STRATEGY STUDIO / PUBLIC DATA EXPLORER

ST ELIZABETH HEALTH CENTER SCHOOL FOR NURSE ANESTHETISTS INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
ST ELIZABETH HEALTH CENTER SCHOOL FOR NURSE ANESTHETISTS INC (EIN 34-1840231)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-11-06
IRS object ID
201703109349301920
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

FieldValueIRS element (for citing)
Return2017-11-06T13:58:37-06:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN341912961PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1COHEN & COMPANY LTDBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1OFFICES LISTED ATAddressLine1Txt
CityWWWCOHENCPACOMCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44115ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN341840231EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ST ELIZABETH HEALTH CENTER SCHOOL FORBusinessNameLine1Txt
Business Name Line2NURSE ANESTHETISTS INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlSTELBusinessNameControlTxt
Phone3302865330PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 460AddressLine1Txt
CityCANFIELDCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44406ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTHOMAS DE ASCENTISPersonNm
Person TitleTREASURERPersonTitleTxt
Phone3302865330PhoneNum
Signature2017-10-30SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKERRY R GUBICSPreparerPersonNm
PTINP01881026PTIN
Phone8002291099PhoneNum
Preparation2017-10-30PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address8.42.147.194IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-10-30IPDt
IP Tm15:53:31IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdE7D2372669B67B089896D3C3683BDD91A3ED91F8AtSubmissionCreationDeviceId
At Submission Filing Device Id21B5D1470EA8A117839C889D9C5849498E68A5FCAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTHOMAS DE ASCENTISPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 460AddressLine1Txt
CityCANFIELDCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44406ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$417,404GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressHTTP://WWW.RMSWP.COM/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2005FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or MissionSCHOOL FOR HEALTH CARE PERSONNEL WHO WISH TO BECOME CERTIFIED REGISTERED NURSE ANESTHETISTS.ActivityOrMissionDesc
Voting Members Governing Body3VotingMembersGoverningBodyCnt
Voting Members Independent2VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers2TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$372,845PYProgramServiceRevenueAmt
CY Program Service Revenue$417,381CYProgramServiceRevenueAmt
PY Investment Income$43PYInvestmentIncomeAmt
CY Investment Income$23CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$372,888PYTotalRevenueAmt
CY Total Revenue$417,404CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$285,044PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$365,467CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$83,766PYOtherExpensesAmt
CY Other Expenses$70,194CYOtherExpensesAmt
PY Total Expenses$368,810PYTotalExpensesAmt
CY Total Expenses$435,661CYTotalExpensesAmt
PY Revenues Less Expenses$4,078PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$18,257CYRevenuesLessExpensesAmt
Total Assets BOY$24,223TotalAssetsBOYAmt
Total Assets EOY$5,966TotalAssetsEOYAmt
Total Liabilities BOY$0TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$24,223NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$5,966NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionST. ELIZABETH HEALTH CENTER SCHOOL FOR NURSE ANESTHETISTS, INC. IS AN ALLIANCE OF ANESTHESIA PRACTITIONERS WHO INTEND TO MOTIVATE AND EMPOWER STUDENTS TO EDUCATION THROUGH TEACHING, MENTORING, AND COLLABORATING IN AN ENVIRONMENT OF PERSONAL INTEREST AND CARING. THE SCHOOL COMMUNITY DEVELOPS IN STUDENTS A SENSE OF SELF-WORTH AND FUTURE OPPORTUNITY THAT COMPELS THEM TO MAKE A POSITIVE IMPACT ON OUR SOCIETY. THE SCHOOL SHARES COMMON GOALS WITH MERCY HEALTH AND YOUNGSTOWN STATE UNIVERSITY BY STRIVING TO PROMOTE AN ENVIRONMENT THAT ENCOURAGES ACADEMIC EXCELLENCE AND QUALITY OF SERVICE FOR ALL MEMBERS OF OUR COMMUNITY. THE CORE VALUES OF REVERENCE, COMMITMENT, JUSTICE, STEWARDSHIP, AND INTEGRITY ARE ENHANCED BY THIS ALIGNMENT BETWEEN THE FACILITIES. THE COMBINED PHILOSOPHIES HAVE ENRICHED THE HOLISTIC PRACTICE OF NURSE ANESTHESIA. THE DEPARTMENT OF NURSING SUPPORTS THE MISSIONS OF YOUNGSTOWN STATE UNIVERSITY AND THE BITONTE COLLEGE OF HEALTH AND HUMAN SERVICES. THE DEPARTMENT OF NURSING PROVMissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$327,823ExpenseAmt
Revenue$417,381RevenueAmt
DescEDUCATION ACTIVITIES AND INSTRUCTION FOR 41 STUDENTS.Desc
Total Program Service Expenses$327,823TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School OperatingYes (1)SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members3GoverningBodyVotingMembersCnt
Independent Voting Member2IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc0RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldOHStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THOMAS DE ASCENTISBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3302865330PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 460AddressLine1Txt
CityCANFIELDCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44406ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (5 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
BEVERLY RODGERS
SECRETARY40.00Yes (X)Yes (X)$0$123,912$35,706
STEVEN SHEAKOSKI
PRESIDENT2.00Yes (X)Yes (X)$0$0$0
THOMAS DE ASCENTIS
TREASURER4.00Yes (X)Yes (X)$0$0$0
FREDERICK PEACHMAN
TRUSTEE1.00Yes (X)$0$0$0
RONALD MULLIS JR
VICE PRESIDENT1.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$123,912TotReportableCompRltdOrgAmt
Total Other Compensation$35,706TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
STUDENT TUITION611600$404,031$404,031
APPLICATION FEES611600$13,350$13,350
FieldValueIRS element (for citing)
Total Program Service Revenue$417,381TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$23TotalRevenueColumnAmt
Exclusion$23ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$417,404TotalRevenueColumnAmt
Related Or Exempt Func Income$417,381RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$23ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$123,912TotalAmt
Program Services$61,956ProgramServicesAmt
Management And General$61,956ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$151,427TotalAmt
Program Services$151,427ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$32,756TotalAmt
Program Services$16,378ProgramServicesAmt
Management And General$16,378ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$38,448TotalAmt
Program Services$19,224ProgramServicesAmt
Management And General$19,224ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$18,924TotalAmt
Program Services$9,462ProgramServicesAmt
Management And General$9,462ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$26,636TotalAmt
Program Services$26,636ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$3,146TotalAmt
Program Services$3,146ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,437TotalAmt
Program Services$719ProgramServicesAmt
Management And General$718ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
FACULTY LECTURE FEES$24,500$24,500
ACCREDITATION FEES$11,270$11,270
HUMAN RESOURCES$3,105$3,105
MISCELLANEOUS EXPENSE$100$100

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$435,661TotalAmt
Program Services$327,823ProgramServicesAmt
Management And General$107,838ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$22,786BOYAmt
EOY$5,966EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$19,698LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$19,698LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,437BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$24,223BOYAmt
EOY$5,966EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$24,223BOYAmt
EOY$5,966EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$24,223BOYAmt
EOY$5,966EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$24,223BOYAmt
EOY$5,966EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$18,257ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS Audited0FSAuditedInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
SchoolYes (X)SchoolInd

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$19,698OtherCostOrOtherBasisAmt
Depreciation$19,698DepreciationAmt
Book Value$0BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Schedule E IRS990ScheduleE

FieldValueIRS element (for citing)
Nondiscriminatory Policy StmtYes (1)NondiscriminatoryPolicyStmtInd
Policy Stmt In Brochures EtcYes (1)PolicyStmtInBrochuresEtcInd
Plcy Pblczd Via Broadcast MediaYes (1)PlcyPblczdViaBroadcastMediaInd
Maintain Racial Comp RecsYes (1)MaintainRacialCompRecsInd
Maintain Scholarships RecsYes (1)MaintainScholarshipsRecsInd
Maintain Cpy Of Brochures EtcYes (1)MaintainCpyOfBrochuresEtcInd
Maintain Cpy Of All SolYes (1)MaintainCpyOfAllSolInd
Discriminate Race Stdnts Rghts0DiscriminateRaceStdntsRghtsInd
Discriminate Race Admiss Plcy0DiscriminateRaceAdmissPlcyInd
Discriminate Race Emplm Fculty0DiscriminateRaceEmplmFcultyInd
Discriminate Race Schs0DiscriminateRaceSchsInd
Discriminate Race Educ Plcy0DiscriminateRaceEducPlcyInd
Discriminate Race Use Of Fclts0DiscriminateRaceUseOfFcltsInd
Discriminate Race Athlt Prog0DiscriminateRaceAthltProgInd
Discriminate Race Other Acty0DiscriminateRaceOtherActyInd
Government Financial Aid Rcvd0GovernmentFinancialAidRcvdInd
Government Financial Aid Rvkd0GovernmentFinancialAidRvkdInd
Compliance With Rev Proc7550Yes (1)ComplianceWithRevProc7550Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE E, PART I, LINE 3FormAndLineReferenceDesc
ExplanationADVERTISEMENTS OR OTHER ANNOUNCEMENTS OF THE PROGRAM INDICATE THAT THE PROGRAM DOES NOT DISCRIMINATE.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonBEVERLY RODGERSPersonNm
TitleSECRETARYTitleTxt
Base Compensation Filing Org$0BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$123,912CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$35,706DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$0NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$0NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$0TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$159,618TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE 990 IS REVIEWED BY BOARD MEMBERS AT THE ANNUAL MEETING.
FORM 990, PART VI, SECTION B, LINE 15AANA AND COUNCIL ON ACCREDITATION OF NURSE ANESTHESIA EDUCATIONAL PROGRAMS SURVEYS REVIEWED ANNUALLY.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST.

Schedule R IRS990ScheduleR

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1BEL-PARK ANESTHESIA ASSOCIATES INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 460AddressLine1Txt
CityCANFIELDCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44406ZIPCd
FieldValueIRS element (for citing)
EIN341039898EIN
Primary ActivitiesMEDICAL PRACTICEPrimaryActivitiesTxt
Legal Domicile StateOHLegalDomicileStateCd
Entity TypeCEntityTypeTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
BEL-PARK ANESTHESIA ASSOCIATES
P$334,872FMV
BEL-PARK ANESTHESIA ASSOCIATES
O$90,128FMV