STRATEGY STUDIO / PUBLIC DATA EXPLORER

SWANNANOA VALLEY MEDICAL CENTER INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
SWANNANOA VALLEY MEDICAL CENTER INC (EIN 56-1040100)
Tax period
2016-07-01 to 2017-06-30
Filed
2017-11-14
IRS object ID
201733189349301948
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)
Return2017-11-14T09:36:09-05:00ReturnTs
Tax Period End2017-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN561678110PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1HELGREEN AND DALTON ACCOUNTANTSBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1103 SCOTLAND STREETAddressLine1Txt
CityBLACK MOUNTAINCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28711ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN561040100EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SWANNANOA VALLEY MEDICAL CENTER INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSWANBusinessNameControlTxt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1P O BOX 1446AddressLine1Txt
CityBLACK MOUNTAINCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28711ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonAMBER KNIGHTONPersonNm
Person TitleBOOKKEEPERPersonTitleTxt
Phone8285521201PhoneNum
Signature2017-11-14SignatureDt
Discuss With Paid PreparerfalseDiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonL DEAN GUNTERPreparerPersonNm
PTINP00118942PTIN
Phone8286698784PhoneNum
Preparation2017-11-14PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address24.158.60.146IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-11-14IPDt
IP Tm09:38:03IPTm
Federal Original Submission Id6924332017318niuia3eFederalOriginalSubmissionId
Federal Original Submission Id2017-11-14FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdFAD24777D90CF4BE4A953A90EA60D4071D805D61AtSubmissionCreationDeviceId
At Submission Filing Device IdFAD24777D90CF4BE4A953A90EA60D4071D805D61AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerCARL ZIEGLERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1101 HAWTHORNE DRIVEAddressLine1Txt
CitySWANNANOACityNm
State AbbreviationNCStateAbbreviationCd
ZIP28778ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$77,382GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1974FormationYr
Legal Domicile StateNCLegalDomicileStateCd
Activity Or MissionMEDICAL FACILITY CHARITABLEActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$21PYContributionsGrantsAmt
CY Contributions Grants$1CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$1,260PYInvestmentIncomeAmt
CY Investment Income$2,233CYInvestmentIncomeAmt
PY Other Revenue$19,522PYOtherRevenueAmt
CY Other Revenue$23,635CYOtherRevenueAmt
PY Total Revenue$20,803PYTotalRevenueAmt
CY Total Revenue$25,869CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$25,037PYOtherExpensesAmt
CY Other Expenses$29,964CYOtherExpensesAmt
PY Total Expenses$25,037PYTotalExpensesAmt
CY Total Expenses$29,964CYTotalExpensesAmt
PY Revenues Less Expenses-$4,234PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$4,095CYRevenuesLessExpensesAmt
Total Assets BOY$422,866TotalAssetsBOYAmt
Total Assets EOY$446,501TotalAssetsEOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$422,866NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$446,501NetAssetsOrFundBalancesEOYAmt
MissionMEDICAL FACILITY CHARITABLEMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$29,964ExpenseAmt
DescPROVIDE MEDICAL FACILITIES FOR THE SWANNANOA VALLEY CHARITABLE RELIGIOUS EDUCATIONAL AND SCIENTIFIC PURPOSES INCLUDINGMAKING CONTRIBUTIONS TO ORGANIZATIONS THAT QUALIFY AS EXEMPT ORGANIZATIONS UNDER SECTION 501 C 3Desc
Total Program Service Expenses$29,964TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document5IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee0EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
DAF Excess Business HoldingsfalseDAFExcessBusinessHoldingsInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyfalseConflictOfInterestPolicyInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldNCStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonAMBER KNIGHTONPersonNm
Phone8285521201PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line157 HERSHEL LANEAddressLine1Txt
CitySWANNANOACityNm
State AbbreviationNCStateAbbreviationCd
ZIP28778ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
NORM GOTTLIEB
BOARD MEMBER1.000.00Yes (X)$0$0$0
STAN BRANK
BOARD MEMBER1.000.00Yes (X)$0$0$0
BETTY MERMALEE
BOARD MEMBER1.000.00Yes (X)$0$0$0
KEVIN WEST
ADMINISTRATOR5.000.00Yes (X)$8,113$0$0
SCOTT COOK
BOARD MEMBER1.000.00Yes (X)$0$0$0
WILLIAM LOCKLEAR
BOARD MEMBER1.000.00Yes (X)$0$0$0
CARL ZIEGLER
CHAIRMAN1.000.00$0$0$0Yes (X)
SHARON ZIEGLER
SECRETARY1.000.00$0$0$0Yes (X)
MARY SOYENOVA
VICE CHAIR1.000.00$0$0$0Yes (X)
CONNIE SMITH
TREASURER1.000.00$0$0$0Yes (X)
MARK CRAWFORD
ADMINISTRATOR1.000.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$8,113TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Membership Dues$1MembershipDuesAmt
Total Contributions$1TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,233TotalRevenueColumnAmt
Related Or Exempt Func Income$2,233RelatedOrExemptFuncIncomeAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$75,148RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$51,513RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$23,635RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$23,635TotalRevenueColumnAmt
Related Or Exempt Func Income$23,635RelatedOrExemptFuncIncomeAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$25,869TotalRevenueColumnAmt
Related Or Exempt Func Income$25,868RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$6,875TotalAmt
Program Services$6,875ProgramServicesAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$1,525TotalAmt
Program Services$1,525ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,800TotalAmt
Program Services$1,800ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,645TotalAmt
Program Services$1,645ProgramServicesAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,736TotalAmt
Program Services$1,736ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$16,383TotalAmt
Program Services$16,383ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$29,964TotalAmt
Program Services$29,964ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$900BOYAmt
EOY$204EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$263,922BOYAmt
EOY$236,088EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$681,895LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$471,686LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$158,044BOYAmt
EOY$210,209EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$422,866BOYAmt
EOY$446,501EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$390,704BOYAmt
EOY$446,501EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$32,100BOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$62BOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$422,866BOYAmt
EOY$446,501EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$422,866BOYAmt
EOY$446,501EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$4,095ReconcilationRevenueExpnssAmt
Prior Period Adjustments$27,730PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewYes (true)AccountantCompileOrReviewInd

Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
FS AuditedfalseFSAuditedInd
Audit CommitteefalseAuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesfalseOtherActivitiesInd
Not Described Section501c3falseNotDescribedSection501c3Ind

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$75,750InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$3,250OtherCostOrOtherBasisAmt
Book Value$79,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$602,895InvestmentCostOrOtherBasisAmt
Depreciation$471,686DepreciationAmt
Book Value$131,209BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$210,209TotalBookValueLandBuildingsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Members or stockholder classes and rights Part VI line 6EACH RENTOR PAYS AN ANNUAL MEMBERSHIP TO THE SWANNANOA VALLEY MEDICAL CENTER THE MEMBERSHIP DOES NOT PROVIDE FOR ANY VOTING PRIVILEGES ON THE BOARD OF DIRECTORS
Form 990 governing body review Part VI line 11THE FORM 990 IS REVIEWED AT THE NEXT REGULAR BOARD OF DIRECTORS MEETING AFTER COMPLETION
Governing documents etc available to public Part VI line 19ALL GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST OF THE BOARD OF DIRECTORS
Explanation of other changes in net assets or fund balances Part XI line 9NET INCREASE IN MARKET VALUE OF INVESTMENTS