BAD DEBT EXPENSE | $12,728,951 | $11,074,187 | $1,654,764 |
| MEDICAL SUPPLIES | $6,115,226 | $5,320,247 | $794,979 |
| OTHER OPERATING EXPENSE | $1,038,900 | $1,038,900 | |
| PHYSICIAN RECRUITING | $592 | $592 |
Other Income Schedule2 OtherIncomeSchedule2
Other Income Detail OtherIncomeDetail (2 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Adjusted Net IncomeAdjustedNetIncomeAmt |
|---|---|---|
| PATIENT REV LESS DISCOUNTS | $71,351,968 | $71,351,968 |
| OTHER REVENUE | $3,820,224 | $3,820,224 |
Other Increases Schedule OtherIncreasesSchedule
Other Increases Detail OtherIncreasesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PRIOR PERIOD ADJUSTMENT | Desc |
| Amt | $19,938 | Amt |
Other Liabilities Schedule OtherLiabilitiesSchedule
Other Liabilities Detail OtherLiabilitiesDetail (4 entries)
| DescDesc | BOY Book ValueBOYBookValueAmt | EOY Book ValueEOYBookValueAmt |
|---|---|---|
| OPERATING LEASE LIABILITY | $3,616,099 | -$1,000 |
| GOODWILL | $24,718,550 | $24,363,883 |
| INTERCOMPANY ACCOUNTS | $32,597 | |
| OTHER ACCRUED LIABILITIES | $1,539,053 |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees Detail OtherProfessionalFeesDetail (2 entries)
| CategoryCategoryTxt | AmtAmt | Adjusted Net IncomeAdjustedNetIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| CONTRACT LABOR | $1,651,729 | $1,437,004 | $214,725 |
| PURCHASED SERVICES | $14,322,823 | $12,460,856 | $1,861,967 |